Key result
Delayed activation and electrotonic interactions increase SA node cell refractoriness, contributing to intermittent block.
Why the study?
The influence of electrotonic interactions on propagation within the SA node and their role in delayed activation and block were not fully understood.
Electrotonic interactions in the SA node can increase action potential duration and refractoriness, contributing to conduction delays and Wenckebach block.
Answers are grounded in this paper and cite their sources.
Does not inform clinical sinus node management; leaves open electrotonic mechanisms in human conduction disorders.
The influence of electrotonic interactions on propagation within the SA node was studied by recording transmembrane potentials simultaneously from two neighboring (less than 1 mm apart) subsidiary pacemaker cells within the sinoatrial (SA) node of the guinea pig. As single premature stimuli were delivered progressively earlier in diastole, retrograde propagation between cells was delayed progressively. Cells activated earlier displayed secondary depolarizations that were coincident with the depolarization of neighboring cells activated later. The secondary depolarizations increased action potential duration markedly. Rapid pacing elicited secondary depolarizations that resulted in a progressive increase in action potential duration and decrease in upstroke amplitude. These changes were associated with a progressive delay in retrograde propagation that led to intermittent block with Wenckebach periodicity. Exposure to tetrodotoxin (10(-5) g/ml) delayed antegrade propagation, resulting in electrotonically mediated secondary depolarizations and exit block with Wenckebach periodicity. It is concluded that delayed activation and electrotonically mediated interactions between cells can increase action potential duration and refractoriness. These changes contribute to progressive delays in propagation that may result in intermittent block with Wenckebach periodicity within the SA node.
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Stephen L. Lipsius (1983) studied Sinoatrial node electrophysiology. Premature stimuli, rapid pacing, and tetrodotoxin was evaluated on Electrotonic interactions, action potential duration, and propagation delay. Delayed activation and electrotonically mediated interactions between guinea pig SA node cells increased action potential duration and refractoriness, contributing to intermittent block.
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