Over the past decade, rapid progress in the molecular studies of cardiac ion channels and stem cells biology has led to efforts to create a biological pacemaker to supplement the widely-used electronic pacemaker. This review focuses on the main concepts of cardiac pacemaker activities in different heart regions and the patented approaches to design a working biological pacemaker. The gene-based and cell-based approaches to meet the requirements of a working biological pacemaker are reviewed. Possible future development and precautions for creation of an effective biological pacemaker superior to the electronic counterpart are discussed.
Keywords: Cardiac pacemaker activity, biological pacemaker, HCN pacemaker channels, Kir2.1 potassium channels, inward current, outward current, gene transfer, stem cell, ventricular rate control
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