The electrical system in the human heart allows it to beat a staggering 100,000 times a day. The problem is that sometimes the electricals misfire, causing cardiac arrhythmias. Arrhythmias can be debilitating or even deadly (the Stroke Foundation of Australia says that the most common, atrial fibrillation (AF), is implicated in one in four strokes). They are also difficult to treat effectively.
Medicinal approaches don’t work for everyone. The pacemakers used for serious cases are more an emergency fallback than a direct treatment. Then there’s ablation, where a catheter inserted in the groin is guided to the heart to scar – using radio frequencies or electrical pulse fields – the problem tissue.
This can be effective but is also hit and miss: 50 percent of patients must undergo the procedure multiple times. That said, ablation offers the most hope, and three University of Sydney researchers are working to address its weaknesses.
Collaborating at the Westmead Institute of Medical Research in western Sydney under the supervision of noted heart rhythm specialist, Dr Pierre Qian (PhD ’20), the trio is part of an emerging generation of researchers expanding into product development and industry engagement.
The explorer: Dr Poonam Balaji
Poonam’s work focuses on understanding the effects of radiation treatment on heart cells.
From childhood, Poonam remembers loving science and particularly medicine. Today, she works to destroy the source points of arrhythmias non‑invasively with an unlikely technique: radiation.
As in cancer treatment, the method involves directing beams of radiation at target points identified by a painstaking mapping process. Each beam can pass through tissue without damaging it – but at the point where they meet, the cells are irradiated and die.
It has already shown an 80-95 percent improvement in patient arrhythmia. Incredible, yes, but there is a catch. It is currently used only on compassionate grounds, where a person’s arrhythmia is otherwise untreatable: just 200 times worldwide so far.
“The challenge is at this stage, we don’t know what the long‑term effects and risks are,” says Poonam. “My project is to understand the mechanism of what radiation does to a heart cell so we can determine the safest and most effective treatment.” She does this by manipulating ordinary human skin cells to become pluripotent stem cells, and then heart cells.
Under the microscope, the cells beat like tiny hearts as Poonam applies radiation. Looking at the cell function and biochemistry generates vast amounts of data to interpret. It’s fair to say Poonam is busy. Still, she loves what she does and the procedure’s potential.
“It has an amazing success rate, and you don’t even have an anaesthetic during the procedure,” she says. “It seems too good to be true, so we have to make sure it is true.”
The inventor: Dr Duc Nguyen Minh
Duc is involved in both the research and commercialisation process for a solution to a common issue in cardiological procedures.
Born and raised in the Vietnamese capital of Hanoi, Duc (PhD ’20) says, “It was my dream to be an inventor, so I went to Hanoi University of Science and Technology.”
By 20, Duc fell into making medical devices, “I love designing. It’s like it puts dopamine into my head.” An early device of his is still used in Vietnamese hospitals to filter blood. “I realised that the bigger problem in Vietnam was heart diseases, so I switched to that.”
One of his cardiac devices earned him a full PhD scholarship at the University of Sydney. His work concentrates on a core problem in treating arrhythmias: “even though the ablation procedure is carefully planned, during the procedure, the cardiologist can’t actually see what’s going on inside the tissue.”
If the catheter doesn’t go deep enough, the target tissue may later recover, requiring another ablation. If it goes too deeply, organs beyond the heart might be affected. Surgeons refer to this navigation as the “clinical guess.” Duc’s answer is a device called LesioLogic, an electrode vest worn by the patient that delivers biological values and images that allow the cardiologists to judge precisely when the target has been treated.
“The LesioLogic research is mostly done. Now we’re spinning out a startup,” says Duc with excitement. “This is the business side of getting through regulatory processes and looking for investors and government support.”
In the past, it might have been unusual for the researcher to be part of the commercialisation process, but according to Duc, these days universities are “returning to the researchers, who really understand the idea, and saying, let’s commercialise it together.”
The bridge builder: Dr Edward Yang
Edward is uniquely able to explain and pitch complex biomedical engineering ideas to investors and companies.
When talking to Edward (PhD ’24) about high blood pressure, his passion for the topic is undeniable. “People with hypertension can take several medications to control it,” he says. “Yet up to 30 percent of people don’t take their meds. Plenty of people also don’t make the lifestyle changes they should.”
So, could there be a surgical solution? In fact, there already is. Called renal denervation, it stops aging or damaged kidneys from causing hypertension through a similar process to ablation. And like arrhythmia treatment, renal denervation is only used in people with severe and untreatable hypertension. Alongside the safety concerns, the technology needed work. “It was too big, so I worked to miniaturise it. In the process, we generated lots of technology patents.”
Remembering himself as a quiet student, Edward’s time at the University has caused a dramatic change. “Thinking about what I really wanted to do brought out something new in me. I realised I wasn’t actually an introvert.”
Exploring his options with cardiologist Dr Qian gave Edward his new path in biomedical engineering. As he developed his skillset, the one‑time introvert found himself pitching ideas to investors and manufacturing companies – for example, ideas using high‑resolution 3D printing that work at scales thinner than a human hair.
“We 3D print our ablation catheters, so we can do very unique stuff,” he says. “When we showed the cardiologists, they were astounded, and came back with even more ideas for us to test.” Edward’s abilities have made him invaluable in the research process. “Academics and businesspeople can really struggle to talk to each other,” he says. “I’ve found I can be a translator for academics to business, and business to academics. It makes collaboration so much easier.”
The supporters: The McCusker Charitable Foundation
These three researchers have an important thing in common: support from the McCusker Charitable Foundation. Many university researchers aren’t employed by the university – they have access to university resources but must fund their own wages by applying for grants. This onerous – albeit critical – task takes Poonam, Duc and Edward away from their research projects, and the technical work required to propel their ambitious developments in cardiovascular technologies.
Tonya McCusker AM and the Honourable Malcolm McCusker AC CVO KC of the McCusker Charitable Foundation wanted to lighten the load by funding the three researchers in the critical first year of the project. “We want young researchers to focus on their research rather than spending time writing grant applications.”
Tonya and Malcolm have supported Australian medical research for more than 20 years. They believe the puzzles posed by the human body can “only be solved by investing in, and supporting, early-career researchers. We need to provide all the support possible to attract and retain them in the medical research industry.”
Written by George Dodd for the donor publication . Photography by Fiona Wolf.
