20.5.3 Cardiac Pacemakers

Cardiac pacemakers are considered the essential biomedical device responsible for

prolonging the lives of the patient affected by sinus syndrome or heart block by stimu­

lating the cardiac muscle and regulating the heartbeat by using an electric pulse produced

by the associated electronic circuit associated with the pacemaker. The main limitations of

the present-day pacemakers are the life span of the batteries that can be replaced by using

self-powering technology to power the device. Ouyang et al. proposed a TENG-based

pacemaker in 2019 that consisted of three parts: TENG, energy management unit, and the

pacemaker (Figure 20.7) [29]. The effective functioning of the pacemaker led to decreasing

the systolic blood pressure from 100 mm to 60 mm of Hg, thus preventing further decline

of the heart condition of the subject. However, studies revealed that compared to TENG,

PENG is more effective in converting mechanical energy to electrical energy, especially in

very compact spaces (in-vivo conditions). The performance of the PENG is independent of

the time and location. Recently, Azimi et al. (2021) proposed a pacemaker based on the

PENG, which was biocompatible and flexible and was driven by cardiac motions [30].

The PENG was sutured on the pericardium because the left ventricle amplitude is larger

than the right ventricle. The PENG reportedly produced a voltage amplitude of ap­

proximately 3.9 V and successfully powered a commercial pacemaker.

FIGURE 20.6

(a) E-skin and its performance under (b) pressure sensing and (c) temperature sensing. Adapted with permission

[ 26], Copyright (2018), American Chemical Society. (d) The device generated for wound healing using an electric

field that is tested on a rat model, (e–h) shows the healing of the wound under application of an electric field in

comparison to control. Adapted with permission [ 27], Copyright (2018), American Chemical Society.

Self-Powered Devices

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