Biological therapies for cardiac arrhythmias: can genes and cells replace drugs and devices?
Cardiac rhythm disorders reflect failures of impulse generation and/or conduction. With the exception of ablation methods that yield selective endocardial destruction, present therapies are nonspecific and/or palliative. Progress in understanding the underlying biology opens up prospects for new alternatives. This article reviews the present state of the art in gene- and cell-based therapies to correct cardiac rhythm disturbances. We begin with the rationale for such approaches, briefly discuss efforts to address aspects of tachyarrhythmia, and review advances in creating a biological pacemaker to cure bradyarrhythmia. Insights gained bring the field closer to a paradigm shift away from devices and drugs, and toward biologics, in the treatment of rhythm disorders.
Cho
Hee Cheol
HC
Cedars-Sinai Heart Institute, 8700 Beverly Blvd., Los Angeles, CA 90048, USA. chohc@cshs.org
Marbán
Eduardo
E
D000200:Action Potentials / Q000235:genetics; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D001683:Biological Clocks / Q000235:genetics*; D017690:Cell Transplantation; D004562:Electrocardiography; D015316:Genetic Therapy; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate / Q000235:genetics*; D006801:Humans; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents