In an episode of “Star Trek: The Next Generation,” Lieutenant Worf is badly injured, but recovers when it is discovered that his body holds a lot of redundant parts and organs — for example, 23 ribs — that allow him to regenerate.
A team of researchers at The Ohio State University Wexner Medical Centre discovered that the human heart contains its own fail-safe backup “battery” system to regulate the heartbeat.
Their findings were published in Science Translational Medicine.
If further testing is successful, fewer people might need mechanical pacemakers in the future.
The potential market is big.
More than 200,000 people in the United States have a pacemaker implanted every year.
Our natural ‘pacemakers’
The research is still preliminary, but scientists hope to turn it into practical use some day.
“In the future we want to develop something that practitioners would welcome,” Vadim Fedorov, PhD, an associate professor of physiology and cell biology at The Ohio State University College of Medicine, told Healthline.
Fedorov explained that an implanted pacemaker works by replacing the heart’s defective natural pacemaker functions.
The sinoatrial node (SA) node, or sinus node, is the heart’s natural pacemaker. It’s a small mass of specialized cells in the top of the right atrium (upper chamber of the heart). It produces the electrical impulses that cause the heart to beat.
The heart is hardwired to maintain consistency. Irregular heartbeat, or arrhythmia, can be due to heart disease or other problems, such as changes in diet or hormones or electrolyte imbalance.
Optical and molecular mapping of the human heart revealed that the SA node is home to multiple pacemakers, specialised cardiomyocytes that generate electrical heartbeat-inducing impulses.
Total cardiac arrest occurs only when all pacemakers and conduction pathways fail.
It’s like a battery
Think of it as a car battery. One day your car won’t start. Turns out the battery is still good, but one of the connector cables is bad.
So you clean or replace the wire and save yourself from major repairs.
The Ohio State team’s discovery showed that the human heart “battery” restarts itself.
To prove their point, the researchers actually restarted hearts that were destined for the trash heap.
Most of them came from people getting new hearts or accident victims whose hearts were not suitable for transplant.
“We kept them in a special solution,” he said. “When we warm them to body temperature, they will beat.”
Where the research could lead
The discovery, while exciting, is not going to change clinical practice in the next 60 days.
But it offers promise.
Dr John Hummel, FACC, is a cardiologist at The Ohio State University Wexner Medical Centre and is director of the electrophysiology research section and professor of cardiovascular medicine.
He told Healthline the study is intriguing.
“These findings finally give us insight as to the actual structure and behaviour of the natural pacemaker of the human heart,” he said. “Diagnosing disease of the natural pacemaker is often straightforward, but can also be one of the more challenging diagnoses to make.”
“Dr Fedorov’s findings will likely allow us to develop new approaches to discriminate disease from normal behaviour of the sinus node, and give our patients a definitive diagnosis of health or disease of the heart’s natural pacemaker,” Hummel explained.
“Funding to translation of this bench research to clinic research is the next step,” he added.
Dr Gordon Tomaselli, professor of medicine, cellular and molecular medicine at the Johns Hopkins School of Medicine and past president of the American Heart Association, expressed similar thoughts.
“The work by Vadim Fedorov’s group is a beautifully done study on explanted [not used for transplant] human hearts,” Tomaselli told Healthline.
He called the infrared optical mapping studies with pharmacological interventions demonstrating the functional redundancy and complexity of the sinoatrial node (SAN) the most compelling part of the work.
Being able to view the hearts in three dimensions increases the research’s usefulness.
Tomaselli pointed out that researchers have known for decades from previous work in animals, and in clinical human electrophysiological labs, that SAN is functionally redundant and anatomically complex.
He urged caution.
“I do not think this paper will fundamentally change the management of patients with regard to pacemaker implantation,” he said. “Although around half of pacemakers are implanted for diseases of the sinus node or atrium, they are implanted not to prolong life but instead to relieve symptoms [fatigue, shortness of breath particularly with exercise].”
He went on, “The more life-threatening problems with electrical conduction in the heart for which we put in pacemakers to prolong life involve the electrical system that connects the top and bottom chamber [called the AV node] and the conduction system in the lower chambers. This paper does not address this problem.”
So, for the meantime, a Klingon skeleton might be your best bet.