Oxidative mediated lipid peroxidation recapitulates proarrhythmic effects on cardiac sodium channels

Koji Fukuda, Sean S. Davies, Tadashi Nakajima, Boon Hooi Ong, Sabina Kupershmidt, Joshua Fessel, Venkataraman Amarnath, Mark E. Anderson, Penelope A. Boyden, Prakash C. Viswanathan, L. Jackson Roberts, Jeffrey R. Balser

Research output: Contribution to journalArticlepeer-review

106 Scopus citations


Sudden cardiac death attributable to ventricular tachycardia/fibrillation (VF) remains a catastrophic outcome of myocardial ischemia and infarction. At the same time, conventional antagonist drugs targeting ion channels have yielded poor survival benefits. Although pharmacological and genetic models suggest an association between sodium (Na+) channel loss-of-function and sudden cardiac death, molecular mechanisms have not been identified that convincingly link ischemia to Na+ channel dysfunction and ventricular arrhythmias. Because ischemia can evoke the generation of reactive oxygen species, we explored the effect of oxidative stress on Na+ channel function. We show here that oxidative stress reduces Na+ channel availability. Both the general oxidant tert-butyl-hydroperoxide and a specific, highly reactive product of the isoprostane pathway of lipid peroxidation, E 2-isoketal, potentiate inactivation of cardiac Na+ channels in human embryonic kidney (HEK)-293 cells and cultured atrial (HL-1) myocytes. Furthermore, E2-isoketals were generated in the epicardial border zone of the canine healing infarct, an arrhythmogenic focus where Na + channels exhibit similar inactivation defects. In addition, we show synergistic functional effects of flecainide, a proarrhythmic Na+ channel blocker, and oxidative stress. These data suggest Na+ channel dysfunction evoked by lipid peroxidation is a candidate mechanism for ischemia-related conduction abnormalities and arrhythmias.

Original languageEnglish (US)
Pages (from-to)1262-1269
Number of pages8
JournalCirculation research
Issue number12
StatePublished - Dec 2005
Externally publishedYes


  • Isoketals
  • Lipid-peroxidation
  • Myocardial infarction
  • Sodium channels

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine


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