A multichannel implantable telemetry system for flow, pressure, and ECG measurements

Evolution of Biotelemetry in Medical Devices: From Radio Pills to mm-Scale Implants

The advent of semiconductor technology in the mid-20th century created unprecedented opportunities to develop a new generation of small-scale wireless medical sensing devices that can support remote monitoring of patients' vital signs. The first radio pills were developed as early as the 1950's using only a few transistors. These swallowable capsules could sense and wirelessly transmit vital parameters from inside the human body. Since then we have witnessed the rapid progress of medical devices driven by the evolution of semiconductor technology, from single-transistor oscillators to complex mixed-signal multi-channel and multi-modal systems. This paper retraces the evolution of biotelemetry devices from their very early inception to the smart miniaturized systems of modern days, focusing on semiconductor-enabled sensing methods and circuits developed over the last six decades. The paper also includes the author's perspective on current and future trends in the development of CMOS-based biotelemeters, focusing on concepts of implant modularity, miniaturization and hybrid energy harvesting solutions.

Longitudinal hemodynamic measurements in swine heart failure using a fully implantable telemetry system

Chronic monitoring of heart rate, blood pressure, and flow in conscious free-roaming large animals can offer considerable opportunity to understand the progression of cardiovascular diseases and can test new diagnostics and therapeutics. The objective of this study was to demonstrate the feasibility of chronic, simultaneous measurement of several hemodynamic parameters (left ventricular pressure, systemic pressure, blood flow velocity, and heart rate) using a totally implantable multichannel telemetry system in swine heart failure models. Two solid-state blood pressure sensors were inserted in the left ventricle and the descending aorta for pressure measurements. Two Doppler probes were placed around the left anterior descending (LAD) and the brachiocephalic arteries for blood flow velocity measurements. Electrocardiographic (ECG) electrodes were attached to the surface of the left ventricle to monitor heart rate. The telemeter body was implanted in the right side of the abdomen under the skin for approximately 4 to 6 weeks. The animals were subjected to various heart failure models, including volume overload (A-V fistula, n = 3), pressure overload (aortic banding, n = 2) and dilated cardiomyopathy (pacing-induced tachycardia, n = 3). Longitudinal changes in hemodynamics were monitored during the progression of the disease. In the pacing-induced tachycardia animals, the systemic blood pressure progressively decreased within the first 2 weeks and returned to baseline levels thereafter. In the aortic banding animals, the pressure progressively increased during the development of the disease. The pressure in the A-V fistula animals only showed a small increase during the first week and remained stable thereafter. The results demonstrated the ability of this telemetry system of long-term, simultaneous monitoring of blood flow, pressure and heart rate in heart failure models, which may offer significant utility for understanding cardiovascular disease progression and treatment.

Biomedical signal acquisition with streaming wireless communication for recording evoked potentials

BACKGROUND

Commercial electrophysiology systems for recording evoked potentials always connect patients to the acquisition unit via long wires. Wires guarantee timely transfer of signals for synchronization with the stimuli, but they are susceptible to electromagnetic and electrostatic interferences. Though wireless solutions are readily available (e.g. Bluetooth), they introduce high delay variability that will distort the evoked potential traces. We developed a complete wireless acquisition system with a fixed delay.

METHODS

The system supports up to 4 bipolar channels; each is amplified by 20,000× and digitized to 24 bits. The system incorporates the "driven-right-leg" circuit to lower the common noise. Data are continuously streamed using radio-frequency transmission operating at 915 MHz and then tagged with the stimulus SYNC signal at the receiver. The delay, noise level and transmission error rate were measured. Flash visual evoked potentials were recorded monocularly from both eyes of six adults with normal vision. The signals were acquired via wireless and wired transmissions simultaneously. The recording was repeated on some participants within 2 weeks.

RESULTS

The delay was constant at 20 ms. The system noise was white and Gaussian (2 microvolts RMS). The transmission error rate was about one per million packets. The VEPs recorded with wireless transmission were consistent with those with wired transmission. The VEP amplitudes and shapes showed good intra-session and inter-session reproducibility and were consistent across eyes.

CONCLUSIONS

The wireless acquisition system can reliably record visual evoked potentials. It has a constant delay of 20 ms and very low error rate.

A wireless recording system that utilizes Bluetooth technology to transmit neural activity in freely moving animals

A new wireless transceiver is described for recording individual neuron firing from behaving rats utilizing Bluetooth transmission technology and a processor onboard for discrimination of neuronal waveforms and associated time stamps. This universal brain activity transmitter (UBAT) is attached to rodents via a backpack and amplifier headstage and can transmit 16 channels of captured neuronal firing data via a Bluetooth transceiver chip over very large and unconstrained distances. The onboard microprocessor of the UBAT allows flexible online control over waveform isolation criteria via transceiver instruction and the two-way communication capacity allows for closed-loop applications between neural events and behavioral or physiological processes which can be modified by transceiver instructions. A detailed description of the multiplexer processing of channel data as well as examples of neuronal recordings in different behavioral testing contexts is provided to demonstrate the capacity for robust transmission within almost any laboratory environment. A major advantage of the UBAT is the long transmission range and lack of object-based line of sight interference afforded by Bluetooth technology, allowing flexible recording capabilities within multiple experimental paradigms without interruption. Continuous recordings over very large distance separations from the monitor station are demonstrated providing experimenters with recording advantages not previously available with other telemetry devices.

A 1-MHz, 5-Kb/s wireless command receiver for electronic site selection in multichannel neural biopotential recording

This paper reports on a battery-powered telemetric command receiver for electronic site selection in multichannel neural recording applications. The receiver selects seven recording sites from a total of 28 available sites, according to four pre-defined site-selection patterns, via a 1-MHz, 5-Kb/s, amplitude-shift-keyed (ASK) link. The seven selected sites can then be wirelessly monitored via a 100-MHz frequency-modulated (FM) link. The receiver also performs power management to increase battery service lifetime. A bidirectional wireless recording microsystem incorporating this receiver is fabricated on a 4.6times4.6-mm(2) chip using the AMI 1.5 microm 2P2M n-well CMOS process. Design methodology and architecture of the receiver together with measurement results from its wireless analog front-end are presented.

A novel, fully implantable, multichannel biotelemetry system for measurement of blood flow, pressure, ECG, and temperature

Biotelemetry provides high-quality data in awake, free-ranging animals without the effects of anesthesia and surgery. Although many biological parameters can be measured using biotelemetry, simultaneous telemetric measurements of pressure and flow have not been available. The objective of this study was to evaluate simultaneous measurements of blood flow, pressure, ECG, and temperature in a fully implantable system. This novel system allows the measurement of up to four channels of blood flow, up to three channels of pressure, and a single channel each of ECG and temperature. The system includes a bidirectional radio-frequency link that allows the implant to send data and accept commands to perform various tasks. The system is controlled by a base station decoder/controller that decodes the data stream sent by the implant into analog signals. The system also converts the data into a digital data stream that can be sent via ethernet to a remote computer for storage and/or analysis. The system was chronically implanted in swine and alligators for up to 5 wk. Both bench and in vivo animal tests were performed to evaluate system performance. Results show that this biotelemetry system is capable of long-term accurate monitoring of simultaneous blood flow and pressure. The system allows, within the room, recordings, since the implant transmission range is between 6 and 10 m, and, with a relay, backpack transmission distance of up to 500 m can be achieved. This system will have significant utility in chronic models of cardiovascular physiology and pathology.

Wireless multichannel biopotential recording using an integrated FM telemetry circuit

This paper presents a four-channel telemetric microsystem featuring on-chip alternating current amplification, direct current baseline stabilization, clock generation, time-division multiplexing, and wireless frequency-modulation transmission of microvolt- and millivolt-range input biopotentials in the very high frequency band of 94-98 MHz over a distance of approximately 0.5 m. It consists of a 4.84-mm2 integrated circuit, fabricated using a 1.5-microm double-poly double-metal n-well standard complementary metal-oxide semiconductor process, interfaced with only three off-chip components on a custom-designed printed-circuit board that measures 1.7 x 1.2 x 0.16 cm3, and weighs 1.1 g including two miniature 1.5-V batteries. We characterize the microsystem performance, operating in a truly wireless fashion in single-channel and multichannel operation modes, via extensive benchtop and in vitro tests in saline utilizing two different micromachined neural recording microelectrodes, while dissipating approximately 2.2 mW from a 3-V power supply. Moreover, we demonstrate successful wireless in vivo recording of spontaneous neural activity at 96.2 MHz from the auditory cortex of an awake marmoset monkey at several transmission distances ranging from 10 to 50 cm with signal-to-noise ratios in the range of 8.4-9.5 dB.

A 1.48-mW low-phase-noise analog frequency modulator for wireless biotelemetry

This paper presents a low-phase-noise, hybrid LC-tank, analog frequency modulator for wireless biotelemetry employing on-chip NMOS varactors in the inversion region as the frequency tuning element. We demonstrate that a correct estimate for the destination signal-to-noise ratio, which quantifies the quality of the wirelessly received signal in a frequency-modulated biotelemetry system, is only achieved after taking into account the large-signal oscillation effect on the tank varactor. A prototype chip is fabricated using AMI 1.5-microm double-poly double-metal n-well CMOS process, and exhibits a measured gain factor of 1.21 MHz/V in the mid-range of the tuning voltage and a phase noise of -88.6 dBc/Hz at 10-kHz offset from the 95.1-MHz carrier while dissipating 1.48 mW from a 3 V power supply leading to a figure of merit (FOM) of -166.5 dBc/Hz. The VCO is successfully interfaced with a penetrating silicon microelectrode with 700 microm2 iridium recording sites for wireless in vitro recording of a 50 Hz simulated normal sinus rhythm signal from saline over a distance of approximately 0.25 m. Given a typical gain of approximately 40 dB for fully integrated front-end bioamplifiers, a wireless recording microsystem employing this VCO would be capable of detecting input biopotentials down to the submilivolt range.

A radiotelemetry system for chronic measurement of blood pressure and heart rate in the unrestrained rat validation of the method

Chronic measurements of systemic arterial blood pressure and heart rate via a chronically implanted telemetric transmitter in unrestrained rats, was validated in a three-phase study. In the first part, week-to-week variability of systolic, diastolic, and mean arterial pressures, and heart rate was found to be minimal over the course of nine weeks. In the second part, the reproducibility of cardiovascular response to three successive administration of sotalol, an antihypertensive agent, was studied. In the last part, cardiovascular parameters determined by telemetry were compared to those obtained by direct arterial catheterization and showed a good linear correlation between those two methods.

Cardiovascular responses in turkeys as affected by diurnal variation and stressors

Ten hypertensive (hyper) and hypotensive (hypo) turkeys of both sexes were used to evaluate the effect of various stimuli on blood pressure (BP) and heart rate (HR). Blood pressures were recorded from the brachial artery via a catheter and radio telemetric system. After a 48 hr baseline monitoring, the birds were subjected to exercise, fright, and mating and the BP and HR changes recorded. Mean arterial BP was 4.5 mm Hg less during night than day, and the BP of the hyper strain was significantly (P less than or equal to .05) higher than the hypo strain. Tracings from quiescent birds revealed fluctuations in BP that varied by 100 mm Hg. These were unexplainable fluctuations and occurred in both hyper and/or hypo birds at various times. The application of various stressful situations, such as exercise and fright, had little effect on BP but appeared to cause marked changes in HR. The highest recorded BP occurred during one of the mating exercises where systolic BP approached 350 mm Hg and HR increased by approximately 100%. Noises created with dog whistles and a .22 caliber pistol shot did not cause marked changes in BP and HR.