Disclosed are compositions, methods and systems for preventing or treating
cardiac dysfunction, particularly cardiac pacing dysfunction by genetic
modification of cells of targeted regions of the cardiac conduction
system. In particular, a bio-pacemaker composition is delivered to
cardiac cells to increase the intrinsic pacemaking rate of the cells,
wherein the bio-pacemaker composition increases expression of a channel
or subunit thereof that produces funny current and a T-type Ca.sup.2+
channel or subunit thereof, and expresses one or more molecules that
suppresses the expression of the wild type potassium channel.