Reentrant waves in a ring of embryonic chick ventricular cells imaged with a Ca2+ sensitive dye

According to the classic model initially formulated by Mines, reentrant cardiac arrhythmias may be associated with waves circulating in a ring geometry. This study was designed to study the dynamics of reentry in a ring geometry of cardiac tissue culture. Reentrant calcium waves in rings of cultured embryonic chick cardiac myocytes were imaged using a macroscope to monitor the fluorescence of intracellular Calcium Green-1 dye. The rings displayed a variety of stable rhythms including pacemaker activity and spontaneous reentry. Waves originating from a localized pacemaker could lead to reentry as a consequence of unidirectional block. In addition, more complex patterns were observed due to the interactions between reentrant and pacemaker rhythms. These rhythms included instances in which pacemakers accelerated the reentrant rhythm, and instances in which the excitation was blocked in the vicinity of pacemakers. During reentrant activity an appropriately timed electrical stimulus could induce resetting of activity or cause complete annihilation of the propagating waves. This experimental preparation reveals many spontaneously occuring complex rhythms. These complex rhythms are hypothesized to reflect interactions between spontaneous pacemakers, wave propagation, refractory period, and overdrive suppression. This preparation may serve as a useful model system to further investigate complex dynamics arising during reentrant rhythms in cardiac tissue.     

Fertilisation calcium signals in the ascidian egg

The egg of ascidians (urochordate), as virtually all animal and plant species, displays Ca2+ signals upon fertilisation. These Ca2+ signals are repetitive Ca2+ waves that initiate in the cortex of the egg and spread through the whole egg interior. Two series of Ca2+ waves triggered from two distinct Ca2+ wave pacemakers entrain the two meiotic divisions preceding entry into the first interphase. The second messenger inositol (1,4,5) trisphosphate (IP3) is the main mediator of these global Ca2+ waves. Other Ca2+ signalling pathways (RyR and NAADPR) are functional in the egg but they mediate localised cortical Ca2+ signals whose physiological significance remains unclear. The meiosis I Ca2+ wave pacemaker is mobile and relies on intracellular Ca2+ release from the endoplasmic reticulum (ER) induced by a large production of IP3 at the sperm aster site. The meiosis II Ca2+ wave pacemaker is stably localised in a vegetal protrusion called the contraction pole. It is probable that a local production of IP3 in the contraction pole determines the site of this second pacemaker while functional interactions between ER and mitochondria regulate its activity. Finally, a third ectopic pacemaker can be induced by a global increase in IP3, making the ascidian egg a unique system where three different Ca2+ wave pacemakers coexist in the same cell.     

Bilaterally propagating waves of spontaneous activity arising from discrete pacemakers in the neonatal mouse cerebral cortex

Spontaneous electrical activity that moves in synchronized waves across large populations of neurons plays widespread and important roles in nervous system development. The propagation patterns of such waves can encode the spatial location of neurons to their downstream targets and strengthen synaptic connections in coherent spatial patterns. Such waves can arise as an emergent property of mutually excitatory neural networks, or can be driven by a discrete pacemaker. In the mouse cerebral cortex, spontaneous synchronized activity occurs for approximately 72 h of development centered on the day of birth. It is not known whether this activity is driven by a discrete pacemaker or occurs as an emergent network property. Here we show that this activity propagates as a wave that is initiated at either of two homologous pacemakers in the temporal region, and then propagates rapidly across both sides of the brain. When these regions of origin are surgically isolated, waves do not occur. Therefore, this cortical spontaneous activity is a bilateral wave that originates from a discrete subset of pacemaker neurons. © 2009 Wiley Periodicals, Inc. Develop Neurobiol, 2009     

Transition from an excitable to an oscillatory state in dictyostelium discoideum

Under conditions of starvation, populations of the amoebae Dictyostelium discoideum aggregate are mediated by chemical excitation waves of cAMP. Two types of waves can be observed, either spiral or circular-shaped ones. We investigate transitions from rotating spirals to circular shaped waves (target patterns). Two different experiments demonstrating this phenomenon are presented. In the first case a continuous transition from the spiral type pattern to target waves was observed at the later stages of aggregation. In the second case the transition was induced by annihilation of waves by a spatially homogeneous cAMP pulse. Instead of the originally present spiral waves, oscillating spots bearing target patterns emerged. On the basis of a model for Dictyostelium aggregation, we provide a theoretical explanation for such transitions. It is shown that cell density can be an effective bifurcation parameter. Under certain conditions, the system is shifted from the excitable to the oscillatory state while the frequency of oscillations is proportional to the square root of the cell density. Thus, the regions with the highest cell density during the early stages of the spatial rearrangement of the cells become pacemakers and produce target patterns. The analytic results were confirmed in numerical simulations of the model.     

Reaction-diffusion equations for simulation of calcium signalling in cell systems.

Numerous experimental and theoretical studies have recently pointed to the importance of calcium signals and their propagation as waves of various kinds inside cells. This phenomenon has been particularly noted in fertilized egg cells. Ca2+ plays a fundamental role in these cells as it is capable of stimulating, by means of a first, large wave, the beginning of an organism's life at fertilization, immediately after sperm penetration. Furthermore, calcium is involved in numerous subsequent processes that are essential for the development of the future embryo, e.g. in contraction of cortical cytoplasm, protein synthesis and cell differentiation. Calcium waves, which are generated by self-oscillating pacemakers and propagate in excitable media, have been observed in some types of egg cells after fertilization. These waves adopt different shapes according to their emission frequency, wavelength, velocity and curvature, and they can occur as solitary waves, target waves or spiral waves. The mathematical models that study the progress of these waves have been developed by means of partial differential equations of the "reaction-diffusion" type. This study will discuss some significant models of intracellular Ca2+ dynamics. Some preliminary considerations will then be made in order to develop a model that describes the propagation of Ca2+ waves in ascidian eggs.     

Comparison of atrial premature depolarization topography during vagal stimulation and humoral acetylcholine administration

Epicardial atrial mapping in open-chest dogs during different cholinergic influences has shown that, in acetylcholine administration and vagal stimulation, spatial distribution of atrial premature depolarisation (APDs) seems to be similar to prevalence of ectopic sources from both atria and atrial septum. Spatial distribution of the APDs in acetylcholine administration in the sinus node artery was limited to the region of this artery so that the APDs mainly arise from intercaval area of the right atrium and from atrial septum, but never from the left atrium. The latent pacemakers spread over both atria and atrial septum, could participate in initiation of cholinergically-induced APDs and atrial fibrillation. A direct effect of acetylcholine seems to be necessary for development of arrhythmic activity of the latent pacemakers.     

Roles of interstitial cells of Cajal in regulating gastrointestinal motility: in vitro versus in vivo studies

The aim of this article is to provide a better understanding of the roles of interstitial cells of Cajal (ICC) in regulating gastrointestinal motility by reviewing in vitro and in vivo physiological motility studies. Based on the in vitro studies, ICC are proposed to have the following functions: to generate slow waves, to mediate neurotransmission between the enteric nerves and the gastrointestinal muscles and to act as mechanoreceptors. However, there is limited evidence available for these hypotheses from the in vivo motility studies. In this review, we first introduce the major subtypes of ICC and their established functions. Three Kit mutant mouse and rodent models are presented and the loss of ICC subtypes in these mutants is reviewed. The physiological motility findings from various in vitroand in vivo experiments are discussed to give a critical review on the roles of ICC in generating slow waves, regulating gastrointestinal motility, mediating neural transmission and serving as mechanoreceptors. It is concluded that the role of ICC as pacemakers may be well established, but other cells may also be involved in the generation of slow waves; the theory that ICC are mediators of neurotransmission is challenged by the majority of the in vivo motility studies; the hypothesis that ICC are mechanoreceptors has not found supportive evidence from the in vivo studies yet. More studies are needed to explain discrepancies in motility findings between the in vitro and in vivo experiments.     

Waves of crown-of-thorns starfish outbreaks —where do they come from?

To explain the southward propagating waves of crown-of-thorns outbreaks on the Great Barrier Reef, it has been proposed that the northern region acts as a seed area for these waves. In this paper we study whether the highly variable current pattern of this region facilitates the start of local outbreaks, making the northern region the seed area or pace-maker of travelling waves of outbreaks. To this end we construct an artificial reef system, which resembles the Great Barrier Reef by having a northern area with a random current pattern, and a central and southern region with a (southward) biased current pattern. Travelling waves running from north to south are observed in the system both with and without a deviant current pattern in the northern area. This demonstrates that travelling waves are an emergent property of the system. The result indicates that the observed waves of crown-of-thorns outbreaks on the Great Barrier Reef do not necessarily imply that there is a seed area in the north.     

Inhibition of a Demand Pacemaker and Interference with Monitoring Equipment by Radio-frequency Transmissions

During the initial testing of Radio Leicester a swept-frequency technique for testing radio antennae was shown to affect demand pacemakers by inhibition of the pacing impulse and to interfere with physiological monitoring equipment. Adequate filtering of demand pacemakers is necessary to eliminate this interference. There is no evidence that such testing has any effect on the function of fixed-rate pacemakers. There is also a potential danger to implanted demand pacemakers by the use of similar polyscope generators used for servicing radio and television apparatus in industry.     

Circadian ovulatory rhythms in Japanese quail: role of ocular and extraocular pacemakers

Previous studies have shown that the circadian system of Japanese quail is composed of multiple photic inputs and multiple oscillators. Among these are extraretinal photoreceptors that mediate both circadian and photoperiodic responses and circadian pacemakers in the eyes that, via neural and hormonal outputs, help to maintain rhythmicity of central circadian clocks (presumably located in the suprachiasmatic area of the hypothalamus). Furthermore, a component of the central circadian system is influenced by reproductive hormones. Under certain conditions, the circadian system of female quail can be induced to split into two circadian components: one driven by ocular pacemakers and one driven by feedback from reproductive hormones. Importantly, ovulation is either inhibited or permitted as these two oscillators (or sets of oscillators) constantly change internal phase relationships with each other, suggesting an "internal coincidence" mechanism in the control of ovulation. The oviposition patterns of quail in light-dark (LD) cycles also support an internal coincidence mechanism. The authors tested the hypothesis that the ocular pacemakers are an important component of an internal coincidence mechanism controlling ovulation by examinig the effects of blinding by complete eye removal (EX), and the effects of eye-patching, on the body temperature and oviposition patterns of quail exposed to 24-h LD cycles. They also examined the effects of EX on quail exposed to continuous light (LL) and to continuous darkness (DD). Neither EX nor eye-patching affected the oviposition patterns of birds in LD. Furthermore, robust body temperature and oviposition rhythms continued in EX birds in LL, but body temperature became arrhythmic in DD with the cessation of ovulation. The results do not show a role for ocular pacemakers in the control of ovulation, but they do support the hypotheses that (1) entrainment of the central oscillators by extraretinally perceived light is sufficient to preserve a normal ovulatory pattern in LD in the absence of the ocular pacemakers, and (2) in LL, feedback of reproductive hormones onto the central oscillators is sufficient to organize the circadian system even in the absence of the ocular pacemakers. Whether or not the ocular pacemakers are normally involved in the control of ovulation is still an open question.     

Effect of histamine on spontaneous rhythmogenesis of the guinea pig ureter

Histamine changed characteristics of the perinephric spontaneous spike activity and of the spreading electrical wave. It was shown that histamine could activate latent pacemakers of the ureter's middle area. Morphological picture of the histamine effect was also shown.     

Calcium waves and oscillations in eggs

Eggs from several protostomes (molluscs, annelids, nemerteans, etc.) and two deuterostomes (mammals and ascidians) display repetitive calcium signals. Oscillations in the level of intracellular calcium concentration are occasionally triggered by maturing hormones (as in some molluscs) and mostly observed after fertilization which occurs at different stages of the meiotic cell cycle (oocytes are arrested in prophase, metaphase I or metaphase II). In most eggs examined so far, calcium oscillations last until the end of meiosis just before male and female pronuclei form. This ability depends on the sensitivity of InsP3 channels and on the permeability of the plasma membrane to extracellular calcium. In eggs that undergo cytoplasmic reorganization at fertilization (annelids, nemerteans, ascidians, etc.) the repetitive calcium signals are waves that originate from localized cortical sites that become calcium waves pacemakers. In ascidians we have identified the site of initiation of repetitive calcium waves as an accumulation of endoplasmic reticulum sandwiched between the plasma membrane and an accumulation of mitochondria. We compare and discuss the generation of calcium signals in the different eggs, their relationship with the cell cycle and the possible roles they play during development.     

Ocular clocks are tightly coupled and act as pacemakers in the circadian system of Japanese quail

Our previous studies showed that the eyes of Japanese quail contain a biological clock that drives a daily rhythm of melatonin synthesis. Furthermore, we hypothesized that these ocular clocks are pacemakers because eye removal abolishes freerunning rhythms in constant darkness (DD). If the eyes are indeed acting as pacemakers, we predicted that the two ocular pacemakers in an individual bird must remain in phase in DD and, furthermore, the two ocular pacemakers would rapidly regain coupling after being forced out of phase. These predictions were confirmed by demonstrating that 1) the ocular melatonin rhythms of the two eyes maintained phase for at least 57 days in DD and 2) after ocular pacemakers were forced out of phase by alternately patching the eyes in constant light, two components of body temperature were observed that fused into a consolidated rhythm after 5-6 days in DD, showing pacemaker recoupling. The ability to maintain phase in DD and rapidly recouple after out-of-phase entrainment demonstrates that the eyes are strongly coupled pacemakers that work in synchrony to drive circadian rhythmicity in Japanese quail.     

Clocks,oscillation, and temporal delays in morphogenesis

The presence and morphogenetic role of relatively autonomous pacemakers (“clocks”) during ontogeny is discussed. Although autonomous pacemakers in the strict sense seem nonexistent, the study of temporal processes is of great importance for recognizing the fundamental morphogenetic mechanisms. The most important and insufficiently understood questions in this field include the presence of hierarchies of characteristic times and their smoothing during critical developmental periods and also regulation of spatial processes via temporal delays.     

The role of cAMP dependent protein kinase in modulating spontaneous intracellular Ca waves in interstitial cells of Cajal from the rabbit urethra

Interstitial cells of Cajal (ICC) serve as electrical pacemakers in the rabbit urethra. Pacemaking activity in ICC results from spontaneous intracellular Ca²⁺ waves that rely on Ca²⁺ release from endoplasmic reticulum (ER) stores. The purpose of this study was to investigate if the action of protein kinase A (PKA) affected the generation of Ca²⁺ waves in ICC. Intracellular [Ca²⁺] was measured in fluo-4 loaded ICC, freshly isolated from the rabbit urethra using a Nipkow spinning disc confocal microscope. Application of the PKA inhibitor H-89 (10 μM) significantly inhibited the generation of spontaneous Ca²⁺ waves in ICC and this was associated with a significant decrease in the ER Ca²⁺ load, measured with 10 mM caffeine responses. Ca²⁺ waves could be rescued in the presence of H-89 by stimulating ryanodine receptors (RyRs) with 1 mM caffeine but not by activation of inositol 1,4,5 tri-phosphate receptors (IP₃Rs) with 10 μM phenylephrine. Increasing intracellular PKA with the cAMP agonists forskolin and 8-bromo-cAMP failed to yield an increase in Ca²⁺ wave activity. We conclude that PKA may be maximally active under basal conditions in ICC and that inhibition of PKA with H-89 leads to a decreased ER Ca²⁺ load sufficient to inactivate IP₃Rs but not RyRs.     

Sex differences in selection of pacemakers: retrospective observational study

Objective: To evaluate the effect of patients’ sex on selection of pacemakers. Design: Retrospective univariate and multivariate analysis of a large database. Setting: German central pacemaker register. Subjects: Records collected at the register for 1992 and 1993 (n=31 913), covering 64% of all implantations in Germany. Main outcome measure: Probability of receiving a single chamber, dual chamber, or rate responsive pacemaker in relation to sex. Results: Univariate analysis showed that women were more likely to receive single chamber pacemakers and less likely to receive dual chamber or rate responsive systems than men. After demographic and clinical variables were controlled for, women were still more likely to receive a single chamber system (atrial pacing: odds ratio 0.89, 95% confidence interval 0.74 to 1.07; ventricular pacing: 0.85, 0.80 to 0.92) and less likely to receive a dual chamber (1.20, 1.12 to 1.30) or a rate responsive system (1.26, 1.17 to 1.37) than men. Conclusions: The data suggest sex differences in the selection of a pacemaker system which cannot be explained by the underlying cardiac disorder. Further research is needed to evaluate why guidelines for implanting pacemakers are not better adhered to.

Key messages

• Use of pacemakers varies despite guidelines, and the reasons for this are unclear
• In this study women were more likely to receive single chamber pacemakers and less likely to receive dual chamber and rate responsive pacemakers than men
• Demographic and clinical variables cannot fully explain these differences
• Prospective studies are needed to evaluate the effect of sex and other non-medical variables on the selection of pacemakers

     

Biological pacing by gene and cell therapy

At present, cardiac rhythm disorders such as sick sinus syndrome (SSS) or AV nodal block (AVB) are usually treated by electronic pacemakers. These devices have significant shortcomings, including lack of autonomic modulation, and the need for repetitive procedures for battery replacement or lead repositioning. Biological pacemakers as replacement or complement to electronic pacemakers have been the subject of increasing research interest. This research has resulted in many encouraging preclinical studies. Various approaches in the field of gene and cell therapy have been developed by different groups and this combined effort makes it increasingly realistic that this therapy will eventually find its way to clinical applicability. (Neth Heart J 2007;15:318-22.)     

Utilisation of cardiac pacemakers over a 20-year period: Results from a nationwide pacemaker registry

The implantation of cardiac pacemakers has become a well-established therapy for conduction disorders and sinus node dysfunction. In many countries pacemaker registries have been initiated in order to collect information on patient characteristics, trends in numbers and the types of pacemakers used, to identify problematic devices, and for safety monitoring. For this utilisation study the Central Pacemaker Patients Registration (CPPR) from the Netherlands Pacemaker Registry Foundation (CPPR-SPRN) containing data collected for more than 20 years was used. During this period nearly 97,000 first pacemakers were implanted. Analyses show an increase in the rate of implanted devices. The change in pacemaker type from VVI to DDD, followed by biventricular stimulation, is reflected by the number of simultaneously implanted leads, which is partly a consequence of cardiac resynchronisation therapy. Our data demonstrate that indications for implantation and type of pacemaker are comparable with other European countries.     

Autonomous pacemakers in the basal ganglia: who needs excitatory synapses anyway?

Autonomous pacemakers are crucial elements in many neural circuits. This is particularly true for the basal ganglia. This richly interconnected group of nuclei is rife with both fast- and slow-spiking pacemakers. Our understanding of the ionic mechanisms underlying pacemaking in these neurons is rapidly evolving, yielding new insights into the normal functioning of this network and how it goes awry in pathological states such as Parkinson's disease.     

Background sodium current stabilizes bursting in respiratory pacemaker neurons

Endogenous pacemaker properties have been proposed to generate rhythmic activity underlying many behaviors including respiration. For pacemakers to generate regenerative bursting, background currents maintain their membrane potential (Vm) within a range where bi-stable properties are expressed, thereby stabilizing rhythmogenesis. We previously found that the baseline Vm of respiratory pacemakers is stabilized against hyperpolarizing shifts in their Vm. In response to prolonged hyperpolarizing current injection synaptically isolated respiratory pacemakers steadily depolarize and resume bursting, suggesting a stabilizing background current is involved. What is the ionic basis of this background current in respiratory pacemakers? Here we demonstrate that in low-[Na(+)](o) ACSF, synaptically isolated respiratory pacemakers hyperpolarized and remained outside the bursting window, but could burst upon depolarizing current injection. These data suggest that pacemakers possess a background sodium current that is necessary to bring their Vm into a bursting range. Low-[Na(+)](o) ACSF also abolished the depolarizing shift evoked during prolonged hyperpolarizing current injection, and bursting did not resume. This depolarizing shift persisted in the presence of I(h)-current blockers, but was abolished in tetrodotoxin. Although, under control conditions, the Vm of synaptically isolated respiratory pacemaker neurons was not significantly affected when [K(+)](o) was changed from 3 to 8 mM, the Vm is altered when [K(+)](o) was raised in low-[Na(+)](o) ACSF. Thus, current-clamp studies suggest that respiratory pacemaker neurons possess a background sodium current that maintains their membrane potential within a range where they express bursting, thereby stabilizing rhythmogenesis.