Neurocardiac organ - on - a - chip: a convergence of microfluidics, electrophysiology, and the heart – brain axis

The neurocardiac axis represents a critical intersection of cardiac and neural physiology, orchestrating bidirectional communication that governs heart – brain function. Advances in microfluidic organ - on - chip (OoC) technologies have enabled the creation of n eurocardiac platforms capable of mimicking this complex interface with unprecedented precision. By integrating dual - chamber microfluidics, conductive hydrogels, bioelectronic electrodes, and real - time electrophysiological readouts, these systems allow simu ltaneous interrogation of neuronal and cardiomyocyte activity, bridging cellular dynamics with tissue - level responses. When coupled with artificial intelligence and multi - omics analyses, neurocardiac organ - on - chip models provide predictive, patient - specifi c insights for disease modeling, pharmacological screening, and personalized therapeutics. This review highlights the evolution of neurocardiac OoC platforms, their engineering strategies, functional validation, and translational applications, emphasizing their potential to transform our understanding of heart – brain interactions and accelerate the development of precision cardiovascular medicine .