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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鈥檛 work for everyone. The pacemakers used for serious cases are more an emergency fallback than a direct treatment. Then there鈥檚 ablation, where a catheter inserted in the groin is guided to the heart to scar 鈥� using radio frequencies or electrical pulse fields 鈥� 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 Applied Research Centre in western Sydney under the supervision of noted heart rhythm specialist, Dr Pierre Qian (PhD 鈥�20), the trio is part of an emerging generation of researchers expanding into product development and industry engagement.

The explorer:聽Dr Poonam Balaji

From childhood, Poonam remembers loving science and particularly medicine. Today, she works to destroy the source points of arrhythmias non鈥慽nvasively 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 鈥� but at the point where they meet, the cells are irradiated and die.

It has already shown an 80鈥�95 percent improvement in patient arrhythmia. Incredible, yes, but there is a catch. It is currently used only on compassionate grounds, where a person鈥檚 arrhythmia is otherwise untreatable: just 200 times worldwide so far.

鈥淭he challenge is at this stage, we don鈥檛 know what the long鈥憈erm effects and risks are,鈥� says Poonam. 鈥淢y project is to understand the mechanism of what radiation does to a heart cell so we can determine the safest and most effective treatment.鈥� 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鈥檚 fair to say Poonam is busy. Still, she loves what she does and the procedure鈥檚 potential.

鈥淚t has an amazing success rate, and you don鈥檛 even have an anaesthetic during the procedure,鈥� she says. 鈥淚t seems too good to be true, so we have to make sure it is true.鈥�

The inventor:聽Dr Duc Nguyen Minh

Born and raised in the Vietnamese capital of Hanoi, Duc (PhD 鈥�20) says, 鈥淚t was my dream to be an inventor, so I went to Hanoi University of Science and Technology.鈥�

By 20, Duc fell into making medical devices, 鈥淚 love designing. It鈥檚 like it puts dopamine into my head.鈥� An early device of his is still used in Vietnamese hospitals to filter blood. 鈥淚 realised that the bigger problem in Vietnam was heart diseases, so I switched to that.鈥�

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: 鈥渆ven though the ablation procedure is carefully planned, during the procedure, the cardiologist can鈥檛 actually see what鈥檚 going on inside the tissue.鈥�

If the catheter doesn鈥檛 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 鈥渃linical guess.鈥� Duc鈥檚 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.

鈥淭he LesioLogic research is mostly done. Now we鈥檙e spinning out a startup,鈥� says Duc with excitement. 鈥淭his is the business side of getting through regulatory processes and looking for investors and government support.鈥�

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 鈥渞eturning to the researchers, who really understand the idea, and saying, let鈥檚 commercialise it together.鈥�

The bridge builder: Dr Edward Yang

When talking to Edward (PhD 鈥�24) about high blood pressure, his passion for the topic is undeniable. 鈥淧eople with hypertension can take several medications to control it,鈥� he says. 鈥淵et up to 30 percent of people don鈥檛 take their meds. Plenty of people also don鈥檛 make the lifestyle changes they should.鈥�

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. 鈥淚t was too big, so I worked to miniaturise it. In the process, we generated lots of technology patents.鈥�

Remembering himself as a quiet student, Edward鈥檚 time at the University has caused a dramatic change. 鈥淭hinking about what I really wanted to do brought out something new in me. I realised I wasn鈥檛 actually an introvert.鈥�

Exploring his options with cardiologist Dr Qian gave Edward his new path in biomedical engineering. As he developed his skillset, the one鈥憈ime introvert found himself pitching ideas to investors and manufacturing companies 鈥� for example, ideas using high鈥憆esolution 3D printing that work at scales thinner than a human hair.

鈥淲e 3D print our ablation catheters, so we can do very unique stuff,鈥� he says. 鈥淲hen we showed the cardiologists, they were astounded, and came back with even more ideas for us to test.鈥� Edward鈥檚 abilities have made him invaluable in the research process. 鈥淎cademics and businesspeople can really struggle to talk to each other,鈥� he says. 鈥淚鈥檝e found I can be a translator for academics to business, and business to academics. It makes collaboration so much easier.鈥�

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鈥檛 employed by the university 鈥� they have access to university resources but must fund their own wages by applying for grants. This onerous 鈥� albeit critical 鈥� 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. 鈥淲e want young researchers to focus on their research rather than spending time writing grant applications.鈥�

Tonya and Malcolm have supported Australian medical research for more than 20 years. They believe the puzzles posed by the human body can 鈥渙nly 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.鈥�

Written by George Dodd for the聽donor publication. Photography by Fiona Wolf.