The AV blockage affects one in 14,000-20,000 live births. In this condition, the heart beats incorrectly due to problems with the cardiac conduction system. Currently, in serious cases the infants are treated with the implantation of a pacemaker. This treatment has many disadvantages. This treatment has many disadvantages. Batteries are finite and leads can fail to conduct a signal due to poor placement, movement or growth of the patient or lastly encapsulation by fibrotic tissue. Additionally, implantation in pediatric patients is further complicated by the limited space available and the need for readjustments to the leads as the child grows.
The aim of this project is to create a permanent solution for AV block using the principles of tissue engineering. We have optimized a technique for generating small tubular constructs using fibrin gel. The conductive cardiomyocyte cells are loaded into these tubes, generating a living conductive ‘wire’ that can be used to bypass non-functional areas of the conduction. These constructs have been validated in vitro and have shown to be functional. Currently preparations are under way for a first preclinical study.
The project has great potential to overcome the current challenges of creating a living construct and integrating it into a growing organism. Thus, a permanent, functional implant could be provided and the great burden of re-operations could be prevented.