Superaligned Carbon Nanotubes Guide Oriented Cell Growth and Promote Electrophysiological Homogeneity for Synthetic Cardiac Tissues

Cardiac engineering of patches and tissues is a promising option to restore infarcted hearts, by seeding cardiac cells onto scaffolds and nurturing their growth in vitro. However, current patches fail to fully imitate the hierarchically aligned structure in the natural myocardium, the fast electrotonic propagation, and the subsequent synchronized contractions. Here, superaligned carbon-nanotube sheets (SA-CNTs) are explored to culture cardiomyocytes, mimicking the aligned structure and electrical-impulse transmission behavior of the natural myocardium. The SA-CNTs not only induce an elongated and aligned cell morphology of cultured cardiomyocytes, but also provide efficient extracellular signal-transmission pathways required for regular and synchronous cell contractions. Furthermore, the SA-CNTs can reduce the beat-to-beat and cell-to-cell dispersion in repolarization of cultured cells, which is essential for a normal beating rhythm, and potentially reduce the occurrence of arrhythmias. Finally, SA-CNT-based flexible one-piece electrodes demonstrate a multipoint pacing function. These combined high properties make SA-CNTs promising in applications in cardiac resynchronization therapy in patients with heart failure and following myocardial infarctions.