Inherited arrhythmias and gene therapy: Are there any ethical considerations to take into account?

Abstract

Interventional electrophysiology represents a relatively recent subspecialty within the field of cardiology. In the past half-century, there has been significant advancement in the development and implementation of innovative ablation treatments and approaches. However, the treatment of arrhythmias continues to be inadequate. Several arrhythmias, such as ventricular tachycardia and atrial fibrillation, pose significant challenges in terms of therapeutic efficacy, whether through interventional procedures or the administration of antiarrhythmic drugs. Cardiologists are engaged in ongoing research to explore innovative methodologies, such as genome editing, with the purpose of effectively managing arrhythmias and meeting the growing needs of patients afflicted with rhythm disturbances. The field of genome editing has significant promise and has the potential to serve as a highly effective personalized therapy for rhythm disorders in patients. However, several ethical issues must be considered.

Keywords: Arrhythmia; Sudden cardiac death; Genome editing; Long QT; Channelopathies; Mutation

Core Tip: The use of genome editing to treat rhythm disturbances at the substrate level could provide a revolutionary treatment for disorders that the current standard of care is inadequate. Our knowledge of the disease is the only limit in identifying a perfect genome editing tool for several rhythm disturbances. As our understanding of gene vectors and transfer techniques progress, a novel therapy approach will be upon us, where cardiac muscles are altered to be impervious to rhythm disturbances, enhancing patients’ quality of living and relieving the burden on healthcare organizations. Ethical issues will eventually arise, as the treatments will be expensive.