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Embryological Development of Pacemaker Hierarchy and Membrane Currents Related to the Function of the Adult Sinus Node: Implications for Autonomic Modulation of Biopacemakers

  • Chapter
Biopacemaking

Part of the book series: Series in Biomedical Engineering ((BIOMENG))

Abstract

The sinus node is an inhomogeneous structure. In the embryonic heart all myocytes have sinus node type pacemaker channels (I f) in their sarcolemma. Shortly before birth, these channels disappear from the ventricular myocytes. The response of the adult sinus node to changes in the interstitium, in particular to (neuro)transmitters, results from the interplay between the responses of all of its constituent cells. The response of the whole sinus node cannot be simply deduced from these cellular responses, because all cells have different responses to specific agonists. A biological pacemaker will be more homogeneous. Therefore it can be anticipated that tuning of cycle length may be problematic. It is discussed that efforts to create a biological pacemaker responsive to vagal stimulation, may be counterproductive, because it may have the potential risk of’ standstill’ of the biological pacemaker. A normal sinus node remains spontaneously active at high concentrations of acetylcholine, because it has areas that are unresponsive to acetylcholine. The same is pertinent to other substances with a negative chronotropic effect. Such functional inhomogeneity is lacking in biological pacemakers.

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Authors and Affiliations

  1. Experimental and Molecular Cardiology Group, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Tobias Opthof

  2. Department of Medical Physiology, University Medical Center Utrecht, Utrecht, The Netherlands

    Tobias Opthof

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  1. Tobias Opthof
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Editors and Affiliations

  1. Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    J. A. E Spaan

  2. Department of Experimental Cardiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Ruben Coronel

  3. Department of Experimental Cardiology Center for Heart Failure Research, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam

    Jacques M. T. de Bakker

  4. The Heart Lung Center, University Medical Center, Utrecht

    Jacques M. T. de Bakker

  5. The Interuniversity Cardiology, Institute of the Netherlands, Utrecht, The Netherlands

    Jacques M. T. de Bakker

  6. Dipartimento di Biotecnologie e Bioscienze, UniversitĂ  di Milano-Bicocca, Piazza della Scienza 2, 20126, Milano, Italy

    Antonio Zaza

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Opthof, T. (2007). Embryological Development of Pacemaker Hierarchy and Membrane Currents Related to the Function of the Adult Sinus Node: Implications for Autonomic Modulation of Biopacemakers. In: Spaan, J.A.E., Coronel, R., de Bakker, J.M.T., Zaza, A. (eds) Biopacemaking. Series in Biomedical Engineering. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-72110-9_2

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  • DOI: https://doi.org/10.1007/978-3-540-72110-9_2

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