A Novel Model of the Rabbit Atrial Myocyte for the Study of Ca2+ Mediated Arrhythmia

Maxx Holmes1, Alan P Benson1, Oleg Aslanidi2, Michael A Colman3
1University of Leeds, 2King's College London, 3University of Manchester / University of Leeds


Abstract

Atrial fibrillation (AF) and heart failure (HF) are two cardiac conditions with increasing incidence. Confounding the problem is that patients with HF frequently develop AF, and vice-versa. Dysfunction of the intracellular calcium (Ca2+) handling system, which may involve remodeled channel expression and/or T-system morphological changes, has been conjectured to under-lie both perturbed excitation-contraction coupling and an increase in ar-rhythmic events at the cellular scale; the role of T-system remodeling in the development of pro-arrhythmic cellular events such as spontaneous Ca2+ release and Ca2+ transient alternans remains unclear. A contemporary model describing rabbit atrial electrophysiology (Aslani-di, et al., Biophys. J. 96(3):798-817, 2009) was integrated with our novel model describing stochastic spatio-temporal Ca2+ dynamics (Colman et al. PLOS Comp. Biol. 13, e1005714, 2017). Atrial T-system remodeling, associated with HF, was incorporated in isolation from other remodeling which may occur, through removal of the sarcolemmal ion-channel currents from individual CRUs, either assigned randomly or in pre-defined patches of varying sizes. Rapid pacing protocols were applied to induce Ca2+ transient alternans, and load the sarcoplasmic reticulum Ca2+ content. The model reproduces rabbit atrial action potential and Ca2+ transient morphology associated with normal cardiac excitation. In isolation to other HF-related remodeling, variation in T-system density and organization showed an inverse correlation between density and susceptibility to two arrhythmogenic mechanisms: Ca2+ alternans and spontaneous release events; the former was determined by alternating successful and failed propagation of the Ca2+ into the regions without T-tubules; the latter was determined by an interaction of localized SR Ca2+ loading and reduced efflux, promoting successful Ca2+ wave propagation. Conclusion: We have developed a novel model of rabbit atrial electro-physiology and Ca2+ handling. T-system remodeling in our atrial cell model suggests alterations to T-system morphology may play a role in the initiation and maintenance of AF in the presence of HF.