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About 3 million Americans live with pacemakers today, and hundreds of thousands more receive them each year. These small, battery-powered devices save lives by keeping the heart beating in rhythm. But they come at a cost: surgery, risk of infection, wires threaded into the heart, and replacements every few years. For older or medically fragile patients, the procedure itself can be too dangerous to attempt.
Now, a team led by. Chen Gong, a former USC Viterbi Ph.D. student and now an MIT postdoctoral researcher, has taken a major step toward that goal. Working with Qifa Zhou, his former adviser, and collaborators across MIT, UCLA, Harvard and Caltech, the researchers have developed a wearable, noninvasive pacemaker that uses ultrasound instead of implanted wires.
“Pacemakers have saved millions of lives, but the need for invasive surgery has always been a major limitation,” said Zhou, Zohrab A. Kaprielian Professor in the Alfred E. Mann Department of Biomedical Engineering and the Department of Ophthalmology. “What we are trying to do is remove that barrier entirely and make heart rhythm management safer and more accessible.”
Their findings are detailed in a paper titled “A Wearable Noninvasive Sonogenetic Pacemaker,” published in Nature Biomedical Engineering in June 2026. The study’s corresponding authors include Zhou, MIT professor Xuanhe Zhao and MIT researcher Gengxi Lu.
From electricity to ultrasound
At the center of the work is a deceptively simple idea: use sound, not electricity, to control the heartbeat.
The system relies on a two-step process. First, patients would receive a one-time gene therapy injection that equips heart cells with a special ion channel, essentially a molecular gate, that responds to ultrasound. Then, a small wearable device placed on the chest sends targeted ultrasound pulses into the body.
“When the ultrasound waves reach those engineered heart cells, the ion channels open, calcium flows in, and the cells contract,” MIT’s Lu said. “That’s how we can control the heartbeat without touching the heart at all.”
The wearable itself is about the size of a postage stamp, a flexible ultrasound sticker that adheres to the skin. Inside are tiny transducers that generate precisely tuned sound waves, along with electronics that connect to a small, pocket-sized controller.
In lab experiments and animal studies, the system successfully restored normal heart rhythms, including in models of arrhythmia.
For decades, researchers have explored using ultrasound to stimulate the heart. The challenge was reliability. Sound waves alone produced weak, inconsistent effects.
The breakthrough came from combining ultrasound with sonogenetics, a technique that makes cells responsive to sound.
“For the first time, we achieved precise, noninvasive cardiac pacing using a wearable device,” USC’s Gong said. “By giving heart cells a better ‘ear’ for ultrasound, we turned something that was unreliable into something that is controlled, synchronized and clinically meaningful.”
Zhao, professor of mechanical engineering and professor of civil and environmental engineering at MIT, sees it as a turning point for the field.
“This is not just an incremental improvement,” he said. “It shows that we can control a vital organ like the heart from outside the body, with high precision and without surgery. That opens the door to an entirely new class of medical devices.”
The new system also opens access to patients who currently have few options, Gong added.
“This could be especially important for people who are too frail for surgery,” he said. “It could also serve as a temporary or bridge therapy for patients who don’t yet need a permanent implant.”
A smarter pacemaker
One of the system’s most powerful features is its ability to both monitor and respond to the heart in real time.
Using built-in imaging and AI, the device forms what researchers call a “closed-loop” system: it continuously observes the heart, interprets those signals, and adjusts stimulation as needed, creating an ongoing feedback cycle rather than delivering fixed pulses.
“If the heart changes, our system adapts in real time,” Gong said.
This approach marks a major leap beyond traditional pacemakers, which rely on simpler sensors and cannot directly visualize the heart.
The wearable system is also designed for practical, everyday use. The current prototype can run for up to about eight hours on a standard portable battery pack, similar to a phone power bank, before needing to be recharged. Researchers are working to extend battery life and make the system smaller and more integrated, with the goal of comfortable, long-term wear.
The project drew on expertise from multiple institutions. USC, led by Zhou’s group, handled the ultrasound transducer design, wearable system engineering and core sonogenetics work. MIT researchers contributed advanced materials, including the bioadhesive hydrogel that allows the device to stick to skin while transmitting sound efficiently. Collaborators at UCLA, Harvard, Caltech and Brigham and Women’s Hospital brought expertise in chemistry, bioengineering, medical engineering and clinical medicine.
For Zhou, the project builds on a long career in ultrasound technology.
“We developed advanced ultrasound transducers for imaging,” he said. “Now we’re combining that with biology to create something that can not only see the body but also treat it.”
Before the technology can be commercialized, researchers will need to demonstrate long-term safety and durability in larger animal models and human trials, particularly for the gene therapy component. The device will also need to meet regulatory standards and be refined for continuous, everyday use outside the lab.
Looking beyond the heart
The implications extend far beyond cardiology.
Because ultrasound can penetrate deep into the body, and sonogenetics can target specific cell types, the same approach could be used in other organs.
“We see this as a platform technology,” Gong said. “You could imagine similar systems for the brain, for pain management, or for organs like the pancreas or bladder.”
Zhao agrees.
“One day, you might have different stickers placed on different parts of the body, each one monitoring and treating a specific condition,” he said. “That’s the long-term vision.”
For now, the focus remains on the heart, a place where the need is urgent and the potential impact enormous.
“Seeing the heart respond to a signal from outside the body, without any surgery, is something we once thought was impossible,” Gong said. “Now that we’ve shown it can be done, the question is how far we can take it.”
Published on June 3rd, 2026
Last updated on June 3rd, 2026