Development of distributed wireless implantable sensors for the management of heart failure (HF)

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Heart failure affects more than 600,000 Canadians and 26 million people worldwide. The direct economic impact of heart failure is estimated to be $2.8 billion per year in Canada, with a significant portion of this cost associated to hospitalizations and emergency room visits. Beside frequent hospitalizations, HF patients must undergo uncomfortable diagnostic procedures and physical examinations. Remote monitoring (or telemonitoring) was introduced in the 1990's to detect the worsening of a patient's condition at a home setting before the need for emergency hospitalization. At the time, remote monitoring relied on patients to record their physiological parameters, such as weight and blood pressure, and communicate them to their clinical team over the phone. The need for more effective methods of remote monitoring led medical companies to incorporate sensors in traditional implantable pacemaker and cardioverter devices. These sensors are capable of real-time monitoring of several parameters, including electrical activity, blood pressure and fluid levels in the lungs, which are directly related to potential heart failure. While these devices no longer required patients' active participation and compliance, they did involve additional surgical procedure leading to potential risks and complications. To eliminate the need to implant long extension cables, insertable wireless monitors have recently been developed. Sized like paperclips, these monitors can be inserted through small incisions or simple catheter procedures. In the context of heart failure, the most successful clinical device is a pressure sensor implanted in the pulmonary artery. While this device is currently widely adopted as an early indicator of worsening of heart failure, the system requires patients to operate an external electronic unit daily. Moreover, current wireless monitors are designed to measure one parameter from one specific anatomical area. The true ambition of cardiac research is to measure several relevant parameters concurrently from different anatomical regions using non-invasive or minimally invasive tools. To fulfill this goal, this program proposes the development of a smart network of miniaturized wireless biosensing modules for remote monitoring of heart failure. By distributing these sensors across relevant anatomical regions, accurate measurement of physical, electrical and chemical parameters will be possible without the need for expensive and uncomfortable procedures. Leveraging semiconductor technology, the biosensing devices will be miniaturized to the scale of a grain of rice without sacrificing performance. A central implant unit will be responsible of collecting data and controlling sensor activity. Combined multi-parameter data will provide rich information about the patients' status in real-time and will ensure timely monitoring and management of heart failure.