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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.<\/jats:p>","DOI":"10.1126\/sciadv.aeh6700","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:58:53Z","timestamp":1792173533000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Magnetically gated millimeter-scale capsule power system for leadless electrotherapy"],"prefix":"10.1126","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9074-5801","authenticated-orcid":true,"given":"Feiyao","family":"Yang","sequence":"first","affiliation":[{"name":"Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, P. R. 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