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  • Review Article
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Self-powered cardiovascular electronic devices and systems

Abstract

Cardiovascular electronic devices have enormous benefits for health and quality of life but the long-term operation of these implantable and wearable devices remains a huge challenge owing to the limited life of batteries, which increases the risk of device failure and causes uncertainty among patients. A possible approach to overcoming the challenge of limited battery life is to harvest energy from the body and its ambient environment, including biomechanical, solar, thermal and biochemical energy, so that the devices can be self-powered. This strategy could allow the development of advanced features for cardiovascular electronic devices, such as extended life, miniaturization to improve comfort and conformability, and functions that integrate with real-time data transmission, mobile data processing and smart power utilization. In this Review, we present an update on self-powered cardiovascular implantable electronic devices and wearable active sensors. We summarize the existing self-powered technologies and their fundamental features. We then review the current applications of self-powered electronic devices in the cardiovascular field, which have two main goals. The first is to harvest energy from the body as a sustainable power source for cardiovascular electronic devices, such as cardiac pacemakers. The second is to use self-powered devices with low power consumption and high performance as active sensors to monitor physiological signals (for example, for active endocardial monitoring). Finally, we present the current challenges and future perspectives for the field.

Key points

  • The introduction of implantable or wearable electronic devices has revolutionized diagnosis and therapy in cardiovascular medicine, reducing morbidity and mortality of millions for patients with cardiovascular disease.

  • Current battery-powered cardiovascular electronic devices have a limited life and do not allow long-term, uninterrupted monitoring or treatment of cardiovascular disease, which is crucial for preventing death and/or improving quality of life.

  • Abundant sources of energy exist in the human body and the surrounding environment, such as biomechanical, solar, thermal and biochemical energy.

  • Self-powered technology, which converts energy from the human body or surrounding environment into electricity, can provide a sustainable source of power to replace or supplement battery technology.

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Fig. 1: Existing electronic devices for cardiac conduction disease.
Fig. 2: Existing self-powered technologies and their fundamental features.
Fig. 3: Implementation path for building a self-powered cardiovascular electronic system.
Fig. 4: Evolution of implantable PENGs and TENGs to build self-powered CIEDs.
Fig. 5: Current self-powered cardiovascular electronic devices.

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Acknowledgements

The authors’ work on self-powered medical devices is funded by the National Natural Science Foundation of China (no. 61875015 and 81971770), the Key Project of the National Natural Science Foundation (no. 81530012), the National Key R&D Project from the Ministry of Science and Technology, China (2016YFA0202703), the Beijing Natural Science Foundation (7204333), the University of Chinese Academy of Sciences and the National Youth Talent Support Program.

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Q.Z. and Z.L. researched the data for the article and wrote the manuscript. All the authors discussed the content of the article and reviewed and/or edited it before submission.

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Correspondence to Zhong Lin Wang or Zhou Li.

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Nature Reviews Cardiology thanks S.-G. Kim and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Piezoelectric effect

The capacity of certain materials to generate an electrical charge in response to applied mechanical force.

Crystal

A solid material whose constituents (such as atoms, molecules and ions) are arranged in a highly ordered microscopic structure to form a crystal lattice that extends in all directions.

Electric dipole moment

The separation of a positive charge and a negative charge by a distance; a measure of the polarity of a system.

Wurtzite structure

A hexagonal crystal structure that occurs in various binary compounds; named after the mineral wurtzite.

C-axis

In crystal drawings, by convention, the c-axis is usually oriented vertically in the plane of the paper; all crystals except those with a cubic (or isometric) crystal structure have a c-axis.

Charge centre

The position in a charge distribution with non-zero total charge where the electric dipole moment vanishes.

Superposition

Superposition is the capacity of a quantum system to be in multiple states at the same time until it is measured.

Triboelectrification

A type of contact electrification whereby certain materials become electrically charged after they are separated from a different material with which they were in contact.

Electrostatic induction

A method to create or generate static electricity in a material by bringing an electrically charged object near to it, which causes the electrical charges to be redistributed in the material, resulting in one side having an excess of either positive or negative charges.

Electron-capture properties

During electron capture, an electron in the inner shell of an atom is drawn into the nucleus where it combines with a proton, forming a neutron and a neutrino; the neutrino is ejected from the atom’s nucleus, and the overall effect is for an unstable atom to become more stable.

Photovoltaic effect

A process in which two dissimilar materials in close contact produce an electrical voltage when struck by light or other form of radiant energy.

Electromagnetic effect

A process in which either a stationary conductor is put in a moving magnetic field or a moving conductor is put in a stationary magnetic field, producing a voltage or electromotive force across the electrical conductor.

Open-circuit voltage

(Voc). The difference in electric potential between two terminals of a device when disconnected from any circuit (no external load is connected and no external electric current is flowing between the terminals).

Short-circuit current

The excess current flowing through an electrical circuit as a result of an unintended path in the circuit with no or very low electrical impedance.

Rectifier

An electrical device that converts alternating current, which periodically reverses direction, into direct current, which flows in only one direction.

Quartz clock

Inside a quartz clock or watch, the battery sends electricity to the quartz crystal through an electronic circuit; the quartz crystal oscillates (vibrates back and forth) at the precise frequency of 32,768 times per second.

Spin Seebeck effect

The generation of spin ‘voltage’ as a result of a temperature gradient; when a metallic magnet is subjected to a temperature gradient, it generates different driving powers of electrons in different spin channels along the temperature gradient.

n-Type organic semiconductor

Organic materials that are generally electrical insulators but which become semiconducting when charges are injected from appropriate electrodes; n-type organic semiconductors are electron acceptors with a low-lying lowest unoccupied molecular orbital.

Organic electrochemical transistor

A transistor in which the drain current is controlled by the injection of ions from an electrolyte into a semiconductor channel; the injection of ions in the channel is controlled through the application of a voltage to the gate electrode.

Young’s modulus

A measure of the capacity of a material to withstand changes in length when under lengthwise tension or compression.

Impedance mismatch

In electrical engineering, an impedance mismatch occurs when the input impedance of an electrical load does not match the output impedance of the signal source, resulting in signal reflection or an inefficient power transfer (depending on the type of matching required).

DC-to-DC converters

Electronic circuits or electromechanical devices that convert a source of direct current (DC) from one voltage level to another.

Charge pumps

DC-to-DC converters that use capacitors for electrical charge storage to raise or lower the voltage.

Buffer capacitors

A capacitor designed to suppress voltage surges that might otherwise damage other components in an electrical circuit.

Sputtered metals

A process by which metals form a thin layer of conducting material on a surface as a result of sputtering, a method of physical vapour deposition.

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Zheng, Q., Tang, Q., Wang, Z.L. et al. Self-powered cardiovascular electronic devices and systems. Nat Rev Cardiol 18, 7–21 (2021). https://doi.org/10.1038/s41569-020-0426-4

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