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.