I(f) is present in human LVMs. Its electrophysiological characteristics resemble those previously described in hypertrophied rat LVMs and suggest that I(f) could be an arrhythmogenic mechanism in patients with severe heart failure.

No abstract

A time-dependent, cesium-sensitive increasing inward current, that we had previously described having the electrophysiological properties of the pacemaker current I(f), was elicited by negative steps (-60 to -130 mV) from a holding potential of -40 mV. Boltzmann fit of control activation curves gave a midpoint (V1/2) of -88.9 +/- 2.6 mV (n = 14). 5-HT (1 microM) consistently caused a positive shift of V1/2 of 11.0 +/- 2.0 mV (n = 8, p < 0.001) of the activation curve toward less negative potentials, thus increasing the amount of current activated by clamp steps near the physiological maximum diastolic potential of these cells. The effect was dose-dependent, the EC50 being 0.14 microM. Maximum current amplitude was not changed by 5-HT. 5-HT did not increase I(f) amplitude when the current was maximally activated by cAMP perfused into the cell. The selective 5-HT4 antagonists, DAU 6285 (10 microM) and GR 125487 (1 microM), completely prevented the effect of 5-HT on I(f). The shift of V1/2 caused by 1 microM 5-HT in the presence of DAU 6285 or GR 125487 was 0.3 +/- 1 mV (n = 6) and 1.0 +/- 0.6 mV (n = 5), respectively (p < 0.01 versus 5-HT alone). The effect of 5-HT4 receptor blockade was specific, since neither DAU 6285 nor GR 125487 prevented the effect of 1 microM isoprenaline on I(f). Thus, 5-HT4 stimulation increases I(f) in human atrial myocytes; this effect may contribute to the arrhythmogenic action of 5-HT in human atrium.

1 We used single human atrial myocytes to study I f occurrence, properties and pharmacological modulation. Cells were obtained by chunk enzymatic digestion from samples of right atrial appendages of patients undergoing corrective cardiac surgery. 2 Patch-clamped cells in the whole-cell con®guration were superfused with a modi®ed Tyrode solution to reduce contamination by interfering currents and to amplify I f . The average cell membrane capacitance was 85.06+2.41 pF (n=531). Data were consistent with the geometrical dimensions of the cells (length 94.2+1.89 mm, width 17.9+0.42 mm, n=126). 3 When hyperpolarizing to 7120 mV from a holding potential of 740 mV, 252 of 306 tested cells (82%) expressed a hyperpolarization-activated inward current (I f density =3.77+0.25 pA pF 71 ); the current was considered to be present in a given cell if its density at 7120 mV was larger than 0.5 pA pF 71 . 4 Current activation was sigmoidal and ®tted a Boltzmann model; the average activation curve (n=25) showed a maximum current amplitude of 205.97+19.94 pA, corresponding to 3.87+0.63 pA pF 71 , voltage of half-maximal activation (V 1/2 ) at 786.68+2.19 mV and a slope of 711.39+0.69 mV. The reversal potential of I f measured by tail-current analysis was 713.07+1.92 mV (n=6). The addition of CsCl (5 mM) fully and reversibly blocked the current. 5 In the presence of the b-adrenoceptor agonist isoprenaline (Iso, 1 mM), V 1/2 was signi®cantly shifted toward less negative potentials by 6.06+1.96 mV (n=16, P=0.0039). The selective A 1 -adenosine receptor agonist cyclopentyladenosine (CPA, 1 mM) caused a statistically signi®cant shift of V 1/2 toward more negative potentials with respect to the control curve, both in the absence (77.37+1.83 mV, P=0.0005, n=11) and in the presence of 1 mM Iso (74.97+1.78, P=0.031, n=6). 6 These results demonstrate that a current with the properties of I f described in cardiac primary and secondary pacemakers occurs in the majority of human atrial cells. While the pathophysiological relevance of I f in human atrial tissue remains to be de®ned, our data clearly show that it is modulated through stimulation of b-adrenoceptors and A 1 -adenosine receptors.

rhythmias, and ischemic heart disease. The poten-