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A Quali-Quantitative Analysis of Biosensing and Biotransducing Systems for Cardiovascular Monitoring: Pacemakers
Insights
This study assesses the long-term reliability of permanent pacemakers (PPMs) in patients with cardiovascular disease. Advanced imaging and analysis techniques evaluate PPM performance under varying physiological conditions to ensure patient safety and device longevity.
Area of Science:
- Biomedical Engineering
- Cardiovascular Medicine
- Medical Imaging
Background:
- Cardiovascular diseases pose a significant global health burden, necessitating continuous heart monitoring.
- Permanent pacemakers (PPMs) are crucial implantable devices for managing irregular heart rhythms.
- Assessing the long-term reliability of PPMs in patients is essential for effective cardiovascular care.
Purpose of the Study:
- To determine the reliability of permanent pacemakers (PPMs) over time in patients with cardiovascular diseases.
- To investigate how physiological changes (posture, temperature, metabolic demand) affect PPM operating modes.
- To evaluate the performance of PPMs as nanobiosensors and biotransducers.
Main Methods:
- Utilized atomic force microscopy for 3D structural reconstruction of PPM sidewall roughness from CT scans.
- Applied angular equivocation (angular entropy) to quantify image gradient orientation uncertainty.
- Conducted bispectral analysis and contour plots to address nonlinearities from metallic components and biological interactions.
Main Results:
- Characterized PPM sidewall roughness and quantified image orientation uncertainty.
- Identified and analyzed distortions caused by metallic PPM components and biological tissues.
- Demonstrated the utility of CT-based cardiac examinations for monitoring implantable device status.
Conclusions:
- PPM reliability can be affected by natural patient physiological variations.
- Advanced imaging and spectral analysis provide insights into implantable device performance.
- Monitoring PPMs using CT cardiac examinations is valuable for preserving patient life.
Abstract:
The global health burden of cardiovascular diseases, including MI (myocardial infarction), CAD (coronary artery disease), heart arrhythmias, cerebrovascular disease, and HF (heart failure), is substantial. As a primary cause of mortality, there is a pressing need for continuous and real-time heart monitoring to identify and treat irregular heart rhythms. PPMs (permanent pacemakers) constantly monitor the heart's spontaneous electrical activity and only activate when it is either defiant or absent. The PPMs under investigation in our research are special implantable biosensors and biotransducers with nanoscale components. The PPMs do not generally contain biochemical reactants but they interact with physiological fluids to be considered as biosensors, and nanobiosensors if they encompass nanomaterials, as for our case. The objective of this study is to determine the reliability of PPM structures that have been implanted in patients who are suffering from one of the cardiovascular diseases over time. Even though the PPMs have been certified for the above use, however, natural patient conditions such as changes in body posture, temperature, or even changes in metabolic demand, can affect their operating modes. The sidewall roughness surface of PPMs is analyzed using atomic force microscopic 3D structural reconstruction, which is based on the grey images of PPMs from CT scanning for each patient. The angular equivocation (also known as angular entropy) approach is implemented to quantify the uncertainty in the distribution of edge or gradient orientation in PPMs images. Then, in order to address nonlinearities and interactions caused by metallic components in the PPM that introduce harmonic and distortions from biological tissues and device motion, we have conducted a bispectral analysis followed by contour representation plots. Different results obtained are of interest for monitoring the state of implantable devices in activity based on CT cardiac examinations in order to preserve the patient's extended life.
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