MODULE 2

Module - 2
HUMAN ORGAN SYSTEMS AND BIO DESIGNS - 1 (QUALITATIVE):

Brain as a CPU system (architecture, CNS and Peripheral Nervous System, signal transmission, EEG,
Robotic arms for prosthetics. Engineering solutions for Parkinson’s disease).Eye as a Camera system
(architecture of rod and cone cells, optical corrections, cataract, lens materials, bionic eye).Heart as
a pump system (architecture, electrical signalling - ECG monitoring and heart related issues, reasons
for blockages of blood vessels, design of stents, pace makers, defibrillators).

HUMAN ORGAN SYSTEMS AND BIO DESIGNS:

The human body is a biological machine made of body systems; groups of organs that work
together to produce and sustain life. Organ systems are:
Skeletal system, Muscular system, Cardiovascular system, Respiratory system, Nervous system,
Digestive system, Urinary system, Endocrine system, Lymphatic system, Reproductive system,
Integumentary system.

Biodesign is the use of living organisms in design. Its processes can be used in the creation of
fashion, textiles, furniture and architecture. Nonprofits, design companies and universities around
the world, including UC Davis, increasingly implement biodesign practices into research and
product development.

Bio-design (actual or conceptual) embodies an emerging design movement which incorporates the
use of living materials, or ‘moist media,’ such as fungi, algae, yeast, bacteria, and cultured tissue.
This can be as part of standard crafting methods or the more complex fields of biomimicry and
synthetic biology. The idea is to create a product whose properties are enhanced as a result of the
use of these living materials. Some examples are explained below.

The Human Brain

The brain or human brain is quite a complex and abstract system. It is constituted with neurons
and synapses. A typical human brain contains around 100 billion neurons and about
1012 synapses per cm3. A human brain has a capability to encode, retain, and store the information.
This ability is termed as memory, and it the place of brain where all the information, learned
processes and past experiences retained.
In the brain, neurons are the living cells that used as the storage unit. These neurons are made
up of synapses. Synapses are responsible for transmitting the electric neural impulses from one
neuron to another. One most interesting characteristic of the human brain is that it has infinite
storage capacity

What is a Computer?
A computer is an electronic device that can perform a task based on instructions of the user. A
computer can perform several tasks based on its programming. A computer is a very powerful
machine that can process billions of instructions in few seconds, but when we compare it with
the human brain, it is far backward. It is because a computer needs user’s instruction for data
processing and also can perform those tasks for which it is preprogrammed. That means it cannot
make decisions on its own.
A computer is built up of several electronic components like transistors, logic gates, capacitors,
diodes, etc. All these electronic components are connected in a certain fashion to realize the
circuit of the computer. In a computer, several types of memory devices are used to store data
and information. These memory devices have a fixed storage capacity. When we need to share
information among different computers, we have to establish computer networks having a
definite topology.
BRAIN AS A CPU SYSTEM:

Both CPU and brain use electrical signals to send messages. The brain uses chemicals to transmit
information; the computer uses electricity. Even though electrical signals travel at high speeds in
the nervous system, they travel even faster through the wires in a computer. Both transmit
information.

A BCI system is a computer-based system that takes brain signals, analyses them and translates
them into commands that are relayed to a device to trigger a desired action. A BCI system does
not use peripheral nerves and head muscles. The CNS (Central Nervous System), for example, is
used to measure signals produced by the central nervous system. Thus, for example, a sensor that
is activated by the voice or the movement of a muscle is not a BCI system. Also an EEG is not
BCI itself, because it only records brain signals but it does not produce an output that acts on the
user's environment. It is also wrong to think that BCI is a mind-reader. They do not export
information from unsuspecting users or users unwillingly using the system. They allow users to
act in their environment when they want it by reading their brain signals rather than muscles. The
user and the BCI work together. The user, after a training session, produces brain signals encoded
by the BCI system. The BCI then translates these commands and transmits them into an output
device. Brain computer interfaces have contributed to various areas of research. Applications that
are about medicine, neuro-technology and smart environment, neuro-marketing and advertising,
education and self-regulation, games and entertainment, as well as security and identification.
The nervous system has two main parts: The central nervous system is made up of the brain and
spinal cord. The peripheral nervous system is made up of nerves that branch off from the spinal
cord and extend to all parts of the body.

1) CNS:
CNS includes the brain and spinal cord. The brain is the body’s “control center.” The CNS has
various centers located within it that carry out the sensory, motor and integration of data. These
centers can be subdivided to Lower Centers (including the spinal cord and brain stem) and higher
centers communicating with the brain via effectors.

2) PNS:
PNS is a vast network of spinal and cranial nerves that are linked to the brain and the spinal cord.
It contains sensory receptors which help in processing changes in the internal and external
environment. This information is sent to the CNS via afferent sensory nerves. The PNS is then
subdivided into the autonomic nervous system and the somatic nervous system. The autonomic
has involuntary control of internal organs, blood vessels, smooth and cardiac muscles. The somatic
has voluntary control of skin, bones, joints, and skeletal muscle. The two systems function
together, by way of nerves from the PNS entering and becoming part of the CNS, and vice versa.

COURTESY: MARC SEYMOUR

SIGNAL TRANSMISSION:

A neuron sending a signal (i.e., a presynaptic neuron) releases a chemical called a neurotransmitter,
which binds to a receptor on the surface of the receiving (i.e., postsynaptic) neuron.
Neurotransmitters are released from presynaptic terminals, which may branch to communicate
with several postsynaptic neurons.
Axon terminals are where neurotransmission begins. Hence, it is at axon terminals where the
neuron sends its OUTPUT to other neurons. At electrical synapses, the OUTPUT will be the
electrical signal itself. At chemical synapses, the OUTPUT will be neurotransmitter.
The correct outline for the sequence of transmission of an electrical impulse through a neuron is
dendrites, cell body, axon, axon terminal
COURTESY: OPENSTAX COLLEGE,BIOLOGY

ELECTRO ENCEPHALO GRAM [EEG]:

An electroencephalogram (EEG) is a test that measures electrical activity in the brain using small,
metal discs (electrodes) attached to the scalp. Brain cells communicate via electrical impulses and
are active all the time, even during asleep. This activity shows up as wavy lines on an EEG
recording.
An EEG is one of the main diagnostic tests for epilepsy. An EEG can also play a role in diagnosing
other brain disorders.
An EEG can find changes in brain activity that might be useful in diagnosing brain disorders,
especially epilepsy or another seizure disorder. An EEG might also be helpful for diagnosing or
treating:
 Brain tumors
 Brain damage from head injury
 Brain dysfunction that can have a variety of causes (encephalopathy)
 Sleep disorders
 Inflammation of the brain (herpes encephalitis)
 Stroke
 Sleep disorders
  Creutzfeldt-Jakob disease
An EEG might also be used to confirm brain death in someone in a persistent coma. A continuous
EEG is used to help find the right level of anesthesia for someone in a medically induced coma.
Voltage fluctuations measured by the EEG bioamplifier and electrodes allow the evaluation of
normal brain activity including the posterior dominant rhythm (PDR), first described by Hans
Berger. EEG can detect abnormal electrical discharges such as sharp waves, spikes or spike-and-
wave complexes that are seen in people with epilepsy, thus it is often used to inform the medical
diagnosis. EEG can detect the onset and spatio-temporal evolution of seizures and the presence of
status epilepticus. It is also used to help diagnose sleep disorders, depth of anesthesia, coma,
encephalopathies, cerebral hypoxia after cardiac arrest, and brain death. EEG used to be a first-
line method of diagnosis for tumors, stroke and other focal brain disorders, but this use has
decreased with the advent of high-resolution anatomical imaging techniques such as magnetic
resonance imaging (MRI) and computed tomography (CT). Despite limited spatial resolution, EEG
continues to be a valuable tool for research and diagnosis. It is one of the few mobile techniques
available and offers millisecond-range temporal resolution which is not possible with CT, PET or
MRI.

Derivatives of the EEG technique include evoked potentials (EP), which involves averaging the
EEG activity time-locked to the presentation of a stimulus of some sort (visual, somatosensory, or
auditory). Event-related potentials (ERPs) refer to averaged EEG responses that are time-locked
to more complex processing of stimuli; this technique is used in cognitive science, cognitive
psychology, and psychophysiological resea

COURTESY: Z. JANE WAng

ROBOTIC ARMS FOR PROSTHETICS:

Robotic prosthetic limb is a well-established research area that integrates advanced mechatronics,
intelligent sensing, and control for achieving higher order lost sensorimotor functions while
maintaining the physical appearance of amputated limb. Robotic prosthetic limbs are expected to
replace the missing limbs of an amputee restoring the lost functions and providing aesthetic
appearance. The main aspects are enhanced social interaction, comfortable amputee’s life, and
productive amputee to the society. With the advancement of sensor technology, in the last few
decades significant contributions have been made in this area.
Most current robotic prostheses work by recording—from the surface of the skin—electrical
signals from muscles left intact after an amputation. Some amputees can guide their artificial hand
by contracting muscles remaining in the forearm that would have controlled their fingers.
If you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which is
called a prosthesis, can help you to perform daily activities such as walking, eating, or dressing.
Robotic arms can be used to automate the process of placing goods or products onto pallets. By
automating the process, palletizing becomes more accurate, cost-effective, and predictable. The
use of robotic arms also frees human workers from performing tasks that present a risk of bodily
injury.

COURTESY: RESEARCH GATE

ENGINEERING SOLUTIONS FOR PARKINSON’S DISEASE:

Parkinson's disease is a progressive disorder that affects the nervous system and the parts of the
body controlled by the nerves. Symptoms start slowly. The first symptom may be a barely
noticeable tremor in just one hand. Tremors are common, but the disorder may also cause stiffness
or slowing of movement.
In Parkinson's disease, certain nerve cells (neurons) in the brain gradually break down or die. Many
of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain
called dopamine. When dopamine levels decrease, it causes atypical brain activity, leading to
impaired movement and other symptoms of Parkinson's disease.
Parkinson's disease can't be cured, but medications can help control the symptoms, often
dramatically. In some more advanced cases, surgery may be advised. Your health care provider
may also recommend lifestyle changes, especially ongoing aerobic exercise.

ENGINEERING SOLUTIONS TO THIS DISEASE ARE:

Deep Brain Stimulation – Deep Brain Stimulation (DBS) involves surgically implanting a
neurotransmitter that sends electrical impulses to specific areas of your brain. This procedure has
helped many people with Parkinson's reduce symptoms such as tremor, rigidity, and bradykinesia.
There are six main types of medications available to treat symptoms of Parkinson disease:
levodopa, dopamine agonists, and inhibitors of enzymes that inactivate dopamine (monoamine
oxidase type B [MAO B] inhibitors and catechol-O-methyl transferase [COMT] inhibitors,
anticholinergic drugs, and amantadine.

ENGINEERING NEURONS are another treatment method for this.

Transplantation of embryonic neurons can restore functional dopaminergic neurons in the brains
of patients with Parkinson's disease. But while promising, cell transplantation therapy is still out
of reach to most patients, in part because of the inaccessibility of human embryonic tissue.

First obtained neuronal stem cells from mouse cells transfected with a transcription factor that
encourages cells to adopt a neuronal fate. They then co-cultured the cells with astrocytes, which
release a factor that induces development into dopaminergic neurons. The engineered cells
released dopamine, and some maintained the characteristics of dopaminergic neurons for up to two
weeks after implantation into mouse brains.
EYE AS A CAMERA SYSTEM:

The human eye is a wonderful instrument, relying on refraction and lenses to form images. There
are many similarities between the human eye and a camera, including:
A diaphragm to control the amount of light that gets through to the lens. This is the shutter in a
camera, and the pupil, at the center of the iris, in the human eye. A lens to focus the light and create
an image. The image is real and inverted. A method of sensing the image. In a camera, film is used
to record the image; in the eye, the image is focused on the retina, and a system of rods and cones
is the front end of an image-processing system that converts the image to electrical impulses and
sends the information along the optic nerve to the brain.
There are two photoreceptors: RODS AND CONES

These photoreceptors are localized around an area near the centre of the retina called the macula,
which is the functional center of the retina. The fovea is located in the centre of the macula. The
macula is responsible for high-resolution, color vision, provided by different types of
photoreceptors.

Photoreceptors in the retina are classified into two groups, named after their physical
morphologies. Rod cells are highly sensitive to light and function in night vision, whereas cone
cells are capable of detecting a wide spectrum of light photons and are responsible for colour
vision. Rods and cones are structurally compartmentalized. They consist of five principal regions:
Outer segment, connecting cilium, Inner segment, nuclear region, Synaptic region, Rods are
responsible for vision at low light levels (scotopic vision). They do not mediate color vision and
have a low spatial acuity.
Cones are active at higher light levels (photopic vision), are capable of color vision and are
responsible for high spatial acuity. The central fovea is populated exclusively by cones. There are
3 types of cones which we will refer to as the short-wavelength sensitive cones, the middle-
wavelength sensitive cones and the long-wavelength sensitive cones or S-cone, M-cones, and L-
cones for short.
 COURTESY: EASY BIOLOGY CLASS

OPTICAL CORRECTIONS:

A slight modification of geometrically correct lines (as of a building) for the purpose of making
them appear correct to the eye.
The ability to see images or objects with clear, sharp vision results from light entering the eye.
Light rays bend or refract when they hit the retina, sending nerve signals to the optic nerve, which
then sends these signals to the brain. The brain processes them into images, allowing you to
understand what you see. When these light rays bend incorrectly, it results in a refractive error and
typically causes blurry or cloudy vision.
Since the primary cause of vision problems is caused by light bending incorrectly as it enters the
eye, virtually any method of treatment that changes this can be categorized as a form of vision
correction.
Eyeglasses and contact lenses – the most common types of corrective measures – are almost always
recommended as the first course of treatment for vision problems. While they are considered a
very basic method of vision correction, they are unable to control the refractive error from
progressing. Patients whose vision worsens over time need new glasses or contacts. In these cases,
longer-term solutions are needed.

CATARACT:
A cataract is a clouding of the normally clear lens of the eye. At first, the cloudiness in your vision
caused by a cataract may affect only a small part of the eye's lens and you may be unaware of any
vision loss. As the cataract grows larger, it clouds more of your lens and distorts the light passing
through the lens. This may lead to more-noticeable symptoms. A cataract is a cloudy lens. The
lens is positioned behind the colored part of your eye (iris). The lens focuses light that passes into
your eye, producing clear, sharp images on the retina — the light-sensitive membrane in the eye
that functions like the film in a camera.
As you age, the lenses in your eyes become less flexible, less transparent and thicker. Age-related
and other medical conditions cause proteins and fibers within the lenses to break down and clump
together, clouding the lenses.

As the cataract continues to develop, the clouding becomes denser. A cataract scatters and blocks
the light as it passes through the lens, preventing a sharply defined image from reaching your
retina. As a result, your vision becomes blurred. Cataracts generally develop in both eyes, but not
always at the same rate. The cataract in one eye may be more advanced than the other, causing a
difference in vision between eyes. Cataracts may be partial or complete, stationary or progressive,
hard or soft. Histologically, the main types of age-related cataracts are nuclear sclerosis, cortical,
and posterior subcapsular.

Nuclear sclerosis is the most common type of cataract, and involves the central or 'nuclear' part of
the lens. This eventually becomes hard, or 'sclerotic', due to condensation on the lens nucleus and
the deposition of brown pigment within the lens. In its advanced stages, it is called a brunescent
cataract. In early stages, an increase in sclerosis may cause an increase in refractive index of the
lens. This causes a myopic shift (lenticular shift) that decreases hyperopia and enables presbyopic
patients to see at near without reading glasses. This is only temporary and is called second sight.
Cortical cataracts are due to the lens cortex (outer layer) becoming opaque. They occur when
changes in the fluid contained in the periphery of the lens causes fissuring. When these cataracts
are viewed through an ophthalmoscope, or other magnification system, the appearance is similar
to white spokes of a wheel. Symptoms often include problems with glare and light scatter at night.
Posterior subcapsular cataracts are cloudy at the back of the lens adjacent to the capsule (or bag)
in which the lens sits. Because light becomes more focused toward the back of the lens, they can
cause disproportionate symptoms for their size.

An immature cataract has some transparent protein, but with a mature cataract, all the lens protein
is opaque. In a hypermature or Morgagnian cataract, the lens proteins have become liquid.
Congenital cataract, which may be detected in adulthood, has a different classification and includes
lamellar, polar, and sutural cataracts.
COURTESY: THE EYE HEALTH CENTRE

LENS MATERIALS:

Corrective spherocylindrical lenses are commonly used to treat refractive errors such as myopia,
hyperopia, presbyopia, and astigmatism. Both lenses and prisms are also frequently used to
improve eye alignment and treat diplopia in strabismus. Eyeglasses also serve an important role in
protecting the eyes from physical trauma and harmful radiation. Lenses can be produced using a
variety of materials and designed with several optical profiles to optimize use in specific
applications. Critical lens properties include refractive index, Abbe number (chromatic
dispersion), specific gravity, and ultraviolet absorption.
The most common lens material is, of course, optical glass, but crystals and plastics are frequently
used, while mirrors can be made of essentially anything that is capable of being polished.
There are 5 main types of lens materials for eyeglasses and sunglasses. Each type of lens material
can help correct refractive errors such as nearsightedness, farsightedness, astigmatism, or
presbyopia.
Types of lens materials:

1. CR-39: The most used plastic lens material for years was CR-39. It was first developed as a
replacement for glass lenses during World War II. It still has 55% of world market at age 60. The
patent was awarded to Muskat and Strain of Pittsburgh Plate Glass Company (now named PPG)
in 1946. CR-39 is available in all lens styles and from multiple manufacturers. The basic monomer
comes from PPG, and then each company adds their own materials to create their
lenses. Advantages include light weight, good optical properties, and tinting well. Disadvantages
of CR-39 are that it is the thickest material and scratches easily.

2. Crown Glass is the most commonly used clear glass for ophthalmic lenses. In general, glass is
the most durable material used for lenses. Crown glass is used mainly for single vision lenses and
the distance carrier for most glass bifocals and trifocals. It has an index of refraction of 1.523, and
an Abbe value of 59. It is approximately 4% thinner than CR-39 resin lenses and is 40% heavier
than polycarbonate lenses and is slightly lighter than high index glass. It blocks out about 10% of
UV light.

3. Flint Glass uses lead oxides in its chemical make up to increase its index of refraction to
approximately 1.58 to 1.69. Its Abbe value ranges from 30 to 40. This material is relatively soft,
displays a brilliant luster and has chromatic aberration. Although it was used in the past as a single
vision alternative for higher Rx lenses, its use today is often limited to segments for some fused
bifocals.
The advantages of glass lenses include optical clarity, resistance to scratches, and it is the least
susceptible to chemicals. The disadvantages include that it is the heaviest material and it is less
impact resistant than other materials.

4. Polycarbonate Lenses: Polycarbonate lenses were first developed by a company named

Gentex. Polycarbonate is a thermoplastic which means it is moldable under sufficient heat. In the
1950's it was marketed under the name Lexan and due to its extraordinary resistance to impact was
originally manufactured for safety devices.

BIONIC EYES:

bionic eye, electrical prosthesis surgically implanted into a human eye in order to allow for the
transduction of light (the change of light from the environment into impulses the brain can process)
in people who have sustained severe damage to the retina.
The bionic eye comprises an external camera and transmitter and an internal microchip. The
camera is mounted on a pair of eyeglasses, where it serves to organize the visual stimuli of the
environment before emitting high-frequency radio waves. The stimulator microchip consists of an
electrode array that is surgically implanted into the retina. That functions as an electrical relay in
place of degenerated retinal cells. The radio waves that are emitted by the external camera and
transmitter are received by the stimulator, which then fires electrical impulses. The impulses are
relayed by the few remaining retinal cells and are transduced as normal to the optic nerve pathway,
resulting in vision.

The bionic vision system consists of a camera, attached to a pair of glasses, which transmits high-
frequency radio signals to a microchip implanted in the retina. Electrodes on the implanted chip
convert these signals into electrical impulses to stimulate cells in the retina that connect to the optic
nerve.
It is an expensive treatment and not everyone can afford it. b. Since research is still going on results
are yet not 100% successful.

It’s an artificial eye which provide visual sensations to the brain. It consist of electronic systems
having image sensors, microprocessors, receivers, radio transmitters and retinal chips. Technology
provided by this help the blind people to get vision again.
It consist of a computer chip which is kept in the back of effected person eye and linked with a
mini video camera built into glasses that they wear. Then an image captured by the camera are
focused to the chip which converts it into electronic signal that brain can interpret. The images
produced by Bionic eye were not be too much perfect but they could be clear enough to recognize.
The implant bypasses the diseased cells in the retina and go through the remaining possible cells.

COURTESY: CIRCUITDIGEST

The device consists of 3,500 micro photodiodes which are set at the back part of the retina. The
electrical signal which is sent to brain is obtained from these miniature solar cells array as they
convert the normal light to electrical signal.
HEART AS A PUMP SYSTEM:

Heart is sort of like a pump, or two pumps in one. The right side of your heart receives blood from
the body and pumps it to the lungs. The left side of the heart does the exact opposite: It receives
blood from the lungs and pumps it out to the body. While an LVAD consists of thick tubes and a
pump connected externally to the heart muscle and aorta, percutaneous heart pumps place a much
smaller tube inside the heart's chambers. These tiny heart pumps are placed in the heart via a thin
tube called a catheter that is threaded through a puncture site in the skin. The human heart is very
strong and is capable of pumping blood up to 30 feet distance. An average heart beats maximum
of 70-80 beats per minute and is considered healthy. The efficiency of the heart can be maintained
and improved by performing physical activity. The heart is called a double pump because each
side pumps blood to a different circulation. Deoxygenated blood from the body drains to the right
side of the heart. This is the first pump that sends blood to the lungs, called the pulmonary
circulation, where it becomes oxygenated and releases carbon dioxide.

Here is what happens as blood flows through the heart and lungs:
The blood first enters the right atrium. The blood then flows through the tricuspid valve into the
right ventricle. When the heart beats, the ventricle pushes blood through the pulmonic valve into
the pulmonary artery. The pulmonary artery carries blood to the lungs where it “picks up” oxygen.
It then leaves the lungs to return to the heart through the pulmonary vein. The blood enters the left
atrium. It drops through the mitral valve into the left ventricle. The left ventricle then pumps blood
through the aortic valve and into the aorta. The aorta is the artery that feeds the rest of the body
through a system of blood vessels. Blood returns to the heart from the body via two large blood
vessels called the superior vena cava and the inferior vena cava. This blood carries little oxygen,
as it is returning from the body where oxygen was used. The vena cava pump blood into the right
atrium and the cycle begins all over again.
 COURTESY: SEER TRAINING MODULES

The human heart is a four-chambered muscular organ, shaped and sized roughly like a man's closed
fist with two-thirds of the mass to the left of midline. The heart is enclosed in a pericardial sac that
is lined with the parietal layers of a serous membrane. The visceral layer of the serous membrane
forms the epicardium.
The myocardium of the heart wall is a working muscle that needs a continuous supply of oxygen
and nutrients to function efficiently. For this reason, cardiac muscle has an extensive network of
blood vessels to bring oxygen to the contracting cells and to remove waste products.

ELECTRICAL SIGNALING:

The sinus node generates an electrical stimulus regularly, 60 to 100 times per minute under normal
conditions. The atria are then activated. The electrical stimulus travels down through the
conduction pathways and causes the heart's ventricles to contract and pump out blood.

ECG MONITORING:

ECG monitoring systems have been developed and widely used in the healthcare sector for the
past few decades and have significantly evolved over time due to the emergence of smart enabling
technologies.
Nowadays, ECG monitoring systems are used in hospitals, homes, outpatient ambulatory settings,
and in remote contexts. They also employ a wide range of technologies such as IoT, edge
computing, and mobile computing. In addition, they implement various computational settings in
terms of processing frequencies, as well as monitoring schemes. They have also evolved to serve
purposes and targets other than disease diagnosis and control, including daily activities, sports,
and even mode-related purposes.

This massive diversity in ECG monitoring systems’ contexts, technologies, computational

schemes, and purposes makes it hard for researchers and professionals to design, classify, and
analyze ECG monitoring systems. Some efforts attempted to provide a common understanding of
ECG monitoring systems’ processes, guiding the design of efficient monitoring systems. However,
these studies lack comprehensiveness and completeness.
They work for specific contexts, serve specific targets, or are suitable for specific technologies.
This makes the available ECG monitoring system processes and architectures hard to generalize
and reuse. On the other hand, some studies attempted to analyze ECG monitoring systems’
attributes and provide classification taxonomies, supporting better analysis and understanding of
the ECG systems reported in the literature. However, exiting reviews related to ECG monitoring
in the literature can be intuitive and incomprehensive.

They do not consider the latest technological trends, and they target very narrow research niches,
such as wearable sensors, mobile sensors, disease diagnosis, heartbeat detection, emotion
recognition, or ECG compression methods. Hence, there is a need to provide a comprehensive,
expert-verified taxonomy of ECG monitoring systems, a common architecture, and a complete set
of processes to guide the classification, analysis, and design of these systems.
COURTESY: MDPI

The existing ECG classification algorithms usually include signal preprocessing, such as wavelet
transform and manual feature extraction, but the amount of computation will increase the delay of
the real-time classification system. In recent years, deep learning algorithm with their advantages
of automatic learning features is increasingly used in the field of health care, such as medical image
recognition and segmentation, time series data monitoring, and analysis. At present, the
outstanding algorithm can establish an end-to-end DNN network to learn the characteristics of
ECG records by using the extensive digital characteristics of ECG data, which saves a lot of signal
preprocessing steps. Because the performance of DNN increases with the amount of training data,
this method can make good use of the extensive digitization of ECG data.
Arrhythmias are any abnormal activation sequence of the myoscardium. Some of these include
myocardial infarction, which is caused by the sudden loss of blood supply to the heart. One of the
most difficult and essential health problems in the real world is the prediction of heart disease.
This condition affects the function of blood vessels and can weaken the body of the patient.
According to the WHO, around 18 million people die yearly due to heart disease globally.
Due to the increasing prevalence of cardiac diseases, people are prone to prevent devastating event
from happening. They are used to diagnose a patient's cardiac condition.
Electrocardiography (ECG) is a quick and easily accessible method for diagnosis and screening of
cardiovascular diseases including heart failure (HF). Artificial intelligence (AI) can be used for
semi-automated ECG analysis. The aim of this evaluation was to provide an overview of AI use
in HF detection from ECG signals and to perform a meta-analysis of available studies.

Evaluation of symptoms suggestive of HF currently demands physicians to valuate various

parameters including imaging and laboratory data and the electrocardiogram (ECG). Besides a
standard examination that includes an ECG, imaging information, such as echocardiography or
magnetic resonance imaging, is seen as gold standard in diagnosis of HF. Nevertheless, an
adequate use of such imaging data is associated with relevant technical infrastructure and medical
expertise. The ECG is a well-established, quick, and easily accessible method for diagnosis and
screening of various cardiovascular diseases. It provides specific features that indicate presence of
HF or prognosis in HF patients especially to rule out HF in case of a normal ECG. However, use
of an ECG as primary diagnostic instrument often only yields insufficient diagnostic specificity.
Further, general practitioner–based ECG reporting has varying results, introducing further
diagnostic uncertainty.
Devices providing medically relevant information generated directly by individuals outside the
healthcare system such as smartphones with health applications or wearables including
smartwatches are an emerging trend. This development promises that a growing number of, e.g.,
ECG data generated at home will be available for a diagnostic screening. Such data have already
shown potential in computer-aided decision support systems to warn patients of rhythmic
abnormalities. Management of this quantity of data, however, might be a challenge for the
individual healthcare professional, as well as for the healthcare system itself. The potentially
beneficial use of artificial intelligence (AI) in cardiology in general has been discussed already,
e.g., as a tool for clinicians that could facilitate precision in daily practice and even might improve
patient outcomes. AI might also be able to help in interpretation of ECG signals and could therefore
be used to analyze ECG data in specific cases and on a large scale for early identification of
cardiovascular diseases such as HF.

REASONS FOR BLOCKAGES OF BLOOD VESSELS:

Coronary artery disease is a common heart condition. The major blood vessels that supply the heart
(coronary arteries) struggle to send enough blood, oxygen and nutrients to the heart muscle.
Cholesterol deposits (plaques) in the heart arteries and inflammation are usually the cause of
coronary artery disease.

Signs and symptoms of coronary artery disease occur when the heart doesn't get enough oxygen-
rich blood. If you have coronary artery disease, reduced blood flow to the heart can cause chest
pain (angina) and shortness of breath. A complete blockage of blood flow can cause a heart attack.
Coronary artery disease starts when fats, cholesterols and other substances collect on the inner
walls of the heart arteries. This condition is called atherosclerosis. The buildup is called plaque.
Plaque can cause the arteries to narrow, blocking blood flow. The plaque can also burst, leading
to a blood clot.
Besides high cholesterol, damage to the coronary arteries may be caused by:
Diabetes or insulin resistance, High blood pressure, Not getting enough exercise (sedentary
lifestyle), Smoking or tobacco use.

DESIGN OF STENTS:

A stent is a tiny tube that can play a big role in treating your heart disease. It helps keep your
arteries -- the blood vessels that carry blood from your heart to other parts of your body, including
the heart muscle itself -- open.
Most stents are made out of wire mesh and are permanent. Some are made out of fabric. These are
called stent grafts and are often used for larger arteries.
Others are made of a material that dissolves and that your body absorbs over time. They're coated
in medicine that slowly releases into your artery to prevent it from being blocked again.

Why Would You Need a Stent?

If a fatty substance called plaque builds up inside an artery, it can reduce blood flow to your heart.
This is called coronary heart disease and it can cause chest pain.
The plaque can also cause a blood clot that blocks blood flowing to your heart, which may lead to
a heart attack.
By keeping an artery open, stents lower your risk of chest pain. They can also treat a heart attack
that's in progress.
Doctor usually inserts a stent using a minimally invasive procedure. They will make a small
incision and use a catheter to guide specialized tools through your blood vessels to reach the area
that needs a stent. This incision is usually in the groin or arm. One of those tools may have a
camera on the end to help your doctor guide the stent. During the procedure, doctor may also use
an imaging technique called an angiogram to help guide the stent through the vessel.
Using the necessary tools, doctor will locate the broken or blocked vessel and install the stent.
Then they will remove the instruments from your body and close the incision.

DESIGN:

Most of these stents are constructed from a nickel titanium alloy. Balloon expandable stents are
susceptible to permanent deformation when they are compressed extrinsically, which is not an
issue in the coronary tree. Self-expanding stents do not have this limitation. Furthermore, self-
expanding stents have less axial stiffness and are thus more flexible and will conform to the shape
of the vessel rather than the vessel conforming to the shape of the stent. Balloon expandable stents,
by virtue of their design, resist expansion by the balloon, but they have less acute recoil when they
are placed in a poorly compliant lesion. However, after the initial deployment, the stent is at its
maximal diameter and cannot get larger, whereas a self-expanding stent that is appropriately
oversized for the vessel will exhibit a chronic outward force on the lesion and may lead to a larger
lumen over time. For the reasons above, there are some coronary lesions where balloon expandable
stents are not ideal, such as aneurysmal, ectatic vessels, thrombus laden vessels, and vessels that
are tapering with a large size mismatch between distal reference and proximal reference vessels.

PACE MAKERS:

A pacemaker is a small device that's placed (implanted) in the chest to help control the heartbeat.
It's used to prevent the heart from beating too slowly. Implanting a pacemaker in the chest requires
a surgical procedure.
A pacemaker is also called a cardiac pacing device.

Types:
Single chamber pacemaker. This type usually carries electrical impulses to the right ventricle of
your heart.
Dual chamber pacemaker. This type carries electrical impulses to the right ventricle and the right
atrium of your heart to help control the timing of contractions between the two chambers.
Biventricular pacemaker. Biventricular pacing, also called cardiac resynchronization therapy, is
for people who have heart failure and heartbeat problems. This type of pacemaker stimulates both
of the lower heart chambers (the right and left ventricles) to make the heart beat more efficiently.
A pacemaker is implanted to help control your heartbeat. Your doctor may recommend a
temporary pacemaker when you have a slow heartbeat (bradycardia) after a heart attack, surgery
or medication overdose but your heartbeat is otherwise expected to recover. A pacemaker may be
implanted permanently to correct a chronic slow or irregular heartbeat or to help treat heart failure.
Pacemakers work only when needed. If your heartbeat is too slow (bradycardia), the pacemaker
sends electrical signals to your heart to correct the beat.

Some newer pacemakers also have sensors that detect body motion or breathing rate and signal
the devices to increase heart rate during exercise, as needed.

COURTESY: WIKIMEDIA COMMONS

A pacemaker has two parts:

1) Pulse generator. This small metal container houses a battery and the electrical circuitry that
controls the rate of electrical pulses sent to the heart.
2) Leads (electrodes). One to three flexible, insulated wires are each placed in one or more
chambers of the heart and deliver the electrical pulses to adjust the heart rate. However, some
newer pacemakers don't require leads. These devices, called leadless pacemakers, are implanted
directly into the heart muscle.
DEFIBRILLATORS:

Defibrillators are devices that send an electric pulse or shock to the heart to restore a normal
heartbeat. They are used to prevent or correct an arrhythmia, an uneven heartbeat that is too slow
or too fast. If the heart suddenly stops, defibrillators can also help it beat again. Different types of
defibrillators work in different ways. Automated external defibrillators (AEDs), which are now
found in many public spaces, are used to save the lives of people experiencing cardiac arrest. Even
untrained bystanders can use these devices in an emergency.
Other defibrillators can prevent sudden death among people who have a high risk of a life-
threatening arrhythmia. They include implantable cardioverter defibrillators (ICDs), which are
surgically placed inside your body, and wearable cardioverter defibrillators (WCDs), which rest
on the body. It can take time and effort to get used to living with a defibrillator, and it is important
to be aware of possible complications.
There are three types of defibrillators: AEDs, ICDs, and WCDs.

An AED is a lightweight, battery-operated, portable device that checks the heart’s rhythm and
sends a shock to the heart to restore normal rhythm. The device is used to help people having
cardiac arrest.
Sticky pads with sensors, called electrodes, are attached to the chest of someone who is having
cardiac arrest. The electrodes send information about the person's heart rhythm to a computer in
the AED. The computer analyzes the heart rhythm to find out whether an electric shock is needed.
If it is needed, the electrodes deliver the shock.
ICDs are placed through surgery in the chest or stomach area, where the device can check for
arrhythmias. Arrhythmias can interrupt the flow of blood from your heart to the rest of your body
or cause your heart to stop. The ICD sends a shock to restore a normal heart rhythm.
An ICD can give off a low-energy shock that speeds up or slows down an abnormal heart rate, or
a high-energy shock to correct a fast or irregular heartbeat. If low-energy shocks do not restore
your normal heart rhythm, the device may switch to high-energy shocks for defibrillation.
ICDs are similar to pacemakers, but pacemakers deliver only low-energy electrical shocks. ICDs
have a generator connected to wires that detect your heart’s beats and deliver a shock when needed.
Some ICDs have wires that rest inside one or two chambers of the heart. Others do not have wires
going into the heart chambers but instead rest on the heart to monitor its rhythm.
The ICD can also record the heart's electrical activity and heart rhythms. The recordings can help
your healthcare provider fine-tune the programming of the device so it works better to correct
irregular heartbeats. The device is programmed to respond to the type of arrhythmia you are most
likely to have.

WCDs have sensors that attach to the skin. They are connected by wires to a unit that checks your
heart’s rhythm and delivers shocks when needed. Like an ICD, the WCD can deliver low- and
high-energy shocks. The device has a belt attached to a vest that is worn under your clothes. Your
provider fits the device to your size. It is programmed to detect a specific heart rhythm.