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电子起搏器自应用于临床拯救了无数生命，尽管其不断改进，但仍存在许多弊端，极大地促进了生物起搏器的发展。在过去10年，生物起搏器取得了显著的改善，窦房结发育的关键调控因子Tbx18能直接将心肌细胞转化为起搏样细胞发挥作用，取得了瞩目的成就，但仍遗留有与长期预后和安全相关的问题。文章对Tbx18在生物起博中研究进展进行综述。“,”Since its introduction into clinical practice , electronic pacing has saved many lives .Despite continuous improvements , electronic pacemakers have important shortcomings , which stimulated the development of biological alterna-tives.Over the past decade , significant improvements have been made in biological pacemakers , human embryonic transcrip-tion factor Tbx18 can directly convert ordinary ventricular cardiomyocytes into pacemaker cells and has made remarkable a -chievements ,but issues remain in relation to long term outcomes and safety .Whether biologicals will ultimately supplement or supplant electronics remains to be seen .This paper reviews the research progress of Tbx 18 in biological initiation .