title: Gadolinium decreases stretch-induced vulnerability to atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is frequently associated with atrial dilatation caused by pressure or volume overload. Stretch-activated channels (SACs) have been found in myocardial cells and may promote AF in dilated atria. To prove this hypothesis, we investigated the effect of the SAC blocker gadolinium (Gd(3+)) on AF propensity in the isolated rabbit heart during atrial stretch.
  
  
  RESULTS
  In 16 isolated Langendorff-perfused rabbit hearts, the interatrial septum was perforated to equalize biatrial pressures. Caval and pulmonary veins were occluded. Intra-atrial pressure (IAP) was increased in steps of 2 to 3 cm H(2)O by increasing the pulmonary outflow fluid column. Vulnerability to AF was evaluated by 15-second burst pacing at each IAP level. At baseline, IAP needed to be raised to 8.8+/-0.2 cm H(2)O (mean+/-SEM) to induce AF. A dose-dependent decrease in AF vulnerability was observed after Gd(3+) 12.5, 25, and 50 micromol/L was added. AF threshold increased to 19.0+/-0.5 cm H(2)O with Gd(3+) 50 micromol/L (P<0.001 versus baseline). Spontaneous runs of AF occurred in 5 hearts on a rise of IAP to 13.8+/-3.3 cm H(2)O at baseline but never during Gd(3+). Atrial effective refractory period shortened progressively from 78+/-3 ms at 0.5 cm H(2)O to 52+/-3 ms at 20 cm H(2)O (P<0.05). Gd(3+) 50 micromol/L had no significant effect on effective refractory period.
  
  
  CONCLUSIONS
  Acute atrial stretch significantly enhances the vulnerability to AF. Gd(3+) reduces the stretch-induced vulnerability to AF in a dose-dependent manner. Block of SAC might represent a novel antiarrhythmic approach to AF under conditions of elevated atrial pressure or volume.
authors.affiliation: Department of Pharmacology, Georgetown University, Veterans Affairs Medical Center, Washington, DC 20422, USA.
authors.forename: F
authors.initials: F
authors.lastname: Bode
authors.forename: A
authors.initials: A
authors.lastname: Katchman
authors.forename: R L
authors.initials: RL
authors.lastname: Woosley
authors.forename: M R
authors.initials: MR
authors.lastname: Franz
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004594:Electrophysiology; D005682:Gadolinium / Q000494:pharmacology* / Q000627:therapeutic use; D066298:In Vitro Techniques; D009200:Myocardial Contraction / Q000187:drug effects*; D011817:Rabbits; D013314:Stress, Mechanical
chemical_list: D005682:Gadolinium