RT Journal Article T1 Functional modulation of atrio-ventricular conduction by enhanced late sodium current and calcium-dependent mechanisms in Scn5a1798insD/+ mice A1 Rivaud, Mathilde R A1 Marchal, Gerard A A1 Wolswinkel, Rianne A1 Jansen, John A A1 van der Made, Ingeborg A1 Beekman, Leander A1 Ruiz-Villalba, Adrián A1 Baartscheer, Antonius A1 Rajamani, Sridharan A1 Belardinelli, Luiz A1 van Veen, Toon A B A1 Basso, Cristina A1 Thiene, Gaetano A1 Creemers, Esther E A1 Bezzina, Connie R A1 Remme, Carol Ann AB Aims: SCN5A mutations are associated with arrhythmia syndromes, including Brugada syndrome, long QT syndrome type 3 (LQT3), and cardiac conduction disease. Long QT syndrome type 3 patients display atrio-ventricular (AV) conduction slowing which may contribute to arrhythmogenesis. Methods/Results: We assessed electrophysiological and molecular alterations underlying AV-conduction abnormalities in mice carrying the Scn5a1798insD/+ mutation (mutants). Langendorff-perfused mutants hearts showed prolonged AV-conduction compared to wild type (WT) without changes in atrial and His-ventricular (HV) conduction. The late sodium current (INa,L) inhibitor ranolazine (RAN) normalized AV-conduction in mutants mice, likely by preventing the mutation-induced increase in intracellular sodium ([Na+]i) and calcium ([Ca2+]i) concentrations. Indeed, further enhancement of [Na+]i and [Ca2+]i by the Na+/K+-ATPase inhibitor ouabain caused excessive increase in AV-conduction time in mutants hearts. Mutants mice from the 129P2 strain displayed more severe AV-conduction abnormalities than FVB/N-mutants mice, in line with their larger mutation-induced INa,L. Transverse aortic constriction (TAC) caused excessive prolongation of AV-conduction in FVB/N-Scn5a1798insD/+ mice (while HV-intervals remained unchanged), which was prevented by chronic RAN treatment. Mutants-TAC hearts showed decreased mRNA levels of conduction genes in the AV-nodal region, but no structural changes in the AV-node or His bundle. In mutants-TAC mice deficient for the transcription factor Nfatc2 (effector of the calcium-calcineurin pathway), AV-conduction and conduction gene expression were restored to WT levels.Conclusions: Our findings indicate a detrimental role for enhanced INa,L and consequent calcium dysregulation on AV-conduction in Scn5a1798insD/+ mice, providing evidence for a functional mechanism underlying AV-conduction disturbances secondary to gain-of-function SCN5A mutations. PB Oxford University Press YR 2020 FD 2020 LK https://hdl.handle.net/10630/33702 UL https://hdl.handle.net/10630/33702 LA eng DS RIUMA. Repositorio Institucional de la Universidad de Málaga RD 20 ene 2026