Biological Modification of Arrhythmogenic Substrates by Cell-Free Therapeutics

Heart Lung Circ. 2023 Jul;32(7):844-851. doi: 10.1016/j.hlc.2023.05.016. Epub 2023 Jun 22.

Abstract

Ventricular arrhythmias (VAs) represent a major cause of sudden cardiac death and afflict patients with heart failure from both ischaemic and non-ischaemic origins, and inherited cardiomyopathies. Current VA management, including anti-arrhythmic medications, autonomic modulation, implantable cardioverter-defibrillator implantation, and catheter ablation, remains suboptimal. Catheter ablation may even cause significant cardiomyocyte loss. Cell-based therapies and exosome treatment have been proposed as promising strategies to lessen cardiomyocyte death, modulate immune reaction, and reduce myocardial scarring, and, therefore, are potentially beneficial in treating VAs. In this review, we summarise the current cornerstones of VA management. We also discuss recent advances and ongoing evidence regarding cell-based and exosome therapy, with special attention to VA treatment.

Keywords: Cardiosphere-derived cells; Catheter ablation; Exosomes; Extracellular Vesicles; Stem cells; Ventricular arrhythmias.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents
  • Arrhythmias, Cardiac / therapy
  • Cardiomyopathies* / complications
  • Catheter Ablation* / adverse effects
  • Death, Sudden, Cardiac / etiology
  • Defibrillators, Implantable* / adverse effects
  • Humans
  • Tachycardia, Ventricular* / surgery

Substances

  • Anti-Arrhythmia Agents