Department of Pharmacology, Center for Molecular Therapeutics, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, PH7 West-321, New York, NY 10032, USA.
Nat Rev Cardiol. 2011 Aug 16;8(11):656-66. doi: 10.1038/nrcardio.2011.120.
The field of biological pacing is entering its second decade of active investigation. The inception of this area of study was serendipitous, deriving largely from observations made by several teams of investigators, whose common interest was to understand the mechanisms governing cardiac impulse initiation. Research directions taken have fallen under the broad headings of gene therapy and cell therapy, and biomaterials research has also begun to enter the field. In this Review, we revisit certain milestones achieved through the construction of a 'roadmap' in biological pacing. Whether the end result will be a clinically applicable biological pacemaker is still uncertain. However, promising constructs that achieve physiologically relevant heart rates and good autonomic responsiveness are now available, and proof of principle studies are giving way to translation to large-animal models in long-term studies. Provided that interest in the field continues, the next decade should see either biological pacemakers become a clinical reality or the improvement of electronic pacemakers to a point where the biological approach is no longer a viable alternative.
生物起搏领域正进入积极研究的第二个十年。这一研究领域的起源纯属偶然，主要源自几个研究团队的观察结果，这些团队的共同兴趣是了解控制心脏冲动发起的机制。研究方向分为基因治疗和细胞治疗，生物材料研究也开始进入该领域。在这篇综述中，我们回顾了通过构建生物起搏“路线图”所取得的某些里程碑式的进展。最终是否会产生一种临床适用的生物起搏器仍不确定。然而，现在已经有了能够实现生理相关心率和良好自主反应的有前途的构建体，并且原理验证研究正在向长期研究中的大型动物模型转化。只要对该领域的兴趣持续存在，未来十年应该会看到生物起搏器成为临床现实，或者电子起搏器得到改善，使生物方法不再是可行的替代方案。
