Nanoscale numerical simulations explain apparently opposing experimental findings on ephaptic coupling

A classical study found no excitation transfer when isolated cardiomyocytes were placed side by side, whereas a recent paper reported action potential transfer in carrdiomyocytes placed end to end. We use nanoscale numerical simulations based on the full Poisson-Nernst-Planck equations to investigate whether these apparently opposing observations can be explained by the different geometrical configurations. The computations show that in the end-to-end configuration, ephaptic coupling occurs when the intercellular cleft is sufficiently narrow and a sufficiently large fraction of the sodium channels is localized at the intercalated disc. Coupling is strengthened when the sodium channels are concentrated in fewer clusters and when ionic diffusion within the cleft is reduced. Under these conditions, excitation transfer occurs on a timescale consistent with rapid cell-to-cell activation. Conduction depends biphasically on cleft width and terminates abruptly beyond a critical width. Localization of potassium channels at the intercalated disc has only a moderate effect, whereas gap junctions substantially improve conduction and reduce the relative contribution of ephaptic coupling. In the side-by-side configuration, excitation transfer does not occur under physiological conditions and requires highly flattened cells, minimal separation, and unrealistically strong sodium-channel clustering. The different outcomes of the side-by-side and end-to-end experiments can therefore be explained by the fundamentally different geometrical conditions for ephaptic coupling.