中文摘要：

近年来，关于窦房结起搏功能的电生理机制和窦房结疾病起搏治疗的研究取得了诸多进展。目前对窦房结的起搏功能以“钙钟学说”（Calcium Clock，肌浆网的自动钙释放）和“膜钟学说”（Membrane Clock，膜离子通道的周期性激活与失活）及二者的协同作用来解释；各个国家对窦房结疾病的起搏治疗也发布了最新的指南，而对生物心脏起搏的研究更是如火如荼。本述评将对窦房结起搏机制的现代学说和窦房结疾病起搏治疗的现状进行概述。

英文摘要：

In recent years, major advances have been made in the electrophysiological processes governing the heart beat and the pacing therapy of sinoatrial node （SAN） disease. Presently the pacing function of SAN is explained by the theory that the Ca2＋ clocks （rhythmic spontaneous sarcoplasmic reticulum Caz＋ release） and membrane clock （cyclic activation and deactivation of membrane ion channels） jointly regulate automaticity. Guide- lines on cardiac pacing in SAN disease have been issued by different countries. The research on biological cardiac pacemaking is in full swing. This comment presents an overview of modern concepts of the pacing mechanisms of the SNA and provides a glimpse into the current status of pacing therapy. Key words sinoatrial node; pacemaking; biological cardiac pacemaking