title: New Approaches to Biological Pacemakers: Links to Sinoatrial Node Development.
abstract: Irreversible degeneration of the cardiac conduction system is a common disease that can cause activity intolerance, fainting, and death. While electronic pacemakers provide effective treatment, alternative approaches are needed when long-term indwelling hardware is undesirable. Biological pacemakers comprise electrically active cells that functionally integrate with the heart. Recent findings on cardiac pacemaker cells (PCs) within the sinoatrial node (SAN), along with developments in stem cell technology, have opened a new era in biological pacing. Recent experiments that have derived PC-like cells from non-PCs have brought the field closer than ever before to biological pacemakers that can faithfully recapitulate SAN activity. In this review, I discuss these approaches in the context of SAN biology and address the potential for clinical translation.
authors.affiliation: Department of Medicine, Cardiology Division, University of California, San Francisco, CA, USA; Gladstone Institute of Cardiovascular Disease, San Francisco, CA, USA. Electronic address: vedanthamv@medicine.ucsf.edu.
authors.forename: Vasanth
authors.initials: V
authors.lastname: Vedantham
mesh_terms: D000818:Animals; D001683:Biological Clocks; D018507:Gene Expression Regulation, Developmental; D006329:Heart Conduction System / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008954:Models, Biological; D012849:Sinoatrial Node / Q000196:embryology* / Q000473:pathology / Q000503:physiopathology; D057170:Translational Research, Biomedical