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Therapeutic Advances in Cardiovascular Disease
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Perspectives - biological pacing, a clinical reality?

Gwilym M. Morris1* and Mark R. Boyett2

1 Cardiovascular Medicine, University of Manchester, Manchester, UK
2 Cardiovascular Medicine, School of Medicine, University of Manchester, Manchester, UK

* To whom correspondence should be addressed. E-mail: gwilym.morris{at}postgrad.man.ac.uk.


   Abstract

Bradyarrhythmias are common and may be caused by sinus node dysfunction or conduction block. Many of these conditions can be treated by the implantation of electronic cardiac pacemakers that reduce mortality and morbidity in carefully selected patient groups. Implantable electronic pacemakers are small, sophisticated and reliable but not without complication and limitation. Efforts have been made to create a de novo sinus node using gene therapy, the so-called biopacemaker. This approach has potential as permanent cure for bradyarrythmias with greater physiological responsiveness than that provided by rate-responsive electronic pacemakers. This article reviews the current approaches to the problem and gives a perspective on the challenges remaining to bring the therapy to clinical practice.

First published on August 28, 2009
Therapeutic Advances in Cardiovascular Disease 2009, doi:10.1177/1753944709345792


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