Creating a cardiac pacemaker by gene therapy

Med Biol Eng Comput. 2007 Feb;45(2):145-55. doi: 10.1007/s11517-006-0135-0. Epub 2006 Dec 1.

Abstract

While electronic cardiac pacing in its various modalities represents standard of care for treatment of symptomatic bradyarrhythmias and heart failure, it has limitations ranging from absent or rudimentary autonomic modulation to severe complications. This has prompted experimental studies to design and validate a biological pacemaker that could supplement or replace electronic pacemakers. Advances in cardiac gene therapy have resulted in a number of strategies focused on beta-adrenergic receptors as well as specific ion currents that contribute to pacemaker function. This article reviews basic pacemaker physiology, as well as studies in which gene transfer approaches to develop a biological pacemaker have been designed and validated in vivo. Additional requirements and refinements necessary for successful biopacemaker function by gene transfer are discussed.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac / metabolism
  • Arrhythmias, Cardiac / physiopathology
  • Arrhythmias, Cardiac / therapy*
  • Autonomic Nervous System / physiology
  • Genetic Therapy / methods*
  • Heart Conduction System / physiology*
  • Humans
  • Ion Channels / genetics
  • Ion Channels / metabolism
  • Mesenchymal Stem Cell Transplantation / methods
  • Myocytes, Cardiac / metabolism
  • Receptors, Adrenergic / genetics
  • Receptors, Adrenergic / metabolism

Substances

  • Ion Channels
  • Receptors, Adrenergic