Optimisation and material considerations of piezoelectric implants for cardiac applications

Abstract

The capacity of piezoelectric materials for mechanoelectrical transduction has led to a variety of piezoelectric cardiac implants that could revolutionise cardiac-related healthcare delivery. To advance their clinical translation, critical factors including energy output, biocompatibility, biodegradability/durability, and flexibility need to be collectively assessed to ensure successful medical implantation. This review aims to systematically discuss these critical factors, providing insights into corresponding progress and covering relevant mechanisms and strategies in a clinical setting. The concept of additive-free output optimisation has been proposed which focuses on enhancing piezoelectric output based on existing material systems so that biosafety risks and the time-consuming examination processes induced by introducing additional components can be minimised. Critical discussions regarding the biocompatibility and biodegradability of piezoelectric implants were subsequently conducted. This involved reviewing the biocompatibility of material systems associated with piezoelectric implants and introducing biodegradability mechanisms and potential manipulation strategies. The flexibility of implants was also discussed in conjunction with fabrication methods. Current novel piezoelectric cardiac treatments were summarised covering in vivo energy harvesting, hemodynamic sensing, and cardiac tissue regeneration and stimulation. Lastly, challenges and future perspectives were proposed to inspire future work focused on the translation of reliable piezoelectric implants for addressing cardiac diseases.