MEMS-Based Flexible Force Sensor for Tri-Axial Catheter Contact Force Measurement

Atrial fibrillation (AFib) is a significant healthcare problem caused by the uneven and rapid discharge of electrical signals from pulmonary veins (PVs). The technique of radiofrequency (RF) ablation can block these abnormal electrical signals by ablating myocardial sleeves inside PVs. Catheter contact force measurement during RF ablation can reduce the rate of AFib recurrence, since it helps to determine effective contact of the catheter with the tissue, thereby resulting in effective power delivery for ablation. This paper presents the development of a three-dimensional (3D) force sensor to provide the real-time measurement of tri-axial catheter contact force. The 3D force sensor consists of a plastic cubic bead and five flexible force sensors. Each flexible force sensor was made of a PEDOT:PSS strain gauge and a PDMS bump on a flexible PDMS substrate. Calibration results show that the fabricated sensor has a linear response in the force range required for RF ablation. To evaluate its working performance, the fabricated sensor was pressed against gelatin tissue by a micromanipulator and also integrated on a catheter tip to test it within deionized water flow. Both experiments simulated the ventricular environment and proved the validity of applying the 3D force sensor in RF ablation

Engineering approaches for characterizing soft tissue mechanical properties: A review

From cancer diagnosis to detailed characterization of arterial wall biomechanics, the elastic property of tissues is widely studied as an early sign of disease onset. The fibrous structural features of tissues are a direct measure of its health and functionality. Alterations in the structural features of tissues are often manifested as local stiffening and are early signs for diagnosing a disease. These elastic properties are measured ex vivo in conventional mechanical testing regimes, however, the heterogeneous microstructure of tissues can be accurately resolved over relatively smaller length scales with enhanced spatial resolution using techniques such as micro-indentation, microelectromechanical (MEMS) based cantilever sensors and optical catheters which also facilitate in vivo assessment of mechanical properties. In this review, we describe several probing strategies (qualitative and quantitative) based on the spatial scale of mechanical assessment and also discuss the potential use of machine learning techniques to compute the mechanical properties of soft tissues. This work details state of the art advancement in probing strategies, associated challenges toward quantitative characterization of tissue biomechanics both from an engineering and clinical standpoint

MEMS-Based Flexible Force Sensor for Tri-Axial Catheter Contact Force Measurement

Atrial fibrillation (AFib) is a significant healthcare problem caused by the uneven and rapid discharge of electrical signals from pulmonary veins (PVs). The technique of radiofrequency (RF) ablation can block these abnormal electrical signals by ablating myocardial sleeves inside PVs. Catheter contact force measurement during RF ablation can reduce the rate of AFib recurrence, since it helps to determine effective contact of the catheter with the tissue, thereby resulting in effective power delivery for ablation. This paper presents the development of a three-dimensional (3D) force sensor to provide the real-time measurement of tri-axial catheter contact force. The 3D force sensor consists of a plastic cubic bead and five flexible force sensors. Each flexible force sensor was made of a PEDOT:PSS strain gauge and a PDMS bump on a flexible PDMS substrate. Calibration results show that the fabricated sensor has a linear response in the force range required for RF ablation. To evaluate its working performance, the fabricated sensor was pressed against gelatin tissue by a micromanipulator and also integrated on a catheter tip to test it within deionized water flow. Both experiments simulated the ventricular environment and proved the validity of applying the 3D force sensor in RF ablation

Futuristic medical implants using bioresorbable materials and devices

Implantable medical devices have been used for real-time monitoring of physical parameters (temperature, pressure and biopotentials), sustained drug release, cardiovascular and pulmonary stents and other clinical applications. Several biocompatible materials (titanium and its alloys, aluminium, cobalt-alloys, stainless steel, poly-ethylene, polyurethanes, polyglycolide and polylactides) have been commercially used for fabricating implantable devices. However, these devices require retrieval operations after a certain period. Bioresorbable materials disintegrate gradually in vivo and their derivatives get absorbed completely in the body fluid with no residue and with minimal toxic effects, thus, eliminating the need for retrieval operations. In this article, state-ofthe-art advances in materials, fabrication techniques and clinical applications of bioresorbable implantable devices are reviewed. We first discuss the bioresorbable materials (e.g., magnesium, molybdenum, tungsten, silicon, germanium, silicon dioxide, silicon nitride, silk and synthetic polymers) used in the fabrication of implantable devices. Later, an overview of processes to fabricate pressure, temperature, electrical and chemical sensors are discussed, followed by their applications as implantable devices in biomedical engineering

Force sensing technologies for catheter ablation procedures

Cardiac Arrhythmia, a condition of abnormal activation and conduction of electrical impulses in the heart is observed in a large proportion of the world population. Radio frequency (RF) ablation catheters have revolutionized the treatment of cardiac arrhythmias. Over the years, researchers have been extensively working towards developing a more promising catheter technology that ensures definitive treatment. Since RF energy is based on the principle of resistive heating, to optimize effective lesion formation, a catheter to adequately sense tissue contact force becomes vital. The review focuses on state-of-the-art advancement in force sensors, design specification and their need for interfacing with cardiac catheters. Minimally invasive medical procedures for cardiac ablation followed by various controlling methods used for providing quality lesion have been overviewed. Several design prototypes and variants of force sensors that can potentially be integrated with ablation catheters are reviewed with their sensing principles and implementation

Emerging technologies for antibiotic susceptibility testing

Superbugs such as infectious bacteria pose a great threat to humanity due to an increase in bacterial mortality leading to clinical treatment failure, lengthy hospital stay, intravenous therapy and accretion of bacteraemia. These disease-causing bacteria gain resistance to drugs over time which further complicates the treatment. Monitoring of antibiotic resistance is therefore necessary so that bacterial infectious diseases can be diagnosed rapidly. Antimicrobial susceptibility testing (AST) provides valuable information on the efficacy of antibiotic agents and their dosages for treatment against bacterial infections. In clinical laboratories, most widely used AST methods are disk diffusion, gradient diffusion, broth dilution, or commercially available semi-automated systems. Though these methods are cost-effective and accurate, they are time-consuming, labour-intensive, and require skilled manpower. Recently much attention has been on developing rapid AST techniques to avoid misuse of antibiotics and provide effective treatment. In this review, we have discussed emerging engineering AST techniques with special emphasis on phenotypic AST. These techniques include fluorescence imaging along with computational image processing, surface plasmon resonance, Raman spectra, and laser tweezer as well as micro/nanotechnology-based device such as microfluidics, microdroplets, and microchamber. The mechanical and electrical behaviour of single bacterial cell and bacterial suspension for the study of AST is also discussed

Rapid Real-Time Antimicrobial Susceptibility Testing with Electrical Sensing on Plastic Microchips with Printed Electrodes

Rapid antimicrobial susceptibility testing is important for efficient and timely therapeutic decision making. Due to globally spread bacterial resistance, the efficacy of antibiotics is increasingly being impeded. Conventional antibiotic tests rely on bacterial culture, which is time-consuming and can lead to potentially inappropriate antibiotic prescription and up-front broad range of antibiotic use. There is an urgent need to develop point-of-care platform technologies to rapidly detect pathogens, identify the right antibiotics, and monitor mutations to help adjust therapy. Here, we report a biosensor for rapid (<90 min), real time, and label-free bacteria isolation from whole blood and antibiotic susceptibility testing. Target bacteria are captured on flexible plastic-based microchips with printed electrodes using antibodies (30 min), and its electrical response is monitored in the presence and absence of antibiotics over an hour of incubation time. We evaluated the microchip with <i>Escherichia coli</i> and methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) as clinical models with ampicillin, ciprofloxacin, erythromycin, daptomycin, gentamicin, and methicillin antibiotics. The results are compared with the current standard methods, i.e. bacteria viability and conventional antibiogram assays. The technology presented here has the potential to provide precise and rapid bacteria screening and guidance in clinical therapies by identifying the correct antibiotics for pathogens