Contribution of IKr to rate-dependent action potential dynamics in canine endocardium.

Previous modeling studies have suggested that the rapid component of the delayed rectifier (I(Kr)) may contribute importantly to action potential dynamics during tachycardia. To test this idea experimentally, I(Kr) was measured as the E-4031-sensitive current in isolated canine endocardial myocytes at 37 degrees C using the perforated patch-clamp technique. Command potentials were trains of action potential waveforms recorded at cycle lengths (CLs) of 1000, 500, 320, 170, and 120 ms. Action potential duration (APD) alternans occurred at CLs of 170 and 120 ms. During an action potential, I(Kr) increased gradually to a maximum at -55 to -60 mV. Peak I(Kr) increased initially as CL was shortened from 1000 to 500 ms (from 0.55+/-0.03 to 0.57+/-0.03 pA/pF), but decreased progressively as CL was shortened further (to 0.45+/-0.03 pA/pF at CL=120 ms). Baseline I(Kr) was negligible at CLs of 1000 to 320 ms, but increased to 0.12+/-0.01 pA/pF at a CL of 120 ms. During APD alternans, peak I(Kr) was larger for the short than for the long action potential (0.48+/-0.03 versus 0.46+/-0.03 pA/pF). A computer model of I(Kr) based on these data indicated that increasing I(Kr) suppressed alternans and decreasing I(Kr) increased alternans. In support of the latter result, inhibition of I(Kr) by E-4031 increased the maximal amplitude of alternans. These results indicate that I(Kr) contributes importantly to rate-related alterations of repolarization, including APD alternans. Modifying I(Kr) may be a promising approach to suppressing alternans and thereby preventing ventricular tachyarrhythmias.