Mobile and wireless technologies applying on sphygmomanometer and pulsimeter for patients with pacemaker implementation and other cardiovascular complications

doi:10.4236/jbise.2010.31007

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J. Biomedical Science and Engineering, 2010, 3, 47-51

doi:10.4236/jbise.2010.31007 Published Online January 2010 (http://www.SciRP.org/journal/jbise/

JBiSE

Published Online January 2010 in SciRes. http://www.scirp.org/journal/jbise

Mobile and wireless technologies applying on

sphygmomanometer and pulsimeter for patients with

pacemaker implementation and other cardiovascular

complications

Ching-Sung Wang

Department of Electronic Engineering Oriental Institute of Technology, Taipei, Taiwan, China.

Emill: [email protected]

Received 11 August 2009; revised 9 September 2009; accepted 10 September 2009.

ABSTRACT

Continuously monitoring pulse is very important for

the pacemaker patients., and the continuously ob-

serving blood pressure is also a matter of concern for

those who have hypertension, coronary heart disease,

or other cardiovascular diseases, for example cardiac

arrhythmia and hypertension. What we expect is not

only to eliminate arrhythmia, also to treat patients as

a whole of body. Therefore, how to keeping monitor-

ing blood pressure and pulses rise to a very impor-

tant issue. This research edits a wrist-able sphygmo-

manometer and pulsimeter combining with cell

phone, to achieve wireless, continuous, and real-time

observation, early detects any accident occurring

from the patients with pacemaker implementation or

with other cardiovascular complications

Keywords: Pacemaker; Hypertension; Coronary Heart

Disease; Cardiovascular Disease; Sphygmomanometer

and Pulsimeter

1. INTRODUCTION

The population for pacemaker implant is not limited by

age, sex, or race. Over 100,000 pacemakers are impl-

anted per year in the United States. Approximately

500,000 Americans have an implantable permanent

pacemaker device [1]. Pacemaker can be affected by

electromagnetic interference in several different ways,

including temporary inhibition of the pacemaker, tem-

porary function at the fixed noise rate, temporary func-

tion at the fixed magnet rate, permanent inhibition or

malfunction, and random reprogramming. For any of

these results to occur, the E field strength must be

greater than 200V/m or the magnetic field strength must

be greater than 10 Gauss [2].

Cellular telephones can interfere with the function of

implanted cardiac pacemakers [3,4,5]. However, when

telephones are placed over the ear, the normal position,

this interference does not pose a health risk [5]. Barbaro

V, et al. The research of influence between GSM mobile

phone and implanted pacemaker indicates that electro-

magnetic interference effects were detected at a maxi-

mum distance of 10 cm with the pacemaker programmed

at its minimum sensing threshold. When the phone an-

tenna was in direct contact with patient's skin over the

implant, electromagnetic interference effects occurred at

maximum ventricular and a trial sensing thresholds of 4

mV and 2.5 mV, respectively [6]. Therefore, decreasing

wireless emission power and rising pacemaker emission

distance are the most useful methods of lowering the

interference of magnetic to the pacemaker.

In order not to affect users' habits of using mobile and

to avoid the electromagnetic interference effects of pace-

maker, we design a wrist-able sphygmomanometer and

pulsimeter which is using the Bluetooth power class II

[7,8] to be the device for short-distance transmission.

Furthermore, to combine with a cellular phone, we can

do the prolonged distance observation and treatment

immediately for the patients with setting pacemaker or

with other cardiovascular disease.

2. SYSTEM ARCHITECTURE

This research aims at designing wrist-able sphygmoma-

nometer and pulsimeter. We design a non-invasive

sphygmomanometer [9] to remind the user to measure

the blood pressure every hour. Pulsimeter is an elec-

tronic device which is based on pressure sensor, and can

observe pulse continuously. In order to avoid the influ-

ence of electromagnetic wave on the pacemaker, this

research is using the Bluetooth power class II equipment

to shorten the distance which wireless data transmission

device of sphygmomanometer transmits to client-end

cellular phone, then use the GPRS (General Packet Ra-

dio Service)[10,11] to do the long distance data trans-

C. S. Wang / J. Biomedical Science and Engineering 3 (2010) 47-51

Figure 1. System architecture.

Figure 2. Wristable sphygmomanometer and pulsimeter

hardware architecture.

mission. This can transmit blood pressure and pulse rate

to Remote Medical Server and then provide them to spe-

cialist doctors for reference data.

Because of the connecting method of GPRS is a

packet switch [10,11], it doesn’t connect with Remote

Medical Server continuously. Therefore, this research

designs that Remote Medical Server used GSM (Global

System for Mobile Communications) circuit connec-

tion(voice connection) [10,11,12] to inform wrist-able

sphygmomanometer and pulsimeter, and drives sphyg-

momanometer to measure blood pressure immediately.

Then, the sphygmomanometer will send the outcome of

blood pressure to Remote Medical Server by GPRS

[10,11,13]. Figure 1 details the block diagram of system

architecture.

3. HARDWARE ARCHITECTURE

The hardware system of this research is divided into two

parts, one is wrist-able sphygmomanometer and pul-

simeter; the other one is client-end cellular phone. The

below is the detail of them.

3.1. Wristable Sphygmomanometer and

Pulsimeter

Figure 2 details the block diagram of wrist-able sphyg-

momanometer and pulsimeter hardware architecture.

The Controller unit of wrist-able sphygmomanometer

Figure 3. Sphygmomanometer hardware architecture.

Figure 4. Pulsimeter hardware architecture.

and pulsimeter is microcontroller [14], which controls

and reads the peripheral units. Here is the description of

each unit.

1) Sphygmomanometer [9,14,15,16]: The sphygmo-

manometer includes LDO (Low Dropout Regulators) as

power controller, pressure sensor , filter, amplifier circuit

and accessories. The research is using the pressure sen-

sor of SCC series which is manufactured by HoneyWell

company. The pressure sensor will transmit different

message according to the changing pressure. The mes-

sage passes through the procedures of magnifying (mag-

nify the micro-message form sensor), and filtering (re-

move noise), then all the analog messages will be sent to

the microcontroller via A/D (Analog/Digital) interface.

Figure 3 shows the block diagram of sphygmomanome-

ter hardware architecture.

2) Pulsimeter [9,14,15,16] : The pulsimeter includes

LDO, pressure sensor , filter, amplifier circuit and acces-

sories. The circuit is using the SCC series of HonyWell

company, but it is a different sensitivity pressure sensor.

Putting sensor pad on pulse of hand, the pressure sensor

will convert the normal pulse beat to a larger voltage

output by magnifying, filtering, comparing (transform to

digital signal), and then inputs it into microcontroller.

Figure 4 is shown the block diagram of pulsimeter.

3) Bluetooth transceiver [14,17]: The project uses BC3

made by CSR as the Bluetooth transceiver. The micro-

controller communicates with the Bluetooth by UART

(Universal asynchronous receiver/transmitter) interface

and controls all the process by software.

4) Alarm circuit: The main purpose of this part is to

C. S. Wang / J. Biomedical Science and Engineering 3 (2010) 47-51

Figure 5. Client-end Cellular Phone Hardware Architecture.

Figure 6. The software algorithm of continuous

pulse and blood measuring and monitoring proce-

dure.

send a notice to the users, and then to perform blood

pressure measurement. Microcontroller can activate the

alarm circuit every hour. However, on the other one end,

Remote Medical Server can prescribe the blood pressure

measurement, so that the users can measure their blood

pressure when they require.

3.2. Client-End Cellular Phone Hardware

Architecture

Figure 5 details the block diagram of client-end cellular

phone hardware architecture, which includes two main

parts, Bluetooth and GSM/GPRS.

1) Bluetooth transceiver [14,17,18]: The hardware

framework is similar to the Bluetooth transceiver of

wrist-able sphygmomanometer and pulsimeter. It com-

municates with GSM/GPRS module by UART interface.

2) GSM Module [18]: It includes Baseband part and

RF part. The main components are Baseband IC (in-

cluding DSP), TFT-LCD, NOR Flash, SRAM, Power

Management IC and RF IC. We use MT6219 made by

MediaTek as the platform of the GSM/GPRS system.

4. SOFTWARE ALGORITHM

4.1. Continuous Pulse and Blood Measuring and

Monitoring Procedure

Pulse monitor procedure [14,15,16,19]: Microcontroller

Figure 7. The software algorithm of measure blood pre-

sure procedure.

reads the pulsimeter every minute, then transmits the

results to the client-end cellular phone by Bluetooth SPP

(Serial Port Profile).

Blood pressure measure procedures [9,14,15,16,19]:

Microcontroller enables alarm system to inform user

every hour that the time requires to measure the blood

pressure. Users need to put hand on the proper position

so that sphygmomanometer can have a better detection.

While the users put hand on proper position and push

trigger button, then the microcontroller controls pul-

simeter’s LDO to stop action and start to measure the

blood pressure. After that, microcontroller transmits

blood pressure to the cellular phone by Bluetooth SPP,

and to activate pulsimeter. If the user doesn’t do the ac-

tion of blood pressure measurement, the microcontroller

would re-activate pulsimeter after a while. The software

algorithm of continuous pulse and blood measurement

and the monitoring procedure is shown in Figure 6 and

Figure 7.

4.2. Client-End Clelular Phone Data Handling

Procedure

While the Bluetooth of mobile receives the data from the

Bluetooth of wrist-able sphygmomanometer and pul-

simeter, it analyzes the data of blood pressure or pulse

and to store (includes the measurement time) individu-

C. S. Wang / J. Biomedical Science and Engineering 3 (2010) 47-51

Figure 8. The software algorithm of client-end cellular

phone data handling procedure.

Figure 9. The software algorithm of remote medical

server claim for mearuring blood pressure.

ally at first. Finally, it establishes GPRS connection. Af-

ter successful connecting, mobile scans stored blood

pressure and pulse data, and then it transmits to the Re-

mote Medical Server if the data has not been sent yet.

The software algorithm of mobile data handling proce-

dure is shown on Figure 8 [13,19,20,21].

4.3. Remote Medical Server Claim for Measur-

ing Blood Pressure

If the doctor considers that it is necessary to get the pa-

tient’s current blood pressure-immediately, he/she can

call to client-end cellular phone by GSM module on the

Remote Medical Server. While client-end cellular phone

receives incoming call form server-end, the Bluetooth

SPP transmits command of measuring blood pressure to

wrist-able sphygmomanometer and pulsimeter. While

wrist-able sphygmomanometer and pulsimeter receive

the command from the Remote Medical Server, they

activate blood pressure measurement and transmit pro-

cedures (Figure 6, 7, 8). The software algorithm of Re-

mote Medical Gateway claims for measuring blood

pressure is shown in Figure 9 [13,19,20,21].

5. CONCLUSIONS

It is a fatal risk for the patient with artificial pacemaker

implementation while the mobile connection is close to

the heart. The artificial pacemaker will consider the

electromagnetic wave from mobiles is heart signal, then

to do the wrong stimulation on muscle fiber of heart

ventricle. However, continuous pulse and blood pressure

observation is very essential for the patient of arrhythmia

with hypertension coronary arterial heart disease or heart

failure. Based on this following the Bluetooth power

class II RF test specification, we have designed a port-

able Bluetooth medium. We expect this system will be

benefit for the patients of arrhythmia with hypertension

coronary arterial heart disease or heart failure and never

cause any inconvenience to their daily life.

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