Low Power Circuits for Smart Flexible ECG Sensors

Cardiovascular diseases (CVDs) are the world leading cause of death. In-home heart condition monitoring effectively reduced the CVD patient hospitalization rate. Flexible electrocardiogram (ECG) sensor provides an affordable, convenient and comfortable in-home monitoring solution. The three critical building blocks of the ECG sensor i.e., analog frontend (AFE), QRS detector, and cardiac arrhythmia classifier (CAC), are studied in this research. A fully differential difference amplifier (FDDA) based AFE that employs DC-coupled input stage increases the input impedance and improves CMRR. A parasitic capacitor reuse technique is proposed to improve the noise/area efficiency and CMRR. An on-body DC bias scheme is introduced to deal with the input DC offset. Implemented in 0.35m CMOS process with an area of 0.405mm2, the proposed AFE consumes 0.9W at 1.8V and shows excellent noise effective factor of 2.55, and CMRR of 76dB. Experiment shows the proposed AFE not only picks up clean ECG signal with electrodes placed as close as 2cm under both resting and walking conditions, but also obtains the distinct -wave after eye blink from EEG recording. A personalized QRS detection algorithm is proposed to achieve an average positive prediction rate of 99.39% and sensitivity rate of 99.21%. The user-specific template avoids the complicate models and parameters used in existing algorithms while covers most situations for practical applications. The detection is based on the comparison of the correlation coefficient of the user-specific template with the ECG segment under detection. The proposed one-target clustering reduced the required loops. A continuous-in-time discrete-in-amplitude (CTDA) artificial neural network (ANN) based CAC is proposed for the smart ECG sensor. The proposed CAC achieves over 98% classification accuracy for 4 types of beats defined by AAMI (Association for the Advancement of Medical Instrumentation). The CTDA scheme significantly reduces the input sample numbers and simplifies the sample representation to one bit. Thus, the number of arithmetic operations and the ANN structure are greatly simplified. The proposed CAC is verified by FPGA and implemented in 0.18m CMOS process. Simulation results show it can operate at clock frequencies from 10KHz to 50MHz. Average power for the patient with 75bpm heart rate is 13.34W

Southwest Research Institute assistance to NASA in biomedical areas of the technology utilization program

The activities are reported of the NASA Biomedical Applications Team at Southwest Research Institute between 25 August, 1972 and 15 November, 1973. The program background and methodology are discussed along with the technology applications, and biomedical community impacts

Electronic circuits and systems: A compilation

Technological information is presented electronic circuits and systems which have potential utility outside the aerospace community. Topics discussed include circuit components such as filters, converters, and integrators, circuits designed for use with specific equipment or systems, and circuits designed primarily for use with optical equipment or displays

Low Power Bio-potential Amplifier (for EEG)

The size and dependency on power supply of current biopotential data acquisition systems prohibit continuous monitoring of biopotential signals through battery powered devices. As the interest in continuous monitoring of EEG increases for healthcare and research purposes such as seizure detection, there is an increasing need to bring down the power consumption on the biopotential amplifier (BPA). BPA is one of the most power consuming components in the biopotential data acquisition system. In this FYP, we will develop a method to improve the existing BPA using MIMOS 0.35um process technology through implementation of various low power flicker noise cancelation techniques. Techniques used include low impedance node chopping and non-overlapping demodulation chopping. The scope of this FYP is focusing on design and simulation on Cadence software in circuit level implementation. This work provides insights as well as a starting point in lowering the power consumption of bio-potential data acquisition system. This will help to enable battery power system for continuous monitoring of EEG signals in the future. This final report discusses on both the literature review, background of the projects and methodology as well as the outcome of the work. The report is concluded by suggesting future works that can be carried out in this final year project (FYP)

A novel fully differential biopotential amplifier with DC suppression

Fully differential amplifiers yield large differential gains and also high common mode rejection ratio (CMRR), provided they do not include any unmatched grounded component. In biopotential measurements, however, the admissible gain of amplification stages located before dc suppression is usually limited by electrode offset voltage, which can saturate amplifier outputs. The standard solution is to first convert the differential input voltage to a single-ended voltage and then implement any other required functions, such as dc suppression and dc level restoring. This approach, however, yields a limited CMRR and may result in a relatively large equivalent input noise. This paper describes a novel fully differential biopotential amplifier based on a fully differential dc-suppression circuit that does not rely on any matched passive components, yet provides large CMRR and fast recovery from dc level transients. The proposed solution is particularly convenient for low supply voltage systems. An example implementation, based on standard low-power op amps and a single 5-V power supply, accepts input offset voltages up to /spl plusmn/500 mV, yields a CMRR of 102dB at 50 Hz, and provides, in accordance with the AAMI EC38 standard, a reset behavior for recovering from overloads or artifactsPeer Reviewe

Assessment of trends in the cardiovascular system from time interval measurements using physiological signals obtained at the limbs

Cardiovascular diseases are an increasing source of concern in modern societies due to their increasing prevalence and high impact on the lives of many people. Monitoring cardiovascular parameters in ambulatory scenarios is an emerging approach that can provide better medical access to patients while decreasing the costs associated to the treatment of these diseases. This work analyzes systems and methods to measure time intervals between the electrocardiogram (ECG), impedance plethysmogram (IPG), and the ballistocardiogram (BCG), which can be obtained at the limbs in ambulatory scenarios using simple and cost-effective systems, to assess cardiovascular intervals of interest, such as the pulse arrival time (PAT), pulse transit time (PTT), or the pre-ejection period (PEP). The first section of this thesis analyzes the impact of the signal acquisition system on the uncertainty in timing measurements in order to establish the design specifications for systems intended for that purpose. The minimal requirements found are not very demanding yet some common signal acquisition systems do not fulfill all of them while other capabilities typically found in signal acquisition systems could be downgraded without worsening the timing uncertainty. This section is also devoted to the design of systems intended for timing measurements in ambulatory scenarios according to the specifications previously established. The systems presented have evolved from the current state-of-the-art and are designed for adequate performance in timing measurements with a minimal number of active components. The second section is focused on the measurement of time intervals from the IPG measured from limb to limb, which is a signal that until now has only been used to monitor heart rate. A model to estimate the contributions to the time events in the measured waveform of the different body segments along the current path from geometrical properties of the large arteries is proposed, and the simulation under blood pressure changes suggests that the signal is sensitive to changes in proximal sites of the current path rather than in distal sites. Experimental results show that the PAT to the hand-to-hand IPG, which is obtained from a novel four-electrode handheld system, is correlated to changes in the PEP whereas the PAT to the foot-to-foot IPG shows good performance in assessing changes in the femoral PAT. Therefore, limb-to-limb IPG measurements significantly increase the number of time intervals of interest that can be measured at the limbs since the signals deliver information from proximal sites complementary to that of other measurements typically performed at distal sites. The next section is devoted to the measurement of time intervals that involve different waves of the BCG obtained in a standing platform and whose origin is still under discussion. From the relative timing of other physiological signals, it is hypothesized that the IJ interval of the BCG is sensitive to variations in the PTT. Experimental results show that the BCG I wave is a better surrogate of the cardiac ejection time than the widely-used J wave, which is also supported by the good correlation found between the IJ interval and the aortic PTT. Finally, the novel time interval from the BCG I wave to the foot of the IPG measured between feet, which can be obtained from the same bathroom scale than the BCG, shows good performance in assessing the aortic PAT. The results presented reinforce the role of the BCG as a tool for ambulatory monitoring since the main time intervals targeted in this thesis can be obtained from the timing of its waves. Even though the methods described were tested in a small group of subjects, the results presented in this work show the feasibility and potential of several time interval measurements between the proposed signals that can be performed in ambulatory scenarios, provided the systems intended for that purpose fulfill some minimal design requirements.Les malalties cardiovasculars són una tema de preocupació creixent en societats modernes, degut a l’augment de la seva prevalença i l'elevat impacte en les vides dels pacients que les sofreixen. La mesura i monitoratge de paràmetres cardiovasculars en entorns ambulatoris és una pràctica emergent que facilita l’accés als serveis mèdics i permet reduir dràsticament els costos associats al tractament d'aquestes malalties. En aquest treball s’analitzen sistemes i mètodes per la mesura d’intervals temporals entre l’electrocardiograma (ECG), el pletismograma d’impedància (IPG) i el balistocardiograma (BCG), que es poden obtenir de les extremitats i en entorns ambulatoris a partir de sistemes de baix cost, per tal d’avaluar intervals cardiovasculars d’interès com el pulse arrival time (PAT), pulse transit time (PTT) o el pre-ejection period (PEP). En la primera secció d'aquesta tesi s’analitza l’impacte del sistema d’adquisició del senyal en la incertesa de mesures temporals, per tal d’establir els requeriments mínims que s’han de complir en entorns ambulatoris. Tot i que els valors obtinguts de l’anàlisi no són especialment exigents, alguns no són assolits en diversos sistemes habitualment utilitzats mentre que altres solen estar sobredimensionats i es podrien degradar sense augmentar la incertesa en mesures temporals. Aquesta secció també inclou el disseny i proposta de sistemes per la mesura d’intervals en entorns ambulatoris d’acord amb les especificacions anteriorment establertes, a partir de l’estat de l’art i amb l’objectiu de garantir un correcte funcionament en entorns ambulatoris amb un nombre mínim d’elements actius per reduir el cost i el consum. La segona secció es centra en la mesura d’intervals temporals a partir de l’IPG mesurat entre extremitats, que fins al moment només s’ha fet servir per mesurar el ritme cardíac. Es proposa un model per estimar la contribució de cada segment arterial per on circula el corrent a la forma d’ona obtinguda a partir de la geometria i propietats físiques de les artèries, i les simulacions suggereixen que la senyal entre extremitats és més sensible a canvis en arteries proximals que en distals. Els resultats experimentals mostren que el PAT al hand-to-hand IPG, obtingut a partir d’un innovador sistema handheld de quatre elèctrodes, està fortament correlacionat amb els canvis de PEP, mentre que el PAT al foot-to-foot IPG està correlat amb els canvis en PAT femoral. Conseqüentment, l’ILG entre extremitats augmenta de manera significativa els intervals d’interès que es poden obtenir en extremitats degut a que proporciona informació complementària a les mesures que habitualment s’hi realitzen. La tercera secció està dedicada a la mesura d’intervals que inclouen les ones del BCG vertical obtingut en plataformes, de les que encara se’n discuteix l’origen. A partir de la posició temporal relativa respecte altres ones fisiològiques, s’hipostatitza que l’interval IJ del BCG es sensible a variacions del PTT. Els resultats experimentals mostren que la ona I del BCG és un millor indicador de l’ejecció cardíaca que el pic J, tot i que aquest és el més utilitzat habitualment, degut a la bona correlació entre l’interval IJ i el PTT aòrtic. Finalment, es presenta un mètode alternatiu per la mesura del PTT aòrtic a partir de l’interval entre el pic I del BCG i el peu del foot-to-foot IPG, que es pot obtenir de la mateixa plataforma que el BCG i incrementa la robustesa de la mesura. Els resultats presentats reforcen el paper del BCG com a en mesures en entorns ambulatoris, ja que els principals intervals objectiu d’aquesta tesi es poden obtenir a partir de les seves ones. Tot i que els mètodes descrits han estat provats en grups petits de subjectes saludables, els resultats mostren la viabilitat i el potencial de diversos intervals temporals entre les senyals proposades que poden ésser realitzats en entorns ambulatoris, sempre que els sistemes emprats compleixin els requisits mínims de disseny.Postprint (published version

Wired, wireless and wearable bioinstrumentation for high-precision recording of bioelectrical signals in bidirectional neural interfaces

It is widely accepted by the scientific community that bioelectrical signals, which can be used for the identification of neurophysiological biomarkers indicative of a diseased or pathological state, could direct patient treatment towards more effective therapeutic strategies. However, the design and realisation of an instrument that can precisely record weak bioelectrical signals in the presence of strong interference stemming from a noisy clinical environment is one of the most difficult challenges associated with the strategy of monitoring bioelectrical signals for diagnostic purposes. Moreover, since patients often have to cope with the problem of limited mobility being connected to bulky and mains-powered instruments, there is a growing demand for small-sized, high-performance and ambulatory biopotential acquisition systems in the Intensive Care Unit (ICU) and in High-dependency wards. Furthermore, electrical stimulation of specific target brain regions has been shown to alleviate symptoms of neurological disorders, such as Parkinson’s disease, essential tremor, dystonia, epilepsy etc. In recent years, the traditional practice of continuously stimulating the brain using static stimulation parameters has shifted to the use of disease biomarkers to determine the intensity and timing of stimulation. The main motivation behind closed-loop stimulation is minimization of treatment side effects by providing only the necessary stimulation required within a certain period of time, as determined from a guiding biomarker. Hence, it is clear that high-quality recording of local field potentials (LFPs) or electrocorticographic (ECoG) signals during deep brain stimulation (DBS) is necessary to investigate the instantaneous brain response to stimulation, minimize time delays for closed-loop neurostimulation and maximise the available neural data. To our knowledge, there are no commercial, small, battery-powered, wearable and wireless recording-only instruments that claim the capability of recording ECoG signals, which are of particular importance in closed-loop DBS and epilepsy DBS. In addition, existing recording systems lack the ability to provide artefact-free high-frequency (> 100 Hz) LFP recordings during DBS in real time primarily because of the contamination of the neural signals of interest by the stimulation artefacts. To address the problem of limited mobility often encountered by patients in the clinic and to provide a wide variety of high-precision sensor data to a closed-loop neurostimulation platform, a low-noise (8 nV/√Hz), eight-channel, battery-powered, wearable and wireless multi-instrument (55 × 80 mm2) was designed and developed. The performance of the realised instrument was assessed by conducting both ex vivo and in vivo experiments. The combination of desirable features and capabilities of this instrument, namely its small size (~one business card), its enhanced recording capabilities, its increased processing capabilities, its manufacturability (since it was designed using discrete off-the-shelf components), the wide bandwidth it offers (0.5 – 500 Hz) and the plurality of bioelectrical signals it can precisely record, render it a versatile tool to be utilized in a wide range of applications and environments. Moreover, in order to offer the capability of sensing and stimulating via the same electrode, novel real-time artefact suppression methods that could be used in bidirectional (recording and stimulation) system architectures are proposed and validated. More specifically, a novel, low-noise and versatile analog front-end (AFE), which uses a high-order (8th) analog Chebyshev notch filter to suppress the artefacts originating from the stimulation frequency, is presented. After defining the system requirements for concurrent LFP recording and DBS artefact suppression, the performance of the realised AFE is assessed by conducting both in vitro and in vivo experiments using unipolar and bipolar DBS (monophasic pulses, amplitude ranging from 3 to 6 V peak-to-peak, frequency 140 Hz and pulse width 100 µs). Under both in vitro and in vivo experimental conditions, the proposed AFE provided real-time, low-noise and artefact-free LFP recordings (in the frequency range 0.5 – 250 Hz) during stimulation. Finally, a family of tunable hardware filter designs and a novel method for real-time artefact suppression that enables wide-bandwidth biosignal recordings during stimulation are also presented. This work paves the way for the development of miniaturized research tools for closed-loop neuromodulation that use a wide variety of bioelectrical signals as control signals.Open Acces

Electrical Impedance Tomography: From the Traditional Design to the Novel Frontier of Wearables

Electrical impedance tomography (EIT) is a medical imaging technique based on the injection of a current or voltage pattern through electrodes on the skin of the patient, and on the reconstruction of the internal conductivity distribution from the voltages collected by the electrodes. Compared to other imaging techniques, EIT shows significant advantages: it does not use ionizing radiation, is non-invasive and is characterized by high temporal resolution. Moreover, its low cost and high portability make it suitable for real-time, bedside monitoring. However, EIT is also characterized by some technical limitations that cause poor spatial resolution. The possibility to design wearable devices based on EIT has recently given a boost to this technology. In this paper we reviewed EIT physical principles, hardware design and major clinical applications, from the classical to a wearable setup. A wireless and wearable EIT system seems a promising frontier of this technology, as it can both facilitate making clinical measurements and open novel scenarios to EIT systems, such as home monitoring