Power sources and electrical recharging strategies for implantable medical devices

Rotation insensitive implantable wireless power transfer system for medical devices using metamaterial-polarization converter

This article introduces an innovative approach for creating a circular polarization (CP) antenna-based rotation-insensitive implantable wireless power transfer (WPT) system for medical devices. The system is constructed to work in the industrial, scientific, and medical (ISM) frequency band of 902-928 MHz. Initially, a flexible, wide-band, and bio-compatible open-ended CP slot antenna is designed within a single-layer human skin tissue model to serve as the receiving (Rx) element. To form the implantable WPT link, a circular patch antenna is also constructed in the free-space to use as a transmitting (Tx) source. Further, a new metamaterial-polarization converter (MTM-PC) structure is developed and incorporated into the proposed system to enhance the power transfer efficiency (PTE). Furthermore, the rotational phenomenon of the Rx implant has been studied to show how the rotation affects the system's performance. Moreover, a numerical analysis of the specific absorption rate (SAR) is conducted to confirm compliance with safety regulations and prioritize human safety from electromagnetic exposure. Finally, to validate the introduced concept, prototypes of the different elements of the proposed WPT system were fabricated and tested using skin-mimicking gel and porcine tissue. The measured results confirm the feasibility of the introduced approach, exhibiting improved efficiency due to use of the MTM-PC. The amplitude of the transmission coefficient (| S 21 | ) has improved by 6.94 dB in the simulation, whereas the enhancement of 7.04 dB and 6.76 dB is obtained from the experimental study due to the integration of MTM-PC. As a result, the PTE of the proposed MTM-PC integrated implantable WPT system is increased significantly compared to the system without MTM-PC.

Wireless Battery-free and Fully Implantable Organ Interfaces

Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.

Advanced Self-Powered Biofuel Cells with Capacitor and Nanogenerator for Biomarker Sensing

Self-powered biofuel cells (BFCs) have evolved for highly sensitive detection of biomarkers such as noncodon micro ribonucleic acids (miRNAs) in the presence of interfering substrates. Self-charging supercapacitive BFCs for in vivo and in vitro cellular microenvironments represent the most prevalent sensing mechanism for diagnosis. Therefore, self-powered biosensing (SPB) with a capacitor and contact separation with a triboelectric nanogenerator (TENG) offers electrochemical and colorimetric dual-mode detection via improved electrical signal intensity. In this review, we discuss three major components: stretchable self-powered BFC design, miRNA sensing, and impedance spectroscopy. A specific focus is given to 1) assembling of sensors for biomarkers, 2) electrical output signal intensification, and 3) role of supercapacitors and nanogenerators in SPBs. We outline the key features of stretchable SPBs and the sequence of miRNA sensing by SPBs. We have emphasized the need of a supercapacitor and nanogenerator for SPBs in the context of advanced assembly of the sensing unit. Finally, we outline the role of impedance spectroscopy in the detection and estimation of biomarkers. We highlight key challenges in SPBs for biomarker sensing, which needs improved sensing accuracy, integration strategies of electrochemical biosensing for in vitro and in vivo microenvironments, and the impact of miRNA sensing on cancer diagnostics. This article attempts a specific focus on the accuracy and limitations of sensing unit for miRNA biomarkers and associated tool for boosting electrical signal intensity for a potential big step further.

A flexible omnidirectional rotating magnetic array for MRI-safe transdermal wireless energy harvesting through flexible electronics

Magnetic resonance imaging (MRI)-safe implantable wireless energy harvester offers substantial benefits to patients suffering from brain disorders, hearing impairment, and arrhythmias. However, rigid magnets in cutting-edge systems with limited numbers of rotation axis impose high risk of device dislodgement and magnet failure. Here, a flexible omnidirectional rotating magnetic array (FORMA) and a flexible MRI-safe implantable wireless energy-harvesting system have been developed. Miniaturized flexible magnetic balls 1 millimeter in diameter achieved by molding three-dimensional printed templates can rotate freely in elastomer cavities and supply a magnetic force of 2.14 Newtons at a distance of 1 millimeter between an implantable receiver and a wearable transceiver. The system can work stably under an acceleration of 9g and obtain a power output of 15.62 decibel milliwatts at a transmission frequency of 8 megahertz. The development of the FORMA may lead to life-long flexible and batteryless implantable systems and offers the potential to promote techniques for monitoring and treating acute and chronic diseases.

Recent Progress on Hydrogel-Based Piezoelectric Devices for Biomedical Applications

Flexible electronics have great potential in the application of wearable and implantable devices. Through suitable chemical alteration, hydrogels, which are three-dimensional polymeric networks, demonstrate amazing stretchability and flexibility. Hydrogel-based electronics have been widely used in wearable sensing devices because of their biomimetic structure, biocompatibility, and stimuli-responsive electrical properties. Recently, hydrogel-based piezoelectric devices have attracted intensive attention because of the combination of their unique piezoelectric performance and conductive hydrogel configuration. This mini review is to give a summary of this exciting topic with a new insight into the design and strategy of hydrogel-based piezoelectric devices. We first briefly review the representative synthesis methods and strategies of hydrogels. Subsequently, this review provides several promising biomedical applications, such as bio-signal sensing, energy harvesting, wound healing, and ultrasonic stimulation. In the end, we also provide a personal perspective on the future strategies and address the remaining challenges on hydrogel-based piezoelectric electronics.

Embedded Sensor Systems in Medical Devices: Requisites and Challenges Ahead

The evolution of technology enables the design of smarter medical devices. Embedded Sensor Systems play an important role, both in monitoring and diagnostic devices for healthcare. The design and development of Embedded Sensor Systems for medical devices are subjected to standards and regulations that will depend on the intended use of the device as well as the used technology. This article summarizes the challenges to be faced when designing Embedded Sensor Systems for the medical sector. With this aim, it presents the innovation context of the sector, the stages of new medical device development, the technological components that make up an Embedded Sensor System and the regulatory framework that applies to it. Finally, this article highlights the need to define new medical product design and development methodologies that help companies to successfully introduce new technologies in medical devices.

Semiconductor Multimaterial Optical Fibers for Biomedical Applications

Integrated sensors and transmitters of a wide variety of human physiological indicators have recently emerged in the form of multimaterial optical fibers. The methods utilized in the manufacture of optical fibers facilitate the use of a wide range of functional elements in microscale optical fibers with an extensive variety of structures. This article presents an overview and review of semiconductor multimaterial optical fibers, their fabrication and postprocessing techniques, different geometries, and integration in devices that can be further utilized in biomedical applications. Semiconductor optical fiber sensors and fiber lasers for body temperature regulation, in vivo detection, volatile organic compound detection, and medical surgery will be discussed.

A Battery Method to Enhance the Degradation of Iron Stent and Regulating the Effect on Living Cells

Iron is a promising material for cardiovascular stent applications, however, the low biodegradation rate presents a challenge. Here, a dynamic method to improve the degradation rate of iron and simultaneously deliver electrical energy that could potentially inhibit cell proliferation on the device is reported. It is realized by pairing iron with a biocompatible hydrogel cathode in a cell culture media-based electrolyte forming an iron-air battery. This system does not show cytotoxicity to human adipose-stem cells over a period of 21 days but inhibits cell proliferation. The combination of enhanced iron degradation and inhibited cell proliferation by this dynamic method suggests it might be an approach for restenosis inhibition of biodegradable stents.

On-Body Piezoelectric Energy Harvesters through Innovative Designs and Conformable Structures

Recent advancements in wearable technology have improved lifestyle and medical practices, enabling personalized care ranging from fitness tracking, to real-time health monitoring, to predictive sensing. Wearable devices serve as an interface between humans and technology; however, this integration is far from seamless. These devices face various limitations such as size, biocompatibility, and battery constraints wherein batteries are bulky, are expensive, and require regular replacement. On-body energy harvesting presents a promising alternative to battery power by utilizing the human body's continuous generation of energy. This review paper begins with an investigation of contemporary energy harvesting methods, with a deep focus on piezoelectricity. We then highlight the materials, configurations, and structures of such methods for self-powered devices. Here, we propose a novel combination of thin-film composites, kirigami patterns, and auxetic structures to lay the groundwork for an integrated piezoelectric system to monitor and sense. This approach has the potential to maximize energy output by amplifying the piezoelectric effect and manipulating the strain distribution. As a departure from bulky, rigid device design, we explore compositions and microfabrication processes for conformable energy harvesters. We conclude by discussing the limitations of these harvesters and future directions that expand upon current applications for wearable technology. Further exploration of materials, configurations, and structures introduce interdisciplinary applications for such integrated systems. Considering these factors can revolutionize the production and consumption of energy as wearable technology becomes increasingly prevalent in everyday life.

Wearable and Fully Biocompatible All-in-One Structured ″Paper-Like″ Zinc Ion Battery

A power supply with the characteristics of portability and safety will be one of the dominating mainstreams for future wearable electronics and implantable biomedical devices. The conventional energy storage devices with typical sandwich structures have complicated components and low mechanical properties, suffering from the apparent performance degradation during deformation and hindering the possibility of implanting biomedical units. Herein, a novel all-in-one structure ″paper-like″ zinc ion battery (ZIB) was designed and assembled from an electrospun polyacrylonitrile (PAN) nanomembrane (as the separator) with in situ deposited anode (zinc nanosheets) and cathode (MnO₂ nanosheets), which ensures the monolith under different bending states by avoiding the relative sliding and detaching between the integrated layers. Benefiting from the well-designed all-in-one construction and electrodes, the resultant all-in-one ZIB (AZIB) features an ultrathin thickness (about 97 μm), superior specific capacity of 353.8 mAh g^-1 (at 0.1 mA cm^-2), and outstanding cycling stability (98.7% capacity retention after 500 cycles at 1 A cm^-2). And the achieved volumetric energy density is as high as 17.5 mWh cm^-3 at a power density of 116.4 mW cm^-3. Impressively, the concept of wearable electronic applications of the obtained AZIB was fully demonstrated with excellent flexibility and remarkable temperature resistance under various severe conditions. Our AZIB may provide a versatile strategy for applying and developing flexible wearable electronics and implantable biomedical devices.

Degradation Behavior, Biocompatibility, Electrochemical Performance, and Circularity Potential of Transient Batteries

Transient technology seeks the development of materials, devices, or systems that undergo controlled degradation processes after a stable operation period, leaving behind harmless residues. To enable externally powered fully transient devices operating for longer periods compared to passive devices, transient batteries are needed. Albeit transient batteries are initially intended for biomedical applications, they represent an effective solution to circumvent the current contaminant leakage into the environment. Transient technology enables a more efficient recycling as it enhances material retrieval rates, limiting both human and environmental exposures to the hazardous pollutants present in conventional batteries. Little efforts are focused to catalog and understand the degradation characteristics of transient batteries. As the energy field is a property-driven science, not only electrochemical performance but also their degradation behavior plays a pivotal role in defining the specific end-use applications. The state-of-the-art transient batteries are critically reviewed with special emphasis on the degradation mechanisms, transiency time, and biocompatibility of the released degradation products. The potential of transient batteries to change the current paradigm that considers batteries as harmful waste is highlighted. Overall, transient batteries are ready for takeoff and hold a promising future to be a frontrunner in the uptake of circular economy concepts.

Review on Medical Implantable Antenna Technology and Imminent Research Challenges

Implantable antennas are mandatory to transfer data from implants to the external world wirelessly. Smart implants can be used to monitor and diagnose the medical conditions of the patient. The dispersion of the dielectric constant of the tissues and variability of organ structures of the human body absorb most of the antenna radiation. Consequently, implanting an antenna inside the human body is a very challenging task. The design of the antenna is required to fulfill several conditions, such as miniaturization of the antenna dimension, biocompatibility, the satisfaction of the Specific Absorption Rate (SAR), and efficient radiation characteristics. The asymmetric hostile human body environment makes implant antenna technology even more challenging. This paper aims to summarize the recent implantable antenna technologies for medical applications and highlight the major research challenges. Also, it highlights the required technology and the frequency band, and the factors that can affect the radio frequency propagation through human body tissue. It includes a demonstration of a parametric literature investigation of the implantable antennas developed. Furthermore, fabrication and implantation methods of the antenna inside the human body are summarized elaborately. This extensive summary of the medical implantable antenna technology will help in understanding the prospects and challenges of this technology.

Ultrasound-Induced Wireless Energy Harvesting: From Materials Strategies to Functional Applications

Wireless energy harvesting represents an emerging technology that can be integrated into a variety of systems for biomedical, physical, and chemical functions. The miniaturization and ease of implementation are the main challenges for the development of wireless energy harvesting systems. Unlike most reported wireless energy harvesting technologies represented by electromagnetic coupling, the new generation of ultrasound-induced wireless energy harvesting (UWEH) that use propagating ultrasound waves to carry the available energy provides a strategy with higher resolution, deeper penetration, and more security, especially in nanodevices and implantable medical systems where a long-term stable power is required. Recently, advances in nanotechnologies, microelectronics, and biomedical systems are revolutionizing UWEH. In this article, an overview of recent developments in UWEH technologies that use a variety of material strategies and system designs based on the piezoelectric and capacitive energy harvesting mechanisms is provided. Practical applications are also presented, including wireless power for bio-implantable devices, direct cell/tissue electrical stimulations, wireless recording and communication in nervous systems, ultrasonic modulated drug delivery, self-powered acoustic sensors, and ultrasound-induced piezoelectric catalysis. Finally, perspectives and opportunities are also highlighted.

Self-Powered Implantable Medical Devices: Photovoltaic Energy Harvesting Review

Implantable technologies are becoming more widespread for biomedical applications that include physical identification, health diagnosis, monitoring, recording, and treatment of human physiological traits. However, energy harvesting and power generation beneath the human tissue are still a major challenge. In this regard, self-powered implantable devices that scavenge energy from the human body are attractive for long-term monitoring of human physiological traits. Thanks to advancements in material science and nanotechnology, energy harvesting techniques that rely on piezoelectricity, thermoelectricity, biofuel, and radio frequency power transfer are emerging. However, all these techniques suffer from limitations that include low power output, bulky size, or low efficiency. Photovoltaic (PV) energy conversion is one of the most promising candidates for implantable applications due to their higher-power conversion efficiencies and small footprint. Herein, the latest implantable energy harvesting technologies are surveyed. A comparison between the different state-of-the-art power harvesting methods is also provided. Finally, recommendations are provided regarding the feasibility of PV cells as an in vivo energy harvester, with an emphasis on skin penetration, fabrication, encapsulation, durability, biocompatibility, and power management.

Streaming potential in bio-mimetic microvessels mediated by capillary glycocalyx

Implantable medical devices and biosensors are pivotal in revolutionizing the field of medical technology by opening new dimensions in the field of disease detection and cure. These devices need to harness a biocompatible and physiologically sustainable safe power source instead of relying on external stimuli, overcoming the constraints on their applicability in-vivo. Here, by appealing to the interplay of electromechanics and hydrodynamics in physiologically relevant microvessels, we bring out the role of charged endothelial glycocalyx layer (EGL) towards establishing a streaming potential across physiological fluidic conduits. We account for the complex rheology of blood-mimicking fluid by appealing to Newtonian fluid model representing the blood plasma and a viscoelastic fluid model representing the whole blood. We model the EGL as a poroelastic layer with volumetric charge distribution. Our results reveal that for physiologically relevant micro-flows, the streaming potential induced is typically of the order of 0.1 V/mm, which may turn out to be substantial towards energizing biosensors and implantable medical devices whose power requirements are typically in the range of micro to milliwatts. We also bring out the specific implications of the relevant physiological parameters towards establishment of the streaming potential, with a vision of augmenting the same within plausible functional limits. We further unveil that the dependence of streaming potential on EGL thickness might be one of the key aspects in unlocking the mystery behind the angiogenesis pattern. Our results may open up novel bio-sensing and actuating possibilities in medical diagnostics as well as may provide a possible alternative regarding the development of physiologically safe and biocompatible power sources within the human body.

Wireless Power Transfer for Implanted Medical Application: A Review

With ever-increasing concerns on health and environmental safety, there is a fast-growing interest in new technologies for medical devices and applications. Particularly, wireless power transfer (WPT) technology provides reliable and convenient power charging for implant medical devices without additional surgery. For those WPT medical systems, the width of the human body restricts the charging distance, while the specific absorption rate (SAR) standard limits the intensity of the electromagnetic field. In order to develop a high-efficient charging strategy for medical implants, the key factors of transmission distance, coil structure, resonant frequency, etc. are paid special attention. In this paper, a comprehensive overview of near-field WPT technologies in medical devices is presented and discussed. Also, future development is discussed for the prediction of different devices when embedded in various locations of the human body. Moreover, the key issues including power transfer efficiency and output power are addressed and analyzed. All concerning characteristics of WPT links for medical usage are elaborated and discussed. Thus, this review provides an in-depth investigation and the whole map for WPT technologies applied in medical applications.

NAD(P)-dependent glucose dehydrogenase: Applications for biosensors, bioelectrodes, and biofuel cells

This review discusses the physical and chemical properties of nicotinamide redox cofactor dependent glucose dehydrogenase (NAD(P) dependent GDH) and its extensive application in biosensors and bio-fuel cells. GDHs from different organisms show diverse biochemical properties (e.g., activity and stability) and preferences towards cofactors, such as nicotinamide adenine dinucleotide (NAD⁺) and nicotinamide adenine dinucleotide phosphate (NADP⁺). The (NAD(P)⁺) play important roles in biological electron transfer, however, there are some difficulties related to their application in devices that originate from their chemical properties and labile binding to the GDH enzyme. This review discusses the electrode modifications aimed at immobilising NAD⁺ or NADP⁺ cofactors and GDH at electrodes. Binding of the enzyme was achieved by appropriate protein engineering techniques, including polymerisation, hydrophobisation or hydrophilisation processes. Various enzyme-modified electrodes applied in biosensors, enzymatic fuel cells, and biobatteries are compared. Importantly, GDH can operate alone or as part of an enzymatic cascade, which often improves the functional parameters of the biofuel cell or simply allows use of cheaper fuels. Overall, this review explores how NAD(P)-dependent GDH has recently demonstrated high potential for use in various systems to generate electricity from biological sources for applications in implantable biomedical devices, wireless sensors, and portable electronic devices.

Soft and Stretchable Thermoelectric Generators Enabled by Liquid Metal Elastomer Composites

Stretchable thermoelectric generators (TEGs) capable of harvesting electrical energy from body heat under cold weather conditions have the potential to make wearable electronic and robotic systems more lightweight and portable by reducing their dependency on on-board batteries. However, progress depends on the integration of soft conductive materials for robust electrical wiring and thermal management. The use of thermally conductive soft elastomers is especially important for conforming to the body, absorbing body heat, and maintaining a temperature gradient between the two sides of the TEGs in order to generate power. Here, we introduce a soft-matter TEG architecture composed of electrically and thermally conductive liquid metal embedded elastomer (LMEE) composites with integrated arrays of n-type and p-type Bi₂Te₃ semiconductors. The incorporation of a LMEE as a multifunctional encapsulating material allows for the seamless integration of 100 thermoelectric semiconductor elements into a simplified material layup that has a dimension of 41.0 × 47.3 × 3.0 mm. These stretchable thermoelectric devices generate voltages of 59.96 mV at Δ10 °C, 130 mV at Δ30 °C, and 278.6 mV and a power of 86.6 μW/cm² at Δ60 °C. Moreover, they do not electrically or mechanically fail when stretched to strains above 50%, making them well-suited for energy harvesting in soft electronics and wearable computing applications.

Overview of Human Walking Induced Energy Harvesting Technologies and Its Possibility for Walking Robotics

This study is mainly to provide an overview of human walking induced energy harvest. Focusing on the proportion of all energy sources provided by daily activity, the available human walking induced energy is divided with respect to the generation principle. The extensive research on harvesting energy results from body vibration, inertial element, and foot press to convert into electricity is overviewed. Over the past decades, various smart materials have been employed to achieve energy conversion. Generators based on electromagnetic induction or the triboelectric effect were developed and integrated. Small captured power and low overall efficiency are criticized. The concept of human walking energy harvest is extended into the wearable walking robotics using other mediums, such as fluid, to transmit power instead of electricity. By comparison, it is indicated that less energy conversion links are involved in energy regeneration of such applications and expected to guarantee less loss and higher efficiency. Meanwhile, in order to overcome the shortage of relatively low power output, comments are made that the harvester should be capable of adaptation under the condition that the mechanical energy of lower limb and feet is subject to change in different gait phases so as to maximize the collected energy.

Development of a battery-free ultrasonically powered functional electrical stimulator for movement restoration after paralyzing spinal cord injury

BACKGROUND

Functional electrical stimulation (FES) is used to restore movements in paretic limbs after severe paralyses resulting from neurological injuries such as spinal cord injury (SCI). Most chronic FES systems utilize an implantable electrical stimulator to deliver a small electric current to the targeted muscle or nerve to stimulate muscle contractions. These implanted stimulators are generally bulky, mainly due to the size of the batteries. Furthermore, these battery-powered stimulators are required to be explanted every few years for battery replacement which may result in surgical failures or infections. Hence, a wireless power transfer technique is desirable to power these implantable stimulators.

METHODS

Conventional wireless power transduction faces significant challenges for safe and efficient energy transfer through the skin and deep into the body. Inductive and electromagnetic power transduction is generally used for very short distances and may also interfere with other medical measurements such as X-ray and MRI. To address these issues, we have developed a wireless, ultrasonically powered, implantable piezoelectric stimulator. The stimulator is encapsulated with biocompatible materials.

RESULTS

The stimulator is capable of harvesting a maximum of 5.95 mW electric power at an 8-mm depth under the skin from an ultrasound beam with about 380 mW/cm2 of acoustic intensity. The stimulator was implanted in several paraplegic rats with SCI. Our implanted stimulator successfully induced several hindlimb muscle contractions and restored leg movement.

CONCLUSIONS

A battery-free miniature (10 mm diameter × 4 mm thickness) implantable stimulator, developed in the current study is capable of directly stimulating paretic muscles through external ultrasound signals. The required cost to develop the stimulator is relatively low as all the components are off the shelf.

Maximizing Data Transmission Rate for Implantable Devices Over a Single Inductive Link: Methodological Review

Due to the constantly growing geriatric population and the projected increase of the prevalence of chronic diseases that are refractory to drugs, implantable medical devices (IMDs) such as neurostimulators, endoscopic capsules, artificial retinal prostheses, and brain-machine interfaces are being developed. According to many business forecast firms, the IMD market is expected to grow and they are subject to much research aiming to overcome the numerous challenges of their development. One of these challenges consists of designing a wireless power and data transmission system that has high power efficiency, high data rates, low power consumption, and high robustness against noise. This is in addition to minimal design and implementation complexity. This manuscript concerns a comprehensive survey of the latest techniques used to power up and communicate between an external base station and an IMD. Patient safety considerations related to biological, physical, electromagnetic, and electromagnetic interference concerns for wireless IMDs are also explored. The simultaneous powering and data communication techniques using a single inductive link for both power transfer and bidirectional data communication, including the various data modulation/demodulation techniques, are also reviewed. This review will hopefully contribute to the persistent efforts to implement compact reliable IMDs while lowering their cost and upsurging their benefits.

Electrochemically Enhanced Drug Delivery Using Polypyrrole Films

The delivery of drugs in a controllable fashion is a topic of intense research activity in both academia and industry because of its impact in healthcare. Implantable electronic interfaces for the body have great potential for positive economic, health, and societal impacts; however, the implantation of such interfaces results in inflammatory responses due to a mechanical mismatch between the inorganic substrate and soft tissue, and also results in the potential for microbial infection during complex surgical procedures. Here, we report the use of conducting polypyrrole (PPY)-based coatings loaded with clinically relevant drugs (either an anti-inflammatory, dexamethasone phosphate (DMP), or an antibiotic, meropenem (MER)). The films were characterized and were shown to enhance the delivery of the drugs upon the application of an electrochemical stimulus in vitro, by circa (ca.) 10⁻30% relative to the passive release from non-stimulated samples. Interestingly, the loading and release of the drugs was correlated with the physical descriptors of the drugs. In the long term, such materials have the potential for application to the surfaces of medical devices to diminish adverse reactions to their implantation in vivo.

Future of Smart Cardiovascular Implants

Cardiovascular disease remains the leading cause of death in Western society. Recent technological advances have opened the opportunity of developing new and innovative smart stent devices that have advanced electrical properties that can improve diagnosis and even treatment of previously intractable conditions, such as central line access failure, atherosclerosis and reporting on vascular grafts for renal dialysis. Here we review the latest advances in the field of cardiovascular medical implants, providing a broad overview of the application of their use in the context of cardiovascular disease rather than an in-depth analysis of the current state of the art. We cover their powering, communication and the challenges faced in their fabrication. We focus specifically on those devices required to maintain vascular access such as ones used to treat arterial disease, a major source of heart attacks and strokes. We look forward to advances in these technologies in the future and their implementation to improve the human condition.

Current State and Future Perspectives of Energy Sources for Totally Implantable Cardiac Devices

There is a large population of patients with end-stage congestive heart failure who cannot be treated by means of conventional cardiac surgery, cardiac transplantation, or chronic catecholamine infusions. Implantable cardiac devices, many designated as destination therapy, have revolutionized patient care and outcomes, although infection and complications related to external power sources or routine battery exchange remain a substantial risk. Complications from repeat battery replacement, power failure, and infections ultimately endanger the original objectives of implantable biomedical device therapy - eliminating the intended patient autonomy, affecting patient quality of life and survival. We sought to review the limitations of current cardiac biomedical device energy sources and discuss the current state and trends of future potential energy sources in pursuit of a lifelong fully implantable biomedical device.

Effect of growth solution, membrane size and array connection on microbial fuel cell power supply for medical devices

Implanted biomedical devices typically last a number of years before their batteries are depleted and a surgery is required to replace them. A Microbial Fuel Cell (MFC) is a device which by using bacteria, directly breaks down sugars to generate electricity. Conceptually there is potential to continually power implanted medical devices for the lifetime of a patient. To investigate the practical potential of this technology, H-Cell Dual Chamber MFCs were evaluated with two different growth solutions and measurements recorded for maximum power output both of individual MFCs and connected MFCs. Using Luria-Bertani media and connecting MFCs in a hybrid series and parallel arrangement with larger membrane sizes showed the highest power output and the greatest potential for replacing implanted batteries.

A Cytocompatible Robust Hybrid Conducting Polymer Hydrogel for Use in a Magnesium Battery

A cytocompatible robust hybrid conducting-polymer hydrogel, polypyrrole/poly(3,4-ethylenedioxythiophene) is developed. This hydrogel is suitable for electrode-cellular applications. It demonstrates a high battery performance when coupled with a bioresorbable Mg alloy in phosphate-buffered saline. A combination of suitable mechanical and electrochemical properties makes this hydrogel a promising material for bionic applications.

Subdermal Flexible Solar Cell Arrays for Powering Medical Electronic Implants

A subdermally implantable flexible photovoltatic (IPV) device is proposed for supplying sustainable electric power to in vivo medical implants. Electric properties of the implanted IPV device are characterized in live animal models. Feasibility of this strategy is demonstrated by operating a flexible pacemaker with the subdermal IPV device which generates DC electric power of ≈647 μW under the skin.

An Embedded Deep Brain Stimulator for Biphasic Chronic Experiments in Freely Moving Rodents

This paper describes a Deep Brain Stimulation device, portable, for chronic experiments on rodents in the context of Parkinson's disease. Our goal is to equip the animal with a device that mimics the human therapeutic conditions. It implies to respect a set of properties such as bilateral current-mode and charge-balanced stimulation, as well as programmability, low power consumption and re-usability to finally reach a suitable weight for long-term experiments. After the analysis of the solutions found in the literature, the full design of the device is explained. First, the stimulation front-end circuit driven by a processor unit, then the choice of supply sources which is a critical point for the weight and life-time of our system. Our low cost system has been realized using commercial discrete components and the overall power consumption was minimized. We achieved 6 days of maximal current stimulation with the chosen battery for a weight of 13.8 g . Finally, the device was carried out in vivo on rats during a 3 weeks experiment as the used implantation technique allows battery changing. This experiment also permits to emphasize the mechanical aspects including the packaging and electrodes holding.

Experimenting with microbial fuel cells for powering implanted biomedical devices

Microbial Fuel Cell (MFC) technology has the ability to directly convert sugar into electricity by using bacteria. Such a technology could be useful for powering implanted biomedical devices that require a surgery to replace their batteries every couple of years. In steps towards this, parameters such as electrode configuration, inoculation size, stirring of the MFC and single versus dual chamber reactor configuration were tested for their effect on MFC power output. Results indicate that a Top-Bottom electrode configuration, stirring and larger amounts of bacteria in single chamber MFCs, and smaller amounts of bacteria in dual chamber MFCs give increased power outputs. Finally, overall dual chamber MFCs give several fold larger MFC power outputs.

Study on an improved bio-electrode made with glucose oxidase immobilized mesoporous carbon in biofuel cells

Response surface methodology (RSM) was used for process optimization to immobilize glucose oxidase (GOx) on ordered mesoporous carbon (OMC).

Power Approaches for Implantable Medical Devices

Implantable medical devices have been implemented to provide treatment and to assess in vivo physiological information in humans as well as animal models for medical diagnosis and prognosis, therapeutic applications and biological science studies. The advances of micro/nanotechnology dovetailed with novel biomaterials have further enhanced biocompatibility, sensitivity, longevity and reliability in newly-emerged low-cost and compact devices. Close-loop systems with both sensing and treatment functions have also been developed to provide point-of-care and personalized medicine. Nevertheless, one of the remaining challenges is whether power can be supplied sufficiently and continuously for the operation of the entire system. This issue is becoming more and more critical to the increasing need of power for wireless communication in implanted devices towards the future healthcare infrastructure, namely mobile health (m-Health). In this review paper, methodologies to transfer and harvest energy in implantable medical devices are introduced and discussed to highlight the uses and significances of various potential power sources.

Continuous power generation from glucose with two different miniature flow-through enzymatic biofuel cells

Enzymatic biofuel cells (EBFCs) can generate energy from metabolites present in physiological fluids. They represent an attractive alternative to lithium batteries to power implantable devices, as they work at body temperature, are light and easy-to-miniaturise. To be implantable in blood vessels, EBFCs should not only be made of non-toxic and biocompatible compounds but should also be able to operate in continuous flow-through mode. The EBFC devices reported so far, however, implement carbon-based materials of questionable toxicity and stability, such as carbon nanotubes, and rely on the use of external redox mediators for the electrical connection between the enzyme and the electrode. With this study, we demonstrate for the first time continuous power generation by flow through miniature enzymatic biofuel cells fed with an aerated solution of glucose and no redox mediators. Non-toxic highly porous gold was used as the electrode material and the immobilisation of the enzymes onto the electrodes surface was performed via cost-effective and easy-to-reproduce methodologies. The results presented here are a significant step towards the development of revolutionary implantable medical devices that extract the power they require from metabolites in the body.

A simple microbial fuel cell model for improvement of biomedical device powering times

This study describes a Matlab based Microbial Fuel Cell (MFC) model for a suspended microbial population, in the anode chamber for the use of the MFC in powering biomedical devices. The model contains three main sections including microbial growth, microbial chemical uptake and secretion and electrochemical modeling. The microbial growth portion is based on a Continuously Stirred Tank Reactor (CSTR) model for the microbial growth with substrate and electron acceptors. Microbial stoichiometry is used to determine chemical concentrations and their rates of change and transfer within the MFC. These parameters are then used in the electrochemical modeling for calculating current, voltage and power. The model was tested for typically exhibited MFC characteristics including increased electrode distances and surface areas, overpotentials and operating temperatures. Implantable biomedical devices require long term powering which is the main objective for MFCs. Towards this end, our model was tested with different initial substrate and electron acceptor concentrations, revealing a four-fold increase in concentrations decreased the power output time by 50%. Additionally, the model also predicts that for a 35.7% decrease in specific growth rate, a 50% increase in power longevity is possible.

Biocompatible ionic liquid-biopolymer electrolyte-enabled thin and compact magnesium-air batteries

With the surge of interest in miniaturized implanted medical devices (IMDs), implantable power sources with small dimensions and biocompatibility are in high demand. Implanted battery/supercapacitor devices are commonly packaged within a case that occupies a large volume, making miniaturization difficult. In this study, we demonstrate a polymer electrolyte-enabled biocompatible magnesium-air battery device with a total thickness of approximately 300 μm. It consists of a biocompatible polypyrrole-para(toluene sulfonic acid) cathode and a bioresorbable magnesium alloy anode. The biocompatible electrolyte used is made of choline nitrate (ionic liquid) embedded in a biopolymer, chitosan. This polymer electrolyte is mechanically robust and offers a high ionic conductivity of 8.9 × 10(-3) S cm(-1). The assembled battery delivers a maximum volumetric power density of 3.9 W L(-1), which is sufficient to drive some types of IMDs, such as cardiac pacemakers or biomonitoring systems. This miniaturized, biocompatible magnesium-air battery may pave the way to a future generation of implantable power sources.

One-step synthesis of graphene/polypyrrole nanofiber composites as cathode material for a biocompatible zinc/polymer battery

The significance of developing implantable, biocompatible, miniature power sources operated in a low current range has become manifest in recent years to meet the demands of the fast-growing market for biomedical microdevices. In this work, we focus on developing high-performance cathode material for biocompatible zinc/polymer batteries utilizing biofluids as electrolyte. Conductive polymers and graphene are generally considered to be biocompatible and suitable for bioengineering applications. To harness the high electrical conductivity of graphene and the redox capability of polypyrrole (PPy), a polypyrrole fiber/graphene composite has been synthesized via a simple one-step route. This composite is highly conductive (141 S cm(-1)) and has a large specific surface area (561 m(2) g(-1)). It performs more effectively as the cathode material than pure polypyrrole fibers. The battery constructed with PPy fiber/reduced graphene oxide cathode and Zn anode delivered an energy density of 264 mWh g(-1) in 0.1 M phosphate-buffer saline.

Biologically derived melanin electrodes in aqueous sodium-ion energy storage devices

Biodegradable electronics represents an attractive and emerging paradigm in medical devices by harnessing simultaneous advantages afforded by electronically active systems and obviating issues with chronic implants. Integrating practical energy sources that are compatible with the envisioned operation of transient devices is an unmet challenge for biodegradable electronics. Although high-performance energy storage systems offer a feasible solution, toxic materials and electrolytes present regulatory hurdles for use in temporary medical devices. Aqueous sodium-ion charge storage devices combined with biocompatible electrodes are ideal components to power next-generation biodegradable electronics. Here, we report the use of biologically derived organic electrodes composed of melanin pigments for use in energy storage devices. Melanins of natural (derived from Sepia officinalis) and synthetic origin are evaluated as anode materials in aqueous sodium-ion storage devices. Na(+)-loaded melanin anodes exhibit specific capacities of 30.4 ± 1.6 mAhg(-1). Full cells composed of natural melanin anodes and λ-MnO2 cathodes exhibit an initial potential of 1.03 ± 0.06 V with a maximum specific capacity of 16.1 ± 0.8 mAhg(-1). Natural melanin anodes exhibit higher specific capacities compared with synthetic melanins due to a combination of beneficial chemical, electrical, and physical properties exhibited by the former. Taken together, these results suggest that melanin pigments may serve as a naturally occurring biologically derived charge storage material to power certain types of medical devices.

A Prototype of an Implantable Thermoelectric Generator for Permanent Power Supply to Body Inside a Medical Device

Embedding a thermoelectric generator (TEG) in a biological body is a promising way to supply electronic power in the long term for an implantable medical device (IMD). It can resolve the service life mismatch between the IMD and its battery. This paper is dedicated to developing a real prototype, which consists of an implanted TEG and a specified boosted circuit. Two implanted TEG modules were constructed and a boosted circuit with a highly integrated DC/DC converter was fabricated to stabilizing the energy output and improving the voltage output for the implanted TEG. According to the experiments, such a device combination was already capable of supporting a clock circuit in the in vivo rabbit whose power consumption is much higher than an ordinary cardiac pacemaker. Meanwhile, a close to reality theoretical model was established for characterizing the implanted TEG. This study is expected to serve as a valuable reference for future designs of the implanted TEG and its boosted circuit.

Instrumented hip implants: electric supply systems

Instrumented hip implants were proposed as a method to monitor and predict the biomechanical and thermal environment surrounding such implants. Nowadays, they are being developed as active implants with the ability to prevent failures by loosening. The generation of electric energy to power active mechanisms of instrumented hip implants remains a question. Instrumented implants cannot be implemented without effective electric power systems. This paper surveys the power supply systems of seventeen implant architectures already implanted in-vivo, namely from instrumented hip joint replacements and instrumented fracture stabilizers. Only inductive power links and batteries were used in-vivo to power the implants. The energy harvesting systems, which were already designed to power instrumented hip implants, were also analyzed focusing their potential to overcome the disadvantages of both inductive-based and battery-based power supply systems. From comparative and critical analyses of the methods to power instrumented implants, one can conclude that: inductive powering and batteries constrain the full operation of instrumented implants; motion-driven electromagnetic energy harvesting is a promising method to power instrumented passive and active hip implants.

High volumetric power density, non-enzymatic, glucose fuel cells

The development of new implantable medical devices has been limited in the past by slow advances in lithium battery technology. Non-enzymatic glucose fuel cells are promising replacement candidates for lithium batteries because of good long-term stability and adequate power density. The devices developed to date however use an "oxygen depletion design" whereby the electrodes are stacked on top of each other leading to low volumetric power density and complicated fabrication protocols. Here we have developed a novel single-layer fuel cell with good performance (2 μW cm⁻²) and stability that can be integrated directly as a coating layer on large implantable devices, or stacked to obtain a high volumetric power density (over 16 μW cm⁻³). This represents the first demonstration of a low volume non-enzymatic fuel cell stack with high power density, greatly increasing the range of applications for non-enzymatic glucose fuel cells.