Mechanisms of beat-to-beat regulation of cardiac pacemaker cell function by Ca²⁺ Cycling dynamics

Whether intracellular Ca²⁺ cycling dynamics regulate cardiac pacemaker cell function on a beat-to-beat basis remains unknown. Here we show that under physiological conditions, application of low concentrations of caffeine (2-4 mM) to isolated single rabbit sinoatrial node cells acutely reduces their spontaneous action potential cycle length (CL) and increases Ca²⁺ transient amplitude for several cycles. Numerical simulations, using a modified Maltsev-Lakatta coupled-clock model, faithfully reproduced these effects, and also the effects of CL prolongation and dysrhythmic spontaneous beating (produced by cytosolic Ca²⁺ buffering) and an acute CL reduction (produced by flash-induced Ca²⁺ release from a caged Ca²⁺ buffer), which we had reported previously. Three contemporary numerical models (including the original Maltsev-Lakatta model) failed to reproduce the experimental results. In our proposed new model, Ca ²⁺ releases acutely change the CL via activation of the Na ⁺/Ca²⁺ exchanger current. Time-dependent CL reductions after flash-induced Ca²⁺ releases (the memory effect) are linked to changes in Ca²⁺ available for pumping into sarcoplasmic reticulum which, in turn, changes the sarcoplasmic reticulum Ca²⁺ load, diastolic Ca²⁺ releases, and Na⁺/Ca²⁺ exchanger current. These results support the idea that Ca²⁺ regulates CL in cardiac pacemaker cells on a beat-to-beat basis, and suggest a more realistic numerical mechanism of this regulation.