Cardiac Rhythm Disease Management, Medtronic Inc., 8200 Coral Sea Street NE, Mounds View, MN 55112, USA.
J Geriatr Cardiol. 2011 Sep;8(3):147-58. doi: 10.3724/SP.J.1263.2011.00147.
Action potentials generated in the sinoatrial node (SAN) dominate the rhythm and rate of a healthy human heart. Subsequently, these action potentials propagate to the whole heart via its conduction system. Abnormalities of impulse generation and/or propagation in a heart can cause arrhythmias. For example, SAN dysfunction or conduction block of the atrioventricular node can lead to serious bradycardia which is currently treated with an implanted electronic pacemaker. On the other hand, conduction damage may cause reentrant tachyarrhythmias which are primarily treated pharmacologically or by medical device-based therapies, including defibrillation and tissue ablation. However, drug therapies sometimes may not be effective or are associated with serious side effects. Device-based therapies for cardiac arrhythmias, even with well developed technology, still face inadequacies, limitations, hardware complications, and other challenges. Therefore, scientists are actively seeking other alternatives for antiarrhythmic therapy. In particular, cells and genes used for repairing cardiac conduction damage/defect have been investigated in various studies both in vitro and in vivo. Despite the complexities of the excitation and conduction systems of the heart, cell and gene-based strategies provide novel alternatives for treatment or cure of cardiac arrhythmias. This review summarizes some highlights of recent research progress in this field.
窦房结（SAN）产生的动作电位主导着健康人心律和心率。随后，这些动作电位通过其传导系统传播到整个心脏。心脏中冲动产生和/或传导的异常可导致心律失常。例如，SAN 功能障碍或房室结传导阻滞可导致严重的心动过缓，目前可通过植入式电子起搏器进行治疗。另一方面，传导损伤可能导致折返性心动过速，主要通过药物治疗或基于医疗设备的治疗来治疗，包括除颤和组织消融。然而，药物治疗有时可能无效或伴有严重副作用。即使具有先进的技术，心脏心律失常的基于设备的治疗仍然面临不足、限制、硬件并发症和其他挑战。因此，科学家们正在积极寻找其他抗心律失常治疗的替代方法。特别是，用于修复心脏传导损伤/缺陷的细胞和基因已在体外和体内的各种研究中进行了研究。尽管心脏的兴奋和传导系统非常复杂，但基于细胞和基因的策略为治疗或治愈心律失常提供了新的选择。本综述总结了该领域近期研究进展的一些亮点。
