The Invention and Reinvention of Cardiac Pacing

Jeffrey, Kirk

doi:10.1016/s0733-8651(18)30202-9

Cited by 7 publications

(3 citation statements)

References 33 publications

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“…This lifesaving device had its origins in the 19th century, 7 was developed largely in the latter half of the 20th century, [8][9][10][11][12][13] and provides a prime example of how knowledge derived from basic research can translate to a clinically effective outcome. Only because this highly successful therapy is not perfect is there room to consider biological alternatives.…”

Section: The Utility Of Mesenchymal Stem Cells As Biological Pacemakersmentioning

confidence: 99%

The Utility of Mesenchymal Stem Cells as Biological Pacemakers

Rosen

Brink²,

Cohen³

et al. 2008

Congestive Heart Failure

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Section: The Utility Of Mesenchymal Stem Cells As Biological Pacemakersmentioning

confidence: 99%

The Utility of Mesenchymal Stem Cells as Biological Pacemakers

Rosen

Brink²,

Cohen³

et al. 2008

Congestive Heart Failure

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“…18 Then, the early 1960s saw fixed-rate pacing via the transvenous route with the use of permanently implanted power packs. The units were bulky, their batteries had limited functionality, and their shocks too often competed with existing idioventricular rhythms.…”

mentioning

confidence: 99%

“…The resulting pacemakers incorporated a demand mode, could sense competing beats, and could reset to avoid arrhythmogenesis. 11,18,19 We now have nearly achieved a pacemaker nirvana: Atrioventricular (AV) sequential pacing permits the normal staging of atrial and ventricular contractions in patients with normal sinus nodes but with AV block. The coronary sinus permits access to the epicardial veins for biventricular pacing used in the setting of heart failure.…”

mentioning

confidence: 99%

Cardiac Pacing

Rosen

Brink

Cohen

et al. 2008

Circ: Arrhythmia and Electrophysiology

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Abstract-The prevention and treatment of life-threatening bradyarrhythmias have been revolutionized in the last half century by electronic pacemakers. Because this represents a palliative therapy, attempts have begun to effect a cure with the novel tools of gene and cell therapy. Over time, the strategies used have coalesced to focus on achieving a stable and autonomically responsive cardiac rhythm in a setting that ultimately would require no implanted hardware. In this report, we review the history of the disease process being treated, approaches now in progress, and the demands that must be met if biological therapies are to be successful. (Circ Arrhythmia Electrophysiol. 2008;1:54-61.)Key Words: atrioventricular block Ⅲ cell therapy of bradyarrhythmias Ⅲ gene therapy Ⅲ gene therapy of bradyarrhythmias Ⅲ hyperpolarization-activated, cyclic nucleotide-gated channels M ore than 2 millennia ago, the Chinese physician Pien Ch'io 1 reported what appear to have been variations on heart block. He wrote that if 1 heartbeat of 50 were dropped, the patient was normal and had no diseased organs. If the number increased to 1 in 40, then life expectancy was limited to 4 years, and a single organ was diseased (which organ was not specified). As the number of dropped beats increased further, life expectancy diminished and diseased organs increased progressively, until, at 1 dropped beat of 3 to 4, life expectancy was approximately a week.That was about as good a description of a devastating and incurable arrhythmia as existed until 1761, when Morgagni described what later would be referred to as Adams-Stokes attacks. As quoted by Osler, Morgagni wrote: "My fellow citizen, Annastasio Poggi, a grave and worthy priest. . .was in his sixty-eighth year. . .moderately fat and of a florid complexion, when he was first seized with the epilepsy, which left behind it the greatest slowness of pulse, and in like manner a coldness of the body. But this coldness of the body was overcome within seven hours, nor did it return any more, though the disorder often returned; but the slowness of the pulse still remained." 2 The separate reports of Adams 3 (1827) and Stokes 4 (1846) further detailed the symptoms and presenting signs of patients. They did far less well when it came to therapy. In part, the perplexity over treatment stemmed from the fact that the origin and the conduction of the human heartbeat were then mysteries. The structure and beginning appreciation of the function of the sinus node as cardiac pacemaker awaited the work, respectively, of Keith and Flack 5 in 1907 and Lewis and associates 6 in 1910. The beginnings of comprehension of atrioventricular conduction were the work of His 7 in 1893 and Tawara 8 in 1906. Only Purkinje's 9 work on the false tendons in 1845 may have been available to Stokes, and this was an anatomic treatment of the ventricular conducting system.If one does not know the origin of the heartbeat, where and how does one start to treat its dysfunction? In fact, the beginnings of electronic pacemaking antec...

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