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Voltage-
dependent
P/Q-type
calcium channel
subunit
alpha-1A
Voltage-
dependent
L-type calcium
channel subunit
beta-1
Voltage-
dependent
calcium channel
subunit
alpha-2/delta-2
Ryanodine
receptor 2
Tropomyosin
alpha-1 chain
Tropomyosin
beta chain
Sodium channel
protein type 5
subunit alpha
Potassium
voltage-gated
channel
subfamily D
member 3
Kv channel-
interacting
protein 2
Potassium
voltage-gated
channel
subfamily E
member 2
Potassium
voltage-gated
channel
subfamily H
member 2
Putative Dol-P-
Glc:Glc(2)Man(9)GlcNAc(2)-
PP-Dol
alpha-1,2-
glucosyltransferase
Potassium
voltage-gated
channel
subfamily KQT
member 1
Potassium
voltage-gated
channel
subfamily E
member 1
ATP-binding
cassette
sub-family C
member 8
ATP-sensitive
inward
rectifier
potassium
channel 8
ATP-sensitive
inward
rectifier
potassium
channel 11
ATP-binding
cassette
sub-family C
member 9
Inward
rectifier
potassium
channel 2
Inward
rectifier
potassium
channel 4
Potassium
voltage-gated
channel
subfamily A
member 5
Disks large
homolog 1
G protein-
activated
inward
rectifier
potassium
channel 1
G protein-
activated
inward
rectifier
potassium
channel 4
Potassium
channel
subfamily K
member 1
Potassium/sodium
hyperpolarization-
activated
cyclic
nucleotide-
gated channel 4
Voltage-
dependent
T-type calcium
channel subunit
alpha-1H
Voltage-
dependent
T-type calcium
channel subunit
alpha-1G
cAMP-dependent
protein kinase
catalytic
subunit alpha
cAMP
Ca
+
Ajmaline
Ca
+
Ca
+
Ca
+
K
+
K
+
K
+
K
+
K
+
K
+
K
+
K
+
K
+
Na
+
Na
+
K
+
Na
+
Na
+
Ajmaline
cAMP-dependent
protein kinase
type I-alpha
regulatory
subunit
Troponin
Troponin
Muscle
Contraction
Ca
+
T-tubule
Sarcoplasmic Reticulum
Cardiomyocyte
Ajmaline binds to sodium ion
channels, locking them in an
open state and preventing
the influx of sodium ions
needed for depolarization
By slowing depolarization,
the cell cannot effectively
propagate an action
potential and electrical
signals for ventricular
contractions are slowed
Voltage dependent calcium
channels are unable to be
opened due to the slowing of
the depolarization current
Low concentration of calcium
is unable to activate the
ryanodine receptor
Low calcium levels means
calcium is not readily
available to bind to
troponin, which as a result
blocks muscle contraction
from occurring
Actin
Myosin
Actin unbinds from myosin
resulting in the filaments
to slide and smooth muscle
relaxation to occur
Ajmaline is delivered
intravenously
CACNA1A
CACNB1
CACNA2D2
RYR2
TPM1
TPM2
SCN5A
KCND3
KCNIP2
KCNE2
KCNH2
ALG10B
KCNQ1
KCNE1
ABCC8
KCNJ8
KCNJ11
Unknown
KCNJ2
KCNJ4
Unknown
Unknown
KCNJ3
KCNJ5
KCNK1
HCN4
CACNA1H
CACNA1G
PRKACA
cAMP
Calcium
Ajmaline
Calcium
Calcium
Calcium
Potassium
Potassium
Potassium
Potassium
Potassium
Potassium
Potassium
Potassium
Potassium
Sodium
Sodium
Potassium
Sodium
Sodium
Ajmaline
PRKAR1A
Troponin
Troponin
Muscle
Contraction
Calcium