fifth international symposium on medical information and ......microsoft powerpoint -...
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In vivo ULTRAsonic Transponder Systemfor Biomedical Applications
FP7 Collaborative Project, STREPULTRAsponder
Dr. Jacob Bergsland (Partner)Oslo University Hospital, Oslo, Norway
Dr. Ir. Rogier Receveur (Partner)Medtronic Bakken Research Center, Maastricht, The Netherlands
Fifth International Symposium on Medical Information and Communication Technology (ISMICT)
27th to 30th March 2011, Montreux, Switzerland
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English Data 2010
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• Remote control of CHF vs Standard Therapy
Improved Quality of LifeFewer Hospital admissionsSavings of 400-1000 $/ patient/year
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Heart failure and hospitalization costs.
Klersy C et al. Eur J Heart Fail 2011;13:450-459
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2010. For permissions please email: [email protected].
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Budget impact analysis: a simulation study.
Klersy C et al. Eur J Heart Fail 2011;13:450-459
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2010. For permissions please email: [email protected].
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• Hospital admissions for heart failure (US)1996: 877 0002006: 1106 000
• Cost last 2 years of life with heart failure:
156 000 $ (US)
Hospital adm. reduced 39%
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What measurements are of interest in patients with congestive heart failure
• ECG• Dimension (LV diameter)• Intracardiac pressures
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Echocardiography
Healthy: Normal size of cardiacchambers
Heart failure: (enlargement of left ventricleAnd left atrium,
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Cardiac dimensions in healthy humans
8-10 mm
3-5 mm
70-80 mm
50 mm
TE 09
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Pressures
•Worsening symptoms in heart failure patients are attributable to increased filling pressures of left atrium and ventricle resulting in pulmonary congestion•Monitoring cardiac filling pressures may guide fluid management and titration of medical therapy in heart failure
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Dimension (LV diameter)
•LV diameter is a sensitive marker of heart failure. •Increasing LV diameter reflects worsening of heart failure. •Monitoring of small differences (mm) may help in adjusting medical therapy. •LV diameter is needed for calculation of cardiac output in addition to heart rate.
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Impedance and volume
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Impedance and LV function
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Impedance measurements
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Implantable biosensing transponder network
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Communication between the CTRL unit and the body
BodyEnergy +
Data
POTS
GSM
WLAN
Net
wor
k
Data
Pressure
Stimulator
Stimulator
External Control Unit secured on patient’s skin
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Overall Transponder System
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Interfaces
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Transponder
Ultrasound interface
Array
Ti housing
Glue
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Schematic application of sensors
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In vitro test of sensors
. . .
I+/- d V+/-
. . .
/3
Foam
Saline solution 0,9%
SticksConnections
/3
crystal
Lead’s electrodes
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Using IMST breadboard
t
td1d2
ZMDT
ZIMST
IMSTADC
SonometricSystem
d
Zsal
IAC=24uA@4KHz
IAC
V
V
The circuitry used on this breadboard will be integrated in the animal unit and implanted
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Joined testing at BRC
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Pictures of experimental setup
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Results
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Methods, Acute Experiments
• Animals Pigs 35-50 kg• Minimal thoracotomy for box-placement• Placement of electrodes on LV• Measurements of impedance• Volume loading and unloading to measure
impedance at varying loading condition of the LV• Statistical analysis of data
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Objectives
1. Communication and transfer to device2. Impedance measurements acute settings
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Fixation of can (suture)
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Methods, Chronic Experiments
• Induced Heart Failure in pigsLong term ventricular rapid pacing
• Implantation of UltrasponderMonitoring of ImpedanceHemodynamic measurementsEchocardiography
• Correlation of hemodynamic, echo and impedance values
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Future Prospects
Minimalization of UltrasponderLong term animal studiesClinical Studies
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Thank You For Your Attention