Transplanting gene into injured hearts creates biological pacemakers

July 16, 2014
Heart diagram. Credit: Wikipedia

Cardiologists at the Cedars-Sinai Heart Institute have developed a minimally invasive gene transplant procedure that changes unspecialized heart cells into "biological pacemaker" cells that keep the heart steadily beating.

The laboratory animal research, published online and in today's print edition of the peer-reviewed journal Science Translational Medicine, is the result of a dozen years of research with the goal of developing biological treatments for patients with rhythm disorders who currently are treated with surgically implanted pacemakers. In the United States, an estimated 300,000 patients receive pacemakers every year.

"We have been able, for the first time, to create a biological pacemaker using minimally invasive methods and to show that the biological pacemaker supports the demands of daily life," said Eduardo Marbán, MD, PhD, director of the Cedars-Sinai Heart Institute, who led the research team. "We also are the first to reprogram a heart cell in a living animal in order to effectively cure a disease."

These laboratory findings could lead to clinical trials for humans who have but who suffer side effects, such as infection of the leads that connect the device to the heart, from implanted mechanical pacemakers.

Eugenio Cingolani, MD, the director of the Heart Institute's Cardiogenetics-Familial Arrhythmia Clinic who worked with Marbán on biological pacemaker research team, said that in the future, pacemaker cells also could help infants born with congenital heart block.

The video will load shortly
This animation explains how researchers created biological pacemaker cells in pigs using gene therapy. Credit: AAAS/Carla Schaffer

"Babies still in the womb cannot have a pacemaker, but we hope to work with fetal medicine specialists to create a life-saving catheter-based treatment for infants diagnosed with congenital heart block," Cingolani said. "It is possible that one day, we might be able to save lives by replacing hardware with an injection of genes."

"This work by Dr. Marbán and his team heralds a new era of , in which genes are used not only to correct a deficiency disorder, but to actually turn one kind of cell into another type," said Shlomo Melmed, dean of the Cedars-Sinai faculty and the Helene A. and Philip E. Hixson Distinguished Chair in Investigative Medicine.

In the study, laboratory pigs with complete heart block were injected with the gene called TBX18 during a minimally invasive catheter procedure. On the second day after the gene was delivered to the animals' hearts, pigs who received the gene had significantly faster heartbeats than pigs who did not receive the gene. The stronger heartbeat persisted for the duration of the 14-day study.

"Originally, we thought that biological could be a temporary bridge therapy for patients who had an infection in the implanted pacemaker area," Marbán said. "These results show us that with more research, we might be able to develop a long-lasting biological treatment for patients."

If future research is successful, Marbán said, the procedure could be ready for human clinical studies in about three years.

Explore further: Ordinary heart cells become 'biological pacemakers' with injection of a single gene

More information: "Biological pacemaker created by minimally invasive somatic reprogramming in pigs with complete heart block," by Y.-F. Hu et al. Science Translational Medicine, stm.sciencemag.org/lookup/doi/ … scitranslmed.3008681

Related Stories

Ordinary heart cells become 'biological pacemakers' with injection of a single gene

December 16, 2012
Cedars-Sinai Heart Institute researchers have reprogrammed ordinary heart cells to become exact replicas of highly specialized pacemaker cells by injecting a single gene (Tbx18)–a major step forward in the decade-long search ...

Minneapolis Heart Institute Foundation implants its first world's smallest cardiac pacemaker

May 5, 2014
The Minneapolis Heart Institute Foundation (MHIF) announced today the first implant of the world's smallest pacemaker at the Minneapolis Heart Institute. The device was implanted as part of a global clinical trial and the ...

Heart expert sees pacemaker as cardiac management milestone

June 11, 2014
(Medical Xpress)—The BBC reported Monday that the world's smallest' pacemaker, the Micra Transcatheter Pacing System, was fitted for the first time in England. The pacemaker is one-tenth the size of traditional models. ...

Leadless pacemaker showing promising results after one year

May 9, 2014
Vivek Reddy, MD, Director of Arrhythmia Services for The Mount Sinai Hospital, reported his promising12-month follow-up data showing the world's first leadless pacemaker is demonstrating overall device performance comparable ...

World's smallest, leadless heart pacemaker implanted at Ohio State

May 6, 2014
It's about the size of a large vitamin pill and, for the first time in Ohio, the smallest heart pacemaker available is being tested at The Ohio State University Wexner Medical Center.

New pacemaker that synchronises heart rate with breathing

June 23, 2014
Pacemaker research from the Universities of Bath and Bristol could revolutionise the lives of over 750,000 people who live with heart failure in the UK.

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

fahmbo
not rated yet Jul 16, 2014
simply badass.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.