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.

Implantable medical devices provide an effective therapeutic approach for neurological and cardiovascular diseases. With the development of transient electronics, a new power source with biocompatibility, controllability, and bioabsorbability becomes an urgent demand for medical sciences. Here, various fully bioabsorbable natural-materials-based triboelectric nanogenerators (BN-TENGs), in vivo, are developed. The "triboelectric series" of five natural materials is first ranked, it provides a basic knowledge for materials selection and device design of the TENGs and other energy harvesters. Various triboelectric outputs of these natural materials are achieved by a single material and their pairwise combinations. The maximum voltage, current, and power density reach up to 55 V, 0.6 µA, and 21.6 mW m , respectively. The modification of silk fibroin encapsulation film makes the operation time of the BN-TENG tunable from days to weeks. After completing its function, the BN-TENG can be fully degraded and resorbed in Sprague-Dawley rats, which avoids a second operation and other side effects. Using the proposed BN-TENG as a voltage source, the beating rates of dysfunctional cardiomyocyte clusters are accelerated and the consistency of cell contraction is improved. This provides a new and valid solution to treat some heart diseases such as bradycardia and arrhythmia.