ABSTRACT
Complete atrioventricular conductionblock, a significant complication of many heart diseases, is a serious threat to human health, and the biological pacemaker is a research focus in this area. In this paper, we discussed the current obstacles of biological pacemaker from laboratory to clinical application and summarized our practice. We put forward the following considerations for establishing a new atrioventricular conduction pathway: (1) engineered conduction tract or tissue (ECT) is a relatively ideal way to treat atrioventricular conduction block with biological pacing; (2) a transgene-independent method for the generating pacemaker or conduction cells from adult stemcells makes it easy for the biological pacemaker or ECT application; (3) the conduction velocity regulation is important to achievethe physiological atrioventricular conduction in clinical application with ECT; and (4) the feasible solutions of regulating the conduction velocity depend on the cell types and connexins expressions in ECT. It is believed that ECT will soon have a significant impact on the clinical transformation of biological pacing application.