Pacemaker activity resulting from the coupling with nonexcitable cells.

Fibroblasts are nonexcitable cells that are sometimes coupled with excitable cells (cardiomyocytes). Due to a higher resting potential, these cells may act as a current source or sink and therefore disturb the electrical activity of the surrounding excitable cells. The possible occurrence of spontaneous pacemaker activity resulting from these electrotonic interactions was investigated in a theoretical model of two coupled cells as well as in a multicellular fiber model based on the Courtemanche kinetics. The results indicate that repeated spontaneous activations can be observed after an alteration in the activation and recovery properties of the sodium current (changes in excitability properties), provided that the difference in the resting potential as well as the coupling between the excitable and nonexcitable cells is sufficiently high. This may constitute a mechanism of focal sources triggering arrhythmias such as atrial fibrillation.