Magnetically gated millimeter-scale capsule power system for leadless electrotherapy

Temporary cardiac pacing is indispensable for bridging transient bradyarrhythmic indications over days to weeks, yet existing systems remain constrained by device dimensions, surgical complexity, patient burden, and intrinsic operational principles. Here, these challenges are addressed through a millimeter-scale capsule power system with magnetically gated activation via a reed switch, which eliminates the stringent orientation and implantation-depth requirements of optically controlled approaches. In contrast to conventional reed switch-based pacemakers, this capsule system extends the functionality of the reed switch by integrating electrode materials directly onto its surface, thereby enabling a monolithic miniaturized architecture. Pulsed magnetic fields wirelessly actuate intermittent switching, enabling controlled discharge, with robust cardiac pacing demonstrated in large animals. A proof-of-concept closed-loop system is further realized, establishing the feasibility of future integration with a wearable electronic module to enable autonomous electrotherapy upon arrhythmia detection. Collectively, this strategy addresses a key limitation in temporary pacing and may provide a versatile framework for the development of temporary electrotherapeutic systems across cardiac, neural, and regenerative applications.