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Arrhythmogenic ionic remodeling: adaptive responses with maladaptive consequences.

S Nattel·P Khairy·G Schram
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Abstract

Compensatory changes in ion transport mechanisms occur in response to a variety of cardiac disease processes. Recent work has demonstrated that these adaptive responses can produce the arrhythmogenic substrate for a variety of important cardiac rhythm disorders. Two important paradigms are atrial tachycardia-induced remodeling and ionic remodeling caused by congestive heart failure. Atrial tachycardia promotes cellular Ca(2)+ loading and downregulates a variety of ion channels, particularly L-type Ca(2)+ channels, thereby promoting the occurrence and maintenance of atrial fibrillation. Congestive heart failure alters the expression and function of a variety of membrane transport processes, including several K(+)-channels and key Ca(2)+-transport systems, favoring the occurrence of arrhythmogenic afterdepolarizations. An improved understanding of the mechanisms and consequences of arrhythmogenic ionic remodeling promises to lead to novel and improved therapeutic approaches.

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AnimalsArrhythmias, CardiacDogsHeart FailureHumansIon TransportRabbitsSignal TransductionTachycardiaVentricular RemodelingJournal ArticleReview

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BibTeXRIS

S Nattel, P Khairy, G Schram. 2001. Arrhythmogenic ionic remodeling: adaptive responses with maladaptive consequences.. https://doi.org/10.1016/s1050-1738(01)00134-7

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