The pacemaker current: From basics to the clinics

Activation of the pacemaker ("funny," I-f) current during diastole is the main process underlying generation of the diastolic depolarization and spontaneous activity of cardiac pacemaker cells. I-f modulation by autonomic transmitters is responsible for the chronotropic regulation of heart rate. Given its role in pacemaking, I-f has been a major target of investigation aimed to exploit its rate-controlling function in a clinical perspective. In this short review, we describe some of the most recent clinically relevant applications of the concept of I-f-based pacemaking.