Carbon nanotube materials for electrocardiography

Robust, self-adhesive and anti-bacterial silk-based LIG electrodes for electrophysiological monitoring

Flexible wearable electrodes have been extensively used for obtaining electrophysiological signals towards smart health monitoring and disease diagnosis. Here, low-cost, and non-conductive silk fabric (SF) have been processed into highly conductive laser induced graphene (LIG) electrodes while maintaining the original structure of SF. A CO2-pulsed laser was utilized to produce LIG-SF with controlled sheet resistance and mechanical properties. Laser processing of SFs under optimized conditions yielded LIG-SF electrodes with a high degree of homogeneity on both, top and bottom layers. Silk fibroin/Ca2+ adhesive layers effectively promoted the adhesive, anti-bacterial properties and provided a conformal contact of LIG-SF electrodes with human skin. Compared with conventional Ag/AgCl electrodes, LIG-SF electrodes possesses a much lower contact impedance in contact with human skin enabling highly stable electrophysiological signals recording. The applicability of adhesive LIG-SF electrodes to acquire electrocardiogram (ECG) signals was investigated. ECG signals recordings of adhesive LIG-SF electrodes showed excellent performance compared to conventional Ag/AgCl electrodes at intense body movements while running at different speeds for up to 9 km over a duration of 24 h. Therefore, our proposed adhesive LIG-SF electrodes can be applied for long-term personalized healthcare monitoring and sports management applications.

Stimuli-bioresponsive hydrogels as new generation materials for implantable, wearable, and disposable biosensors for medical diagnostics: Principles, opportunities, and challenges

Hydrogels are excellent water-swollen polymeric materials for use in wearable, implantable, and disposable biosensors. Hydrogels have unique properties such as low cost, ease of preparation, transparency, rapid response to external conditions, biocompatibility and self-adhesion to the skin, flexibility, and strain sensitivity, making them ideal for use in biosensor platforms. This review provides a detailed overview of advanced applications of stimuli-responsive hydrogels in biosensor platforms, from hydrogel synthesis and functionalization for bioreceptor immobilization to several important diagnostic applications. Emphasis is placed on recent advances in the fabrication of ultrasensitive fluorescent and electrically conductive hydrogels and their applications in wearable, implantable, and disposable biosensors for quantitative measurements. Design, modification, and assembly techniques of fluorescent, ionically conductive, and electrically conductive hydrogels to improve performance will be addressed. The advantages and performance improvements of immobilizing bioreceptors (e.g., antibodies, enzymes, and aptamers), and incorporating fluorescent and electrically conductive nanomaterials are described, as are their limitations. Potential applications of hydrogels in implantable, wearable, disposable portable biosensors for quantitative detection of the various bioanalytes (ions, molecules, drugs, proteins, and biomarkers) are discussed. Finally, the global market for hydrogel-based biosensors and future challenges and prospects are discussed in detail.

Paintable Carbon Nanotube Coating-Based Textronics for Sustained Holter-Type Electrocardiography

A growing population suffering from or at high risk of developing cardiovascular diseases can benefit from rapid, precise, and readily available diagnostics. Textronics is an interdisciplinary approach for designing and manufacturing high-performance flexible electronics integrated with textiles for various applications, with electrocardiography (ECG) being the most convenient and most frequently used diagnostic technique for textronic solutions. The key challenges that still exist for textronics include expedient manufacturing, adaptation to human subjects, sustained operational stability for Holter-type data acquisition, reproducibility, and compatibility with existing solutions. The present study demonstrates conveniently paintable ECG electroconductive coatings on T-shirts woven from polyester or 70% polyamide and 30% polyester. The up to 600-μm-thick coatings encompass working electrodes of low resistivity 60 Ω sq^-1 sheathed in the insulated pathways-conjugable with a wireless, multichannel ECG recorder. Long (800 μm) multiwalled carbon nanotubes, with scalable reproducibility and purity (18 g per round of synthesis), constituted the electroactive components and were embedded into a commercially available screen-printing acrylic base. The resulting paint had a viscosity of 0.75 Pa·s at 56 s^-1 and 25 °C and was conveniently applied using a paintbrush, making this technique accessible to manufacturers. The amplified and nondigitally processed ECG signals were recorded under dry-skin conditions using a certified ECG recorder. The system enabled the collection of ECG signals from two channels, allowing the acquisition of cardiac electrical activity on six ECG leads with quality at par with medical diagnostics. Importantly, the Holter-type ECG allowed ambulatory recording for >24 h under various activities (sitting, sleeping, walking, and running) in three male participants. The ECG signal was stable for >5 cycles of washing, a level of stability not reported yet previously. The developed ECG-textronic application possesses acceptable and reproducible characteristics, making this technology a suitable candidate for further testing in clinical trials.

Hybrid 1D/2D nanocarbon-based conducting polymer nanocomposites for high-performance wearable electrodes

A low interfacial contact resistance is a challenge in polymer nanocomposites based on conductive nanomaterials for high-performance wearable electrode applications. Herein, a polydimethylsiloxane (PDMS)-based flexible nanocomposite incorporating high-conductivity 1D single-walled carbon nanotubes (SWCNTs) and 2D reduced graphene oxide (r-GO) was developed for high-performance electrocardiogram (ECG) wearable electrodes. A PDMS-SWCNT (P-SW; type I) nanocomposite containing only SWCNTs (2 wt%), exhibited rough and non-uniform surface morphology owing to the strong bundling effect of as-grown SWCNTs and randomly entangled aggregate structures and because of inefficient vacuum degassing (i.e., R _P-SW = 1871 Ω). In contrast, owing to the hybrid structure of the SWCNTs (1 wt%) and r-GO (1 wt%), the PDMS-SWCNTs/r-GO (P-SW/r-GO; type II) nanocomposite exhibited uniform surface characteristics and low contact resistance (i.e., R _P-SW/r-GO = 63 Ω) through the formation of hybrid and long conducting pathways. The optimized nanocomposite (P-SW/r-GO/f; type III) possessed a fabric-assisted structure that enabled tunable and efficient vacuum degassing and curing conditions. Additionally, a long and wide conducting pathway was formed through more uniform and dense interconnected structures, and the contact resistance was drastically reduced (i.e., R _P-SW/r-GO/f = 15 Ω). The performance of the electrodes fabricated using the optimized nanocomposites was the same or higher than that of commercial Ag/AgCl gel electrodes during real-time measurement for ECG Bluetooth monitoring. The developed high-performance hybrid conducting polymer electrodes are expected to contribute significantly to the expansion of the application scope of wearable electronic devices and wireless personal health monitoring systems.

Effects of electrically conductive nano-biomaterials on regulating cardiomyocyte behavior for cardiac repair and regeneration

Myocardial infarction (MI) represents one of the most prevalent cardiovascular diseases, with a highly relevant and impactful role in public health. Despite the therapeutic advances of the last decades, MI still begets extensive death rates around the world. The pathophysiology of the disease correlates with cardiomyocyte necrosis, caused by an imbalance in the demand of oxygen to cardiac tissues, resulting from obstruction of the coronary flow. To alleviate the severe effects of MI, the use of various biomaterials exhibit vast potential in cardiac repair and regeneration, acting as native extracellular matrices. These hydrogels have been combined with nano sized or functional materials which possess unique electrical, mechanical, and topographical properties that play important roles in regulating phenotypes and the contractile function of cardiomyocytes even in adverse microenvironments. These nano-biomaterials' differential properties have led to substantial healing on in vivo cardiac injury models by promoting fibrotic scar reduction, hemodynamic function preservation, and benign cardiac remodeling. In this review, we discuss the interplay of the unique physical properties of electrically conductive nano-biomaterials, are able to manipulate the phenotypes and the electrophysiological behavior of cardiomyocytes in vitro, and can enhance heart regeneration in vivo. Consequently, the understanding of the decisive roles of the nano-biomaterials discussed in this review could be useful for designing novel nano-biomaterials in future research for cardiac tissue engineering and regeneration. STATEMENT OF SIGNIFICANCE: This study introduced and deciphered the understanding of the role of multimodal cues in recent advances of electrically conductive nano-biomaterials on cardiac tissue engineering. Compared with other review papers, which mainly describe these studies based on various types of electrically conductive nano-biomaterials, in this review paper we mainly discussed the interplay of the unique physical properties (electrical conductivity, mechanical properties, and topography) of electrically conductive nano-biomaterials, which would allow them to manipulate phenotypes and the electrophysiological behavior of cardiomyocytes in vitro and to enhance heart regeneration in vivo. Consequently, understanding the decisive roles of the nano-biomaterials discussed in the review could help design novel nano-biomaterials in future research for cardiac tissue engineering and regeneration.

Carbon Nanotube Wearable Sensors for Health Diagnostics

This perspective article highlights a recent surge of interest in the application of textiles containing carbon nanotube (CNT) sensors for human health monitoring. Modern life puts more and more pressure on humans, which translates into an increased number of various health disorders. Unfortunately, this effect either decreases the quality of life or shortens it prematurely. A possible solution to this problem is to employ sensors to monitor various body functions and indicate an upcoming disease likelihood at its early stage. A broad spectrum of materials is currently under investigation for this purpose, some of which already entered the market. One of the most promising materials in this field are CNTs. They are flexible and of high electrical conductivity, which can be modulated upon several forms of stimulation. The article begins with an illustration of techniques for how wearable sensors can be built from them. Then, their application potential for tracking various health parameters is presented. Finally, the article ends with a summary of this field's progress and a vision of the key directions to domesticate this concept.