Cardiovascular Drugs and Therapy

, Volume 27, Issue 1, pp 91–101 | Cite as

Late Sodium Current Inhibition in Acquired and Inherited Ventricular (dys)function and Arrhythmias

  • Carol Ann Remme
  • Arthur A. M. Wilde


The late sodium current has been increasingly recognized for its mechanistic role in various cardiovascular pathologies, including angina pectoris, myocardial ischemia, atrial fibrillation, heart failure and congenital long QT syndrome. Although relatively small in magnitude, the late sodium current (INaL) represents a functionally relevant contributor to cardiomyocyte (electro)physiology. Many aspects of INaL itself are as yet still unresolved, including its distribution and function in different cell types throughout the heart, and its regulation by sodium channel accessory proteins and intracellular signalling pathways. Its complexity is further increased by a close interrelationship with the peak sodium current and other ion currents, hindering the development of inhibitors with selective and specific properties. Thus, increased knowledge of the intricacies of the complex nature of INaL during distinct cardiovascular conditions and its potential as a pharmacological target is essential. Here, we provide an overview of the functional and electrophysiological effects of late sodium current inhibition on the level of the ventricular myocyte, and its potential cardioprotective and anti-arrhythmic efficacy in the setting of acquired and inherited ventricular dysfunction and arrhythmias.


Late sodium current Pharmacology Myocardial ischemia Heart failure Arrhythmias Long QT syndrome 



Dr. C.A. Remme is supported by the InterUniversity Cardiology Institute of the Netherlands (ICIN; 061.02) and the Division for Earth and Life Sciences (ALW) with financial aid from the Netherlands Organization for Scientific Research (NWO; 836.09.003).


Dr. C.A. Remme receives a research grant from Gilead Sciences.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Clinical and Experimental Cardiology, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Experimental CardiologyAcademic Medical Center, Room K2-110AmsterdamThe Netherlands

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