Dynamic interactions and mutual synchronization of sinoatrial node pacemaker cells. A mathematical model.

Dynamic interactions and mutual entrainment of coupled sinoatrial pacemaker cells with different intrinsic frequencies were investigated using a computerized mathematical model. Transmembrane potentials were simulated using equations of individual membrane currents based on voltage clamp data for the sinoatrial node. The intrinsic frequency of a given cell was altered by applying bias hyperpolarizing current, or by changing the amount of slow inward current. Cells were coupled through simple ohmic resistances to form linear arrays of two or more cells. Simulations closely reproduced previous experimental work showing that the mutual interactions between pacemakers are mediated electrotonically and show phase dependence. Results from the present simulations provide an explanation for the ionic basis of these phase-dependent interactions. In addition, it is demonstrated that the mutual entrainment of coupled pacemakers can lead to their coordinated behavior (synchronization). Two pacemaker cells can synchronize at simple harmonic (i.e., 1:1, 2:1, etc.) or more complex ratios (3:2, 5:3, etc.), depending on the differences in intrinsic frequencies and the degree of electrical coupling between cells. Simulations using larger numbers of linearly connected cells yielded various patterns of pacemaker activity including 2:1 sinoatrial block and complex dysrhythmic activity. The overall results may be used to predict higher order interactions of thousands of cells comprising the sinus node. Under such a scheme, synchronization occurs not by the conducted influence of a dominant pacemaker cell, but by the mutual "democratic" interaction of individual pacemaker cells.