Recent Achievements of Epicardial Patch Electronics Using Adhesive and Conductive Hydrogels.

Implantable cardiac devices are critical in improving patients' quality of life through precise and continuous interaction between the device and pathological cardiac tissue. Due to the inherently rigid nature of conventional devices, several complications arise when interacting with soft cardiac tissue, caused by a mechanical mismatch between the device and myocardium. This leads to the excessive formation of fibrous tissue around the implanted device, ultimately compromising both device functionality and tissue health. To address these challenges, flexible electronics based on polymers and elastomers significantly softer than conventional rigid metals and silicon have been explored. The epicardial approach enables the device to conform to the curved myocardial surface and deform synchronously with cardiac motion, thereby improving mechanical compatibility. However, modulus mismatches between soft polymers and cardiac tissue can still lead to mechanical instability and non-uniform adhesion, potentially affecting long-term performance. This review comprehensively summarizes recent research advancements in epicardial patch electronics based on bioadhesive and conductive hydrogels. We emphasize current research directions, highlighting the potential of hydrogels in epicardial electronics applications. Critical discussion includes recent trends, ongoing challenges, and emerging strategies aimed at improving the properties of hydrogel-based epicardial patches. Future research directions to facilitate clinical translation are also outlined.