Vtb. Nguyen-tran et al., A novel genetic pathway for sudden cardiac death via defects in the transition between ventricular and conduction system cell lineages, CELL, 102(5), 2000, pp. 671-682
HF-1b, an SP1-related transcription factor, is preferentially expressed in
the cardiac conduction system and ventricular myocytes in the heart. Mice d
eficient for HF-1b survive to term and exhibit normal cardiac structure and
function but display sudden cardiac death and a complete penetrance of con
duction system defects, including spontaneous ventricular tachycardia and a
high incidence of AV block. Continuous electrocardiographic recordings cle
arly documented cardiac arrhythmogenesis as the cause of death. Single-cell
analysis revealed an anatomic substrate for arrhythmogenesis, including a
decrease and mislocalization of connexins and a marked increase in action p
otential heterogeneity. Two independent markers reveal defects in the forma
tion of ventricular Purkinje fibers. These studies identify a novel genetic
pathway for sudden cardiac death via defects in the transition between ven
tricular and conduction system cell lineages.