A self-powered biomimetic triptych triboelectric nanogenerator (TRI-TENG) cardiac patch is introduced, which integrates energy harvesting, therapeutic and diagnostic functions in one device. This patch, composed of a polydopamine (PDA)-modified reduced graphene oxide (rGO) membrane and a polyvinylidene fluoride (PVDF) triboelectric layer with leaf vein structure, enhances electroactivity of the infarcted heart and wirelessly monitors electrocardiovascular activity. RNA sequencing analysis shows that the patch regulates cardiac muscle contraction, energy metabolism, and vascular regulation-related mRNA expressions. The patch's unique double-spacer design allows it to function as a therapeutic electrode, energy generator, and real-time electrocardio monitoring device. The patch improves cardiac function in minipig myocardial infarction (MI) models by enhancing electroactivity and restoring cardiac function. The patch's performance was evaluated in vitro and in vivo, showing high sensitivity to mechanical stimuli and stable output voltage. The patch was transplanted in minipigs and successfully monitored ECG signals, demonstrating its potential for real-time cardiac monitoring. The patch also improved the maturation and synchronization of cardiac muscle cells (CMs), as evidenced by increased sarcomeric α-actinin and connexin 43 (CX43) expression. The patch enhanced the electroactivity of the infarcted heart in rat MI models, improving contractility and restoring electrophysiological function. The patch showed significant improvements in cardiac function compared to other treatments, with increased LV wall thickness and reduced fibrosis in the infarct region. The patch's performance was further validated in porcine MI models, demonstrating its potential for cardiac repair and monitoring. The patch's unique design and multifunctional capabilities make it a promising candidate for future cardiac therapies.A self-powered biomimetic triptych triboelectric nanogenerator (TRI-TENG) cardiac patch is introduced, which integrates energy harvesting, therapeutic and diagnostic functions in one device. This patch, composed of a polydopamine (PDA)-modified reduced graphene oxide (rGO) membrane and a polyvinylidene fluoride (PVDF) triboelectric layer with leaf vein structure, enhances electroactivity of the infarcted heart and wirelessly monitors electrocardiovascular activity. RNA sequencing analysis shows that the patch regulates cardiac muscle contraction, energy metabolism, and vascular regulation-related mRNA expressions. The patch's unique double-spacer design allows it to function as a therapeutic electrode, energy generator, and real-time electrocardio monitoring device. The patch improves cardiac function in minipig myocardial infarction (MI) models by enhancing electroactivity and restoring cardiac function. The patch's performance was evaluated in vitro and in vivo, showing high sensitivity to mechanical stimuli and stable output voltage. The patch was transplanted in minipigs and successfully monitored ECG signals, demonstrating its potential for real-time cardiac monitoring. The patch also improved the maturation and synchronization of cardiac muscle cells (CMs), as evidenced by increased sarcomeric α-actinin and connexin 43 (CX43) expression. The patch enhanced the electroactivity of the infarcted heart in rat MI models, improving contractility and restoring electrophysiological function. The patch showed significant improvements in cardiac function compared to other treatments, with increased LV wall thickness and reduced fibrosis in the infarct region. The patch's performance was further validated in porcine MI models, demonstrating its potential for cardiac repair and monitoring. The patch's unique design and multifunctional capabilities make it a promising candidate for future cardiac therapies.