TY - JOUR
T1 - Circadian rhythm of cardiac electrophysiology, arrhythmogenesis, and the underlying mechanisms
AU - Black, Nicholas
AU - D'Souza, Alicia
AU - Wang, Yanwen
AU - Piggins, Hugh
AU - Dobrzynski, Halina
AU - Morris, Gwilym
AU - Boyett, Mark R.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Cardiac arrhythmias are a leading cause of cardiovascular death. It has long been accepted that life-threatening cardiac arrhythmias (ventricular tachycardia, ventricular fibrillation, and sudden cardiac death) are more likely to occur in the morning after waking. It is perhaps less well recognized that there is a circadian rhythm in cardiac pacemaking and other electrophysiological properties of the heart. In addition, there is a circadian rhythm in other arrhythmias, for example, bradyarrhythmias and supraventricular arrhythmias. Two mechanisms may underlie this finding: (1) a central circadian clock in the suprachiasmatic nucleus in the hypothalamus may directly affect the electrophysiology of the heart and arrhythmogenesis via various neurohumoral factors, particularly the autonomic nervous system; or (2) a local circadian clock in the heart itself (albeit under the control of the central clock) may drive a circadian rhythm in the expression of ion channels in the heart, which in turn varies arrhythmic substrate. This review summarizes the current understanding of the circadian rhythm in cardiac electrophysiology, arrhythmogenesis, and the underlying molecular mechanisms.
AB - Cardiac arrhythmias are a leading cause of cardiovascular death. It has long been accepted that life-threatening cardiac arrhythmias (ventricular tachycardia, ventricular fibrillation, and sudden cardiac death) are more likely to occur in the morning after waking. It is perhaps less well recognized that there is a circadian rhythm in cardiac pacemaking and other electrophysiological properties of the heart. In addition, there is a circadian rhythm in other arrhythmias, for example, bradyarrhythmias and supraventricular arrhythmias. Two mechanisms may underlie this finding: (1) a central circadian clock in the suprachiasmatic nucleus in the hypothalamus may directly affect the electrophysiology of the heart and arrhythmogenesis via various neurohumoral factors, particularly the autonomic nervous system; or (2) a local circadian clock in the heart itself (albeit under the control of the central clock) may drive a circadian rhythm in the expression of ion channels in the heart, which in turn varies arrhythmic substrate. This review summarizes the current understanding of the circadian rhythm in cardiac electrophysiology, arrhythmogenesis, and the underlying molecular mechanisms.
KW - Arrhythmia
KW - Autonomic nervous system
KW - Cardiac conduction system
KW - Cardiac pacemaking
KW - Circadian rhythm
KW - Ion channel remodeling
UR - http://www.scopus.com/inward/record.url?scp=85060258355&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2018.08.026
DO - 10.1016/j.hrthm.2018.08.026
M3 - Article (Academic Journal)
C2 - 30170229
AN - SCOPUS:85060258355
VL - 16
SP - 298
EP - 307
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
IS - 2
ER -