Abstract

PACEMAKERS-PAST, PRESENT, AND THE FUTURE OF CARDIAC ELECTRICITY HEALTH-AN UPDATED REVIEW ARTICLE

Fahad Alabeidi*, Anoud Saud Alanizi, Layla Aqeel Alanizi, Sarah Abdullah Alsaeed and Fouad Hamed Alamri

ABSTRACT

Background: Despite advancements in electronic pacemakers, significant limitations remain, including inadequate autonomic responsiveness, battery life issues, and susceptibility to complications like infections and lead fractures. Recent research into biological pacemakers offers a promising alternative, leveraging advancements in gene and cell therapies. Aim: This review aims to explore the evolution of pacemakers, focusing on the transition from traditional electronic devices to emerging biological alternatives, while examining historical developments and contemporary innovations. Methods: The review synthesizes historical data on electronic pacing from its inception in the 19th century through the technological advancements of the 20th century, leading to the present state of pacemaker technology. Additionally, it evaluates ongoing research on biological pacing strategies involving gene transfer and molecular modifications. Results: Key historical milestones include the development of the first portable external pacemaker in the 1920s and the introduction of leadless systems and biologically based pacing strategies in contemporary research. Current biological pacing strategies aim to optimize diastolic depolarization through various ion channel modifications and gene therapies. Conclusion: Biological pacemakers hold potential advantages over electronic devices, including improved physiological responsiveness and long-term effectiveness. Further research and clinical trials are essential to validate these innovative therapies and their applications in managing cardiac conditions.

Keywords: Pacemakers, biological pacing, electronic pacing, heart rhythm, gene therapy.