Background: Previous studies have associated slowed ventricular conduction in the arrhythmogenesis mediated by the gap junction and sodium channel inhibitor heptanol in mouse hearts but did not study the propagation patterns that might contribute to the arrhythmic substrate. This study used a multi-electrode array mapping technique, to further investigate different conduction abnormalities in Langendorff-perfused mouse hearts exposed to 0.1 or 2 mM heptanol. Methods: Multi-electrode array recordings were made from the left ventricular epicardium in spontaneously beating hearts, during right ventricular regular 8 Hz pacing or S1S2 pacing. Results: In spontaneously beating hearts, heptanol at 0.1 and 2 mM significantly reduced the heart rate from 314±25 to 189±24 and 157±7 bpm, respectively (ANOVA, P<0.05 and P<0.001). During regular 8 Hz pacing, Mean LATs were increased by 0.1 and 2 mM heptanol from 7.1±2.2 ms to 19.9±5.0 ms (P<0.05) and 18.4±5.7 ms (P<0.05). The standard deviation of mean LATs was increased from 2.5±0.8 ms to 10.3±4.0 ms and 8.0±2.5 ms (P< 0.05), and the median of phase differences was significantly increased from 1.7±1.1 ms to 13.9±7.8 ms and 12.1±5.0 ms by 0.1 and 2 mM heptanol (P<0.05). P5 took a value of 0.2±0.1 ms and was not significantly altered by heptanol at 0.1 or 2 mM (1.1±0.9 ms and 0.9±0.5 ms, P>0.05). P50 was increased from 7.3±2.7 ms to 24.0±12.0 ms by 0.1 mM heptanol and then to 22.5±7.5 ms by 2 mM heptanol (P< 0.05). P95 was increased from 1.7±1.1 ms to 13.9±7.8 ms by 0.1 mM heptanol and to 12.1±5.0 ms by 2 mM heptanol (P<0.05). These changes led to increases in the absolute inhomogeneity in conduction (P5-95) from 7.1±2.6 ms to 31.4±11.3 ms, 2 mM: 21.6±7.2 ms, respectively (P<0.05). The inhomogeneity index (P5-95/P50) was significantly reduced from 3.7±1.2 to 3.1±0.8 by 0.1 mM and then to 3.3±0.9 by 2 mM heptanol (P<0.05). Conclusion: Increased activation latencies, reduced CVs and increased dispersion index of conduction were associated with both spontaneous and induced ventricular arrhythmias.

Previous studies have quantified repolarization variability using time-domain, frequency-domain and non-linear analysis in mouse hearts. Here, we investigated the relationship between these parameters and ventricular arrhythmogenicity in a hypokalaemia model of acquired long QT syndrome. Methods: Left ventricular monophasic action potentials (MAPs) were recorded during right ventricular regular 8 Hz pacing during normokalaemia (5.2 mM [K+]), hypokalaemia modelling LQTS (3 mM [K+]) or hypokalaemia with 0.1 mM heptanol in Langendorff-perfused mouse hearts. Results: During normokalaemia, mean APD was 33.5±3.7 ms. Standard deviation (SD) of APDs was 0.63±0.33 ms, coefficient of variation was 1.9±1.0% and the root mean square (RMS) of successive differences in APDs was 0.3±0.1 ms. Low- and high-frequency peaks were 0.6±0.5 and 2.3±0.7 Hz, respectively, with percentage powers of 38±22 and 61±23%. Poincaré plots of APDn+1 against APDn revealed ellipsoid morphologies with SD along the line-of-identity (SD2) to SD perpendicular to the line-of-identity (SD1) ratio of 4.6±1.1. Approximate and sample entropy were 0.49±0.12 and 0.64±0.29, respectively. Detrended fluctuation analysis revealed short- and long-term fluctuation slopes of 1.62±0.27 and 0.60±0.18, respectively. Hypokalaemia provoked ventricular tachycardia in six of seven hearts, prolonged APDs (51.2±7.9 ms), decreased SD2/SD1 ratio (3.1±1.0), increased approximate and sample entropy (0.68±0.08 and 1.02±0.33) and decreased short-term fluctuation slope (1.23 ± 0.20) (ANOVA, P<0.05). Heptanol prevented VT in all hearts studied without further altering the above repolarization parameters observed during hypokalaemia. Conclusion: Reduced SD2/SD1, increased entropy and decreased short-term fluctuation slope are associated with ventricular arrhythmogenesis in hypokalaemia. Heptanol exerts anti-arrhythmic effects without affecting repolarization variability.