Abstract
Bradycardia is a trigger of ventricular arrhythmias in patients with arrhythmia including Brugada syndrome and long QT syndrome. The HCN4 channel controls the heart rate, and its mutations predispose to inherited sick sinus syndrome and long QT syndrome associated with bradycardia. We found a 4 base-insertion at the splice donor site of the HCN4 gene in a patient with idiopathic ventricular tachycardia, which was supposed to generate a truncated channel. To investigate the role of the HCN4 channel in ventricular arrhythmia, we introduced a ventricular action potential of If channel produced by HCN4 in a computer simulation model and found that the If channel generated a leaky outward current during the plateau phase of ventricular action potential. Currents through the If channel were suggested to contribute to the shortening of the action potential duration and the prevention of early after-depolarization in bradycardia. These observations suggested that the HCN4 channel played a preventive role in triggering bradycardia-induced ventricular arrhythmias.
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Acknowledgements
We thank Drs J Yamada, T Miura, M Kanamoto, T Tamura, N Miya, Y Horie, H Sakurada, S Ogawa, M Nishizaki, T Sakamoto, T Ueyama, K Hirao and J Nitta for their contributions in collecting blood samples and clinical records from the patients with BrS and LQTS. This study was supported in part by Grant-in-Aids from the Ministry of Education, Culture, Sports, Science and Technology, Japan and a research grant from the Ministry of Health, Labour and Welfare, Japan.
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Ueda, K., Hirano, Y., Higashiuesato, Y. et al. Role of HCN4 channel in preventing ventricular arrhythmia. J Hum Genet 54, 115–121 (2009). https://doi.org/10.1038/jhg.2008.16
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DOI: https://doi.org/10.1038/jhg.2008.16
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