The major membrane currents responsible for sinoatrial and idioventricular rhythm-generation were studied in isolated rat heart preparations, perfused in Langendorff mode. The rates of whole isolated hearts beating with sinoatrial rhythm decreased with cesium and ivabradine, both blockers of the funny current, and were not affected by nickel, at a dose which blocks T-type calcium current. The sinoatrial rhythm was completely abolished by reduction or removal of sodium from the perfusate (interventions that inhibit calcium-extrusive mode of the sodium/calcium exchanger), or by nifedipine, an L-type calcium channel blocker. Idioventricular rhythm, however, was arrested only by reduction of sodium in the perfusate. Ivabradine reduced the idioventricular rate, nickel did not cause any change, while nifedipine in some cases increased it. The inferences made based on these observations are that INCX and ICaL are obligatory rhythm-generating currents in the sinoatrial node, while INCX is the only obligatory mechanism for an idioventricular rhythm. The funny current is not an obligatory requirement for sinoatrial as well as idioventricular rhythm-generation. However, it enhances the frequency of LCRs. Our results in the isolated whole heart are in corroboration with results from isolated cells.

Background It is unknown whether assessment of autonomic pathway integrity in newly injured traumatic cervical spinal cord injury (SCI) patients contributes to their neurological prognosis. Objective The objective is to investigate the relationship of heart rate variability (HRV) and sympathetic skin response (SSR) at initial evaluation of American Spinal Injury Association Impairment Scale (AIS) A/B tetraplegic patients, with their short-term neurological recovery. Methods In this prospective cohort study, short-term HRV indices and SSR to supra-lesional stimuli were computed in 24 acute traumatic cervical AIS A/B SCI patients at admission for rehabilitation. The relationship of these autonomic parameters with motor and sensory score improvement, AIS grade improvement, and time taken for recovery was tested, respectively, with Spearman’s correlation coefficient test, Fisher’s exact test, and Kaplan–Meier analysis. Results SSR was present in 11 (45.8%) patients at initial evaluation. After rehabilitation, 5 (20.8%) patients improved from AIS A/B to AIS C (greater recovery), while the rest remained at AIS A/B (lesser recovery). Both AIS improvement and mean time for ‘greater’ recovery did not associate with the presence/absence of SSR. Further, HRV indices did not correlate with improvement in motor or sensory scores. Conclusions Interim neurological recovery was not related to autonomic parameters of short-term HRV indices and SSR in the AIS A/B tetraplegic patients of our study. Interestingly, about half of the patients with clinically complete SCI had evidence of preserved autonomic function. Our data add to the knowledge base of autonomic findings in cervical SCI patients and will promote research relating neurophysiological parameters and recovery.