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Background: The incidence of atrial fibrillation (AF) in rheumatic heart diseases (RHD) is very high and increases with age. Occurrence and maintenance of AF are very complicated process accompanied by many different mechanisms. Ion-channel remodeling, including the voltage-gated potassium channel Kv1.5, plays an important role in the pathophysiology of AF. However, the changes of Kv1.5 channel expression in Han Chinese patients with RHD and AF remain poorly understood. The aim of the present study was to investigate whether the Kv1.5 channels of the right atria may be altered with RHD, age, and sex to contribute to AF., Material/methods: Right atrial appendages were obtained from 20 patients with normal cardiac functions who had undergone surgery, and 26 patients with AF. Subjects were picked from 4 groups: adult and aged patients in normal sinus rhythm (SR) and AF. Patients were divided into non-RHD and RHD groups or men and women groups in normal SR and AF, respectively. The expression of Kv1.5 protein and messenger RNA (mRNA) were measured using Western blotting and polymerase chain reaction (PCR) method, respectively., Results: Compared with the SR group, the expression of Kv1.5 protein decreased significantly in the AF group. However, neither Kv1.5 protein nor KCNA5 mRNA had significant differences in adult and aged groups, non-RHD and RHD group, and men and women group of AF., Conclusions: The expression of Kv1.5 channel protein changes with AF but not with age, RHD, and sex in AF.

Objective: To compare the amplitude of the SK2 current (small conductance calcium-activated potassium channel) in human atrial myocytes with or without persistent atrial fibrillation (AF)., Methods: Right atrial appendage was obtained from 15 patients with sinus rate (SR) and 7 patients with AF underwent surgical valve replacement. Single myocyte was isolated by enzymatic dissociation method and the SK2 channel current density was recorded using whole-cell patch clamp techniques to detect the changes. Immunofluorescence was used to observe SK2 channel protein distribution on right atrial appendage., Results: Using the whole cell patch-clamp recording techniques, an inward rectifier K(+) mix currents could be obtained from both SR (n = 15) and AF (n = 7) samples, I(K1) mix currents density in single myocyte of AF group was significantly increased than in SR group [(-16.42 ± 5.32) pA/pF vs (-6.59 ± 2.24) pA/pF, P < 0.01], which could be partially inhibited by apamin (100 nmol/L). The apamin-sensitive current was obtained by subtraction of the currents before and after treatment with apamin. SK2 current density was significantly increased in AF group than that of SR group [(-9.81 ± 2.54) pA/pF vs (-3.67 ± 0.37) pA/pF, P < 0.01]. SK2 channel protein was evidenced with immunofluorescence method in right atrial appendage from AF group and SR group., Conclusion: SK2 channel protein and current were present in atrial myocytes. The SK2 current density was significantly increased in AF group than in SR group suggesting that the increase of SK2 current might contribute to the electrical remodeling in AF patients.

Objective: To investigate the changes of L-type Ca(2+) channel current (I(Ca-L)) and its voltage-dependent activation and inactivation in atrial myocytes of patients with atrial fibrillation (AF)., Methods: The specimens of right atrial appendage were obtained from 18 patients with normal sinus rhythm (NSR) and 12 patients with chronic atrial fibrillation (CAF). Single myocytes were isolated by enzymatic dissociation with two-step method and the ionic currents were recorded using whole-cell patch clamp techniques to detect the changes of I(Ca-L) density and kinetic properties., Results: (1) I(Ca-L) density was (-1.32 +/- 0.19) pA/pF in CAF group (n = 12) and (-4.58 +/- 0.39) pA/pF in NSR group (n = 21) at the test potential from -40 mV to 0 mV. I(Ca-L) density of CAF group was significantly reduced (P < 0.01), compared with the NSR group. (2) No significant differences were noted between the two groups in the voltage-dependent activation parameters (V(1/2), K) and inactivation parameters (V(1/2), K)., Conclusions: I(Ca-L) density of CAF group was significantly decreased whereas it's voltage-dependent kinetic properties had no change. This phenomenon may be one of the mechanisms of atrial electrophysiological remodeling in chronic atrial fibrillation.

Objective: To compare the changes of both inward rectifying K(+) (Kir) current(I(k1)) density and mRNA expression level of Kir2.1, a major subfamily of Kir in chronic human atrial fibrillation (CAF) with those in normal sinus rhythm (NSR)., Methods: I(k1) density was measured with whole-cell patch clamp technique in single myocyte isolated by an enzymatic dissociation method from right atrial appendages in patients with CAF (n = 8) and those with NSR (n = 12). The mRNA expression levels of Kir2.1 was determined in right atrial appendages from CAF (n = 19) and NSR (n = 18) by semiquantitative reverse-transcription polymerase chain reaction (RT-PCR)., Result: The average resting membrane potentials were similar between CAF and NSR (-78.95 mV +/- 4.67 mV and -70.22 mV +/- 11.08 mV, P>0.05). I(k1) density in single myocyte significantly increased at hyperpolarized potential level (-100 mV) in CAF compared to that in NSR (-9.59 pA/pF +/- 2.47 pA/pF vs. -5.58 pA/pF +/- 2.52 pA/pF, P<0.01). The mRNA level of Kir2.1 was also significantly higher in CAF than that of NSR (0.50+/-0.16 vs. 0.34+/-0.09, P<0.05)., Conclusion: The data suggest that Kir2.1 up-regulation and I(k1) current increase might contribute to the electrical remodeling in CAF patients.