Abstract The inherent complexities of excitable cardiac, nervous, and skeletal muscle tissues pose great challenges in constructing artificial counterparts with bioelectrical, structural, and mechanical properties that closely resemble their natural states. Recent advances have increasingly revealed the beneficial impact of bioelectrical microenvironments on cellular behaviors, functional tissue regeneration, and improved therapeutic outcomes for these excitable tissues. This review aims to unveil the mechanisms by which electrical microenvironments enhance the regeneration and functionality of excitable cells and tissues, considering both endogenous electrical cues from electroactive biomaterials and exogenous electrical stimuli from external electronic systems. We explore the synergistic effects of these electrical microenvironments, combined with structural and mechanical guidance, on the regeneration of excitable tissues using tissue engineering scaffolds. Additionally, the emergence of micro/nanoscale bioelectronics has significantly expanded the scope of this field, enabling intimate interactions between implantable bioelectronics and excitable tissues at the cellular, tissue, and organ levels. These interactions allow for precise data extraction and localized modulation of cell and tissue functionalities through intricately designed electronic components according to physiological needs. The integration of tissue engineering and bioelectronics holds the potential to achieve optimal outcomes, highlighting a growing trend in engineering living tissue construct-bioelectronic hybrids for restoring and monitoring damaged excitable tissues. Furthermore, we envision critical challenges in engineering the next generation of these hybrids, focusing on integrated fabrication strategies, the development of ionic conductive biomaterials, and their convergence with biosensors.
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