Biomedical tech board

Biomedical Tech Board

Anatomy and physiology of the Heart

Implantable Pacemaker

Defibrillators

Electrosurgical units

References

Implantable Pacemaker

Principal applications

How could it be improved?

Must know

How do they work?

old and modern

Advantages and limitations

Defibrillators

How could it be improved?

Principal applications

Must know

How do they work?

old and modern

Advantages and limitations

Electrosurgical units

How could it be improved?

Principal applications

Must know

How do they work?

old and modern

Advantages and limitations

Must Know

• A pacemaker’s main function is to regulate the heart rate by sending electrical signals whenever the natural pulses are below normal or safe frequencies.
• A pacemaker will not send pulses when the heart rate is faster than normal.
• There are 3 types: single chamber (right ventricle), dual chamber (right ventricle and right atrium), biventricular (right and left ventricles).
• The lifespan of pacemakers will depend on the periodicity of the electrical pulses, but for most devices it sits between 10 and 15 years.

How do they work?

A pacemaker is composed of a pulse generator, and one or two leads with an electrode each.

Pulse generator

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Leads and electrodes

Advantages and Limitations

Aplications & improvements

• Pacemakers with wireless-remote monitoring systems would provide information about specific patients, allowing the medic to tailor a pacemaker which best benefits them
• Resistance to external sources of noice and interference (electromagnetic based) could allow pateients to safely partake in other medical procedures (like MRI)
• Extended battery power would reduce recurrent surgey costs and dangers for patients

• The most common application is regulation for those with bradycardia (slow heart rate)
• Some design monitor the patient’s heart activity for irregular patterns and tachycardias (increased heart rate)
• Preventing heart failure for those who have already experienced it

Old vs Modern

Defibrillators

• Defribillators are mainly needed to correct or prevent arrhythmias.
• There are 3 types of defibrillators: Automated External Defibrillators (AEDs), Implantable Cardioverter Defibrillators (ICDs), Wearable Cardioverter Defribillators (WCDs)
• AEDs are portable, battery-operated devices that check a person's heartbeat and send an electrical shock to restore it to normal levels.
• ICDs are placed through surgery in the chest area, they deliver high-intensity shocks to slow or speed up abnormal heart rates. It can also record the heart’s electrical activity.
• WCDs work through sensors attached to the skin, normally constructed into a vest that can be worn under clothes.

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Defibrillators Function

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Electrosurgical units

• Heat is generated through high-frequency electrical alternating currents.
• It is used routinely to cut, coagulate, dissect, fulgurate, ablate and shrink the tissue.

Electrosurgical units function

Types

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Electrosurgical units function

• There are two main waveforms:

monopolar electrosurgery

Bipolar electrosurgery

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Advantages and Limitations

Aplications & improvements

• Increase its resistance to electromagnetic interference and compatibility with other medical devices to avoid erroneous shocks.
• Increase of successful resuscitation from 90% to somewhere closer to 100%.
• Achieve greater longevity for the step-up transformers to reduce the maintenance costs of defibrillators.

• Restoration of normal heart rate during life-threatening arrhythmia.
• Measurement of heart rate and electrical activity through ICDs.
• Prevention of an irregular heartbeat from developing into a more serious complication.
• Allowing patients to return to physically active and demanding activites (excluding contact sports).

Old vs Modern

Advantages and Limitations

• It can allow the physician to achieve the desired effect due to the different modes of application. Different waveforms can either cut or coagulate a tissue.
• Electrosurgery minimizes bleeding and increases precision during application
• Offers a relatively fast method for tissue resection or ablation
• It is not compatible with other implants due to the heat produced and the damage it may cause to these.
• Use of these devices requires extreme precision and preparation by the physician, making it inaccessible for a lot of the population.
• Lack of maintenance may cause accidental burns due to insulation failure.

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Aplications & improvements

• Reducing possible complications and side effects through automatic and efficient waveform and current control during surgery
• Improve cutting precision, reduce thermal injury, andpresent a more cost-effective minimally invasive surgery
• Monitoring systems which deactivate whenever a dispersion element is not in contact and could cause burns

• Control bleeding and rapidly dissect soft tissue
• Laparascopic procedures to treat endometrial and cervical cancer
• Management of polycystic ovary syndrome which causes infertility
• Removal of skin lesions (non-cancerous moles, warts, etc.)

+ info

Old vs Modern

[1] Electrocardiogram (ECG) - Electrocardiography. (2019). [Website]. Retrieved from https://www.cardiosecur.com/magazine/specialist-articles-on-the-heart/electrocardiogram-ecg [2] Pacemaker. (December 2, 2021). MayoClinic. [Website]. Retrieved from https://www.mayoclinic.org/tests-procedures/pacemaker/about/pac-20384689#:~:text=Overview,called%20a%20cardiac%20pacing%20device [3] Parker, B., Furman, S. (1975). Engineering in Medicine: Pacemaker Electronic Circuits. Springer, Berlin. 55-72. [PDF]. Retrieved from https://page-one.springer.com/pdf/preview/10.1007/978-3-642-66187-7_4 [4] Permanent Pacemaker.(February 28, 2022). Cleveland Clinic. [Website]. Retrieved from https://my.clevelandclinic.org/health/treatments/17360-permanent-pacemaker [5] What Are Pacemakers? (March 24, 2022). National Heart, Lung, and Blood Institute. [Website]. Retrieved from https://www.nhlbi.nih.gov/health/pacemakers [6] Fornell, D. (February 13, 2018). New Pacemaker Technologies. Diagnostic and Interventional Cardiology. [Website]. Retrieved from https://www.dicardiology.com/article/new-pacemaker-technologies [7] Aquilina O. (2006). A brief history of cardiac pacing. Images in paediatric cardiology, 8(2), 17-81. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232561/#:~:text=Mains%2Dpowered%20pacemakers%20were%20developed,obtain%20their%20alternating%20current%20power [8] What are Deribrillators? (March 24, 2022). National Heart, Lung, and Blood Institute. [Website]. Retrieved from https://www.nhlbi.nih.gov/health/defibrillators#:~:text=An%20AED%20is%20a%20lightweight,who%20is%20having%20cardiac%20arrest [9] Singh, S., Ingham, R. & Golding, J. (2011). Basics of electricity for anaesthetists. Continuing Education in Anaesthesia, Critical Care & Pain. 11. 224-228. Retrieved from https://www.researchgate.net/publication/275304884_Basics_of_electricity_for_anaesthetists [10] Implantable Cardioverter-defibrillators (ICDs). (December 2, 2021). MayoClinic. [Website]. Retrieved from https://www.mayoclinic.org/tests-procedures/implantable-cardioverter-defibrillators/about/pac-20384692 [11] Gierula, J., Paton, M.F., Witte, K.K. (2021). Advances in cardiac resynchronization and implantable cardioverter/defibrillator therapy: Medtronic Cobalt and Crome. Future Cardiology, 17(4). Retrieved from https://www.futuremedicine.com/doi/full/10.2217/fca-2020-0117

References

References

[12] Rogers, K. (2017). Defibrillation. Encyclopedia Britannica. Retrieved from https://www.britannica.com/science/defibrillation [13] Cordero, I. (2015). Electrosurgical units - how they work and how to use them safely. Community Eye Health, 28(89). 15-16. Retrieved form https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579996/ [14] Fono-Tamo, R., Ejodakemen, H., & Ndrelan, B. (2021). Design and Construction of a High-Frequency Electrosurgical Unit for Rural Application. 7-12. Retrieved from https://www.researchgate.net/publication/349725205_Design_and_Construction_of_a_High-Frequency_Electrosurgical_Unit_for_Rural_Application [15] Chiappone, G., Bailey, J. (n.d.). Electrosurgery: What is it, How does it Work, and What are the Benefits. [Website]. Retrieved from https://www.steris.com/healthcare/knowledge-center/therapeutic-endoscopy/electrosurgery-what-is-it-types-benefits [16] Aminimoghaddamn, S., Pahlevani, R., Kazemi, M. (2018). Electrosurgery and clinical applications of electrosurgical devices in gynecologic procedures. Medical Hournal of the Islamic Republic of Iran, 32(90). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377004/ [17] Massarweh, N., Cosgriff, N., Slakey, D. (2006). Electrosurgery: History, Principles, and Current and Future Uses. Journal of the American College of Surgeons, 202. 520-30. Retrieved from https://www.researchgate.net/publication/7277726_Electrosurgery_History_Principles_and_Current_and_Future_Uses