Abstract: The greatest advantage of iPS cell technology is that undifferentiated cells can be obtained from the patient's own cells. Although iPS cell differentiation is easy using the established cell line, its efficiency is extremely poor using patient-derived primary cultured cells because of pathological aging. The purpose of this study was to establish a highly efficient iPS induction method that can be applied to poor quality somatic cells such as pathogenic cells and senescent cells. Method and material: Dermal fibroblasts were isolated and cultured from three elderly patients who had undergone cardiac surgery. As next step, episomatic vectors containing the four Yamanaka factors were transformed into these cells to induce iPS cells. Since it is difficult to induce iPS from pathogenic and senescent cells using the standard iPS cell protocol, we had developed the optimal induction method. Then, we would verify whether the established iPS cell induction method using four-chamber myocardial tissue and fibroblasts derived from dermal tissue of patients with end-stage heart failure isolated by heart transplantation as pathological somatic cells. Results and conclusion: Pathological fibroblasts are mainly myofibroblasts that highly express alpha-smooth muscle actin and they were factors that attenuated iPS induction efficiency. Therefore, by controlling the factors in the culture medium, we succeeded in inducing iPS cells from pathological senescent cells obtained from the heart tissue of patient with end-stage heart failure.