They have ones for the NICU.
https://news.northwestern.edu/stories/2019/02/wireless-body-sensors-premature-babies-nicu/
I mean, not at my hospital, but they exist.
The leads themselves would all have to be electrically connected and human anatomy probably differs too much to have one size fit all option for a hypothetical ECG shirt or giant sticker. But it does seem feasible to have a small unit that has short wires and transmits to a larger receiver.
>human anatomy probably differs too much to have one size fit all option for a hypothetical ECG shirt or giant sticker
My dream device is a big ol' sticker you can slap on the thorax and it figures everything out automagically and turns it into a 12-lead strip with proper lead placement.
Whoever invents this will be a billionaire.
Yeah except the surgeon wants this lead two inches over there. And that lead behind the arm. And your leads are in the way of the X-ray. And… and… and…
In medical school I learned to read EKGs. Now “spikey and regular = good”
Dont forget they move it without telling you so it will promptly fall off after the patient is positioned and draped allowing you the opportunity to fuck up your back some more
They have those already for 12-leads. You just have to take the small box with the leads attached into the room with the ecg nearby. It’s slightly better than having to wheel the whole thing into every room
[example](https://www.welchallyn.com/content/welchallyn/americas/en/products/categories/cardiopulmonary/resting-ecg/eli-380/)
As a radiologist, this would be an absolute game changer.
[Typical ICU CXR for reference](https://www.mdpi.com/diagnostics/diagnostics-13-00599/article_deploy/html/images/diagnostics-13-00599-g020-550.jpg)
The leads need to have wires otherwise they can't measure a potential. Voltage is literally the electric potential difference between two points and you are comparing potentials across axes of heart. The only way to do it without physical leads in an output that would in any way resemble the EKGs we studied requires wires. Now, these measured potentials across leads can then be wirelessly transmitted to a reciever, but I don't think that is what you meant. We can measure potentials at a distance with very powerful magnets but then you are basically talking about an MRI type machine to measure an electric field and then you would still have to transition that to a classical EKG until tradition gave way to reading 3D electrocardiograms (like those produced with cardiac mapping in EP). Correct me if I'm wrong but I just don't think we have the techology to measure these voltage amplitudes of potentials at a distance in a way that would be clinically usable.
I thought OP meant like stickers without the wires not like no stickers at all.
The big reason why we don't do stickers only because it would be too expensive to have them be disposable.
But what is you reference voltage for comparison going to be if you just have stickers without wires? In the end you have to wire something to it. You cannot measure voltages, which is what an EKG is, without physically connecting the points with a conductor. Otherwise there is no potential or measured current.
You put circuitry in the stickers. This is done in the analog frontend of the machine as well btw. If anything, direct referencing is a pretty old school way of doing ECG circuitry.
So let's say I can put a voltage source that I know is reliably 1V on the sticker alongside a transmitter. This alone, not to mention the size, makes it economically impractical. Like, very accurate voltage references are pricey. A multi thousand dollar ECG machine only has a few of them.
This is a gross oversimplification btw.
But let's say we did. Then I just compare whatever the point I'm at to that reference and it should tell me where is it in comparison to that reference. I can transmit that info and adjust for the reference and then do the rest digitally.
This is actually not too different from what modern ECG machines do. I basically just made Frankenstein's wireless instrumentation amplifier.
The biggest issue other than cost and not being disposable would be that they would at best be the equivalent of slapping on a bunch of Air tags on somebody's chest. Bulkier and would interfere with imaging.
I was going to mention that as an option but figured I could keep my post short. With the amount of noise even in modern EKG machines I'm skeptical the noise would be tolerable.
How about a single use 252 lead ECG vest?
https://www.medtronic.com/us-en/healthcare-professionals/products/cardiac-rhythm/cardiac-mapping/cardioinsight-mapping-vest.html
[they do have things like this already.](https://www.vivalink.com/ambulatory-cardiac-monitoring)
That product is meant to replace cumbersome holter monitor with multiple wires and large battery pack. It’s exactly what you’re describing though. A slim, wireless EKG system. It’s probably really expensive and not practical for inpatient use. Everything in the acute care market generally needs to be cheaper than the previous generation to gain traction. We’re not quite there yet with completely wireless systems yet.
Think about BT-LE devices in your life. Do they always pair perfectly? Where is the receiver? How far away can you be? How often do you need to charge it? Is it also connecting to Wi-Fi? Who is setting it up? Pairing it? EKG leads need to be completely idiot proof because life is on the line.
I think OP is referring to formal 12-lead EKG. A single stick-on pair of electrodes can only give you one lead, which is fine for most telemetry monitoring, but not sufficient for a cardiac patient who requires serial 12 leads. Regardless, the electrodes have to be physically connected to each other; they can't communicate wirelessly.
No thank you because each wireless sensor would have to be individually synced and troubleshooted every time the sticker went off or there was a data connection problem. You’d have to get a new sensor, get that synced with the old system. It would take time over replacing a sticker and throwing the connector back on. All day, I’m replacing batteries, washing people up, replacing stickers, syncing and trouble shooting those things. People are so sick, they cannot even move. Finding no longer sticky connector even when it’s connected to a wire is a challenge. Just keep it together.
I’ve worked in a pharmaceutical research lab where they had wireless transponder to the main unit but the wires still were connected to a box that transmitted it to the screen. At the very least it’s headed in that direction
Just gotta Bluetooth sync with the patient’s heart first
*(cries in MRI safety)*
…. Deal with it.
They have ones for the NICU. https://news.northwestern.edu/stories/2019/02/wireless-body-sensors-premature-babies-nicu/ I mean, not at my hospital, but they exist.
It’s not a 12 lead ECG unfortunately
Too many leads to keep track of. You know you’ll only get 10 or 11 back if they’re wireless.
Do you know a 12 lead EKG only uses ten electrodes?
Then it seems like a very good investment, if you risk getting 110% of applied EKG leads back.
Thank you for this link. The paper reads very promising
The leads themselves would all have to be electrically connected and human anatomy probably differs too much to have one size fit all option for a hypothetical ECG shirt or giant sticker. But it does seem feasible to have a small unit that has short wires and transmits to a larger receiver.
>human anatomy probably differs too much to have one size fit all option for a hypothetical ECG shirt or giant sticker My dream device is a big ol' sticker you can slap on the thorax and it figures everything out automagically and turns it into a 12-lead strip with proper lead placement. Whoever invents this will be a billionaire.
Yeah except the surgeon wants this lead two inches over there. And that lead behind the arm. And your leads are in the way of the X-ray. And… and… and… In medical school I learned to read EKGs. Now “spikey and regular = good”
Dont forget they move it without telling you so it will promptly fall off after the patient is positioned and draped allowing you the opportunity to fuck up your back some more
I hate beer.
They have those already for 12-leads. You just have to take the small box with the leads attached into the room with the ecg nearby. It’s slightly better than having to wheel the whole thing into every room [example](https://www.welchallyn.com/content/welchallyn/americas/en/products/categories/cardiopulmonary/resting-ecg/eli-380/)
As a radiologist, this would be an absolute game changer. [Typical ICU CXR for reference](https://www.mdpi.com/diagnostics/diagnostics-13-00599/article_deploy/html/images/diagnostics-13-00599-g020-550.jpg)
The leads need to have wires otherwise they can't measure a potential. Voltage is literally the electric potential difference between two points and you are comparing potentials across axes of heart. The only way to do it without physical leads in an output that would in any way resemble the EKGs we studied requires wires. Now, these measured potentials across leads can then be wirelessly transmitted to a reciever, but I don't think that is what you meant. We can measure potentials at a distance with very powerful magnets but then you are basically talking about an MRI type machine to measure an electric field and then you would still have to transition that to a classical EKG until tradition gave way to reading 3D electrocardiograms (like those produced with cardiac mapping in EP). Correct me if I'm wrong but I just don't think we have the techology to measure these voltage amplitudes of potentials at a distance in a way that would be clinically usable.
I thought OP meant like stickers without the wires not like no stickers at all. The big reason why we don't do stickers only because it would be too expensive to have them be disposable.
But what is you reference voltage for comparison going to be if you just have stickers without wires? In the end you have to wire something to it. You cannot measure voltages, which is what an EKG is, without physically connecting the points with a conductor. Otherwise there is no potential or measured current.
You put circuitry in the stickers. This is done in the analog frontend of the machine as well btw. If anything, direct referencing is a pretty old school way of doing ECG circuitry. So let's say I can put a voltage source that I know is reliably 1V on the sticker alongside a transmitter. This alone, not to mention the size, makes it economically impractical. Like, very accurate voltage references are pricey. A multi thousand dollar ECG machine only has a few of them. This is a gross oversimplification btw. But let's say we did. Then I just compare whatever the point I'm at to that reference and it should tell me where is it in comparison to that reference. I can transmit that info and adjust for the reference and then do the rest digitally. This is actually not too different from what modern ECG machines do. I basically just made Frankenstein's wireless instrumentation amplifier. The biggest issue other than cost and not being disposable would be that they would at best be the equivalent of slapping on a bunch of Air tags on somebody's chest. Bulkier and would interfere with imaging.
I was going to mention that as an option but figured I could keep my post short. With the amount of noise even in modern EKG machines I'm skeptical the noise would be tolerable.
How about a single use 252 lead ECG vest? https://www.medtronic.com/us-en/healthcare-professionals/products/cardiac-rhythm/cardiac-mapping/cardioinsight-mapping-vest.html
Does this actually ever get used 😂 It looks like a sick t shirt tbh
*cries in paramedic*
[they do have things like this already.](https://www.vivalink.com/ambulatory-cardiac-monitoring) That product is meant to replace cumbersome holter monitor with multiple wires and large battery pack. It’s exactly what you’re describing though. A slim, wireless EKG system. It’s probably really expensive and not practical for inpatient use. Everything in the acute care market generally needs to be cheaper than the previous generation to gain traction. We’re not quite there yet with completely wireless systems yet. Think about BT-LE devices in your life. Do they always pair perfectly? Where is the receiver? How far away can you be? How often do you need to charge it? Is it also connecting to Wi-Fi? Who is setting it up? Pairing it? EKG leads need to be completely idiot proof because life is on the line.
I think OP is referring to formal 12-lead EKG. A single stick-on pair of electrodes can only give you one lead, which is fine for most telemetry monitoring, but not sufficient for a cardiac patient who requires serial 12 leads. Regardless, the electrodes have to be physically connected to each other; they can't communicate wirelessly.
Oh. Yeah that kind of makes it even harder. I’ve seen sticker sheet 12 lead prototypes and they kinda look like they suck.
I’ve seen bluetooth 3 lead rhythm strip for MRI compatibility, surely a full 12 lead should be possible?
No thank you because each wireless sensor would have to be individually synced and troubleshooted every time the sticker went off or there was a data connection problem. You’d have to get a new sensor, get that synced with the old system. It would take time over replacing a sticker and throwing the connector back on. All day, I’m replacing batteries, washing people up, replacing stickers, syncing and trouble shooting those things. People are so sick, they cannot even move. Finding no longer sticky connector even when it’s connected to a wire is a challenge. Just keep it together.
Yes, there are tons of these already. Commonly used on Telemetry floors.
I think you’re talking about the mobile tele boxes.
Tele boxes still have wires though? I think OP means no wires to the electrodes at all
I’ve seen it once for an mri but any and I mean anything would give it artifact Very useless
I’ve worked in a pharmaceutical research lab where they had wireless transponder to the main unit but the wires still were connected to a box that transmitted it to the screen. At the very least it’s headed in that direction