Self-rechargeable cardiac pacemaker system with triboelectric nanogenerators

Instantaneous Piezoelectric Nanogenerator for Pacemaker Applications

Implantable nanogenerators (NG) are a promising solution to the self-sustainable power source for cardiovascular implantable electronic devices (CIEDs), such as pacemakers, by harvesting biomechanical energy from heartbeats. Nevertheless, the conversion efficiency of mechanical energy into electrical energy has long been a significant challenge, limiting the practical application of NGs to effectively charge a power storage component. In this work, we report an instantaneous piezoelectric NG (i-PENG) design that converted the wave-like output of a regular PENG into output spikes with ~7 times higher amplitude. Due to the largely raised electrical energy, the i-PENG exhibited a substantially faster charging rate on a capacitor. The i-PENG was further integrated with a rectifier and a micro capacitor, serving as both the contact electrodes and an electrical regulating circuit. When implanted on a pig's heart surface, this integrated power system was able to charge a capacitance of 100 μF to 4 V in 13 minutes. This level of electrical power was able to operate a commercial pacemaker to provide regular stimulation signals. This study provides a design principle that can raise the electrical energy of the piezoelectricity, leading toward practical applications of PENG for powering implantable biomedical devices.

Electrotherapy and health monitoring with piezoelectric and triboelectric technologies

The growing need for advanced therapeutic and diagnostic technologies has spurred interest in self-powered systems for electrotherapy and health monitoring. Traditional battery-dependent medical devices (MDs) face limitations, including short operational lifespans and patient discomfort, underscoring the importance of sustainable alternatives. Mechanical energy harvesting technologies, such as piezoelectric and triboelectric nanogenerators (PENGs and TENGs), have emerged as promising solutions, enabling real-time health monitoring and non-invasive electrotherapy by converting biomechanical energy into electricity. This review explores the latest advancements in PENG and TENG technologies, emphasizing their applications in wound healing, neural regeneration, and real-time physiological monitoring. Strategies to overcome hurdles are discussed, demonstrating the transformative potential of PENG and TENG systems in next-generation MDs. By integrating energy harvesting with therapeutic and monitoring functionalities, piezoelectric and triboelectric systems offer a path toward non-invasive, efficient, and patient-centric medical solutions.

A Body Conformal Ultrasound Receiver for Efficient and Stable Wireless Power Transfer in Deep Percutaneous Charging

Wireless powering of rechargeable-implantable medical devices presents a challenge in developing reliable wireless energy transfer systems that meet medical safety and standards. Ultrasound-driven triboelectric nanogenerators (US-TENG) are investigated for various medical applications, including noninvasive percutaneous wireless battery powering to reduce the need for multiple surgeries for battery replacement. However, these devices often suffer from inefficiency due to limited output performance and rigidity. To address this issue, a dielectric-ferroelectric boosted US-TENG (US-TENGDF-B) capable of producing a high output charge with low-intensity ultrasound and a long probe distance is developed, comparatively. The feasibility and output stability of this deformable and augmented device is confirmed under various bending conditions, making it suitable for use in the body's curved positions or with electronic implants. The device achieved an output of ≈26 V and ≈6.7 mW output for remote charging of a rechargeable battery at a 35 mm distance. These results demonstrate the effectiveness of the output-augmented US-TENG for deep short-term wireless charging of implantable electronics with flexing conditions in curved devices such as future total artificial hearts.

Magnetically driven triboelectric nanogenerator for a wireless, versatile energy transfer system

The development of stable and multifunctional monitoring or actuating systems for implantable biomedical devices necessitates a high-capacity power supply. By using the oscillation of a magnetic field, energy can be transmitted through various media such as skin, fat, liquids, metals, and fabrics. We demonstrate a magnetically actuated implantable triboelectric generator that can effectively transfer energy independently of the surrounding media. The oscillation of the magnetic field enables contact of elastomeric magnets with the top and bottom electrodes of the generator, generating a path for electrical energy through contact electrification. The performance of the magnetically actuated triboelectric generator exhibits high tolerability for lateral and angular misalignment, transferring energy through different media including tissue, liquid, air, wood, metal, and fabrics. This addresses a critical issue present in ultrasound approaches. These findings suggest that a magnetically actuated triboelectric generator can be an alternative technology capable of overcoming the medium-related challenges of ultrasound, providing power to medical implants.

Materials Advances in Devices for Heart Disease Interventions

Heart disease encompasses a range of conditions that affect the heart, including coronary artery disease, arrhythmias, congenital heart defects, heart valve disease, and conditions that affect the heart muscle. Intervention strategies can be categorized according to when they are administered and include: 1) Monitoring cardiac function using sensor technology to inform diagnosis and treatment, 2) Managing symptoms by restoring cardiac output, electrophysiology, and hemodynamics, and often serving as bridge-to-recovery or bridge-to-transplantation strategies, and 3) Repairing damaged tissue, including myocardium and heart valves, when management strategies are insufficient. Each intervention approach and technology require specific material properties to function optimally, relying on materials that support their action and interface with the body, with new technologies increasingly depending on advances in materials science and engineering. This review explores material properties and requirements driving innovation in advanced intervention strategies for heart disease and highlights key examples of recent progress in the field driven by advances in materials research.

An implantable hydrogel-based phononic crystal for continuous and wireless monitoring of internal tissue strains

Conventional implantable electronic sensors for continuous monitoring of internal tissue strains are yet to match the biomechanics of tissues while maintaining biodegradability, biocompatibility and wireless monitoring capability. Here we present a two-dimensional phononic crystal composed of periodic air columns in soft hydrogel, which was named ultrasonic metagel, and we demonstrate its use as implantable sensor for continuous and wireless monitoring of internal tissue strains. The metagel's deformation shifts its ultrasonic bandgap, which can be wirelessly detected by an external ultrasonic probe. We demonstrate ex vivo the ability of the metagel sensor for monitoring tissue strains on porcine tendon, wounded tissue and heart. In live pigs, we further demonstrate the ability of the metagel to monitor tendon stretching, respiration and heartbeat, working stably during 30 days of implantation, and we loaded the metagel with growth factors to achieve different healing rates in subcutaneous wounds. The metagel results almost completely degraded 12 weeks after implantation. Our finding highlights the clinical potential of the ultrasonic sensor for tendon rehabilitation monitoring and drug delivery efficacy evaluation.

Bioelectronics hydrogels for implantable cardiac and brain disease medical treatment application

Hydrogel-based bioelectronic systems offer significant benefits for point-of-care diagnosis, treatment of cardiac and cerebral disease, surgical procedures, and other medical applications, ushering in a new era of advancements in medical technology. Progress in hydrogel-based bioelectronics has advanced from basic instrument and sensing capabilities to sophisticated multimodal perceptions and feedback systems. Addressing challenges related to immune responses and inflammation regulation after implantation, physiological dynamic mechanism, biological toxicology as well as device size, power consumption, stability, and signal conversion is crucial for the practical implementation of hydrogel-based bioelectronics in medical implants. Therefore, further exploration of hydrogel-based bioelectronics is imperative, and a comprehensive review is necessary to steer the development of these technologies for use in implantable therapies for cardiac and brain/neural conditions. In this review, a concise overview is provided on the fundamental principles underlying ionic electronic and ionic bioelectronic mechanisms. Additionally, a comprehensive examination is conducted on various bioelectronic materials integrated within hydrogels for applications in implantable medical treatments. The analysis encompasses a detailed discussion on the representative structures and physical attributes of hydrogels. This includes an exploration of their intrinsic properties such as mechanical strength, dynamic capabilities, shape-memory features, stability, stretchability, and water retention characteristics. Moreover, the discussion extends to properties related to interactions with tissues or the environment, such as adhesiveness, responsiveness, and degradability. The intricate relationships between the structure and properties of hydrogels are thoroughly examined, along with an elucidation of how these properties influence their applications in implantable medical treatments. The review also delves into the processing techniques and characterization methods employed for hydrogels. Furthermore, recent breakthroughs in the applications of hydrogels are logically explored, covering aspects such as materials, structure, properties, functions, fabrication procedures, and hybridization with other materials. Finally, the review concludes by outlining the future prospects and challenges associated with hydrogels-based bioelectronics systems.

Self-powered electrotactile textile haptic glove for enhanced human-machine interface

Human-machine interface (HMI) plays an important role in various fields, where haptic technologies provide crucial tactile feedback that greatly enhances user experience, especially in virtual reality/augmented reality, prosthetic control, and therapeutic applications. Through tactile feedback, users can interact with devices in a more realistic way, thereby improving the overall effectiveness of the experience. However, existing haptic devices are often bulky due to cumbersome instruments and power modules, limiting comfort and portability. Here, we introduce a concept of wearable haptic technology: a thin, soft, self-powered electrotactile textile haptic (SPETH) glove that uses the triboelectric effect and gas breakdown discharge for localized electrical stimulation. Daily hand movements generate sufficient mechanical energy to power the SPETH glove. Its features-softness, lightweight, self-sustainability, portability, and affordability-enable it to provide tactile feedback anytime and anywhere without external equipment. This makes the SPETH glove an enhanced, battery-free HMI suitable for a wide range of applications.

Leadless pacing: a comprehensive review

Over the past decade, leadless pacing has undergone a rapid evolution, resulting in multiple leadless pacemaker (LPM) devices that offer advancements such as atrioventricular synchronized pacing in VDD mode, atrial stimulation, dual-chamber pacing, and longer battery longevity. Studies comparing LPMs with transvenous pacemakers (TVPMs) show a lower rate of device-related complications with LPMs. In the near future, LPMs could be combined with other devices such as non-transvenous implantable cardioverter-defibrillators to provide anti-tachycardia pacing or bradycardia pacing. Future prospectives for leadless cardiac resynchronization therapy and leadless conduction system pacing are being investigated. As LPMs continue to improve, their applications are anticipated to expand further improving patient outcome, promising a bright future for leadless pacing. In this review, the past, present, and future of leadless pacing are discussed with a focus on cutting-edge implantation techniques, clinical outcomes, and modern advancements of LPMs.

Functional Hydrogels for Implantable Bioelectronic Devices

In recent years, with the rapid development of flexible electronics, implantable electronic devices have received increasing attention, and they provide new solutions for medical diagnosis and treatment. To ensure the long-term and stable operation of electronic devices in the internal environment, materials with conductivity, flexibility, biocompatibility, and other properties are in high demand. Hydrogels are polymers with three-dimensional network structures that not only have physical and chemical properties similar to those of biological tissues but can be also modulated by introducing functional groups to regulate the conductivity, adhesion, self-healing, and other functions. Therefore, hydrogel-based implantable bioelectronic devices are considered to be a candidate development direction in the future of the biomedical field. Here, this paper reviews the research progress in the molecular design and performance modulation of functionalized hydrogels based on four key properties of hydrogels: conductivity, self-healing, adhesion, and toughness. The latest progress in the use of functionalized hydrogels in implantable bioelectronic device applications is summarized below. Finally, discussions are given on the challenges and opportunities of hydrogels for implantable bioelectronic devices.

Advances in Triboelectric Nanogenerators for Microbial Disinfection

The global COVID-19 pandemic has highlighted the pivotal role of microbial disinfection technologies, driving the demand for innovative, efficient, and sustainable solutions. Triboelectric technology, known for efficiently converting ambient mechanical energy into electrical energy, has emerged as a promising candidate to address these needs. Self-powered electro-based microbial disinfection using triboelectric nanogenerators (TENGs) has emerged as a promising solution. TENGs have demonstrated effective disinfection capabilities in various settings, including water, air, surfaces, and wounds. This review explores the advancements in TENG-based microbial disinfection, highlighting its mechanisms and applications. By utilizing triboelectric technology, it provides comprehensive insights into the development of sustainable and efficient solutions for microbial control across diverse environments.

Self-powered biomedical devices: biology, materials, and their interfaces

Integrating biomedical electronic devices holds profound promise for advancements in healthcare and enhancing individuals' quality of life. However, the persistent challenges associated with the traditional batteries' limited lifespan and bulkiness hinder these devices' long-term functionality and consistent power supply. Here, we delve into the biology and material interfaces in self-powered medical devices by summarizing the intrinsic electric demands in humans, analyzing material and biological mechanisms for electricity generation and storage, and discussing the pathways toward self-chargeable powering. As a result, the current challenges in material designs and biological integrations emerged to shape the future directions in advancing self-powered medical devices. This paper calls on the community to integrate biology and material science to develop self-powering medical devices and improve their clinical prospects.

Advancements in flexible biomechanical energy harvesting for smart health applications

Advancing flexible electronics enables timely smart health management and diagnostic interventions. However, current health electronics typically rely on replaceable batteries or external power sources, requiring direct contact with the human skin or organs. This setup often results in rigid and bulky devices, reducing user comfort during long-term use. Flexible biomechanical energy harvesting technology, based on triboelectric or piezoelectric strategies, offers a promising approach for continuous and comfortable smart health applications, providing a sustainable power supply and self-powered sensing. This review systematically examines biomechanical energy sources around the human body, explores various energy harvesting mechanisms and their applications in smart health, and concludes with insights and future perspectives in this field.

Electroactive Nanomaterials for the Prevention and Treatment of Heart Failure: From Materials and Mechanisms to Applications

Heart failure (HF) represents a cardiovascular disease that significantly threatens global well-being and quality of life. Electroactive nanomaterials, characterized by their distinctive physical and chemical properties, emerge as promising candidates for HF prevention and management. This review comprehensively examines electroactive nanomaterials and their applications in HF intervention. It presents the definition, classification, and intrinsic characteristics of conductive, piezoelectric, and triboelectric nanomaterials, emphasizing their mechanical robustness, electrical conductivity, and piezoelectric coefficients. The review elucidates their applications and mechanisms: 1) early detection and diagnosis, employing nanomaterial-based sensors for real-time cardiac health monitoring; 2) cardiac tissue repair and regeneration, providing mechanical, chemical, and electrical stimuli for tissue restoration; 3) localized administration of bioactive biomolecules, genes, or pharmacotherapeutic agents, using nanomaterials as advanced drug delivery systems; and 4) electrical stimulation therapies, leveraging their properties for innovative pacemaker and neurostimulation technologies. Challenges in clinical translation, such as biocompatibility, stability, and scalability, are discussed, along with future prospects and potential innovations, including multifunctional and stimuli-responsive nanomaterials for precise HF therapies. This review encapsulates current research and future directions concerning the use of electroactive nanomaterials in HF prevention and management, highlighting their potential to innovating in cardiovascular medicine.

Triboelectric nanogenerator for high-entropy energy, self-powered sensors, and popular education

Triboelectric nanogenerator (TENG) has become a promising option for high-entropy energy harvesting and self-powered sensors because of their ability to combine the effects of contact electrification and electrostatic induction to effectively convert mechanical energy into electric power or signals. Here, the theoretical origin of TENG, strategies for high-performance TENG, and its applications in high-entropy energy, self-powered sensors, and blue energy are comprehensively introduced on the basis of the fundamental science and principle of TENG. Besides, a series of work in popular science education for TENG that includes numerous scientific and technological products from our science education base, Maxwell Science+, is emphatically introduced. This topic provides an angle and notable insights into the development of TENG.

Biomaterial Promotes Triboelectric Nanogenerator for Health Diagnostics and Clinical Application

With the growing demand for personalized healthcare services, biomaterial-based triboelectric nanogenerators (BM-TENGs) have gained widespread attention due to their non-toxicity, biocompatibility, and biodegradability. This review systematically examines the working principles, material choices, biomimetic designs, and clinical application scenarios of BM-TENGs, with a focus on the use of natural biomaterials, biocomposites, hydrogels, and other materials in health diagnostics. Biomaterials show significant potential in enhancing TENG performance, improving device flexibility, and expanding application ranges, especially in early disease detection, health monitoring, and self-powered sensing devices. This paper also addresses the current challenges faced by BM-TENG technology, including performance optimization, biocompatibility, and device durability. By integrating existing research and technological advancements, this review aims to deeply analyze the development of BM-TENG technology, propose corresponding solutions, and explore its practical application prospects in the medical field.

Fully Implantable Wireless Cardiac Pacing and Sensing System Integrated with Hydrogel Electrodes

Cardiac pacemakers play a crucial role in arrhythmia treatment. Existing devices typically rely on rigid electrode components, leading to potential issues such as heart damage and detachment during prolonged cardiac motion due to the mechanical mismatch with cardiac tissue. Additionally, traditional pacemakers, with their batteries and percutaneous leads, introduce infection risks and limit freedom of movement. A wireless, battery-free multifunctional bioelectronic device for cardiac pacing is developed. This device integrates highly conductive (160 S m-1), flexible (Young's modulus of 80 kPa is similar to that of mammalian heart tissue), and stretchable (270%) soft hydrogel electrodes, providing high signal-to-noise ratio (≈28 dB) electrocardiogram (ECG) recordings and effective pacing of the beating heart. The versatile device detects physiological and biochemical signals in the cardiac environment and allows for adjustable pacing in vivo studies. Remarkably, it maintained recording and pacing capabilities 31 days post-implantation in rats. Additionally, the wireless bioelectronic device can be fully implanted in rabbits for pacing. By addressing a major shortcoming of conventional pacemakers, this device paves the way for implantable flexible bioelectronics, which offers promising opportunities for advanced cardiac therapies.

Multi-functional adhesive hydrogel as bio-interface for wireless transient pacemaker

Traditional temporary cardiac pacemakers (TCPs), which employ transcutaneous leads and external wired power systems are battery-dependent and generally non-absorbable with rigidity, thereby necessitating surgical retrieval after therapy and resulting in potentially severe complications. Wireless and bioresorbable transient pacemakers have, hence, emerged recently, though hitting a bottleneck of unfavorable tissue-device bonding interface subject to mismatched mechanical modulus, low adhesive strength, inferior electrical performances, and infection risks. Here, to address such crux, we develop a multifunctional interface hydrogel (MIH) with superior electrical performance to facilitate efficient electrical exchange, comparable mechanical strength to natural heart tissue, robust adhesion property to enable stable device-tissue fixation (tensile strength: ∼30 kPa, shear strength of ∼30 kPa, and peel-off strength: ∼85 kPa), and good bactericidal effect to suppress bacterial growth. Through delicate integration of this versatile MIH with a leadless, battery-free, wireless, and transient pacemaker, the entire system exhibits stable and conformal adhesion to the beating heart while enabling precise and constant electrical stimulation to modulate the cardiac rhythm. It is envisioned that this versatile MIH and the proposed integration framework will have immense potential in overcoming key limitations of traditional TCPs, and may inspire the design of novel bioelectronic-tissue interfaces for next-generation implantable medical devices.

Recent advances in materials and manufacturing of implantable devices for continuous health monitoring

Implantable devices are vital in healthcare, enabling continuous monitoring, early disease detection, informed decision-making, enhanced outcomes, cost reduction, and chronic condition management. These devices provide real-time data, allowing proactive healthcare interventions, and contribute to overall improvements in patient care and quality of life. The success of implantable devices relies on the careful selection of materials and manufacturing methods. Recent materials research and manufacturing advancements have yielded implantable devices with enhanced biocompatibility, reliability, and functionality, benefiting human healthcare. This paper provides a comprehensive overview of the latest developments in implantable medical devices, emphasizing the importance of material selection and manufacturing methods, including biocompatibility, self-healing capabilities, corrosion resistance, mechanical properties, and conductivity. It explores various manufacturing techniques such as microfabrication, 3D printing, laser micromachining, electrospinning, screen printing, inkjet printing, and nanofabrication. The paper also discusses challenges and limitations in the field, including biocompatibility concerns, privacy and data security issues, and regulatory hurdles for implantable devices.

Strategies to Improve the Output Performance of Triboelectric Nanogenerators

Triboelectric nanogenerators (TENGs) can collect and convert random mechanical energy into electric energy, with remarkable advantages including broadly available materials, straightforward preparation, and multiple applications. Over the years, researchers have made substantial advancements in the theoretical and practical aspects of TENG. Nevertheless, the pivotal challenge in realizing full applications of TENG lies in ensuring that the generated output meets the specific application requirements. Consequently, substantial research is dedicated to exploring methods and mechanisms for enhancing the output performance of TENG devices. This review aims to comprehensively examine the influencing factors and corresponding improvement strategies of the output performance based on the contact electrification mechanism and operational principles that underlie TENG technology. This review primarily delves into five key areas of improvement: materials selection, surface modification, component adjustments, structural optimization, and electrode enhancements. These aspects are crucial in tailoring TENG devices to meet the desired performance metrics for various applications.

Advanced Energy Harvesters and Energy Storage for Powering Wearable and Implantable Medical Devices

Wearable and implantable active medical devices (WIMDs) are transformative solutions for improving healthcare, offering continuous health monitoring, early disease detection, targeted treatments, personalized medicine, and connected health capabilities. Commercialized WIMDs use primary or rechargeable batteries to power their sensing, actuation, stimulation, and communication functions, and periodic battery replacements of implanted active medical devices pose major risks of surgical infections or inconvenience to users. Addressing the energy source challenge is critical for meeting the growing demand of the WIMD market that is reaching valuations in the tens of billions of dollars. This review critically assesses the recent advances in energy harvesting and storage technologies that can potentially eliminate the need for battery replacements. With a key focus on advanced materials that can enable energy harvesters to meet the energy needs of WIMDs, this review examines the crucial roles of advanced materials in improving the efficiencies of energy harvesters, wireless charging, and energy storage devices. This review concludes by highlighting the key challenges and opportunities in advanced materials necessary to achieve the vision of self-powered wearable and implantable active medical devices, eliminating the risks associated with surgical battery replacement and the inconvenience of frequent manual recharging.

Self-Powered Hybrid Motion and Health Sensing System Based on Triboelectric Nanogenerators

Triboelectric nanogenerator (TENG) represents an effective approach for the conversion of mechanical energy into electrical energy and has been explored to combine multiple technologies in past years. Self-powered sensors are not only free from the constraints of mechanical energy in the environment but also capable of efficiently harvesting ambient energy to sustain continuous operation. In this review, the remarkable development of TENG-based human body sensing achieved in recent years is presented, with a specific focus on human health sensing solutions, such as body motion and physiological signal detection. The movements originating from different parts of the body, such as body, touch, sound, and eyes, are systematically classified, and a thorough review of sensor structures and materials is conducted. Physiological signal sensors are categorized into non-implantable and implantable biomedical sensors for discussion. Suggestions for future applications of TENG-based biomedical sensors are also indicated, highlighting the associated challenges.

Soft Bioelectronics for Heart Monitoring

Cardiovascular diseases (CVDs) are a predominant global health concern, accounting for over 17.9 million deaths in 2019, representing approximately 32% of all global fatalities. In North America and Europe, over a million adults undergo cardiac surgeries annually. Despite the benefits, such surgeries pose risks and require precise postsurgery monitoring. However, during the postdischarge period, where monitoring infrastructures are limited, continuous monitoring of vital signals is hindered. In this area, the introduction of implantable electronics is altering medical practices by enabling real-time and out-of-hospital monitoring of physiological signals and biological information postsurgery. The multimodal implantable bioelectronic platforms have the capability of continuous heart sensing and stimulation, in both postsurgery and out-of-hospital settings. Furthermore, with the emergence of machine learning algorithms into healthcare devices, next-generation implantables will benefit artificial intelligence (AI) and connectivity with skin-interfaced electronics to provide more precise and user-specific results. This Review outlines recent advancements in implantable bioelectronics and their utilization in cardiovascular health monitoring, highlighting their transformative deployment in sensing and stimulation to the heart toward reaching truly personalized healthcare platforms compatible with the Sustainable Development Goal 3.4 of the WHO 2030 observatory roadmap. This Review also discusses the challenges and future prospects of these devices.

Bioelectronics for electrical stimulation: materials, devices and biomedical applications

Bioelectronics is a hot research topic, yet an important tool, as it facilitates the creation of advanced medical devices that interact with biological systems to effectively diagnose, monitor and treat a broad spectrum of health conditions. Electrical stimulation (ES) is a pivotal technique in bioelectronics, offering a precise, non-pharmacological means to modulate and control biological processes across molecular, cellular, tissue, and organ levels. This method holds the potential to restore or enhance physiological functions compromised by diseases or injuries by integrating sophisticated electrical signals, device interfaces, and designs tailored to specific biological mechanisms. This review explains the mechanisms by which ES influences cellular behaviors, introduces the essential stimulation principles, discusses the performance requirements for optimal ES systems, and highlights the representative applications. From this review, we can realize the potential of ES based bioelectronics in therapy, regenerative medicine and rehabilitation engineering technologies, ranging from tissue engineering to neurological technologies, and the modulation of cardiovascular and cognitive functions. This review underscores the versatility of ES in various biomedical contexts and emphasizes the need to adapt to complex biological and clinical landscapes it addresses.

A micro-dome array triboelectric nanogenerator with a nanocomposite dielectric enhancement layer for wearable pressure sensing and gait analysis

The practical application of a triboelectric nanogenerator (TENG) as a self-powered sensor and an energy harvester is constrained by the need for a wide sensitivity range, significant output power, and structural flexibility. However, most research has focused on physical and chemical surface modifications of the charge-generating layer to enhance the TENG performance. Improving the charge storage ability could otherwise further enhance the overall performance. Here, we propose a flexible TENG design that incorporates a micro-dome array Ecoflex as the tribo-negative layer, coupled with a dielectric enhancement layer composed of a carbon black/Ecoflex composite. The addition of the CB/Eco composite layer to the micro-dome array triboelectric layer enhanced the output voltage performance by forming numerous micro capacitors within the dielectric layer. Furthermore, oxygen-containing fluorocarbon plasma treatment of the micro-dome array increased the surface energy, enhancing the interaction between the triboelectric layers. This leads to an enhancement in the output voltage and energy efficiency, exhibiting a power density of 197.4 mW m-2. The pressure sensitivity of the TENG was systematically investigated, demonstrating 2.57 V kPa-1 in the low-pressure range (0.612 to 8.58 kPa) and 1.70 V kPa-1 in the high-pressure range (8.58 to 20.83 kPa). Additionally, the encapsulated TENG sensor with spacers was integrated into insoles for self-powered gait analysis, providing real-time insights into walking patterns and frequencies. Exploring the TENG's energy harvesting capability revealed a peak-peak voltage of 89.4 V when two TENGs are connected in series. The comprehensive performance characterization of the TENG demonstrates its promising applications in wearable, self-powered sensing, and energy harvesting systems.

Softening implantable bioelectronics: Material designs, applications, and future directions

Implantable bioelectronics, integrated directly within the body, represent a potent biomedical solution for monitoring and treating a range of medical conditions, including chronic diseases, neural disorders, and cardiac conditions, through personalized medical interventions. Nevertheless, contemporary implantable bioelectronics rely heavily on rigid materials (e.g., inorganic materials and metals), leading to inflammatory responses and tissue damage due to a mechanical mismatch with biological tissues. Recently, soft electronics with mechanical properties comparable to those of biological tissues have been introduced to alleviate fatal immune responses and improve tissue conformity. Despite their myriad advantages, substantial challenges persist in surgical handling and precise positioning due to their high compliance. To surmount these obstacles, softening implantable bioelectronics has garnered significant attention as it embraces the benefits of both rigid and soft bioelectronics. These devices are rigid for easy standalone implantation, transitioning to a soft state in vivo in response to environmental stimuli, which effectively overcomes functional/biological problems inherent in the static mechanical properties of conventional implants. This article reviews recent research and development in softening materials and designs for implantable bioelectronics. Examples featuring tissue-penetrating and conformal softening devices highlight the promising potential of these approaches in biomedical applications. A concluding section delves into current challenges and outlines future directions for softening implantable device technologies, underscoring their pivotal role in propelling the evolution of next-generation bioelectronics.

Bias-Free Cardiac Monitoring Capsule

Cardiovascular disease (CVD) remains the leading cause of death worldwide. Patients often fail to recognize the early signs of CVDs, which display irregularities in cardiac contractility and may ultimately lead to heart failure. Therefore, continuously monitoring the abnormal changes in cardiac contractility may represent a novel approach to long-term CVD surveillance. Here, a zero-power consumption and implantable bias-free cardiac monitoring capsule (BCMC) is introduced based on the triboelectric effect for cardiac contractility monitoring in situ. The output performance of BCMC is improved over 10 times with nanoparticle self-adsorption method. This device can be implanted into the right ventricle of swine using catheter intervention to detect the change of cardiac contractility and the corresponding CVDs. The physiological signals can be wirelessly transmitted to a mobile terminal for analysis through the acquisition and transmission module. This work contributes to a new option for precise monitoring and early diagnosis of CVDs.

Self-Powered Water Splitting of Ni3FeN@Fe24N10 Bifunctional Catalyst Improved Catalytic Activity and Durability by Forming Fe24N10 on Catalyst Surface via the Kirkendall Effect

Highly efficient water splitting electrocatalyst for producing hydrogen as a renewable energy source offers potential to achieve net-zero. However, it has significant challenges in using transition metal electrocatalysts as alternatives to noble metals due to their low efficiency and durability, furthermore, the reliance on electricity generation for electrocatalysts from fossil fuels leads to unavoidable carbon emissions. Here, a highly efficient self-powered water splitting system integrated is designed with triboelectric nanogenerator (TENG) and Ni3FeN@Fe24N10 catalyst with improved catalytic activity and durability. First, the durability of the Ni3FeN catalyst is improved by forming N, P carbon shell using melamine, polyetherimide, and phytic acid. The catalyst activity is improved by generating Fe24N10 in the carbon shell through the Kirkendall effect. The synthesized Ni3FeN@Fe24N10 catalyst exhibited excellent bifunctional catalytic activity (ηOER = 261.8 mV and ηHER = 151.8 mV) and remarkable stability (91.7% in OER and 90.5% in HER) in 1 m KOH. Furthermore, to achieve ecofriendly electricity generation, a rotation-mode TENG that sustainably generate high-performance is realized using butylated melamine formaldehyde. As a result, H2 is successfully generated using the integrated system composed of the designed TENG and catalyst. The finding provides a promising approach for energy generation to achieve net-zero.

Beyond 25 years of biomedical innovation in nano-bioelectronics

Nano-bioelectronics, which blend the precision of nanotechnology with the complexity of biological systems, are evolving with innovations such as silicon nanowires, carbon nanotubes, and graphene. These elements serve applications from biochemical sensing to brain-machine interfacing. This review examines nano-bioelectronics' role in advancing biomedical interventions and discusses their potential in environmental monitoring, agricultural productivity, energy efficiency, and creative fields. The field is transitioning from molecular to ecosystem-level applications, with research exploring complex cellular mechanisms and communication. This fosters understanding of biological interactions at various levels, such as suggesting transformative approaches for ecosystem management and food security. Future research is expected to focus on refining nano-bioelectronic devices for integration with biological systems and on scalable manufacturing to broaden their reach and functionality.

Acoustically Enhanced Triboelectric Stethoscope for Ultrasensitive Cardiac Sounds Sensing and Disease Diagnosis

Electronic stethoscope used to detect cardiac sounds that contain essential clinical information is a primary tool for diagnosis of various cardiac disorders. However, the linear electromechanical constitutive relation makes conventional piezoelectric sensors rather ineffective to detect low-intensity, low-frequency heart acoustic signal without the assistance of complex filtering and amplification circuits. Herein, it is found that triboelectric sensor features superior advantages over piezoelectric one for microquantity sensing originated from the fast saturated constitutive characteristic. As a result, the triboelectric sensor shows ultrahigh sensitivity (1215 mV Pa-1) than the piezoelectric counterpart (21 mV Pa-1) in the sound pressure range of 50-80 dB under the same testing condition. By designing a trumpet-shaped auscultatory cavity with a power function cross-section to achieve acoustic energy converging and impedance matching, triboelectric stethoscope delivers 36 dB signal-to-noise ratio for human test (2.3 times of that for piezoelectric one). Further combining with machine learning, five cardiac states can be diagnosed at 97% accuracy. In general, the triboelectric sensor is distinctly unique in basic mechanism, provides a novel design concept for sensing micromechanical quantities, and presents significant potential for application in cardiac sounds sensing and disease diagnosis.

Recent Progress in Implantable Drug Delivery Systems

In recent years, tremendous effort is devoted to developing platforms, such as implantable drug delivery systems (IDDSs), with temporally and spatially controlled drug release capabilities and improved adherence. IDDSs have multiple advantages: i) the timing and location of drug delivery can be controlled by patients using specific stimuli (light, sound, electricity, magnetism, etc.). Some intelligent "closed-loop" IDDS can even realize self-management without human participation. ii) IDDSs enable continuous and stable delivery of drugs over a long period (months to years) and iii) to administer drugs directly to the lesion, thereby helping reduce dosage and side effects. iv) IDDSs enable personalized drug delivery according to patient needs. The high demand for such systems has prompted scientists to make efforts to develop intelligent IDDS. In this review, several common stimulus-responsive mechanisms including endogenous (e.g., pH, reactive oxygen species, proteins, etc.) and exogenous stimuli (e.g., light, sound, electricity, magnetism, etc.), are given in detail. Besides, several types of IDDS reported in recent years are reviewed, including various stimulus-responsive systems based on the above mechanisms, radio frequency-controlled IDDS, "closed-loop" IDDS, self-powered IDDS, etc. Finally, the advantages and disadvantages of various IDDS, bottleneck problems, and possible solutions are analyzed to provide directions for subsequent research.

E-cardiac patch to sense and repair infarcted myocardium

Conductive cardiac patches can rebuild the electroactive microenvironment for the infarcted myocardium but their repair effects benefit by carried seed cells or drugs. The key to success is the effective integration of electrical stimulation with the microenvironment created by conductive cardiac patches. Besides, due to the concerns in a high re-admission ratio of heart patients, a remote medicine device will underpin the successful repair. Herein, we report a miniature self-powered biomimetic trinity triboelectric nanogenerator with a unique double-spacer structure that unifies energy harvesting, therapeutics, and diagnosis in one cardiac patch. Trinity triboelectric nanogenerator conductive cardiac patches improve the electroactivity of the infarcted heart and can also wirelessly monitor electrocardiosignal to a mobile device for diagnosis. RNA sequencing analysis from rat hearts reveals that this trinity cardiac patches mainly regulates cardiac muscle contraction-, energy metabolism-, and vascular regulation-related mRNA expressions in vivo. The research is spawning a device that truly integrates an electrical stimulation of a functional heart patch and self-powered e-care remote diagnostic sensor.

Permanent fluidic magnets for liquid bioelectronics

Brownian motion allows microscopically dispersed nanoparticles to be stable in ferrofluids, as well as causes magnetization relaxation and prohibits permanent magnetism. Here we decoupled the particle Brownian motion from colloidal stability to achieve a permanent fluidic magnet with high magnetization, flowability and reconfigurability. The key to create such permanent fluidic magnets is to maintain a stable magnetic colloidal fluid by using non-Brownian magnetic particles to self-assemble a three-dimensional oriented and ramified magnetic network structure in the carrier fluid. This structure has high coercivity and permanent magnetization, with long-term magnetization stability. We establish a scaling theory model to decipher the permanent fluid magnet formation criteria and formulate a general assembly guideline. Further, we develop injectable and retrievable permanent-fluidic-magnet-based liquid bioelectronics for highly sensitive, self-powered wireless cardiovascular monitoring. Overall, our findings highlight the potential of permanent fluidic magnets as an ultrasoft material for liquid devices and systems, from bioelectronics to robotics.

Ultra-low frequency magnetic energy focusing for highly effective wireless powering of deep-tissue implantable electronic devices

The limited lifespan of batteries is a challenge in the application of implantable electronic devices. Existing wireless power technologies such as ultrasound, near-infrared light and magnetic fields cannot charge devices implanted in deep tissues, resulting in energy attenuation through tissues and thermal generation. Herein, an ultra-low frequency magnetic energy focusing (ULFMEF) methodology was developed for the highly effective wireless powering of deep-tissue implantable devices. A portable transmitter was used to output the low-frequency magnetic field (<50 Hz), which remotely drives the synchronous rotation of a magnetic core integrated within the pellet-like implantable device, generating an internal rotating magnetic field to induce wireless electricity on the coupled coils of the device. The ULFMEF can achieve energy transfer across thick tissues (up to 20 cm) with excellent transferred power (4-15 mW) and non-heat effects in tissues, which is remarkably superior to existing wireless powering technologies. The ULFMEF is demonstrated to wirelessly power implantable micro-LED devices for optogenetic neuromodulation, and wirelessly charged an implantable battery for programmable electrical stimulation on the sciatic nerve. It also bypassed thick and tough protective shells to power the implanted devices. The ULFMEF thus offers a highly advanced methodology for the generation of wireless powered biodevices.

Perovskite Nanocrystals Induced Core-Shell Inorganic-Organic Nanofibers for Efficient Energy Harvesting and Self-Powered Monitoring

The emerging field of wearable electronics requires power sources that are flexible, lightweight, high-capacity, durable, and comfortable for daily use, which enables extensive use in electronic skins, self-powered sensing, and physiological health monitoring. In this work, we developed the core-shell and biocompatible Cs2InCl5(H2O)@PVDF-HFP nanofibers (CIC@HFP NFs) by one-step electrospinning assisted self-assembly method for triboelectric nanogenerators (TENGs). By adopting lead-free Cs2InCl5(H2O) as an inducer, CIC@HFP NFs exhibited β-phase-enhanced and self-aligned nanocrystals within the uniaxial direction. The interface interaction was further investigated by experimental measurements and molecular dynamics, which revealed that the hydrogen bonds between Cs2InCl5(H2O) and PVDF-HFP induced automatically well-aligned dipoles and stabilized the β-phase in the CIC@HFP NFs. The TENG fabricated using CIC@HFP NFs and nylon-6,6 NFs exhibited significant improvement in output voltage (681 V), output current (53.1 μA) and peak power density (6.94 W m-2), with the highest reported output performance among TENGs based on halide-perovskites. The energy harvesting and self-powered monitoring performance were further substantiated by human motions, showcasing its ability to charge capacitors and effectively operate electronics such as commercial LEDs, stopwatches, and calculators, demonstrating its promising application in biomechanical energy harvesting and self-powered sensing.

Biomechanical MEMS Electrostatic Energy Harvester for Pacemaker Application: A Study of Optimal Interface Circuit

The leadless pacemaker is the most recent pacemaker concept, developed to overcome conventional pacemakers' limitations. This technology offers better comfort to the patients, lower risk from implantation, and higher reliability. However, these devices suffer from limited battery lifetime due to the extreme miniaturization required for implantation inside the heart cavities. This work proposes extending the battery lifetime by converting biomechanical heartbeat energy into electricity using an innovative electrostatic MEMS energy harvesting device. Based on theoretical models and experiments, we propose a general approach to choosing the optimal interface circuit which considers the parasitic capacitance of the circuit, as it is an imperfection that significantly affects the power performance. According to the energy consumed by the last generation commercial leadless pacemakers, the proposed MEMS solution with optimal interface circuit experimentally showed the possibility of extending the pacemaker battery lifetime by up to 44%.

Triboelectric Nanogenerators for Preventive Health Monitoring

With the improvement in life quality, the increased focus on health has expedited the rapid development of portable preventative-health-monitoring devices. As one of the most attractive sensing technologies, triboelectric nanogenerators (TENGs) are playing a more and more important role in wearable electronics, machinery condition monitoring, and Internet of Things (IoT) sensors. TENGs possess many advantages, such as ease of fabrication, cost-effectiveness, flexibility, material-selection variety, and the ability to collect low-frequency motion, offering a novel way to achieve health monitoring for human beings in various aspects. In this short review, we initially present the working modes of TENGs based on their applications in health monitoring. Subsequently, the applications of TENG-based preventive health monitoring are demonstrated for different abnormal conditions of human beings, including fall-down detection, respiration monitoring, fatigue monitoring, and arterial pulse monitoring for cardiovascular disease. Finally, the discussion summarizes the current limitations and future perspectives. This short review encapsulates the latest and most influential works on preventive health monitoring utilizing the triboelectric effect for human beings and provides hints and evidence for future research trends.

NaxSb Alloy-Based Low-Frequency Mechanical Energy Harvesters for Virtual Taste Sensations

Batteries can be activated by external mechanical force and generate current, enabling a smart class of electrochemical-mechanical strain energy harvesters therefrom. Here, we have developed a NaxSb alloy-based harvester that is able to electrochemically convert low-frequency bending or pressing mechanical energy into electrical energy. The device is designed as a flexible symmetric cell incorporating two sodiated antimony nanoflake electrodes, whose peak power and energy output are more than twice those of other sodium-alloyed electrochemical-mechanical strain energy harvesters reported. We demonstrate that the open-circuit voltage of the device is an asymptotic function of the curvature radius in the bending mode and a linear function of pressure in the pressing mode. Taking advantage of the tunability of voltage, we present a new technology that simulates various tastes by releasing low-voltage electrical signals from the harvester. This technology can not only help people with impaired taste but also be integrated into a virtual reality system to create immersive taste experiences.

A Review of Recent Advances in Human-Motion Energy Harvesting Nanogenerators, Self-Powering Smart Sensors and Self-Charging Electronics

In recent years, portable and wearable personal electronic devices have rapidly developed with increasing mass production and rising energy consumption, creating an energy crisis. Using batteries and supercapacitors with limited lifespans and environmental hazards drives the need to find new, environmentally friendly, and renewable sources. One idea is to harness the energy of human motion and convert it into electrical energy using energy harvesting devices-piezoelectric nanogenerators (PENGs), triboelectric nanogenerators (TENGs) and hybrids. They are characterized by a wide variety of features, such as lightness, flexibility, low cost, richness of materials, and many more. These devices offer the opportunity to use new technologies such as IoT, AI or HMI and create smart self-powered sensors, actuators, and self-powered implantable/wearable devices. This review focuses on recent examples of PENGs, TENGs and hybrid devices for wearable and implantable self-powered systems. The basic mechanisms of operation, micro/nano-scale material selection and manufacturing processes of selected examples are discussed. Current challenges and the outlook for the future of the nanogenerators are also discussed.

Self-Powered and Self-Healable Extraocular-Muscle-Like Actuator Based on Dielectric Elastomer Actuator and Triboelectric Nanogenerator

Although dielectric elastomer actuators (DEAs) are promising artificial muscles for use as visual prostheses in patients with oculomotor nerve palsy (ONP), high driving voltage coupled with vulnerable compliant electrodes limits their safe long-term service. Herein, a self-healable polydimethylsiloxane compliant electrode based on reversible imine bonds and hydrogen bonds is prepared and coated on an acrylic ester film to develop a self-healable DEA (SDEA), followed by actuation with a high-output triboelectric nanogenerator (TENG) to construct a self-powered DEA (TENG-SDEA). Under 135.9 kV mm-1 , the SDEA exhibits an elevated actuated strain of 50.6%, comparable to the actuation under DC power. Moreover, the mechanically damaged TENG-SDEA displays a self-healing efficiency of over 90% for 10 cycles. The TENG ensures the safe using of TENG-SDEAs and an extraocular-muscle-like actuator with oriented motion ability integrated by several TENG-SDEAs is constructed. Additionally, the SDEA is directly used as a flexible capacitive sensor for real-time monitoring of the patient's muscle movement. Accordingly, a medical aid system based on a conjunction of the extraocular-muscle-like actuator and a flexible capacitive sensor is manufactured to help the patients suffering from ONP with physical rehabilitation and treatment.

A self-powered intracardiac pacemaker in swine model

Harvesting biomechanical energy from cardiac motion is an attractive power source for implantable bioelectronic devices. Here, we report a battery-free, transcatheter, self-powered intracardiac pacemaker based on the coupled effect of triboelectrification and electrostatic induction for the treatment of arrhythmia in large animal models. We show that the capsule-shaped device (1.75 g, 1.52 cc) can be integrated with a delivery catheter for implanting in the right ventricle of a swine through the intravenous route, which effectively converts cardiac motion energy to electricity and maintains endocardial pacing function during the three-week follow-up period. We measure in vivo open circuit voltage and short circuit current of the self-powered intracardiac pacemaker of about 6.0 V and 0.2 μA, respectively. This approach exhibits up-to-date progress in self-powered medical devices and it may overcome the inherent energy shortcomings of implantable pacemakers and other bioelectronic devices for therapy and sensing.

High-Performing and Capacitive-Matched Triboelectric Implants Driven by Ultrasound

In implantable bioelectronics, which aim for semipermanent use of devices, biosafe energy sources and packaging materials to protect devices are essential elements. However, research so far has been conducted in a direction where they cannot coexist. Here, the development of capacitance-matched triboelectric implants driven is reported by ultrasound under 500 mW cm-2 safe intensity and realize a battery-free, miniatured, and wireless neurostimulator with full titanium (Ti) packaging. The triboelectric implant with high dielectric composite, which has ultralow output impedance, can efficiently deliver sufficient power to generate the stimulation pulse without an energy-storing battery, despite ultrasound attenuation due to the Ti, and has the highest energy transmission efficiency among those reported so far. In vivo study using a rat model demonstrated that the proposed device system is an effective solution for relieving urinary symptoms. These achievements provide a significant step toward permanently implantable devices for controlling human organs and treating various diseases.

Survey on Energy Harvesting for Biomedical Devices: Applications, Challenges and Future Prospects for African Countries

Self-powered biomedical devices, which are the new vision of Internet Of Things (IOT) healthcare, are facing many technical and application challenges. Many research works have reported biomedical devices and self-powered applications for healthcare, along with various strategies to improve the monitoring time of self-powered devices or to eliminate the dependence on electrochemical batteries. However, none of these works have especially assessed the development and application of healthcare devices in an African context. This article provides a comprehensive review of self-powered devices in the biomedical research field, introduces their applications for healthcare, evaluates their status in Africa by providing a thorough review of existing biomedical device initiatives and available financial and scientific cooperation institutions in Africa for the biomedical research field, and highlights general challenges for implementing self-powered biomedical devices and particular challenges related to developing countries. The future perspectives of the aforementioned research field are provided, as well as an architecture for improving this research field in developing countries.

The Micra Transcatheter Pacing System: past, present and the future

Leadless permanent pacemakers represent an important innovation in cardiac device developments. Although transvenous permanent pacemakers have become indispensable in managing bradyarrhythmia and saving numerous lives, the use of transvenous systems comes with notable risks tied to intravascular leads and subcutaneous pockets. This drawback has spurred the creation of leadless cardiac pacemakers. Within this analysis, we compile existing clinical literature and proceed to evaluate the efficacy and safety of the Micra Transcatheter Pacing System. We also delve into the protocols for addressing a malfunctioning or end-of-life Micra as well as device extraction. Lastly, we explore prospects in this domain, such as the emergence of entirely leadless cardiac resynchronization therapy-defibrillator devices.

Implantable Triboelectric Nanogenerators for Self-Powered Cardiovascular Healthcare

Triboelectric nanogenerators (TENGs) have gained significant traction in recent years in the bioengineering community. With the potential for expansive applications for biomedical use, many individuals and research groups have furthered their studies on the topic, in order to gain an understanding of how TENGs can contribute to healthcare. More specifically, there have been a number of recent studies focusing on implantable triboelectric nanogenerators (I-TENGs) toward self-powered cardiac systems healthcare. In this review, the progression of implantable TENGs for self-powered cardiovascular healthcare, including self-powered cardiac monitoring devices, self-powered therapeutic devices, and power sources for cardiac pacemakers, will be systematically reviewed. Long-term expectations of these implantable TENG devices through their biocompatibility and other utilization strategies will also be discussed.

Contact efficiency optimization for tribovoltaic nanogenerators

Energy harvesters based on the tribovoltaic effect that can convert mechanical energy into electricity offer a potential solution for the energy supply of decentralized sensors. However, a substantial disparity in output current, exceeding 106 times, exists between micro- and macro-contact tribovoltaic nanogenerators (TVNGs). To tackle this challenge, we develop a quantification method to determine the effective contact efficiency of conventional large-scale TVNGs, revealing a mere 0.038% for a TVNG of 1 cm2. Thus, we implement an optimization strategy by contact interface design resulting in a remarkable 65-fold increase in effective contact efficiency, reaching 2.45%. This enhancement leads to a current density of 23 A m-2 and a record-high charge density of 660 mC m-2 for the TVNG based on Cu and p-type silicon. Our study reveals that increasing the effective contact efficiency will not only address the existing disparities but also have the potential to significantly enhance the output current in future advancements of large-scale TVNGs.

Miniature battery-free bioelectronics

Miniature wireless bioelectronic implants that can operate for extended periods of time can transform how we treat disorders by acting rapidly on precise nerves and organs in a way that drugs cannot. To reach this goal, materials and methods are needed to wirelessly transfer energy through the body or harvest energy from the body itself. We review some of the capabilities of emerging energy transfer methods to identify the performance envelope for existing technology and discover where opportunities lie to improve how much-and how efficiently-we can deliver energy to the tiny bioelectronic implants that can support emerging medical technologies.

A Review of Contact Electrification at Diversified Interfaces and Related Applications on Triboelectric Nanogenerator

The triboelectric nanogenerator (TENG) can effectively collect energy based on contact electrification (CE) at diverse interfaces, including solid-solid, liquid-solid, liquid-liquid, gas-solid, and gas-liquid. This enables energy harvesting from sources such as water, wind, and sound. In this review, we provide an overview of the coexistence of electron and ion transfer in the CE process. We elucidate the diverse dominant mechanisms observed at different interfaces and emphasize the interconnectedness and complementary nature of interface studies. The review also offers a comprehensive summary of the factors influencing charge transfer and the advancements in interfacial modification techniques. Additionally, we highlight the wide range of applications stemming from the distinctive characteristics of charge transfer at various interfaces. Finally, this review elucidates the future opportunities and challenges that interface CE may encounter. We anticipate that this review can offer valuable insights for future research on interface CE and facilitate the continued development and industrialization of TENG.

A self-assembled implantable microtubular pacemaker for wireless cardiac electrotherapy

The current cardiac pacemakers are battery dependent, and the pacing leads are prone to introduce valve damage and infection, plus a complete pacemaker retrieval is needed for battery replacement. Despite the reported wireless bioelectronics to pace the epicardium, open-chest surgery (thoracotomy) is required to implant the device, and the procedure is invasive, requiring prolonged wound healing and health care burden. We hereby demonstrate a fully biocompatible wireless microelectronics with a self-assembled design that can be rolled into a lightweight microtubular pacemaker for intravascular implantation and pacing. The radio frequency was used to transfer energy to the microtubular pacemaker for electrical stimulation. We show that this pacemaker provides effective pacing to restore cardiac contraction from a nonbeating heart and have the capacity to perform overdrive pacing to augment blood circulation in an anesthetized pig model. Thus, this microtubular pacemaker paves the way for the minimally invasive implantation of leadless and battery-free microelectronics.