The implantable cardioverter-defibrillator (ICD) is an effective method to prevent sudden cardiac death in high-risk patients. However, the transvenous lead is incompatible with large-area electrophysiological mapping and cannot accommodate selective multichannel precision stimulations. Moreover, it involves high-energy shocks, resulting in pain, myocardial damage, and recurrences of ventricular tachyarrhythmia (VTA). We present a method for VTA treatment based on subthreshold electrical stimulations using a stretchable epicardial multichannel electrode array, which does not disturb the normal contraction or electrical propagation of the ventricle. In rabbit models with myocardial infarction, the infarction was detected by mapping intracardiac electrograms with the stretchable epicardial multichannel electrode array. Then, VTAs could be terminated by sequential electrical stimuli from the epicardial multichannel electrode array beginning with low-energy subthreshold stimulations. Last, we used these subthreshold stimulations to prevent the occurrence of additional VTAs. The proposed protocol using the stretchable epicardial multichannel electrode array provides opportunities toward the development of innovative methods for painless ICD therapy.

Interfaces between implantable bioelectrodes and tissues provide critical insights into the biological and pathological conditions of targeted organs, aiding diagnosis and treatment. While conventional bioelectronics, made from rigid materials like metals and silicon, have been essential for recording signals and delivering electric stimulation, they face limitations due to the mechanical mismatch between rigid devices and soft tissues. Recently, focus has shifted toward soft conductive materials, such as conductive hydrogels and hydrogel nanocomposites, known for their tissue-like softness, biocompatibility, and potential for functionalization. This review introduces these materials and provides an overview of recent advances in soft hydrogel nanocomposites for implantable electronics. It covers material strategies for conductive hydrogels, including both intrinsically conductive hydrogels and hydrogel nanocomposites, and explores key functionalization techniques like biodegradation, bioadhesiveness, injectability, and self-healing. Practical applications of these materials in implantable electronics are also highlighted, showcasing their effectiveness in real-world scenarios. Finally, we discuss emerging technologies and future needs for chronically implantable bioelectronics, offering insights into the evolving landscape of this field.

Stretchable metallic nanocomposites are viable material candidates for high‐performance soft biointerfacing electrodes. However, it is still challenging to fabricate a stretchable metallic nanocomposite that features outstanding charge transfer capability and low impedance as well as high conductivity and mechanical stability. Herein, a material strategy for a stretchable conductor that meets such requirements by integrating stretchable conductive nanocomposites with stretchable conductive nanomembranes (NMs) is presented. The silver nanowire (Ag NW) NM fabricated by the float assembly method is integrated with the Ag NW nanocomposite prepared by the drop‐casting method. The compactly assembled NWs in the NM maximize conductivity by reinforcing the percolation networks of the nanocomposite. Moreover, the NM lowers impedance by allowing efficient charge transfer to the target tissue through the exposed NWs. After their integration, a high conductivity of ≈35 700 S cm⁻¹ is obtained, and the impedance is decreased by ≈88.9% (at 1000 Hz) in comparison with the original Ag NW‐based nanocomposite (i.e., without integration of the NM). The soft bioelectrode using the stretchable conductor successfully records electrograms from the rat heart, recognizes various arrhythmic events, and applies feedback pacing.

Soft implantable multichannel cardiac electrode arrays that establish direct monolithic interfaces with the heart are key components for advanced cardiac monitoring and electrical modulation. A significant technological advancement in this area is the development of stretchable conductive nanocomposites, fabricated through the integration of metallic nanomaterials and elastic polymers, aimed at achieving both high electrical conductivity and mechanical elasticity. Despite these advances, further progress in material performance and device designs is required to ensure seamless, reliable, biocompatible, and high‐fidelity cardiac interfacing. Herein, the development of a soft multichannel cardiac patch based on a bifacial architecture of adhesive/low‐impedance hydrogel nanocomposites and highly conductive elastomer nanocomposites is reported. The bifacial design facilitates the integration of the cardiac patch between the heart and other tissues/organs can be achieved. The hydrogel nanocomposite layer, positioned on the epicardial side, provides stable adhesion to the target cardiac tissue and enables low‐impedance biocompatible interfacing with the heart, while the elastomer nanocomposite layer, positioned on the opposite side, offers high electrical conductivity for facile electrophysiological signal transfer and a low‐friction surface minimizing unwanted interactions with surrounding tissues. The effectiveness of this bifacial patch in multiple applications involving various cardiac signal recordings and electromechanical modulation demonstrations is showcased.