Operation time of implantable electronic devices is largely constrained by the lifetime of batteries, which have to be replaced periodically by surgical procedures once exhausted, causing physical and mental suffering to patients and increasing healthcare costs. Besides the efficient scavenging of the mechanical energy of internal organs, this study proposes a self-powered, flexible, and one-stop implantable triboelectric active sensor (iTEAS) that can provide continuous monitoring of multiple physiological and pathological signs. As demonstrated in human-scale animals, the device can monitor heart rates, reaching an accuracy of ∼99%. Cardiac arrhythmias such as atrial fibrillation and ventricular premature contraction can be detected in real-time. Furthermore, a novel method of monitoring respiratory rates and phases is established by analyzing variations of the output peaks of the iTEAS. Blood pressure can be independently estimated and the velocity of blood flow calculated with the aid of a separate ar...

Self-Powered, One-Stop, and Multifunctional Implantable Triboelectric Active Sensor for Real-Time Biomedical Monitoring

From the first pacemaker implant in 1958, numerous engineering and medical activities for implantable medical device development have faced challenges in materials, battery power, functionality, electrical power consumption, size shrinkage, system delivery, and wireless communication. With explosive advances in scientific and engineering technology, many implantable medical devices such as the pacemaker, cochlear implant, and real-time blood pressure sensors have been developed and improved. This trend of progress in medical devices will continue because of the coming super-aged society, which will result in more consumers for the devices. The inner body is a special space filled with electrical, chemical, mechanical, and marine-salted reactions. Therefore, electrical connectivity and communication, corrosion, robustness, and hermeticity are key factors to be considered during the development stage. The main participants in the development stage are the user, the medical staff, and the engineer or technician. Thus, there are three different viewpoints in the development of implantable devices. In this review paper, considerations in the development of implantable medical devices will be presented from the viewpoint of an engineering mind.

/pdf/development-of-implantable-medical-devices-from-an-1ubw5n62jm.pdf

Development of Implantable Medical Devices: From an Engineering Perspective

Several conditions and diseases are linked to the elevation or depression of internal pressures from a healthy, normal range, motivating the need for chronic implantable pressure sensors. A simple implantable pressure transduction system consists of a pressure-sensing element with a method to transmit the data to an external unit. The biological environment presents a host of engineering issues that must be considered for long term monitoring. Therefore, the design of such systems must carefully consider interactions between the implanted system and the body, including biocompatibility, surgical placement, and patient comfort. Here we review research developments on implantable sensors for chronic pressure monitoring within the body, focusing on general design requirements for implantable pressure sensors as well as specifications for different medical applications. We also discuss recent efforts to address biocompatibility, efficient telemetry, and drift management, and explore emerging trends.

https://www.mdpi.com/1424-8220/14/11/20620/pdf

Chronically implanted pressure sensors: challenges and state of the field.

This letter describes the design, fabrication, and testing of a wireless bladder-pressure-sensing system for chronic, point-of-care applications, such as urodynamics or closed-loop neuromodulation. The system consists of a miniature implantable device and an external RF receiver and wireless battery charger. The implant is small enough to be cystoscopically implanted within the bladder wall, where it is securely held and shielded from the urine stream. The implant consists of a custom application-specific integrated circuit (ASIC), a pressure transducer, a rechargeable battery, and wireless telemetry and recharging antennas. The ASIC includes instrumentation, wireless transmission, and power-management circuitry, and on an average draws less than 9 μA from the 3.6-V battery. The battery charge can be wirelessly replenished with daily 6-h recharge periods that can occur during the periods of sleep. Acute in vivo evaluation of the pressure-sensing system in canine models has demonstrated that the system can accurately capture lumen pressure from a submucosal implant location.

Low-Power Wireless Micromanometer System for Acute and Chronic Bladder-Pressure Monitoring

Analog integrated circuits (ICs) designed for processing physiological signals are important building blocks of wearable and implantable medical devices used for health monitoring or restoring lost body functions. Due to the nature of physiological signals and the corresponding application scenarios, the ICs designed for these applications should have low power consumption, low cutoff frequency, and low input-referred noise. In this paper, techniques for designing the analog front-end circuits with these three characteristics will be reviewed, including subthreshold circuits, bulk-driven MOSFETs, floating gate MOSFETs, and log-domain circuits to reduce power consumption; methods for designing fully integrated low cutoff frequency circuits; as well as chopper stabilization (CHS) and other techniques that can be used to achieve a high signal-to-noise performance. Novel applications using these techniques will also be discussed.

Analog Integrated Circuits Design for Processing Physiological Signals

A mini-invasive system for long-term bladder urine pressure measurement system is presented. Not only is the design cost reduced, but also the reliability is enhanced by using a 1-atm canceling sensing instrumentation amplifier (IA). Because the urine pressure inside the bladder does not vary drastically, both the sleeping and working modes are required in order to save the battery power for long-term observation. The IA amplifies the signal sensed by the pressure sensor, which is then fed into the following analog-to-digital converter. Owing to the intrinsic 1-atm pressure existing inside the bladder, the IA must be able to cancel such a pressure from the signal picked up by the pressure sensor to keep the required linearity and the resolution for pressure measurement of the bladder urine. The pressure range of the proposed system is found out to be 14.7~19.7 Psi, which covers the range of all of the known unusual bladder syndromes or complications.

A Mini-Invasive Long-Term Bladder Urine Pressure Measurement ASIC and System

This paper presents a novel IA (instrumentation amplifier) design for implantable biomedical devices and systems with a 140-dB CMRR (common-mode rejection ratio). The proposed IA is composed of 3 stages, including a preamplifier, a 2nd-order BPF (band-pass filer), and a DC-level shifter and output buffer stage. A low-noise gm-C amplifier is used in the preamplifier stage so as to reduce the coupled thermal noise which might overwhelm the weak neural signals. The BPF is designed based on an OTA (operational transconductance amplifier) with dual current switches aiming at the low power as well as low noise demands. A source follower is employed to carry out the DC-level shifter and the output buffer, which provides an output signal adequate to drive the following stage, which is usually an ADC (analog to digital converter). Detailed analysis of the proposed circuitry is derived to solidify the proposed architecture. The proposed design is implemented using TSMC 0.35 mum 2P4M CMOS process. The results of post-layout simulations verify the performance of our design. The CMRR is better than 140 dB, and, most important of all, the input noise (RMS) is merely 23.28 dB at all PVT (process, supply voltage, temperature) corners

/pdf/a-140-db-cmrr-low-noise-instrumentation-amplifier-for-neural-20oectsskk.pdf

A 140-dB CMRR Low-noise Instrumentation Amplifier for Neural Signal Sensing

An implantable system for long-term bladder urine pressure measurement system is presented. Not only is the design cost reduced, but also the reliability is enhanced by using a 1-atm canceling sensing IA (instrumentation amplifier). Because the urine pressure inside the bladder does not vary drastically, both the sleeping and working modes are required in order to save the battery power for long-term observation. The IA amplifies the signal sensed by the pressure sensor, which is then fed into the following ADC (analog-to-digital converter). Owing to the intrinsic 1-atm pressure (one atmospheric pressure) existing inside the bladder, the IA must be able to cancel such a pressure from the signal picked up by the pressure sensor to keep the required linearity and the resolution for pressure measurement of the bladder urine. The pressure range of the proposed system is found out to be 14.7 ~ 19.7 Psi, which covers the range of all of the known unusual bladder syndromes or complications.

Jian-Sing Liou

Papers

A Mini-Invasive Long-Term Bladder Urine Pressure Measurement ASIC and System

A 140-dB CMRR Low-noise Instrumentation Amplifier for Neural Signal Sensing

An Implantable Long-term Bladder Urine Pressure Measurement System with a 1-atm Canceling Instrumentation Amplifier