Constitutively active adenosine monophosphate - Activated protein kinase regulates voltage-gated sodium channels in ventricular myocytes

Background-Some PRKAG2 mutations in the human gene encoding for the gamma-subunit of the adenosine monophosphate activated protein kinase (AMPK) recently have been shown to cause rhythm disturbances (often fatal) in affected patients. Methods and Results-Rat ventricular myocytes were infected with an adenoviral vector designed to express a truncated constitutively active mutant (T172D) of the AMPK alpha(1)-subunit (CA-AMPK). The human cardiac sodium channel hH1 and CA-AMPK were also coexpressed in a mammalian cell line. Patch-clamp techniques were used to measure myocyte action potentials and recombinant hH1 sodium channel currents. Our results demonstrate that action potential duration is significantly prolonged in myocytes expressing the CA-AMPK construct, leading to the production of potentially arrhythmogenic early afterdepolarizations. Recombinant sodium channel current analysis revealed that expression of CA-AMPK significantly slowed open-state inactivation and shifted the voltage-activation curve in a hyperpolarizing direction. Conclusion-We propose that sodium channels may be substrates for AMPK, possibly contributing to the observed arrhythmogenic activity in patients with some PRKAG2 mutations.