Therapeutic and Prosthetic Devices

Part I : Cardiac Pacemaker

Dr. Mohamad O. Diab
Assistant Professor College of Engineering Hariri Canadian University (HCU)

Outline
Introduction Physiology of the heart Pacemaker
Asynchronous Synchronous
Demand type Aterial synchronous type Variable rate type

Therapeutic and prosthetic Instruments

Electrically stimulate different parts of the body to relief pain, cure diseases, or replace damaged biological organ in the body.
Examples of Therapeutic and prosthetic devices: Cardiac Pacemakers Ventilators Heart-Lung machines Artificial Kidney Diathermy Devices Electrosurgical Instrument Cochlear Implant Eye Bionic

Physiology of the heart

Electrical conduction system of the heart

Cardiac Pacemakers
Cardiac Pacemaker:

An electric stimulator that produces periodic electric pulses that are conducted to electrode on the surface of the heart, within the heart muscle, or within the cavity of the heart. Two Type of Pacemakers:
1) Asynchronous cardiac pacemaker 2) Synchronous cardiac pacemaker

Types of pacemakers
Pacemakers

Asychronous

Sychronous

Atrial sychronous

Demand type

Variable rate

Asynchronous Cardiac Pacemakers

Power Supply: Lithium iodide Cathode reaction: Li Li+ + eAnode reaction at the Anode: I2 + 2e- 2ITiming Circuit: pulse rate is 70 to 90 pulse per minute Output Circuit: Constant-Voltage Amplitude pulses: 5.0 to 5.5 V with duration of 0.5 to 0.6 msec. Constant-current amplitude pulses: 8 to 10 mA with pulse duration from 1.0 to 1.2 ms.

Block diagram of an asynchronous cardiac pacemaker

Lead Wires and Electrodes

Figure 1. Two of the more commonly applied cardiac pacemaker electrodes (a) Bipolar intraluminal electrode. (b) Intramyocardial electrode.

Synchronous Pacemakers
Provide electric stimulus when the cardiac normal rhythm is stopped. Two type of synchronous pacemakers 1) The demand pacemaker (Irregular SA node firing) 2) The atrial-synchronous pacemaker (AV node is not working)

Figure 2. A demand-type synchronous pacemaker

Atrial-Synchronous Pacemaker

Figure 3. An atrial-synchronous cardiac pacemaker, which detects electric signals corresponding to the contraction of the atria and uses appropriate delays to activate a stimulus pulse to the ventricles. Figure 13.5 shows the waveforms corresponding to the voltages noted.

Rate-Responsive Pacemaker
Physiological variables are used to control the pulse rate of the rate-responsive pacemakers

Physiological Variable Right-ventricle blood temperature Venous blood oxygen saturation Respiratory rate and/or volume

Sensor Thermistor Optical Oximeter Thoracic electricimpedance

Any Questions