An opto-electronic control system for real-time complete (re)shaping of cardiac action potentials on a multicellular scale
Authors: Ordog B , De Coster T , Dekker S O , Bart C I , Zhang J , Deng S , Den Ouden B L , De Vries A F , Pinappels D A 
Published: November 2023

Abstract

Background
Cardiomyocytes maintain a membrane potential (Vm), which fulfills essential regulatory roles in various biological functions, including not only action potential (AP) propagation and mechanical contraction, but also homeostatic regulation. In-depth studies into these roles have been severely hampered by the lack of research methods allowing full control over Vm, especially in multicellular cardiac preparations.

Purpose
We aimed to unlock new research possibilities by the development of an experimental system (APqr) capable of full Vm control, including instantaneous modulation of AP morphology on a multicellular level.

Methods
Immortalized human atrial myocytes (hiAMs) grown in monolayer format (n=7) were genetically modified to express the blue light-activatable cation channel Cheriff and the red light-sensitive inward chloride pump Jaws for depolarizing and hyperpolarizing effects, respectively. Real-time Vm readout was obtained by patch clamp electrophysiology. Dynamic Vm control was achieved by a custom closed-coop controller calculating Vm deviations from reference values. A 470-nm and a 617-nm LED were modulated by the controller in a Vm deviation-dependent manner, selectively activating Cheriff and Jaws. To explore the feasibility of AP restoration, electrical disturbances were introduced by non-selective potassium channel blockade (4-aminopyridine, 4AP, 200 µM) or by a preprogrammed blue-light pulse creating abnormal cation influx during the repolarization phase of the hiAM AP.

Results
4AP induced a 82.4 ± 27.8 ms increase of AP duration at 90% repolarization (APD90) values in hiAM monolayers. Using APs recorded under control conditions (CTL) as reference, the APqr maneuver reduced this APD90 difference to 1.9 ± 3.1 ms. Similarly, APqr suppressed the effects of light-induced abnormal cation influx on APD90 (CTL: 342.9 ± 51.7 ms, blue-light pulse: 700.8 ± 64.5 ms, APqr: 338.3 ± 68 ms) effectively, with Vm deviation less than 2.5 mV in 96.7% of the time. APqr could also be applied for the enforcement of arbitrary AP shapes. In these experiments, the Vm references consisted of AP shapes of hiAM monolayers exposed to drugs with APD-prolonging (4AP) or shortening (carbachol) effects. APqr was able to enforce these reference APs, that were distinctly different from the endogenous AP shapes, on hiAM monolayers with great accuracy, with Vm deviations less than 2.5 mV in 95.8% and 94.4% of the time, respectively.

Conclusions
APqr restores AP morphologies in the presence of electrical perturbations of different origin without any prior knowledge about the disturbance and enforces arbitrary AP morphologies with high accuracy in an immediate and self-regulatory manner. Collectively, these results set the stage for in-depth investigations into the regulatory roles of Vm in healthy and diseased cardiomyocytes via the application of such real-time opto-electronic control systems.Real-time (re)shaping of cardiac APs