Laying the groundwork for a ‘pacemaker in a pill’

Published: 29 September 2026

Researcher Xin Shen is investigating a potential pill alternative to pacemakers for people living with heart failure.

Could a pill one day replace a pacemaker for heart failure?

Heart Foundation-funded researcher Xin Shen, from the University of Auckland, is investigating a natural sensor in heart cells called PIEZO1, that may one day help doctors treat heart failure with medicine as an alternative to an implanted pacemaker device.

Heart failure is a serious long-term condition that occurs when the heart isn't able to pump or relax as well as it should. It affects tens of thousands of New Zealanders and is a major cause of hospital admissions. It particularly affects older adults, Māori and Pacific Peoples.

A team at the University of Auckland, led by Professor Julian Paton and including Senior Research Fellow Xin, have developed a revolutionary pacemaker that mimics the natural rhythm of a healthy heart. Current pacemakers that are used to treat heart failure require a surgical procedure to implant the device and subsequent procedures to replace it every six to 12 years.

Now, Xin, who has received a Heart Foundation Project Grant, believes there is potential to shift from a device to a medicine-based approach.

"What if we could translate the mechanism into a medicine-based approach that could deliver greater scalability and accessibility for patients in need," Xin says.

Heart Foundation Medical Director Dr Gerry Devlin says the research has the potential to open the door to a significant new approach to treating heart failure.

"It may be early days, but this research could pave the way towards a significant shift in heart failure treatment. If it is successful, it'll be like gold dust," Gerry says.

Xin's latest research looks at the role PIEZO1 plays in heart failure. In heart failure, these sensors may no longer work properly and contribute to harmful changes in calcium balance, energy production and cell structure, making it harder for the heart to pump effectively.

Xin is investigating whether these faulty signals could be corrected through a medicinal alternative, such as a pill.

How this research could help people in New Zealand

Xin hopes this project will lead to treatments that do more than slow heart failure progression. He hopes it could one day reverse heart failure by helping repair and re-energise the heart.

Previous research that Xin contributed to found that the heart's structure and function could be restored towards a healthy state.

He believes if he can replicate this impact, the lives of people living with heart failure can be dramatically improved.

"A medicine based on this pathway could be safer, easier to deliver, cheaper and more widely accessible than device-based therapies. This would particularly benefit people living in rural areas and communities with reduced access to specialist services," he continues.

"Families may experience fewer hospital admissions, better quality of life, and greater independence for loved ones living with heart failure."

A personal connection underlines the importance of research funding

Part of Xin's ambition as a heart researcher has been driven by the impact cardiovascular-related diseases have had on his own family. He lost an aunt to diabetes and watched his grandparents live with high blood pressure. These experiences reinforced the importance of research into conditions that affect so many New Zealand families.

"Heart disease is all around us," he says. "It's still the single biggest cause of death in New Zealand, so the necessity for research is always there. Investment from the Heart Foundation and its supporters helps make this work possible."

"This support sustains both the scientific projects and the researchers who spend years studying the mechanisms that drive heart disease. There's so much good research currently being done and it unfortunately isn't enough to rely on government funding alone."

As Xin looks ahead, his goal is to keep asking the fundamental questions about heart failure and turn the answers into safe, accessible treatments for people in New Zealand affected by the condition.