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Am J Physiol Heart Circ Physiol 283: H2074-H2101, 2002; doi:10.1152/ajpheart.00900.2001
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Vol. 283, Issue 5, H2074-H2101, November 2002

Dynamical description of sinoatrial node pacemaking: improved mathematical model for primary pacemaker cell

Yasutaka Kurata1, Ichiro Hisatome2, Sunao Imanishi1, and Toshishige Shibamoto1

1 Department of Physiology, Kanazawa Medical University, Ishikawa 920-0293; and 2 First Department of Internal Medicine, Tottori University School of Medicine, Yonago 683-0826, Japan


    ABSTRACT
TOP
ABSTRACT
INTRODUCTION
THEORY AND METHODS
RESULTS AND DISCUSSION
APPENDIX
REFERENCES

We developed an improved mathematical model for a single primary pacemaker cell of the rabbit sinoatrial node. Original features of our model include 1) incorporation of the sustained inward current (Ist) recently identified in primary pacemaker cells, 2) reformulation of voltage- and Ca2+-dependent inactivation of the L-type Ca2+ channel current (ICa,L), 3) new expressions for activation kinetics of the rapidly activating delayed rectifier K+ channel current (IKr), and 4) incorporation of the subsarcolemmal space as a diffusion barrier for Ca2+. We compared the simulated dynamics of our model with those of previous models, as well as with experimental data, and examined whether the models could accurately simulate the effects of modulating sarcolemmal ionic currents or intracellular Ca2+ dynamics on pacemaker activity. Our model represents significant improvements over the previous models, because it can 1) simulate whole cell voltage-clamp data for ICa,L, IKr, and Ist; 2) reproduce the waveshapes of spontaneous action potentials and ionic currents during action potential clamp recordings; and 3) mimic the effects of channel blockers or Ca2+ buffers on pacemaker activity more accurately than the previous models.

rabbit sinoatrial node; nonlinear dynamical system; computer simulation; bifurcation diagram


    INTRODUCTION
TOP
ABSTRACT
INTRODUCTION
THEORY AND METHODS
RESULTS AND DISCUSSION
APPENDIX
REFERENCES

PACEMAKER ACTIVITY of the sinoatrial (SA) node is well known as the initiation of the spontaneous heart beat. A large body of information on ionic current systems underlying the SA node pacemaker activity has been obtained from recent single cell patch-clamp experiments. On the basis of single cell patch-clamp data, several mathematical models describing the pacemaker activity of a single rabbit SA node cell have been developed in the past decade.

In 1991, Wilders et al. (124) first developed a single SA node cell model based on single cell patch-clamp data to reproduce the electrical behavior of a single rabbit SA node cell quantitatively. Later, Demir et al. (17) proposed a more detailed model for transitional-type cells (rather than for primary pacemaker cells) including intracellular Ca2+ buffering (by calmodulin, troponin, and calsequestrin) and new formulations for Ca2+ handling by the sarcoplasmic reticulum (SR) based on microanatomic data. Dokos et al. (24) developed a different SA node model incorporating new formulations of the Na+/Ca2+ exchanger current (INaCa) and muscarinic K+ channel current (IK,ACh) as a background K+ current. However, these previous models have several difficulties, as follows. First, the formulations of voltage-dependent inactivation and recovery of the L-type Ca2+ channel current (ICa,L) were not based on experimental data. Second, the Ca2+-dependent inactivation of ICa,L, known as an essential property of the L-type Ca2+ channel in the rabbit SA node (10, 67), was not formulated [or not directly dependent on the intracellular Ca2+ concentration ([Ca2+]i), but a function of the inactivation gating variable fL in Wilders et al. (124)]. Although Dokos et al. (24) incorporated a second inactivation gating variable to represent the [Ca2+]i-dependent inactivation process, they assumed an extraordinarily large maximum ICa,L conductance (gCa,L) and a very high affinity for Ca2+ binding to the inactivation site of L-type Ca2+ channels; such a large gCa,L with a high affinity for Ca2+ binding is rather unlikely and has not been demonstrated. Third, these models do not include the slow component of the delayed rectifier K+ current (IKs), 4-aminopyridine (4-AP)-sensitive currents, or sustained inward current (Ist), whereas these currents are known to be present in primary pacemaker cells. Fourth, intracellular Ca2+ transients in their models (2.5~10 µM at the peak) were much higher than those in atrial or ventricular myocytes (~1 µM) (e.g., Refs. 106 and 110; see also Refs. 68 and 71), probably too high for SA node cells. Finally, SR volumes or Ca2+ concentrations in the SR are comparable to or higher than those experimentally determined for ventricular myocytes (see Refs. 17, 63, and 107), probably too large for SA node cells. Recently, Zhang et al. (130) developed separate models for central and peripheral SA node cells based on recent experiments in which the regional differences in action potential (AP) parameters, ionic current densities, and pharmacological responses (i.e., electrophysiological effects of various current blockers) between central and peripheral SA node cells have been studied. Their central and peripheral models provide a theoretical basis for regional differences in AP parameters and are superior to the previous models in that they incorporate novel current systems such as IKs and 4-AP-sensitive currents. However, their models have at least two apparent difficulties. First, intracellular ion concentrations were assumed to be constant in their models (the net ion flux of Na+, K+, or Ca2+ during an AP cycle is not zero), whereas intracellular Ca2+ dynamics and changes in intracellular Na+ ([Na+]i) and K+ concentrations ([K+]i) are known to exert substantial effects on pacemaker activity (e.g., see Refs. 67, 98, and 122). Second, their models lack some sarcolemmal currents, such as Ist and IK,ACh, known to play important roles in regulating the pacemaker activity of rabbit SA node cells. Thus the previous SA node models all have several drawbacks or serious disadvantages; a satisfactory single cell model is not available.

The aim of this study was to develop an improved mathematical model of a single "primary pacemaker cell" of the rabbit SA node that is more suitable than the previous models for investigating the dynamical mechanisms of pacemaker generation. In addition to the drawbacks stated above, the previous single cell models exhibited different bifurcation structures, i.e., different ways of abolishing automaticity (see Ref. 30) from those of real SA node cells during inhibition of ICa,L or the rapid component of the delayed rectifier K+ current (IKr) not suitable for a study on the mechanisms of pacemaker generation (for details, see RESULTS AND DISCUSSION). Thus an improved model cell should have the same bifurcation structures as real SA node cells have as well as the capability of reproducing experimental data more accurately than the previous models. Such a model would also serve as a base model for developing more sophisticated models. On the basis of recent experimental findings, we were able to update the previous models in several ways: 1) Ist, not included in the previous models, has been incorporated; 2) voltage- and Ca2+-dependent inactivation kinetics of ICa,L have been reformulated; 3) expressions for activation kinetics of IKr have renewed; 4) revised kinetic formulas for 4-AP-sensitive currents have been incorporated; 5) voltage- and concentration-dependent kinetics of the Na+-K+ pump current (INaK) have been reformulated; and 6) the subsarcolemmal space as a diffusion barrier for intracellular Ca2+ has been incorporated.

To validate our model, we first compared the simulated dynamics of the model (spontaneous APs and ionic currents during pacemaker activity) with experimental data from the rabbit SA node as well as with those of the previous SA node models. We further validated our model by simulating the effects of modulations of sarcolemmal ionic currents or intracellular Ca2+ dynamics on pacemaker activity. The experimental findings for verification include 1) whole cell voltage-clamp data for ICa,L, IKr, and Ist; 2) waveshapes of spontaneous APs and ionic currents (such as ICa,L and IKr) as observed during AP-clamp recordings; 3) modulations and cessation of pacemaker activity by applications of ICa,L or IKr blockers; 4) modifications of AP waveforms (changes in AP parameters) by blocking the T-type Ca2+ channel current (ICa,T), hyperpolarization-activated current (Ih), or 4-AP-sensitive currents; 5) effects of blocking SR Ca2+ release (by ryanodine) on pacemaker frequency; and 6) negative chronotropic effects of Ca2+ buffers. Our model could reproduce these experimental data more accurately than the previous SA node models. In this study, we particularly focused on the bifurcation structures during applications of ICa,L or IKr blockers and also the differential effects of BAPTA and EGTA on pacemaker frequency. During inhibition of ICa,L or IKr, our model exhibited essentially the same bifurcation structures as observed in real SA node cells, whereas previous models did not; only our model could simulate the differential responses of SA node cells to BAPTA and EGTA. Detailed comparisons of our model with the previous models as well as experimental data are addressed in THEORY AND METHODS (on modeling) and RESULTS AND DISCUSSION (on simulated results).

Glossary

General
4-AP   4-Aminopyridine
AP   Action potential
APA   AP amplitude
APD50   AP duration at 50% repolarization
CL   Cycle length
F   Faraday constant
I   Current
MDP   Maximum diastolic potential
POP   Peak overshoot potential
R   Universal gas constant
SA   Sinoatrial
SR   Sarcoplasmic reticulum
t   Time
T   Absolute temperature
V   Membrane potential (in mV)

Ionic Channel Currents


Ib,Ca   Background Ca2+ current
Ib,K   Background K+ current
Ib,Na   Background Na+ current
ICa,L   L-type Ca2+ channel current
ICa,T   T-type Ca2+ channel current
Ih   Hyperpolarization-activated current
IK   Delayed rectifier K+ current
IK,ACh   Muscarinic K+ channel current
IKr   Rapid component of the delayed rectifier K+ current
IKs   Slow component of the delayed rectifier K+ current
INa   Fast Na+ channel current
INaCa   Na+/Ca2+ exchanger current
INaen   Electroneutral Na+ influx current
INaK   Na+-K+ pump current
INaKmax   Maximum INaK
Ip,Ca   Sarcolemmal Ca2+ pump current
Ist   Sustained inward current
Isus   Sustained component of the 4-AP-sensitive current
Ito   Transient component of the 4-AP-sensitive current

Cell Geometry


Cm   Cell membrane capacitance
Vcell   Cell volume
Vi   Myoplasmic volume available for Ca2+ diffusion
Vrel   Volume of junctional SR (Ca2+ release store)
Vsub   Subspace volume
Vup   Volume of network SR (Ca2+ uptake store)

Ionic Concentrations


Ca2+i   Myoplasmic Ca2+ concentration
[Ca2+]o   Extracellular Ca2+ concentration
[Ca2+]rel   Ca2+ concentration in the junctional SR
[Ca2+]sub   Subspace Ca2+ concentration
[Ca2+]up   Ca2+ concentration in the network SR
[K+]i   Intracellular K+ concentration
[K+]o   Extracellular K+ concentration
[Mg2+]i   Intracellular Mg2+ concentration
[Na+]i   Intracellular Na+ concentration
[Na+]o   Extracellular Na+ concentration

Equilibrium (Reversal) Potentials


ECa,L   Apparent reversal potential of ICa,L
ECa,T   Apparent reversal potential of ICa,T
EK   Equilibrium (Nernst) potential for K+
EKr   Reversal potential of IKr
EKs   Reversal potential of IKs
Emh   Reversal potential of INa
ENa   Equilibrium (Nernst) potential for Na+
Est   Apparent reversal potential of Ist

Sarcolemmal Ionic Currents


L   Activation gating variable for ICa,L
dL,infinity    Steady-state dL
dT   Activation gating variable for ICa,T
dT,infinity    Steady-state dT
fCa   Ca2+-dependent inactivation gating variable for ICa,L
fCa,infinity    Steady-state fCa
fL   Voltage-dependent inactivation gating variable for ICa,L
fL,infinity    Steady-state fL
fT   Inactivation gating variable for ICa,T
fT,infinity    Steady-state fT
FNa   Fraction of slow inactivation of INa
gb,Na   Background Na+ conductance
gCa,L   Maximum ICa,L conductance
gCa,T   Maximum ICa,T conductance
gh   Maximum Ih conductance
gh,K   K+ current component of gh
gh,Na   Na+ current component of gh
gK,ACh   Scaling factor for IK,ACh
gKr   Maximum IKr conductance
gKs   Maximum IKs conductance
gNa   Maximum INa conductance
gst   Maximum Ist conductance
gsus   Maximum Isus conductance
gto   Maximum Ito conductance
h   Inactivation gating variable for INa
hinfinity    Steady-state h
hF   Fast inactivation gating variable for INa
hS   Slow inactivation gating variable for INa
jCa,sm   Net Ca2+ flux through the sarcolemmal membrane
kNaCa   Scaling factor for INaCa
K1ni   Dissociation constant for intracellular Na+ binding to first site on INaCa transporter
K2ni   Dissociation constant for intracellular Na+ binding to second site on INaCa transporter
K3ni   Dissociation constant for intracellular Na+ binding to third site on INaCa transporter
K1no   Dissociation constant for extracellular Na+ binding to first site on INaCa transporter
K2no   Dissociation constant for extracellular Na+ binding to second site on INaCa transporter
K3no   Dissociation constant for extracellular Na+ binding to third site on INaCa transporter
Kci   Dissociation constant for intracellular Ca2+ binding to INaCa transporter
Kco   Dissociation constant for extracellular Ca2+ binding to INaCa transporter
Kcni   Dissociation constant for intracellular Na+ and Ca2+ simultaneous binding to INaCa transporter
KmfCa   Dissociation constant for Ca2+-dependent inactivation of ICa,L
KmKp   Half-maximal [K+]o for INaK
KmNap   Half-maximal [Na+]i for INaK
m   Activation gating variable for INa
minfinity    Steady-state m
n   Activation gating variable for IKs
ninfinity    Steady-state n
pa   Activation gating variable for IKr
pa,infinity    Steady-state pa
paF   Fast activation gating variable for IKr
paS   Slow activation gating variable for IKr
pi   Inactivation gating variable for IKr
pi,infinity    Steady-state pi
q   Inactivation gating variable for Ito
qinfinity    Steady-state q
qa   Activation gating variable for Ist
qa,infinity    Steady-state qa
qi   Inactivation gating variable for Ist
qi,infinity    Steady-state qi
Qci   Fractional charge movement during intracellular Ca2+ occlusion reaction of INaCa transporter
Qco   Fractional charge movement during extracellular Ca2+ occlusion reaction of INaCa transporter
Qn   Fractional charge movement during Na+ occlusion reactions of INaCa transporter
r   Activation gating variable for Ito and Isus
rinfinity    Steady-state r
x   Gating variable
xinfinity    Steady-state value of x
y   Activation gating variable for Ih
yinfinity    Steady-state value of y
 alpha dL   Opening rate constant of dL
 alpha fCa   Ca2+ dissociation rate constant for ICa,L
 alpha qa   Opening rate constant of qa
 alpha qi   Opening rate constant of qi
 alpha n   Opening rate constant of n
 beta dL   Closing rate constant of dL
 beta fCa   Ca2+ association rate constant for ICa,L
 beta n   Closing rate constant of n
 beta qa   Closing rate constant of qa
 beta qi   Closing rate constant of qi
 tau dL   Time constant of dL
 tau dT   Time constant of dT
 tau fCa   Time constant of fCa
 tau fL   Time constant of fL
 tau fT   Time constant of fT
 tau hF   Time constant of hF
 tau hS   Time constant of hS
 tau m   Time constant of m
 tau n   Time constant of n
 tau paF   Time constant of paF
 tau paS   Time constant of paS
 tau q   Time constant of q
 tau qa   Time constant of qa
 tau qi   Time constant of qi
 tau r   Time constant of r
 tau x   Time constant for a gating variable x
 tau y   Time constant of y

Ca2+ Diffusion


jCa,dif   Ca2+ diffusion flux from subspace to myoplasm
 tau dif,Ca   Time constant of Ca2+ diffusion from the subspace to myoplasm

SR Function


jrel   Ca2+ release flux from the junctional SR to subspace
jtr   Ca2+ transfer flux from the network to junctional SR
jup   Ca2+ uptake flux from the myoplasm to network SR
Krel   Half-maximal [Ca2+]sub for Ca2+ release from the junctional SR
Kup   Half-maximal [Ca2+]i for Ca2+ uptake by the Ca2+ pump in the network SR
Prel   Rate constant for Ca2+ release from the junctional SR
Pup   Rate constant for Ca2+ uptake by the Ca2+ pump in the network SR
 tau tr   Time constant for Ca2+ transfer from the network to junctional SR

Ca2+ Buffering


CQtot   Total calsequestrin concentration
[CM]tot   Total calmodulin concentration
fCMi   Fractional occupancy of calmodulin by Ca2+ in myoplasm
fCMs   Fractional occupancy of calmodulin by Ca2+ in subspace
fCQ   Fractional occupancy of calsequestrin by Ca2+
fTC   Fractional occupancy of the troponin-Ca site by Ca2+
fTMC   Fractional occupancy of the troponin-Mg site by Ca2+
fTMM   Fractional occupancy of the troponin-Mg site by Mg2+
kbBAPTA   Ca2+ dissociation constant for BAPTA
kbCM   Ca2+ dissociation constant for calmodulin
kbCQ   Ca2+ dissociation constant for calsequestrin
kbEGTA   Ca2+ dissociation constant for EGTA
kbTC   Ca2+ dissociation constant for the troponin-Ca site
kbTMC   Ca2+ dissociation constant for the troponin-Mg site
kbTMM   Mg2+ dissociation constant for the troponin-Mg site
kfBAPTA   Ca2+ association constant for BAPTA
kfCM   Ca2+ association constant for calmodulin
kfCQ   Ca2+ association constant for calsequestrin
kfEGTA   Ca2+ association constant for EGTA
kfTC   Ca2+ association constant for troponin
kfTMC   Ca2+ association constant for the troponin-Mg site
kfTMM   Mg2+ association constant for the troponin-Mg site
[TC]tot   Total concentration of the troponin-Ca site
[TMC]tot   Total concentration of the troponin-Mg site


    THEORY AND METHODS
TOP
ABSTRACT
INTRODUCTION
THEORY AND METHODS
RESULTS AND DISCUSSION
APPENDIX
REFERENCES

Model Development

We formulated a mathematical model describing the dynamic properties of a single primary pacemaker cell of the rabbit SA node under space-clamp conditions (at 37°C). Our model is an extension of previous SA node models (17, 24, 124, 130) that utilized classical Hodgkin-Huxley formalism, including variations in intracellular ion concentrations, Ca2+ handling by the SR, and Ca2+ buffering. The standard model for normal pacemaker activity is described as a nonlinear dynamical system of 27 simultaneous, first-order, ordinary differential equations. A complete list of the equations and standard parameter values is presented in the APPENDIX.

Geometrical considerations. We assumed our model cell to be a 70-µm-long by 8-µm-diameter cylinder (i.e., a "spindle-shaped" cell with a length of 70 µm and a mean width of 8 µm) and set the cell volume and membrane capacitance to 3.5 pl and 32 pF, respectively. The cell volume of 3.5 pl was nearly identical to that used by Demir et al. (17) but smaller than the value of 5 pl estimated by Denyer and Brown (19) for spindle-shaped isolated SA node cells and used for the models of Wilders et al. (124) and Dokos et al. (24). Primary pacemaker cells are thought to be smaller than transitional or peripheral cells (see Refs. 44 and 130); thus we chose the smaller value of 3.5 pl for our primary pacemaker cell model. The membrane capacitance of 32 pF is derived from Wilders et al. (124) and Dokos et al. (24), smaller than the value of 55 pF used by Demir et al. (17) for their transitional cell model and larger than the value of 20 pF for the central model of Zhang et al. (130). Microanatomic data such as SR volumes used in this study are from Demir et al. (17). The effective intracellular volume of a SA node cell wherein free Ca2+ is available to enter into reaction was set to 46% of the cell volume (1.6 pl), because there are various intracellular structures and organelles, as summarized by Demir et al. (17).

There is now evidence that there exists a small restricted subsarcolemmal domain where Ca2+ concentrations may transiently reach higher levels than in the bulk myoplasm (29, 47, 62, 86, 88, 122). Therefore, we assumed the subsarcolemmal space as a barrier for Ca2+ diffusion to the myoplasm. The subspace volume Vsub was tentatively set to 1% of the cell volume (0.035 pl), assuming that the subspace is limited to 20 nm below the sarcolemmal membrane (see Fig. 1A). The time constant of the Ca2+ diffusion from subspace to myoplasm (tau dif,Ca) was set to 40 µs; this value corresponded to a diffusion coefficient of approx 1 × 10-9 cm2/ms if the mean distance between the openings of the L-type Ca2+ channel or SR Ca2+ release channel and the myoplasmic compartment is assumed to be 200 nm (see Refs. 29, 61, and 113). A tau dif,Ca value of 40 µs was chosen to yield a peak [Ca2+]sub of ~1.8 µM, as reported in the modeling studies of Glukhovsky et al. (29) and Snyder et al. (113). The subspace of our model corresponds to the "fuzzy" space, a functionally restricted intracellular space accessible to the Na+/Ca2+ exchanger as well as to the L-type Ca2+ channel and Ca2+-gated Ca2+ channel in the SR (see Refs. 51 and 62). Note that it is different from the "diadic" space between the L-type Ca2+ channel and the ryanodine receptor (Ca2+-gated Ca2+ channel), where Ca2+ concentrations increase to several tens of micromolars; in ventricular myocytes, the ryanodine receptor and SR Ca2+ release are closely linked to the L-type Ca2+ channel and its Ca2+-dependent inactivation in the diadic space (1, 5, 50, 93, 106, 114, 115). In SA node cells, however, such a microdomain or cross-signaling between the L-type Ca2+ channel and SR Ca2+ release channel has not been demonstrated, being possibly absent because the SR is poorly developed in SA node cells compared with ventricular or atrial myocytes (see Refs. 17 and 47). Thus we did not incorporate the diadic space into our model.


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Fig. 1.   Schematic diagrams depicting a cross section of the model cell (A) and intracellular fluid compartments for Ca2+ (B). R and L represent the radius of the cell (4 µm) and the thickness (depth) of the subsarcolemmal space (20 nm), respectively. Volumes of the cell and each compartment are given in the text. The Ca2+ release from junctional SR (JSR) and Ca2+ uptake to the network SR (NSR) were assumed to be strictly into the restricted subspace and from the bulk myoplasm, respectively. Definitions of the symbols for the Ca2+ concentration in each compartment and Ca2+ flux between compartments are given in the Glossary.

Descriptions of membrane currents. The mathematical expressions used for the membrane current system are essentially the same as those formulated previously (17, 24, 124, 130) with modifications according to newly reported experimental data. The complete model for the normal pacemaking includes 13 membrane current components. The differential equation for the membrane potential (V) is
d<IT>V/</IT>d<IT>t=</IT>−(<IT>I</IT><SUB>Ca,L</SUB><IT>+I</IT><SUB>Ca,T</SUB><IT>+I</IT><SUB>Kr</SUB><IT>+I</IT><SUB>Ks</SUB><IT>+I</IT><SUB>to</SUB><IT>+I</IT><SUB>sus</SUB><IT>+I</IT><SUB>h</SUB><IT>+I</IT><SUB>st</SUB><IT>+I</IT><SUB>Na</SUB><IT>+I</IT><SUB>b,Na</SUB><IT>+I</IT><SUB>K,ACh</SUB><IT>+I</IT><SUB>NaK</SUB><IT>+I</IT><SUB>NaCa</SUB>)<IT>/C</IT><SUB>m</SUB> (1)
where ICa,L and ICa,T represent the L-type and T-type Ca2+ channel currents, respectively. The rapid and slow components of the delayed rectifier K+ current are denoted as IKr and IKs, respectively. The membrane current system also includes the transient (Ito) and sustained (Isus) components of 4-AP-sensitive currents, hyperpolarization-activated current (Ih), sustained inward current (Ist), Na+ channel current (INa), background Na+ current (Ib,Na), muscarinic K+ channel current (IK,ACh), Na+-K+ pump current (INaK), and Na+/Ca2+ exchanger current (INaCa) charging the membrane capacitance (Cm). For parameter adjustments, the regional differences of current densities in the SA node were taken into account (44, 130).

Model equations for channel gating behaviors are essentially the same as those of the previous Hodgkin-Huxley type models. A gating variable, x, can be computed as a solution of the first-order differential equation of the form
d<IT>x/</IT>d<IT>t=</IT>(<IT>x<SUB>∞</SUB>−x</IT>)<IT>/&tgr;<SUB>x</SUB></IT> (2)
where xinfinity and tau x are the steady-state x value and relaxation time constant, respectively, as functions of V. Relaxation time constants have been appropriately scaled for the temperature of 37°C with the use of a Q10 of 1.6~3.0. The functions xinfinity (V) and tau x(V) for individual gating variables are provided in the APPENDIX (Fig. 16).

L-type Ca2+ channel current. The kinetics of ICa,L are described with activation (dL), voltage-dependent inactivation (fL), and Ca2+-dependent inactivation (fCa) gating variables. The inactivation of ICa,L consists of two exponential terms: rapid and slow components. The rapid component is mediated by the intracellular Ca2+-dependent inactivation with a time constant ranging from 10 to 30 ms for rabbit SA node cells, whereas the slower component reflects the voltage-dependent inactivation with a time constant of 30~70 ms (5, 34, 72, 81, 102). To describe the inactivation process, we adopted a simple model in which the Ca2+-dependent inactivation process is independent of the voltage-dependent one (see Refs. 35 and 105); the inactivation process was described by the two Hodgkin-Huxley type gating variables fL and fCa.

The voltage dependences of ICa,L activation and inactivation (steady-state probabilities and time constants for dL and fL) are shown in Fig. 2, top. For the steady-state activation and inactivation curves (dL,infinity and fL,infinity ), we used the formulas of Demir et al. (17) based on the data from Fermini and Nathan (27). Expressions of the activation time constant tau dL were adopted from Demir et al. (17), who modified the formulation of Nilius (84). To formulate the time constant of the voltage-dependent inactivation/recovery (tau fL), the previous models employed different equations with different voltage dependences; however, these equations did not fit the recovery time course of ICa,L experimentally observed in single rabbit cardiac myocytes (see Fig. 2). Therefore, we originally formulated the inactivation time constant tau fL from the data of Nakayama et al. (81), Hagiwara et al. (37), and Kawano and Hiraoka (54). According to Demir et al. (17), a Q10 factor of 2.3 was applied to scale the gating time constant data for a temperature of 37°C. The inactivation/recovery time constant data were fitted to a function similar to that used by Lindblad et al. (68) for a rabbit atrial model and by Nygren et al. (88) for a human atrial model, using a least-square minimization procedure. Formulas for the Ca2+-dependent inactivation fCa are similar to those used by DiFrancesco and Noble (22). We included the subsarcolemmal domain and modeled the Ca2+-dependent inactivation as a function of the subspace Ca2+ concentration ([Ca2+]sub). The half-maximum Ca2+ concentration for the Ca2+-dependent inactivation was set to 0.35 µM, the same value as used by Courtemanche et al. (15). To reproduce the Ca2+-dependent inactivation with a time constant of ~10 ms during voltage-clamp pulses, the rate constant of Ca2+ binding was set to 60 ms-1 · mM-1.


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Fig. 2.   Kinetics of ICa,L. Top: voltage dependence of steady-state probabilities (dL and fL) and time constants for ICa,L activation (tau dL) and inactivation (tau fL). The equations used for the present model are shown as thick lines (K). For comparison, those used for previous models are also shown as thin lines: W, Wilders et al. (124); De, Demir et al. (17); Do, Dokos et al. (24); and Z, Zhang et al. (130). The experimental data for tau fL are from Kawano and Hiraoka (54) (open circle ), Hagiwara et al. (37) (), and Nakayama et al. (81) (). Bottom: computed voltage-clamp records for ICa,L (left) and the peak ICa,L-V relationship (right). Currents were evoked by 100-ms step pulses to test potentials ranging from -30 to +50 mV (in 10-mV increments). The holding potential was -40 mV. Simulating the whole cell perforated-patch recording, [Ca2+]i was not fixed (intracellular Ca2+ was not buffered by EGTA or BAPTA), whereas [Na+]i and [K+]i were fixed at 10 and 140 mM, respectively. The experimental data for the peak ICa,L-V relationship (peak currents normalized to the maximum value at 0 mV) are from Honjo et al. (44) (), Hagiwara et al. (37) (), Vinogradova et al. (122) (triangle ), and Verheijck et al. (120) (black-triangle). See the Glossary for definitions of the abbreviations.

Maximum ICa,L has been formulated as a fully selective Ca2+ current, with its reversal potential (ECa,L) fixed at +45 mV and the maximum conductance gCa,L set to 0.58 nS/pF at 2 mM [Ca2+]o. As Dokos et al. (24) have pointed out, ICa,L has a relatively low ECa,L albeit its high Ca2+ selectivity. Wilders et al. (124) adopted the constant-field formulation to describe the conductance property of ICa,L with a low ECa,L; as suggested by Dokos et al. (24), however, their formulas introduce large unnecessary fluxes of Na+ and K+, leading to an overestimation of INaK. The ECa,L has been reported to shift with changing [Ca2+]o in accordance with an ideal Nernstian Ca2+ electrode, although displaced negatively below ECa (see Ref. 11); thus Dokos et al. (24) formulated ICa,L as a fully selective Ca2+ current with ECa,L displaced at a constant 75 mV negative to ECa. The negative displacement of ECa,L may be attributable to the existence of a high-concentration Ca2+ domain at the intracellular surface of the L-type Ca2+ channel pore. Nevertheless, there are no available data on the [Ca2+]i dependence of ECa,L. It has been suggested that once the L-type Ca2+ channel is open, the Ca2+ concentration at the inner mouth does not change; the Ca2+ concentration in the vicinity of the inner mouth of the channel may be nearly constant (see Refs. 50, 111, and 128). In our model, therefore, ECa,L was set to a constant value of +45 mV, as in the model of Demir et al. (17) utilizing a fully Ca2+-selective formulation of ICa,L with the ECa,L fixed at +46.4 mV. It might be difficult to express ECa,L (or permeation kinetics) as a simple elementary function of ion concentrations, because the mechanisms of ion permeation in the L-type Ca2+ channel have been shown to involve complex ion-ion or ion-channel interactions (e.g., Refs. 41, 76, and 116).

The model-generated ICa,L during voltage-clamp pulses and the peak ICa,L-V relationship are depicted in Fig. 2, bottom. Our model can simulate the Ca2+-dependent inactivation of ICa,L experimentally observed in rabbit SA node cells (10, 67); inactivation time courses of the simulated currents are very similar to the experimental data reported by Hagiwara et al. (37), Honjo et al. (44), Verheijck et al. (120), and Vinogradova et al. (122). The simulated peak ICa,L-V relation is comparable to the experimental data as shown by the symbols. The maximum amplitude of ICa,L measured in the simulated voltage-clamp experiment was 9.44 pA/pF, attained at 0 mV; this value is in good agreement with experimental data (44, 81, 119, 120, 122).

T-type Ca2+ channel current. Contributions of ICa,T to pacemaker depolarization in the previous models are different: Wilders et al. (124) and Dokos et al. (24) assumed small contribution of ICa,T according to the experimental report of Hagiwara et al. (37), whereas Demir et al. (17) assumed much larger ICa,T based on the data from Doerr et al. (23). With the use of the ICa,T expressions of Demir et al. (17), our standard model could reproduce the relatively large effects of blocking ICa,T on CL as observed experimentally (23, 37, 103); in contrast, the spontaneous AP of our standard model cell was little affected by incorporating the ICa,T expressions of Wilders et al. (124), with CL increasing only by 2.1% on eliminating ICa,T. Therefore, we adopted the expressions of Demir et al. (17) rather than those of Wilders et al. (124) or Dokos et al. (24) for the steady-state probabilities and time constants of the activation gating variable dT and inactivation gating variable fT. The conductance property of ICa,T was formulated using a linear voltage relation, with the reversal potential ECa,T fixed at +45 mV and the maximum conductance gCa,T set to 0.458 nS/pF, according to Demir et al. (17).

Delayed rectifier K+ currents. Recent studies in rabbit, guinea pig, and human cardiac myocytes have identified two types of delayed rectifier K+ currents: 1) the rapidly activating component IKr, exhibiting strong inward rectification, and 2) the slowly activating component IKs, exhibiting only weak rectification (2, 34, 64, 66, 100, 101, 123). Whereas IK in the rabbit SA node appears to predominantly reflect only IKr-type behavior (2, 108), the IKs-type component has also been identified in isolated rabbit SA node cells (34, 48, 64). For the standard pacemaker model, therefore, we assumed both IKr- and IKs-type components of IK.

The voltage dependences of IKr activation and inactivation (steady-state probabilities and time constants for the activation gating variable pa and inactivation gating variable pi) are shown in Fig. 3, top, along with those for the previous models. To describe the gating kinetics of IKr, the previous models (17, 24, 124) used the equations provided by Shibasaki (108). However, Ono and Ito (90) recently reported the complete quantitative data on the activation kinetics of IKr in single rabbit SA node cells and mathematically described the activation kinetics with two gating variables, paF and paS. According to their report, therefore, we described the general activation variable pa as a weighted sum of the fast (paF) and slow (paS) activation variables and used their original expressions for IKr activation kinetics (pa,infinity , tau paF, and tau paS). A modified version of the formulation of Ono and Ito (90) for IKr activation was also utilized by Zhang et al. (130). We also employed the expression of Ono and Ito (90) for steady-state inactivation (pi,infinity ). No detailed experimental data are available on the time constant of the voltage-dependent IKr inactivation (tau pi); thus we adopted the expression of Shibasaki (108) for tau pi.


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Fig. 3.   Kinetics of IKr. Top: voltage dependence of steady-state probabilities for IKr activation (pa) and inactivation (pi) and activation time constants (tau pa). Thick lines represent the present model (K); those for previous models (W, De, Do, and Z) are also shown as thin lines for comparison. open circle  and , Experimental data from Ono and Ito (90). Bottom: computed voltage-clamp records for IKr (left) and amplitudes of IKr measured at the end of test pulses as a function of the test potential (right). Currents were elicited by 1-s step pulses from a holding potential of -60 mV to test potentials ranging from -50 to +40 mV (in 10-mV increments). , Experimental data from Ono and Ito (90). See the Glossary for definitions of the abbreviations.

The conductance of IKr was chosen as to allow a maximum diastolic potential (MDP) between -60 and -55 mV (approximately equal to -58 mV) to be achieved. The standard gKr value of our model is smaller than that determined by Ono and Ito (90); this difference in gKr may reflect the regional difference in IKr density between the center and periphery of the SA node (see Ref. 56). We also included a term to describe the "square root" activation of IKr single channel conductance by [K+]o, as reported by Shibasaki (108). Dokos et al. (24) pointed out that the reversal potential of IKr (EKr) is positive to EK by 10~19 mV, thus assumed that IKr channels are slightly permeable to Na+. According to recently published reports (e.g., Refs. 90 and 119), however, EKr is nearly equal to EK; therefore, the IKr channel was assumed to be highly selective to K+. The model-generated IKr during the voltage-clamp pulses simulating the experiment of Ono and Ito (90) are shown in Fig. 3, bottom.

The kinetics of IKs were described by the formulation of Zhang et al. (130). The steady-state activation curve for IKs used in this study is from Lei and Brown (64). There are limited experimental data available for the time constant of the voltage-dependent activation of IKs in rabbit SA node cells. Thus the time constant of IKs activation was described using the expressions of Zhang et al. (130), i.e., the equations of Heath and Terrar (40) based on their data from guinea pig ventricular myocytes.

4-AP-sensitive K+ currents. Recent studies for rabbit SA node cells have identified the transient and sustained outward currents sensitive to 4-AP (46, 65, 119). The models of Zhang et al. (130) incorporated these currents, whereas most previous SA node models did not. Therefore, we incorporated the transient (Ito) and sustained (Isus) components of 4-AP-sensitive currents into our model. According to Zhang et al. (130), we treated the two 4-AP-sensitive components as separated currents and used the same activation variable r for both Ito and Isus.

The steady-state activation and inactivation curves (rinfinity and qinfinity ) were based on the experimental data from Honjo et al. (46) and Lei et al. (65). The time constant of the voltage-dependent activation (tau r) was formulated from the data of Giles and van Ginneken (28) for rabbit crista terminalis cells; the inactivation time constant (tau q) was from Giles and van Ginneken (28) and Honjo et al. (46). To correct the data collected at 20.5~25°C for 37°C, Zhang et al. (130) used a Q10 of 2.18. However, the use of Q10 = 2.18 yielded a pronounced phase 1 notch in APs. Thus we slightly accelerated the gating kinetics by using a Q10 of 3.0. The corrected time constants were comparable to those reported by Honjo et al. (46) and Uese et al. (117).

The values of the scaling parameters (conductances) for Ito and Isus were determined by exploring the change in peak overshoot potential (POP) and variation of [K+]i . The experimentally measured densities of Ito and Isus were significantly correlated with Cm, i.e., cell size, and are larger in cells with a higher Cm (46, 65); this probably reflects the regional differences of the current densities (see Ref. 7). We selected relatively small conductance values for our primary pacemaker cell model with relatively small Cm, because the current densities in the central SA node region would be relatively small (see Refs. 64 and 130). Whereas Zhang et al. (130) set the Isus conductance to a very small value of 3.3 pS/pF for their central model, we used a larger value of 20 pS/pF to accentuate the prolongation of AP duration during the blockade of the 4-AP-sensitive currents, i.e., to reproduce the experimental data of Boyett et al. (7).

Hyperpolarization-activated current. It is difficult to quantify Ih and its participation in the diastolic depolarization, in part due to the large variation in its threshold of activation ranging from -30 to -70 mV, as well as the variation in current density (18, 21, 73, 81, 118). In previous models, the kinetic data from van Ginneken and Giles (118) were used to formulate the gating kinetics of Ih; however, the contributions of Ih to pacemaker depolarization in the model cells are quite different (refer to Table 3). For our standard model, we adopted the formulation of Wilders et al. (124) to reproduce the relatively large effects of blocking Ih on CL as observed in experiments. The data of van Ginneken and Giles (118) were collected at 30~33°C; following Demir et al. (17), activation time constants were corrected for 37°C by the use of a Q10 = 2.3. According to van Ginneken and Giles (118), the maximum conductance and reversal potential of Ih were assumed to be 0.375 nS/pF and -24 mV, respectively. These values were achieved by setting gh,K = 7.4 nS and gh,Na = 4.6 nS for a model cell, as used in Wilders et al. (124).

Sustained inward current. Guo et al. (32) reported a novel pacemaker current activated within the range of pacemaker depolarization in the rabbit SA node (see also Ref. 33). This current, named the sustained inward current (Ist), is carried by Na+ under physiological conditions, blocked by both organic and inorganic Ca2+ channel blockers as well as by external Ca2+ and Mg2+, and enhanced by isoprenaline or a Ca2+ agonist, BAY K 8644. These biophysical and pharmacological characteristics are compatible with those of the monovalent cation conductance of the L-type Ca2+ channel; thus Guo et al. (32) concluded that Ist is generated by a novel subtype of the L-type Ca2+ channel. Ist has also been recorded in SA node cells of other animal species, such as guinea pigs and rats (31, 77, 78, 109). Because Ist was observed only in spontaneously beating SA node cells but was absent in quiescent cells, Ist may play an essential role in the generation of intrinsic cardiac automaticity (32, 78). Therefore, we incorporated Ist in our standard SA node model for a primary pacemaker cell, whereas previous SA node models did not include Ist.

The voltage dependences of Ist activation and inactivation (steady-state probabilities and time constants for the activation gating variable qa and inactivation gating variable qi) are shown in Fig. 4, top. Because there is no detailed report on the gating kinetics (time constant) of Ist in the rabbit SA node, we modified the formulation of Shinagawa et al. (109) for the rat SA node Ist. From the data of Guo et al. (32), the half-activation voltage and slope factor for the activation curve were set to -57.0 and 5.0 mV, respectively. The inactivation and recovery of the rabbit Ist, as reported in Guo et al. (32), appear to be slower than those of the rat Ist reported by Shinagawa et al. (109). Thus the time constants of inactivation and recovery of the rabbit Ist were assumed to be 6.65 times larger than those of the rat Ist. The maximum conductance and reversal potential of Ist were set to 15.0 pS/pF and +37.4 mV, respectively, according to Guo et al. (32). As shown in Fig. 4, bottom, our equations for Ist could reproduce the kinetic properties of Ist reported by Guo et al. (32).


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Fig. 4.   Kinetics of Ist. Top: voltage dependence of steady-state probabilities (qa and qi) and time constants for Ist activation (tau qa) and inactivation (tau qi). Thick lines, present model; thin lines, qa and tau qi formulated by Shinagawa et al. (109) for the rat SA node Ist. open circle  and , Experimental values approximated from the data of Guo et al. (32). Bottom: computed voltage-clamp records for Ist (left) and the peak Ist-V relation (right). Currents were evoked by 500-ms depolarizing test pulses ranging from -70 to +50 mV (in 10-mV increments). The holding potential was -80 mV. See the Glossary for definitions of the abbreviations.

Na+ channel current. Although most of the previous SA node models incorporated the fast Na+ channel current (INa), the contribution of INa to model cell dynamics is relatively small: in the models of Wilders et al. (124) and Dokos et al. (24), eliminating INa yielded only a 0.7~0.9% increase in CL, whereas it yielded a 8.4% increase in the model of Demir et al. (17) for transitional cells. In a preliminary study, we incorporated INa into our model to assess the possible contribution of INa to the pacemaker activity of our model cell. The kinetics of INa were reformulated from the recent experimental data: 1) steady-state activation and inactivation curves are based on the data from Muramatsu et al. (80) and Baruscotti et al. (3); 2) for the time constant of activation, we used the formulation of Zhang et al. (130); and 3) the inactivation of INa was described by a weighted sum of two gating variables, hF and hS, with the fraction of slow inactivation (FNa) being expressed as a function of V (see Ref. 130). The formulation for the inactivation time constant is based on data from Muramatsu et al. (80). According to Lindblad et al. (68), a Q10 of 1.7 was used to correct the experimental data for 37°C. Incorporating INa with a conductance of 1.8 pS/pF, the mean experimental value for transitional or peripheral cells (44), decreased CL only by 5.6% (from 307.4 to 290.2 ms), indicating that the contribution of INa to pacemaking is relatively small in our model cell as well.

INa appears to be completely absent or almost negligible in primary pacemaker cells located in the central region of the SA node (57, 59, 82, 118, 130). Baruscotti et al. (3, 4) reported that both the density and frequency of occurrence of INa in the SA node decrease with development, with INa in adult rabbit SA node cells being very small or negligible. Thus INa would not play an important role in normal pacemaking of primary pacemaker cells. The central model of Zhang et al. (130) for the leading pacemaker cell did not include INa. In our simulations for primary pacemaker (central SA node) cells, therefore, INa was assumed to be zero (negligible or completely inactivated).

Na+-dependent background current and muscarinic K+ channel current. Our model includes two background current components: 1) Na+-dependent background current (Ib,Na), reported by Hagiwara et al. (38), in which Ib,Na was measured as 0.73 ± 0.21 pA/pF at -50 mV; and 2) muscarinic K+ channel current (IK,ACh), reported by Ito et al. (49), who attributed the entire background K+ component in rabbit SA node cells to the spontaneous opening of muscarinic K+ channels in the absence of an ACh agonist and characterized IK,ACh as exhibiting inward rectification with an amplitude of 0.33 ± 0.28 pA/pF at -50 mV under physiological conditions. Following their experimental data, we modeled Ib,Na with an ohmic I-V relationship and defined IK,ACh as a background K+ current component exhibiting inward rectification. The Ib,Na conductance gb,Na was set to 5.4 pS/pF, yielding a current density of 0.65 pA/pF at -50 mV. The gb,Na value of 5.4 pS/pF is comparable to that in the previous SA node models (2.9~7.5 pS/pF). To model the inward rectifying behavior for IK,ACh, we chose the formula of Dokos et al. (24) adopted from Egan and Noble (26). The standard value of IK,ACh amplitude used in this study was 0.23 pA/pF at -50 mV, smaller than the value of 0.46 pA/pF in Dokos et al. (24).

The background Ca2+ current (Ib,Ca) has been frequently incorporated in mathematical models of the SA node to balance the Ca2+ extrusion via Na+/Ca2+ exchange during diastole: the models of Wilders et al. (124), Demir et al. (17), and Zhang et al. (130) included Ib,Ca with a conductance of 0.66~1.25 pS/pF. In our model, however, incorporating an Ib,Ca of 0.66~1.25 pS/pF attenuated pacemaker activity (decreased APA to <70 mV) and induced Ca2+ overload (diastolic [Ca2+]i > 0.3 µM) via unnecessary Ca2+ influx, unfavorable for improving the model. Although the sarcolemmal Ca2+ pump current (Ip,Ca) may balance Ib,Ca, the contribution of Ip,Ca to Ca2+ efflux through the SA node cell membrane is unknown. Ib,Ca has not yet been recorded directly in SA node cells; the report of Hagiwara et al. (38) suggests that the rabbit SA node membrane is impermeable to Ca2+. In our modeling, therefore, Ib,Ca (as well as Ip,Ca) was assumed to be negligible.

Na+-K+ pump current. In previous SA node models, the formulations of INaK were not based on experimental data from SA node cells. The novel INaK formulation used in this study is based on the recent experimental work of Sakai et al. (99) for rabbit SA node cells. Parameter values were determined from the voltage- and concentration-dependent data provided by Sakai et al. (99): Km values for Na+ and K+ binding were set to 14.0 and 1.4 mM, respectively. The voltage dependence of INaK in our model is steeper than that in previous models (see Fig. 17), consistent with experimental data from the rabbit SA node (99). The magnitude of INaK is linked to the influx of Na+ through Ib,Na (and Ist) and efflux of K+ through K+ channels. According to the data of Sakai et al. (99), we set the maximum attainable current (INaKmax) to 3.6 pA/pF, a value high enough to maintain [Na+]i of <10 mM and [K+]i of ~140 mM during long runs of the normal pacemaker activity.

Na+/Ca2+ exchange current. Most existing models of SA node activity have relied on the hypothetical INaCa formulation utilized by DiFrancesco and Noble (22), describing the Na+/Ca2+ exchanger as a simultaneous transfer of the ions with an exponential voltage dependency. In contrast, Dokos et al. (24) utilized a more accurate model of consecutive translocation, i.e., the "E4" model originally formulated by Matsuoka and Hilgemann (74), which correctly reproduces the saturation characteristics of INaCa at large [Ca2+]i and for negative potential-low [Ca2+]i conditions. To describe INaCa kinetics, we adopted the formulation of Dokos et al. (24), a modified version of the Matsuoka-Hilgemann "E4" model. The scaling parameter kNaCa was set to 125 pA/pF, the same value as determined by Dokos et al. (24) from the study of Hagiwara and Irisawa (36), who reported an INaCa density of 1 pA/pF at -40 mV and [Ca2+]i = 0.5 µM. A kNaCa value of 125 pA/pF yielded an INaCa of 0.83 pA/pF at -40 mV and [Ca2+]i = 0.5 µM, giving a diastolic free Ca2+ level in the presumed physiological range of <0.3 µM.

SR functions. The SR was modeled as consisting of two compartments: the Ca2+ uptake store (network SR) and release store (junctional SR), as shown in Fig. 1B. Owing to the lack of available data for updating the kinetic formulation of Ca2+ uptake and release by the SR in SA node cells, we utilized simple formulas similar to those of DiFrancesco and Noble (22), which have been incorporated in previous SA node models (24, 85, 124). The model of Demir et al. (17) utilized more complex SR kinetics based largely on the modeling study by Hilgemann and Noble (42), including the internal SR Ca2+ buffering by calsequestrin. Their formulation is, however, overly complex, given the complete lack of associated data in SA node cells; in their model, Ca2+ concentrations in the SR are unreasonably high compared with those in other models, much higher than experimental values for ventricular myocytes (see Refs. 63 and 107). We therefore opted for simpler kinetics, which are able to reproduce the essential features of both the uptake and release processes. According to Demir et al. (17), the fractional volumes of Ca2+ uptake and release stores in our model cell were taken to be 1.16 and 0.12%, respectively, of the cell volume, corresponding to one-third of the values given for ventricular myocytes.

Because no experimental data are available to estimate the kinetic parameters for SR Ca2+ uptake and release in SA node cells, the parameter values were determined from previous modeling studies. The formula for the Ca2+ release mechanism was adopted from Dokos et al. (24), with the kinetics of Ca2+ release to subspace expressed as a function of [Ca2+]sub (not [Ca2+]i). The values of Krel used in previous models ranged from 0.8 to 2.0 µM; we chose a medium value of 1.2 µM. The Prel value was determined so as to make the peak [Ca2+]sub and [Ca2+]i nearly maximum with a Krel of 1.2 µM. The formulation for Ca2+ uptake was adopted from Luo and Rudy (71). The values of tau tr used in previous SA node models ranged from 6.64 to 400 ms. In our modeling, the tau tr value was set to a medium value of 60 ms, although some reports have suggested a smaller tau tr or single compartment for SR (e.g., Refs. 29 and 113).

Ca2+ buffering. Our model includes the dynamics of three Ca2+ buffers: calmodulin, troponin, and calsequestrin. The amounts of calmodulin and troponin available for Ca2+ binding, and the rate constants for Ca2+ binding to and release from these buffers, were adopted from Demir et al. (17) and Lindblad et al. (68), who used data from Robertson et al. (95). The rate constants for Ca2+ binding to calmodulin and troponin were scaled with the use of a Q10 of 1.8, according to Lindblad et al. (68). The concentration of calsequestrin within the SR release compartment was set to a relatively low value of 10 mM, the value used by Luo and Rudy (71), Courtemanche et al. (15), and Priebe and Beuckelmann (91). The on and off rates for Ca2+ binding to calsequestrin were based on the study of Cannell and Allen (12), adjusted to 37°C via a Q10 of 1.6 (see Ref. 68).

We also examined the effects of exogenous Ca2+ buffers, BAPTA and EGTA, on pacemaker activity. The rate constants for Ca2+ binding to and release from these buffers were adopted from Sham (106), Smith et al. (112), and You et al. (128).

Ion concentration homeostasis. Our model also includes material balance expressions to define the temporal variations in [Na+]i, [K+]i, and [Ca2+]i. [Na+]i and [K+]i were assumed to be homogeneous, because subspace [Na+] (or [K+]) was nearly equal to myoplasmic [Na+] (or [K+]) unless the diffusion time constant for Na+ (or K+) was more than 10 times larger than that for Ca2+. As suggested by Nygren et al. (88), there may be electroneutral Na+ influx (and K+ efflux as well) via electroneutral transport mechanisms such as Na+/H+ exchange and Na+-K+-2Cl