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Cardiac fibrillation: from ion channels to rotors in the human heart
Miguel Vaquero1, David Calvo, José Jalife
1Universidad Complutense, Madrid, Spain.
Insights
Electrical rotors drive atrial and ventricular fibrillation, but specific ion channel roles differ between heart chambers. Understanding these dynamics may lead to improved treatments for fibrillation.
Area of Science:
- Cardiology
- Electrophysiology
- Molecular Biology
Background:
- Electrical rotors and spiral waves are key mechanisms in atrial fibrillation (AF) and ventricular fibrillation (VF).
- Recent advances provide new insights into the dynamics and molecular underpinnings of these phenomena.
- Understanding ion channel contributions is crucial for comprehending fibrillation pathologies.
Purpose of the Study:
- To review the distinct roles of sarcolemmal ion channels in AF and VF.
- To assess the clinical relevance of ion channel involvement in both types of fibrillation.
- To highlight similarities and differences in ion channel function between atrial and ventricular fibrillation.
Main Methods:
- Review of existing scientific literature and human data.
- Analysis of evidence on individual sarcolemmal ion channel functions.
- Comparative assessment of ion channel roles in atria versus ventricles.
Main Results:
- Human data confirm rotors as critical for maintaining both AF and VF.
- Significant differences exist in the roles of specific ion channels between atrial and ventricular fibrillation.
- Similarities in ion channel involvement were also identified.
- Disease evolution and heart structure influence fibrillation mechanisms.
Conclusions:
- Electrical rotors are fundamental to fibrillation maintenance in both atria and ventricles.
- Specific ion channels play distinct roles in AF and VF, with notable differences between the two.
- Knowledge of these mechanisms, including changes during disease, offers potential for novel therapeutic strategies to improve patient outcomes.
Abstract:
Recent new information on the dynamics and molecular mechanisms of electrical rotors and spiral waves has increased our understanding of both atrial fibrillation and ventricular fibrillation. In this brief review, we evaluate the available evidence for the separate roles played by individual sarcolemmal ion channels in atrial fibrillation and ventricular fibrillation, assessing the clinical relevance of such findings. Importantly, although human data support the idea that rotors are a crucial mechanism for fibrillation maintenance in both atria and ventricles, there are clear inherent differences between the 2 chamber types, particularly in regard to the role of specific ion channels in fibrillation. But there also are similarities. This knowledge, together with new information on the changes that take place during disease evolution and between structurally normal and diseased hearts, may enhance our understanding of fibrillatory processes pointing to new approaches to improve disease outcomes.
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