Rendimiento de los Marcapasos Biológicos en Modelos Animales de Bloqueo AV: Una Revisión del Alcance Performance of Biological Pacemakers in Animal Models of AV Block: A Scoping Review

Abstract

The electronic pacemakers have some complications and limitations for which in the last two decades it has been investigated about biological pacemakers as an alternative treatment. The present study undertakes a scoping review of research on biological pacemakers assessed in an in vivo model of complete heart block to determine which approach has promoted the greatest restauration of heart rate. To achieve that, some databases were used to identify papers published 2011-2021, from which we retrieved 151 papers and after the identification and screening process only 6 articles were included. Of these articles, 4 articles had a pig as an animal model and 2 rats. The most common approach to design a biological pacemaker is gene therapy, alone or with cells in a hybrid approach. Only one study had a cell-based approach, which also achieved the heart rate closest to the normal physiological range of pigs. For rat’s models, the heart rate reported after the complete heart block were not physiologically relevant. In conclusion, the most promising therapy is the one based on cells, because it maintained the heart rate of the animal model within relevant physiological values over 2 weeks. In addition, to develop a permanent biological pacemaker is essential research about a better persistence of the expression for gene-based approach and long-term function assessment for any approach.