Wireless networks to revolutionize cardiac care

WBAN solutions are promising, and are likely to revolutionize how healthcare services are utilized and delivered.

Defibrillators have come a long way since their first implantation in humans in 1980, firmly cementing their place in preventing SCD. Despite four decades of continual design improvements and upgrades, defibrillators continue to evolve, and current research is ongoing to refine the ever-expanding indications for their use. With time, it is expected defibrillation will become more cost-effective and safer.

Since more than half a century, cardiac pacing and defibrillation represent a field in constant evolution, and they have shown some great technological advances from its conception to its methods of insertion.

The external defibrillators have come a long way from large-sized manually operated devices to current portable AED and wearable cardioverters and defibrillators. AEDs are an important part of the advanced cardiac life-support system for the treatment of sudden cardiac arrest. They are designed to be operated by a layman during an out-of-hospital cardiac arrest. Apart from automatic analysis of the cardiac rhythm, and delivering appropriate therapy, today’s defibrillator-monitor also offers additional features of vital signs assessment like temperature, BP, 12-lead ECG, and wireless transmission of the waveforms to hospital ahead of the patient arrival, together with SpO2, carbon monoxide, and methemoglobin monitoring. They are also capable of giving audible CPR instructions and delivering higher energy to 360J. They can be used by both emergency medical personnel and code-blue medical team of hospitals. Modern AEDs are made to meet the special needs of air-medical and defense operations also. Over the last three decades, AEDs have been upgraded with several new features, such as rechargeable batteries, LCD screens, voice prompts, CPR tutorials, sophisticated self-testing software, fully automatic operation, and new types of shocks.

While current AEDs are not very heavy or bulky, one can see them becoming much smaller units in the future. This will help in several ways, making them more portable (one could slip it into their backpack on a hike, keep it in the reception of small business, or store in a car first-aid kit, for example), easier to store, and easier to place throughout a building.

Current AEDs are designed to be used by anyone, even children, to safely restart a heartbeat, but the user interface and instructions have not changed much over the years. We live in a time when technology has changed every facet of our lives, creating home assistants, smart appliances, apps, and smartphones that are connected and offer innovative user-friendly interfaces and features. It would be exciting to see some of that spill into the world of AEDs, where people can be empowered more effectively to save lives. Imagine an AED that you could ask questions of and get accurate answers as you treat a person, that connects to emergency services and GPS automatically, and actively supports your lifesaving efforts. This would make bystanders more confident to act, especially in circumstances involving strangers, small children, or unusual environments.

For doctors to treat patients as effectively as possible, especially in a time-sensitive situation like SCA, they need patient data. Some new AED technology records patient data from the moment treatment starts – when the AED is attached to the patient – and makes it transmittable to emergency services and hospitals, ensuring the doctors waiting for the patient’s arrival have the most current and most accurate medical data on which to act. This allows doctors, surgical teams, and medical teams to provide more accurate, more insightful patient care, something that can directly impact on patient outcomes, survival rates, and long-term care requirements.

One of the most significant challenges when it comes to public access and private AEDs is maintenance. Without regular maintenance, which includes running testing procedures, updating software, and replacing key components like electrode pads and batteries (which have a finite lifespan), an AED is unreliable at best during a cardiac emergency. It is up to the staff and the AED owners to keep their unit in good working order.

One of the new technologies on the horizon that may challenge this issue is a single-use, multi-shock AED. Buyers will not have to worry about time-consuming maintenance because they only use the unit once, then they will send it to be recycled. This option was highly cost-prohibitive in the past, but MedTech innovators are seeing promising results for affordable single-use AEDs that run self-checks and are simple to maintain. Every advancement that makes it easier to have an on-site AED makes it just a little bit easier to save lives.

In recent years, there has been a surge in the number of devices used for heart failure and other cardiovascular treatment. With optimism about these devices from experts, several advancements in treating cardiovascular diseases with such devices have occurred over the years. For example, pacemakers, small implantable devices designed to be placed under the skin of the chest, have helped millions of people worldwide continue to live normally after developing heart arrhythmias, with electrical impulses in the pacemakers controlling the pace of the heartbeat.

New and innovative technologies have led to the development of intelligent sensors for pacemakers that permit real-time monitoring of patients. Such devices enable re-synchronization upon detection of cardiac anomalies. Moreover, using an app, these devices can transmit patient data to a physician in real time. Recently, the FDA has approved highly advanced pacemakers, such as cardiac re-synchronization therapy (CRT) pacemakers. Several features, such as smaller sizes, remote monitoring capabilities, faster responsive rates, and a notable improvement in battery longevity of modern implantable pacemakers have resulted in wide acceptance from industry experts and physicians. Wireless body area networks (WBANs) have made real-time monitoring of patients possible, including monitoring potential faults in wireless communications and ensuring safety. WBAN consists of wearable or implanted devices or sensors that are used for monitoring and logging vital parameters of patients. Rapid technological advancements in low-power integrated circuits and high-throughput wireless communication networks have made WBANs possible. Each device on the network is called a node that can transmit real-time data of the patient’s measurable physiological functions to a healthcare center. WBANs can operate autonomously to connect multiple medical sensors and devices connected to or implanted in a human body.

For cardiology, WBANs offer cost-effective solutions for real-time monitoring of temperature, blood pressure, heart rate, ECG, and respiration, which can provide further insights into a person’s health. The advantage of WBANs extends further as patients do not need to remain in the hospital for constant monitoring. Such benefits improve the patient’s quality of life while significantly reducing healthcare expenses.

In addition, patient data collected from the device provides valuable insights on the prognosis of a patient’s condition in a natural environment for a more extended period, which is essential for accurate and faster diagnosis. WBAN solutions are promising and are likely to revolutionize how healthcare services are utilized and delivered.

WBANs connect nodes, such as sensors or actuators situated over the human body, including those under the skin, through a wireless communication channel. Generally, WBANs are known to be application-dependent, and classified into two different types – single-event detection and periodic event detection. In the first type, nodes send data at the occurrence of an event (e.g., when a patient has a heart attack), while in the second type, the nodes send data at periodic intervals (e.g., sending blood pressure measures or heartbeat). Technical evolution has led to advances in high-throughput wireless data communication, thereby allowing for real-time streaming of WBAN device data. WBANs can monitor data using AI statistical classification techniques to detect in patients cardiac anomalies, such as PVC, PAC, and MI, and to alert physicians before any critical scenario occurs. WBANs are also helpful in monitoring the functionalities of implantable cardiac devices (e.g., implantable cardioverter defibrillators, ICDs, and pacemakers). Typically, WBAN is classified as per the operations – devices implanted inside the human body and wearable devices that work on the surface of the human body. Wearable devices monitor activity changes in the surrounding environment with crucial feedback to maintain the optimum status, for example, ECG, EEG, and blood pressure monitoring to monitor patients in a critical state.

Several modern ICDs, pacemakers, and LVADs have incorporated Bluetooth technology to pair devices for communication with healthcare centers for assessing the sensors.

Many leading technologies are focused on developing medical sensor systems, with low power consumption and seamless data transmission. WBANs are vital for such tasks as they act as transceivers for transmitting the signals of an ICD and ensuring reliability during data transmission of essential health data of a patient, such as pulse reports and relevant cardiac functionalities. Another significant advantage of WBANs is the compatibility with several wireless technologies for medical monitoring systems like WLAN, Wi-Fi, GSM, 3G, 4G, WPAN, and WMTS.

A common concern observed with wireless networks is the dependence on hardware, thereby limiting reprogramming possibilities. Different devices require different radio-transmission protocol stacks. Software-defined radio solves many problems related to the hardware and offers several more benefits. SDRs are flexible and reprogrammable with various protocol stacks. They simplify merging with other software to provide features like interference detection, efficiency in frequency distribution, test-repeater operations, and measurement of a parameter, such as identifying spectrum intruders and noise characterization. SDRs can help in several stages, from prototyping to deploying WBAN devices, and allow for testing new protocols, filters, AI algorithms, and error correction, using an FPGA. SDRs also provide real-time monitoring and storage solutions for a vast network of nodes (sensors/devices) on WBANs due to high data throughput.

WBAN is an emerging technology capable of transforming how healthcare services are offered. The emergence of SDRs enhances the capabilities of WBANs with increased accessibility for healthcare monitoring services. As these technologies in communications are integrated into conventional medical systems, they gradually boost patient health status analysis and monitoring efficiency. WBANs and SDRs require reliable and high-performance industry solutions for these technologies. Given the potential, it is evident that they are becoming the key contributors toward a technology that is reshaping affordable and mobile healthcare services.