Bio-pacemaker successfully tested

New hope for the heart disease: biological pacemaker will be used in the future in humans

07/18/2014

People with severe cardiac arrhythmias usually rely on a pacemaker. In Germany alone, about 76,000 of the small electrical appliances were implanted in 2012. But pacemakers hold an increased risk of infection. In addition, they can be manipulated by hackers. For a long time, physicians and biologists have been researching the development of a biological cardiac pacemaker. US researchers have now made their first breakthrough.

At present, electrical pacemakers are the only therapy for severe cardiac arrhythmias
The heart is kept in tact by the so-called sinus node in the right atrium. His impulses are passed on within the organ. In people with cardiac arrhythmia, this system is no longer reliable. That's why they use an electrical pacemaker. This should then ensure a regular heartbeat. Unfortunately, the small devices are prone to infection, the most common complication of pacemakers. If inflammation occurs, devices may need to be removed for two to six weeks for the duration of treatment with antibiotics. This is an additional burden for the patients. For unborn children with cardiac arrhythmias, there is currently no way to treat them successfully. For years, doctors and biologists have been researching a biological and gentle therapeutic option.

Pigs with biological pacemakers by reprogrammed cells
As scientists around Eduardo Marbán from Cedars-Sinai Medical Center in Los Angeles in the journal „Science Translational Medicine“ report, they have recently achieved a breakthrough on the way to the biological pacemaker. They pass pigs with a heart defect through a catheter into a certain area of ​​the right ventricle using a non-toxic virus that carries the gene TBX18. The gene was there to reprogram myocardial cells into sinus node cells.

According to the researchers, in the treated pigs a significantly faster pulse was detected on the second day after the gene transfer than in the untreated animals of the control group. During the 14-day study period, the pigs had a steadily more stable heart rhythm, which weakened slightly towards the end. The clock adapted to both the day-night rhythm and the activity of the animals. According to the researchers, only a minimal adaptation by electrical pacemakers had been necessary. Stronger side effects or arrhythmias were not observed by the physicians.

Hope for cardiac infants through biological pacemakers
„For the first time, we've been able to use a biological pacemaker with minimally invasive procedures and show that it supports the demands of everyday life“, Marbán is cited in a communication from Cedars-Sinai Medical Center. „We're also the first to reprogram a heart cell in the living animal to cure a disease.“

Eugenio Cingolani, director of the heart center and researcher in Marbán's team, reports that it will be possible in the future to treat infants with congenital heart disease with pacemaker cells. „Babies still in the womb can not get a pacemaker, but together with specialists in fetal medicine, we hope to develop a life-saving catheter-based treatment for infants with a diagnosed congenital heart block“, so Cingolani. „It may be possible that someday we will be able to save lives by replacing tissues by injecting genes. "