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Abstract— Cardiovascular disease causes 2.75 million deaths in a pacemaker, patients are advised to avoid direct contact
India annually [1]. Despite major flaws, 20,000 pacemakers are sports as well as close or prolonged exposure to electrical
implanted in patients with bradycardia each year in India. devices or devices that have strong magnetic fields such as cell
These pacemakers contain batteries which must be replaced phones, MP3 players, household appliances, high-tension
every 7-8 years [2]. Battery replacement surgeries overall
wires, metal detectors, industrial welders, and electrical
increase cost, patient discomfort and recovery time, and intra-
op and post-op complications. generators [5].
A. CURRENT PACEMAKERS
This project aims to design an affordable pacemaker that
eliminates surgeries due to battery replacement in patients Current pacemakers are composed of three components:
suffering from bradycardia by incorporating a piezoelectric the pulse generator, leads, and electrodes [5]. The pulse
crystal in order to recharge the pacemaker capacitor with each
generator houses the battery and electrical circuitry which
beat of the heart. Experimental outcomes and analysis show that
it is possible to harness enough energy in one year to sustain a
sends electrical signals to the heart [6]. It is implanted just
rechargeable pacemaker for over 20 years. This could under the skin of the chest, on the collar bone [6]. It is the
potentially improve outcomes for 40,000-50,000 people in India main body of the pacing system. Leads are insulated wires
annually. which deliver the pulse to the electrode located at the end
of the wire [6] .The electrodes are implanted into the heart
Keywords— Cardiovascular disease, affordable, battery muscle. Depending on the type of pacemaker, the device
replacement, intra-op, post-op will have one, two or three leads. Single chamber
pacemakers have one lead, dual-chamber pacemakers
I. BACKGROUND have two leads, and biventricular pacemakers have three
Heart Failure—Heart failure occurs when the heart muscle leads [6]. Electrodes are the termination of leads
does not pump the appropriate amount of blood at the ideal consisting of an anode and cathode. They are in direct
rate. To pump blood throughout the body, the muscles of the contact with the heart and contain pulse sensors that detect
heart must be coordinated perfectly, squeezing the blood in the heart rhythm and send data through the leads to the pulse
right direction, at the right time, with the correct pressure [3]. generator. The generator then sends electrical pulses to the
The heart's activity is directed entirely by electrical impulses. heart through the leads as needed [7].
[3].The electrical signal begins at the Sino-atrial (SA) node —
the heart's natural pacemaker, positioned at the top of the right
B. CURRENT PACEMAKER BATTERIES
atrium. This signal causes the atria to contract, pushing blood
down into the ventricles. This electrical impulse travels
through the Bundle of His located in the center of the heart Current pacemakers most commonly use Lithium-Iodide
and eventually radiates through the ventricles causing them to batteries. Lithium Iodide batteries have increased the life-
contract, shooting blood out. One of the most common forms span of a pacemaker as compared to the previously used
of heart failure stems from the ventricles not contracting in mercury-zinc batteries. They have low-drain current and
sync. This is called an arrhythmia. A common method of voltage characteristics [8].Since 1972, lithium iodine-
treatment is the insertion of a pacemaker. polyvinylpyride has been studied extensively in order to
improve design, chemistry, and performance. [8] While
II. INTRODUCTION great improvements have been made, there are still flaws.
Case studies have reported the corrosive nature of the
An artificial cardiac pacemaker is a small device placed in the battery’s compound can result in pacemaker failure causing
chest or abdomen to help control abnormal heart rhythms major patient complications, re-surgeries, and sometimes
called arrhythmias. A heartbeat that is too fast is called death [8].Without major flaws, the batteries must be
tachycardia, while a heartbeat that is too slow is called replaced typically every seven to eight years. Battery
bradycardia. This device generates electrical impulses which replacement surgeries increase overall cost, patient
are delivered by electrodes to contract the heart muscles and discomfort, recovery time, and intra-op and post-op
regulate the electrical conduction system of the heart [4]. With complications. before or immediately following the
equation.
C. CURRENT IMPLANTATION SURGERY and measured using a force gauge. The force and voltage over
time was measured using a multimeter. The second phase of
The most common pacemaker implantation requires a testing, shown in Figure 2(A), consisted of force application
fluoroscope used by a cardiovascular surgeon assisted by a to the piezo plate via linear actuator. The force and voltage
radiologist and anaesthesiologist [9]. The surgery includes a over time was measured by force gauge and multimeter
one to two-inch incision below the collarbone forming a respectively.
pocket where the pulse generator can be inserted [10]. The
leads are threaded through a large vein into the heart where
they are fixed onto the surface [10]. The leads are then
attached to the pulse generator [10] .Post-procedure, the
patient is typically given pain medication as well as an
antibiotic to prevent infection [10] .The overall procedure
takes approximately one to three hours (assuming there are no
major complications) [10] .The device and procedure typically
cost between 45,000 to 3 lakh [11].
III. METHOD
Figure 2: (A) Phase one testing set up - manually applied, continuous force,
( B) Phase two testing set up - linear actuator applied, periodic force. [14,15]
IV. CALCULATIONS
One can calculate the power output of the heart using the
following derived equations. [16]
While current pacemakers utilize a fully charged, non- Power = work/time (1)
rechargeable battery to supply electrical pulses to the heart,
Work can be calculated by the following formula:
the new generation of pacemakers being developed
incorporate a rechargeable aspect. The FlexPacer uses a
piezoelectric crystal stimulated by the heart’s muscle Work = force*displacement (2)
movement. As shown in Figure 1, the mechanical energy of
the heart can be converted to electrical energy which can then It is known that force = pressure*area. Using this fact,
Equation (2) can be rewritten as the following:
be stored in the capacitor within the microprocessor
preventing the number of re-surgeries.
Work = pressure*area*displacement (3)
PMN-PT has been used as a nano-generator in the biomedical
field to collect infinite mechanical energy and convert to It is known that pressure = height*density*gravity.
electrical signals. The piezoelectric material is an Using this fact, Equation (3) can be rewritten as the
encapsulated lead zirconate titanate (PZT), a ceramic following:
commonly used for transducers. [12]
Work=height*density*gravity*area*displacement (4)
The mechanical motion of internal organs produces enough
energy to charge a 3.8-volt battery. [13] In theory, placing the
It is known that volume = area*displacement. Using this
device on the heart’s left ventricle at an angle would provide
fact, Equation (4) can be rewritten as the following:
the piezo with the most power due to the thickness of the
muscle, power output of the heart, and maximum surface area
Work = height*density*gravity*volume (5)
in contact.
To show the piezoelectricity generation in response to Equation (1) and Equation (5) can be combined and
mechanical stress applied, the breadboard circuit shown in rewritten as the following:
Figure 2 was connected. The breadboard connection consisted
of one piezo plate, a bridge rectifier and a 10 microfarad
Power = (height*density*gravity*volume)/time (6)
capacitor in order to store the charge. The process was divided
into two parts. During the first phase of testing, shown in
Figure 2(B), stress on the piezo plate was applied manually
To calculate the work done by the heart, one can use the
following derived equation. [16]
𝑆𝐴𝑝𝑖𝑒𝑧𝑜 = 𝜋 ∗ 𝑟 2 (9)
𝑆𝐴ℎ𝑒𝑎𝑟𝑡
𝑆𝐴𝑐𝑜𝑣𝑒𝑟𝑒𝑑 = 𝑆𝐴𝑝𝑖𝑒𝑧𝑜
∗ 100% (10)
The power the piezo is capable of producing in one year can be calculated
with a 10% loss using the following equation:
Figure 6: Testing phase two results: time versus force applied to the piezo
Power per year = (max power per hour 0.1) *(24 hours/day) (via linear actuator) and voltage stored in the capacitor with linear trendline
*(365 days/year) (11)
The expected battery life of the pacemaker is calculated in the Table 1: Known values of blood moving through human arteries, the heart, and
following: piezoelectric sensor properties needed for calculating power output and work done by
human heart. [16-17]
N per 1 lb 4.4 N
cm per 1 in 2.54 cm
𝑆𝐴𝑝𝑖𝑒𝑧𝑜,𝑜𝑛𝑒 𝑠𝑖𝑑𝑒 = 𝜋 ∗ (17.5 𝑚𝑚)2 = 962.113𝑚𝑚2 = The results from phase one of testing (manually applied,
9.62𝑥10−4 𝑚2 (9) continuously increasing force) can be seen in Figure 4 and
Figure 5. Though these graphs help identify the
Knowing the surface area of the heart and piezo, Equation relationship between force and voltage, they do not show
(10) can be used to calculate the percent of the heart surface the build-up of voltage stored in the capacitor to its
area covered by the piezo.(10) maximum capacity. Figure 4 shows a direct relation
between force and voltage; as the force applied to the
𝑆𝐴ℎ𝑒𝑎𝑟𝑡 9.62𝑥10−4 𝑚2 piezoelectric sensor increases, the voltage stored in the
𝑆𝐴𝑐𝑜𝑣𝑒𝑟𝑒𝑑 = ∗ 100% = *100%=0.0437% capacitor also increases. Figure 5 shows the same
𝑆𝐴𝑝𝑖𝑒𝑧𝑜 2.2𝑚2
(10) relationship over time also with the dissipation of voltage
in the capacitor once force has stopped being applied.
Given the maximum voltage produced by the piezoelectric Figure 6, the results from phase two of testing, used a
sensor is 2 mW/hour, the power produced in one year linear actuator with a tapping motion applying the force.
considering a 10% loss in efficiency can be calculated In this trial, the maximum voltage of the capacitor was
using Equation (11). found to be approximately 4 V.
Power per year = (.002 W/hour0.1) * (24 hours/day) *(365 The results from phase two of testing (linear actuator
days/year) = 15.768 W/year (11) applied, alternating force) can be seen in Figure 6. The force
alternated between 0 N and .85 N continuously completing
The expected battery life of the pacemaker is calculated in the cycles approximately every 2.5 s for the first 30 s of the
following equations: trial.
It is known that current pacemakers most commonly use a 1.5V As shown by the calculations in Equation (10), the
to 2.5 V battery and typically lasts between seven and 8 years. piezoelectric sensor only covers .0437% of the heart’s outer
Considering an average of 7.5 years and a 10% efficiency loss surface. While all calculations consider only one piezoelectric
in the battery, the considered voltage is now 2.25 V. According sensor, since one sensor covers such a miniscule portion of
to Figure 6 where the FlexPacer capacitor was tested for the heart’s surface, multiple sensors could be incorporated
maximum voltage capacity, the maximum voltage was into the device in order to harness more power if needed.
approximately 4 V. If we assume a 10% loss, the maximum
voltage of the FlexPacer is approximately 3.6 .Taking this into The current pacemaker batteries range between 1.5 V-2.5 V
consideration, one can estimate the battery life of FlexPacer using and usually lasts for seven to eight years. The FlexPacer,
Equation (12). based on approximation from Equation (12), can function
efficiently for 12 years with a 4V battery, or three years with
The expected battery life of the pacemaker is calculated in the a 1 V battery even if the rechargeable aspect fails. This is a
following equations: sufficient amount of time for medical professional
intervention. A 1 V battery was considered in this case due to
It is known that current pacemakers most commonly use a 1.5 V to the larger size of the 4 V battery used in testing. A 1 V battery
2.5 V battery and typically lasts between seven and 8 years. would most likely be used in the final device design to
Considering an average of 7.5 years and a 10% efficiency loss in conserve space.
the battery, the considered voltage is now 2.25 V. According to
Figure 6 where the FlexPacer capacitor was tested for maximum Since the current of our system is .27 A, and the voltage
voltage capacity, the maximum voltage was approximately 4 V. If needed in one year is 0.3V (Equation (12) shows 0.9 V
we assume a 10% loss, the maximum voltage of the FlexPacer is supplies the piezo for three years), one can conclude the
approximately 3.6 V. Taking this into consideration, one can power needed to sustain the FlexPacer for one year is only
estimate the battery life of FlexPacer using Equation (12). 0.081 W. Based on Equation (11), FlexPacer is capable of
outputting 1.752 W/year even considering a 10% efficiency
(7.5 𝑦𝑒𝑎𝑟𝑠)𝑥(3.6𝑉) loss. Furthermore, since the FlexPacer only needs 0.081
𝐸𝑠𝑡𝑖𝑚𝑎𝑡𝑒𝑑 𝑏𝑎𝑡𝑡𝑒𝑟𝑦 𝑙𝑖𝑓𝑒 = = 12 𝑦𝑒𝑎𝑟𝑠 W/year to sustain itself, this means it would need 1.62 W to
2.25𝑉
(12) sustain for 20 years. As mentioned above, the FlexPacer is
theoretically able to harness this much power in only one VII. REFRENCE
year. Ergo, less than one year of a beating heart will supply
the FlexPacer with enough power to sustain for 20 years.
VI. CONCLUSION
In the future, the design will need to be further created for the
full device. This design can be refined with pulse sensors and
miniaturized using biocompatible materials in order to be
implanted within bradycardic patients throughout India and
around the world. A custom piezo will need to be created to fit
the left ventricle, the piezo’s fatigue strength must be
investigated, an anatomical model for testing is needed, and
adhesive methods will have to be investigated to secure the
piezo to the heart. If created with flexible materials and
miniaturized into a cylindrical shape, it may be possible to
perform implantation via catheterization through the femoral
artery. [18]
A laparoscopic, intercostal approach may also be an option.
[19] These smaller incisions, in theory, should lead to less intra-
op and post-op complications as well as lower infection rates.
[19]