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完全性房室传导阻滞是各种心脏病的重要并发症,生物心脏起搏是近年来其治疗研究的热点。本文通过分析目前生物起搏的临床应用所面临的瓶颈和问题,结合笔者的研究实践,就再建心脏房室传导通路这一课题提出如下思考:(1)组织工程化心传导束(ECT)是生物起搏治疗房室传导阻滞策略中一种较为理想的方式;(2)非基因改造成体干细胞诱导为起搏细胞或传导细胞,能够使生物起搏和ECT治疗房室传导阻滞的临床推广应用变得容易;(3)采用ECT实现生理性房室传导及临床应用,必须对其进行传导速度调控;(4)须围绕“ECT组织细胞类型及缝隙连接蛋白表达”这一关键点,设计传导速度调控的可行性方案。相信随着ECT研究工作的深入开展,ECT必将对生物起搏治疗的临床转化产生重要影响。
Complete atrioventricular block is an important complication of various heart diseases. Biological pacing has been a hot spot in recent years. Based on the analysis of the current bottlenecks and problems in the clinical application of biological pacing and the author’s research practice, this article puts forward the following thoughts on the re-establishment of atrioventricular conduction pathway: (1) Tissue-engineered cardiac conduction bundle (ECT) is Biological pacing in the treatment of atrioventricular block strategy is a more ideal way; (2) non-genetically modified adult stem cells induced to paced cells or conductive cells, can make biological pacing and ECT treatment of atrioventricular block clinical Promote the use of easy to use; (3) the use of ECT to achieve atrioventricular conduction and clinical application, it must be its conduction velocity control; (4) to be around the “ECT tissue cell type and connexin expression,” the key Point, the design of the feasibility of transmission rate control program. It is believed that with the further development of ECT research, ECT will definitely have an important impact on the clinical conversion of biological pacing therapy.