Self-powered implantable medical electronic devices that harvest biomechanical energy from cardiac motion, respiratory movement and blood flow are part of a paradigm shift that is on the horizon. Here, we demonstrate a fully implanted symbiotic pacemaker based on an implantable triboelectric nanogenerator, which achieves energy harvesting and storage as well as cardiac pacing on a large-animal scale. The symbiotic pacemaker successfully corrects sinus arrhythmia and prevents deterioration. The open circuit voltage of an implantable triboelectric nanogenerator reaches up to 65.2 V. The energy harvested from each cardiac motion cycle is 0.495 μJ, which is higher than the required endocardial pacing threshold energy (0.377 μJ). Implantable triboelectric nanogenerators for implantable medical devices offer advantages of excellent output performance, high power density, and good durability, and are expected to find application in fields of treatment and diagnosis as in vivo symbiotic bioelectronics.

Mechanical energy in vivo could be harvested by BD-TENG in a designed time frame.

Soft wearable electronics for underwater applications are of interest, but depend on the development of a waterproof, long-term sustainable power source. In this work, we report a bionic stretchable nanogenerator for underwater energy harvesting that mimics the structure of ion channels on the cytomembrane of electrocyte in an electric eel. Combining the effects of triboelectrification caused by flowing liquid and principles of electrostatic induction, the bionic stretchable nanogenerator can harvest mechanical energy from human motion underwater and output an open-circuit voltage over 10 V. Underwater applications of a bionic stretchable nanogenerator have also been demonstrated, such as human body multi-position motion monitoring and an undersea rescue system. The advantages of excellent flexibility, stretchability, outstanding tensile fatigue resistance (over 50,000 times) and underwater performance make the bionic stretchable nanogenerator a promising sustainable power source for the soft wearable electronics used underwater.

Implantable medical devices (IMDs) have become indispensable medical tools for improving the quality of life and prolonging the patient's lifespan. The minimization and extension of lifetime are main challenges for the development of IMDs. Current innovative research on this topic is focused on internal charging using the energy generated by the physiological environment or natural body activity. To harvest biomechanical energy efficiently, piezoelectric and triboelectric energy harvesters with sophisticated structural and material design have been developed. Energy from body movement, muscle contraction/relaxation, cardiac/lung motions, and blood circulation is captured and used for powering medical devices. Other recent progress in this field includes using PENGs and TENGs for our cognition of the biological processes by biological pressure/strain sensing, or direct intervention of them for some special self‐powered treatments. Future opportunities lie in the fabrication of intelligent, flexible, stretchable, and/or fully biodegradable self‐powered medical systems for monitoring biological signals and treatment of various diseases in vitro and in vivo.