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Article
Nature Medicine  7, 1021 - 1027 (2001)
doi:10.1038/nm0901-1021

Abrupt rate accelerations or premature beats cause life-threatening arrhythmias in mice with long-QT3 syndrome

Dieter Nuyens1, Milan Stengl2, Saran Dugarmaa4, Tom Rossenbacker1, Veerle Compernolle1, Yoram Rudy5, Jos F. Smits3, Willem Flameng6, Colleen E. Clancy5, Lieve Moons1, Marc A. Vos2, Mieke Dewerchin1, Klaus Benndorf4, Désiré Collen1, Edward Carmeliet6 & Peter Carmeliet1

1  Center for Transgene Technology and Gene Therapy, Flanders Interuniversity Institute for Biotechnology, KU Leuven, Leuven, Belgium

2  Cardiology, Research Institute Maastricht (CARIM), University of Maastricht, Maastricht, the Netherlands

3  Pharmacology, Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, Maastricht, the Netherlands

4  Klinikum der Friederich-Schiller-Universität Jena, Institut für Physiologie, Jena, Germany

5  Cardiac Bioelectricity Research and Training Center, Case Western Reserve University, Cleveland, Ohio, USA

6  Laboratory of Experimental Cardiac Surgery, KU Leuven, Leuven, Belgium

Correspondence should be addressed to Peter Carmeliet peter.carmeliet@med.kuleuven.ac.be
Deletion of amino-acid residues 1505−1507 (KPQ) in the cardiac SCN5A Na+ channel causes autosomal dominant prolongation of the electrocardiographic QT interval (long-QT syndrome type 3 or LQT3). Excessive prolongation of the action potential at low heart rates predisposes individuals with LQT3 to fatal arrhythmias, typically at rest or during sleep. Here we report that mice heterozygous for a knock-in KPQ-deletion (SCN5ADelta/+) show the essential LQT3 features and spontaneously develop life-threatening polymorphous ventricular arrhythmias. Unexpectedly, sudden accelerations in heart rate or premature beats caused lengthening of the action potential with early afterdepolarization and triggered arrhythmias in Scn5a Delta/+ mice. Adrenergic agonists normalized the response to rate acceleration in vitro and suppressed arrhythmias upon premature stimulation in vivo. These results show the possible risk of sudden heart-rate accelerations. The Scn5a Delta/+ mouse with its predisposition for pacing-induced arrhythmia might be useful for the development of new treatments for the LQT3 syndrome.

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Nature Medicine
ISSN: 1078-8956
EISSN: 1546-170X
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