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Optogenetic modulation of cardiac action potential properties may prevent arrhythmogenesis in short and long QT syndromes
Amit Gruber, Oded Edri, Irit Huber, Gil Arbel, Amira Gepstein, Assad Shiti, Naim Shaheen, Snizhana Chorna, Michal Landesberg, Lior Gepstein
Amit Gruber, Oded Edri, Irit Huber, Gil Arbel, Amira Gepstein, Assad Shiti, Naim Shaheen, Snizhana Chorna, Michal Landesberg, Lior Gepstein
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Research Article Cardiology Stem cells

Optogenetic modulation of cardiac action potential properties may prevent arrhythmogenesis in short and long QT syndromes

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Abstract

Abnormal action potential (AP) properties, as occurs in long or short QT syndromes (LQTS and SQTS, respectively), can cause life-threatening arrhythmias. Optogenetics strategies, utilizing light-sensitive proteins, have emerged as experimental platforms for cardiac pacing, resynchronization, and defibrillation. We tested the hypothesis that similar optogenetic tools can modulate the cardiomyocyte’s AP properties, as a potentially novel antiarrhythmic strategy. Healthy control and LQTS/SQTS patient–specific human induced pluripotent stem cell–derived cardiomyocytes (hiPSC-CMs) were transduced to express the light-sensitive cationic channel channelrhodopsin-2 (ChR2) or the anionic-selective opsin, ACR2. Detailed patch-clamp, confocal-microscopy, and optical mapping studies evaluated the ability of spatiotemporally defined optogenetic protocols to modulate AP properties and prevent arrhythmogenesis in the hiPSC-CMs cell/tissue models. Depending on illumination timing, light-induced ChR2 activation induced robust prolongation or mild shortening of AP duration (APD), while ACR2 activation allowed effective APD shortening. Fine-tuning these approaches allowed for the normalization of pathological AP properties and suppression of arrhythmogenicity in the LQTS/SQTS hiPSC-CM cellular models. We next established a SQTS–hiPSC-CMs–based tissue model of reentrant-arrhythmias using optogenetic cross-field stimulation. An APD-modulating optogenetic protocol was then designed to dynamically prolong APD of the propagating wavefront, completely preventing arrhythmogenesis in this model. This work highlights the potential of optogenetics in studying repolarization abnormalities and in developing novel antiarrhythmic therapies.

Authors

Amit Gruber, Oded Edri, Irit Huber, Gil Arbel, Amira Gepstein, Assad Shiti, Naim Shaheen, Snizhana Chorna, Michal Landesberg, Lior Gepstein

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Figure 7

Dynamic optogenetic-based APD modulation for prevention of reentrant arrhythmias in the SQTS–hiPSC-CCS model.

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Dynamic optogenetic-based APD modulation for prevention of reentrant arr...
(A–C) Optogenetic cross-field protocol to induce spiral waves in the SQTS–hiPSC-CCSs. (A and B) Schemes describing the cross-field optogenetic stimulation protocols in both time (A) and space (B). The coculture is optogenetically paced using a point stimulation (S1) from the left side of the culture. When the S1-induced wavefront reaches the center of the tissue, a perpendicular wavefront is delivered by a broad S2 optogenetic-based stimulation wave originating from the top half of the culture (S2). (C) Sequential fluorescence images taken from the dynamic optical mapping display depicting the process of spiral wave induction. At t = 0 ms, a point optogenetic pacing stimuli (S1) induces a propagation wave traveling from left to right (t = 83 ms). When the propagation wave reaches the center of the culture, a broad optogenetic premature stimulation (S2) produced a new wavefront traveling perpendicular to the initial wave (t = 102 ms). This new wavefront is able preexcite already excitable tissue proximal to the traveling S1 wave (146 ms, marked in a blue circle) and initiate a sustained spiral wave (181–294 ms). (D–F) Optogenetic APD modulation prevents spiral wave induction. (D and E) Schemes depicting the optogenetic cross-field stimulation and dynamic APD modulation protocols in both time (D) and space (E). Following application of S1, an APD-modulating illumination pattern was delivered, which was designed to be identical to the shape of the S1-induced propagating activation wavefront and to follow this wavefront with the same CV and a fixed delay of 40 ms. To complete the cross-field stimulation, a perpendicular wavefront was then induced by S2 as described above. (F) Sequential fluorescence images taken from the dynamic optical-mapping display depicting the prevention of the cross-field–induced spiral wave generation by the APD-modulating signal. The prolongation of the tissue wavelength by the APD-modulating signal is marked with a double-headed blue arrow. This resulted in the prevention of the development of reentrant activity following the premature S2 excitation wavefront.

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ISSN 2379-3708

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