Here, we report advanced materials and devices that enable highefficiency mechanical-to-electrical energy conversion from the natural contractile and relaxation motions of the heart, lung, and diaphragm, demonstrated in several different animal models, each of which has organs with sizes that approach human scales. A cointegrated collection of such energy-harvesting elements with rectifiers and microbatteries provides an entire flexible system, capable of viable integration with the beating heart via medical sutures and operation with efficiencies of ∼2%. Additional experiments, computational models, and results in multilayer configurations capture the key behaviors, illuminate essential design aspects, and offer sufficient power outputs for operation of pacemakers, with or without battery assist.biomedical implants | flexible electronics | transfer printing | wearable electronics | heterogeneous integration N early all classes of active wearable and implantable biomedical devices rely on some form of battery power for operation. Heart rate monitors, pacemakers, implantable cardioverterdefibrillators, and neural stimulators together represent a broad subset of bioelectronic devices that provide continuous diagnostics and therapy in this mode. Although advances in battery technology have led to substantial reductions in overall sizes and increases in storage capacities, operational lifetimes remain limited, rarely exceeding a few days for wearable devices and a few years for implants. Surgical procedures to replace the depleted batteries of implantable devices are thus essential, exposing patients to health risks, heightened morbidity, and even potential mortality. The health burden and costs are substantial, and thus motivate efforts to eliminate batteries altogether, or to extend their lifetimes in a significant way.Investigations into energy-harvesting strategies to replace batteries demonstrate several unusual ways to extract power from chemical, mechanical, electrical, and thermal processes in the human body (1, 2). Examples include use of glucose oxidation (3), electric potentials of the inner ear (4), mechanical movements of limbs, and natural vibrations of internal organs (5-7). Such phenomena provide promising opportunities for power supply to wearable and implantable devices (6-8). A recent example involves a hybrid kinetic device integrated with the heart for applications with pacemakers (7). More speculative approaches, based on analytical models of harvesting from pressure-driven deformations of an artery by magneto-hydrodynamics, also exist (9).Cardiac and lung motions, in particular, serve as inexhaustible sources of energy during the lifespan of a patient. Mechanicalto-electrical transduction mechanisms in piezoelectric materials offer viable routes to energy harvesting in such cases, as demonstrated and analyzed by several groups recently (10-17). For example, proposals exist for devices that convert heartbeat vibrations into electrical energy using resonantly coupled motions of thick (1-2 mm) pi...

Thin, soft, and elastic electronics with physical properties well matched to the epidermis can be conformally and robustly integrated with the skin. Materials and optimized designs for such devices are presented for surface electromyography (sEMG). The findings enable sEMG from wide ranging areas of the body. The measurements have quality sufficient for advanced forms of human-machine interface.

The ability to measure subtle changes in arterial pressure using devices mounted on the skin can be valuable for monitoring vital signs in emergency care, detecting the early onset of cardiovascular disease and continuously assessing health status. Conventional technologies are well suited for use in traditional clinical settings, but cannot be easily adapted for sustained use during daily activities. Here we introduce a conformal device that avoids these limitations. Ultrathin inorganic piezoelectric and semiconductor materials on elastomer substrates enable amplified, low hysteresis measurements of pressure on the skin, with high levels of sensitivity (B0.005 Pa) and fast response times (B0.1 ms). Experimental and theoretical studies reveal enhanced piezoelectric responses in lead zirconate titanate that follow from integration on soft supports as well as engineering behaviours of the associated devices. Calibrated measurements of pressure variations of blood flow in near-surface arteries demonstrate capabilities for measuring radial artery augmentation index and pulse pressure velocity.