Prepared by: Guided by:

Priyanka Dhar Mr. Sarosh Dastoor

B.E IV E&C(8th Sem)
Roll No: 41

1
A Seminar Report
on
Wireless Biotelemetry

Prepared by : Priyanka Dhar

Roll No. : 41

Class : B.E.IV (Electronics & Communication

Engineering.)

Semester : 8th Semester

Year : 2006-2007

Guided by : Mr. Sarosh Dastoor

Department of
Electronics & Communication Engineering.
Sarvajanik College of Engineering & Technology
Dr R.K. Desai Road, Athwalines, Surat - 395001,
India

2
 Sarvajanik College of
Engineering & Technology
Dr R.K. Desai Road,
Athwalines, Surat - 395001,
India.

Department
of
Electronics& Communication Engineering.

CERTIFICATE
This is to certify that the Seminar report entitled _____Wireless
Biotelemetry is prepared & presented by Ms._Priyanka Dhar
Class Roll No. __41____ of final year (B.E.IV) Electronics &
Communication Engineering during year 2006-2007. Her work is

satisfactory.

Signature of Guide Head of Department

Electronics Engineering

Signature of Jury Members

3
 INDEX
Sr. TOPIC Page
No No
1 Acknowledgement………………………………………………………… I
2 Abstract…………………………………………………………………… II
3 List of figures…………………………………………………………….. III
4 Chapter 1: Introduction 1
 1.1 History 2
 1.2 Physiological Parameters 3
5 Chapter 2: Types of Biotelemetry Systems 5
 2.1 Single Channel Telemetry System 5
2.1.1 ECG Telemetry System 5
 2.2 Temperature Telemetry System 7
 2.3 Multi-channel Telemetry System 8
2.3.1 Obstetrical Telemetry System 9
2.3.2 Telemetry In Operating Rooms 9
2.3.3 Sports Physiology Studies Through Telemetry 10
6 Chapter 3: Wireless Radio Frequency (RF) telemetry 11
 3.1 Choice of Radio Carrier Frequency 11
 3.2 Spread-Spectrum Technology 12
 3.3 Channel-Hopping 12
 3.4 Error-Correction & Re-Transmission 12
 3.5 Line-Of-Sight 12
 3.6 Antennas & Cable 13
7 Chapter 4: Operation 14
 4.1 Components 16
 4.2 Mobile Unit 16
 4.3 Modulation Systems 16
4.3.1 Frequency Modulation 17
4.3.2 Pulse Width Modulation 17
 4.4 Working Principle 18
8 Chapter 5: Implantable Units 20
9 Chapter 6: Applications 25
 6.1 Equipments Used in Biotelemetry 25
 6.2 Applications of telemetry in patient care 25
 6.3 Monitoring physiological functions of mammals 28
 6.4 Implantable Biotelemetry System for Preterm Labor and 29
Foetal Monitoring
10 Chapter 7: Benefits 30
11 Chapter 8: Limitations 31
12 Chapter 9: Conclusion 32
13 Chapter 10: Bibliography IV

4
 ACKNOWLEDGEMENT

It gives me great pleasure to thank Mr. Sarosh Dastoor, my seminar guide, who helped
me in successful completion of the report. I would also like to thank my father for having
helped me and supported me as and when required

My very special thanks to our Department In charge Prof. Mehul Raval for motivating
me in choosing a good topic and for being a constant support .

5
 ABSTRACT
With miniaturization and technical advancements in electronics and
communications field, we are now in a position to safely monitor, diagnose and treat
various intricate ailments in patients with relative ease. This has made complex surgeries
simple, easy and efficient.

Wireless communications have enabled development of monitoring devices that

can be made available for general use by individuals/patients and caregivers. New
methods for short-range wireless communications not encumbered by radio spectrum
restrictions (e.g., ultra-wideband) will enable applications of wireless monitoring without
interference in ambulatory subjects, in home care, and in hospitals.

Wireless biomonitoring, first used in human beings for featal heart-rate

monitoring has now become a technology for remote sensing of patients' activity, blood
pulse pressure, oxygen saturation, internal pressures, orthopaedic device loading, and
gastrointestinal endoscopy. Biotelemetry provides a wireless link between the subject and
the remote site where the recording, signal processing, and displaying functions are
performed. Rather than using a traditional radio transceiver, which can only broadcast
over a limited range, now-a-days the readily available cell phones are used to transmit
biological data by creating a link between the subject and a computer receiving the signal
via a landline phone.

Wireless telemetry of bioelectric signals, specifically neural recordings, is

desirable in many research and clinical applications. These include, but are not limited to
telemetry and recording of neural activity in laboratory animals, telemetry of EEG,
telemetry of short-term implanted electrode arrays for epilepsy medical diagnosis,
functional electrical stimulation (FES) systems, and implantable neuroprosthetic devices
for sensory and command control.

This study will focus on Wireless telemetry in general and also details of Wireless
biotelemetry specifically.

6
 List of Figures

Figure No. Title of Figure Page

No
Fig: 1.1 ECG measurement using immersion electrodes. 3
Fig: 2.1.1.1 Block diagram of a single channel telemetry system. 5
Fig: 2.1.1.2 Block Diagram of ECG Telemetry Transmitter 6
Fig: 2.1.1.3 Block diagram of high frequency section of ECG telemetry 6
receiver.
Fig: 2.1.1.4 Schematic diagram of ECG demodulation and ‘inoperate’ circuits 7
in ECG telemetry receiver
Fig:2.2.1 Circuit diagram of a temperature telemetry system. 7
Fig: 2.3.1 Schematic diagram of FM-FM modulated radio telemetry 8
transmitter for ECG and respiration activity simultaneously.
Fig:2.3.1.1 Telemetry receiving system for monitoring foetal heart rate and 9
urine contractions in use .
Fig: 2.3.4 A three channel telemetry system to monitor the physiological data 10
of a sprinter.
Fig . 4.1 Patient data monitor 15
Fig.4.3.1 Biotelemetry mobile unit 16
Fig. 5.1 Different Telemetry Components 20
Fig. 5.2 Single channel implantable transmitter for blood pressure. 21
Fig. 5.3 Transducer implanted in the aorta 21
Fig. 5.4 Cut-away single channel temperature transmitter. 22
Fig.5.5 Complete implantable telemetry system. 23
Fig. 5.6 Cut-away multi-channel telemetry system 23
Fig.5.7 Jacket for partially implanted telemetry system. 24
Fig.6.2.1.1 ECG Telemetry transmitter: (a)Hewlett-Packard type 78100A in 26
hospital use. (b)Electrode placement for telemetered ECG
Fig.6.2.2.1 Emergency medical care system, portable transmitter nit. 27
Fig.6.2.3 Emergency medical care system, transmitter unit in use. 28
Fig.6.2.4 Emergency medical care system, hospital console. 28

7
 1. Introduction
Biotelemetry is defined as a means of transmitting biomedical or physiological
data from a remote location (e.g., astronauts in space) to a location that has the capability
to interpret the data and affect decision making (e.g. ground controllers at Mission
Control Center). Biotelemetry is a vital constituent in the field of medical sciences. It
entails remote measurement of biological parameters. Mode of transmission of
physiological data from point of generation to the point of reception can take many
forms. Use of wires to transmit data may be eliminated by wireless technology.
Biotelemetry, using wireless diagnosis, can monitor electronically the symptoms and
movements of patients.

This development has opened up avenues for medical diagnosis and treatment. It
enables monitoring of activity levels in patients suffering from heart trouble, asthma,
pain, Alzheimer’s disease, mood disorders, cardiovascular problems, accidents, etc. A
patient’s response and reaction to drugs can be investigated for treatment.

Radio-telemetry transmits biological data using various radio transmission

techniques. No wires are required to be attached to the patient’s body. The patient just
carries a bracelet-sized transmitter that enables monitoring of the patient’s symptoms.

Literally, biotelemetry is the measurement of biological parameters over a

distance. The means of transmitting the data from the point of generation to the point of
reception can take many forms. Perhaps the simplest application of the principle of
biotelemetry is the stethoscope, whereby heartbeats are amplified acoustically and
transmitted through a hollow tube system to be picked up by the ear of the physician for
interpretation. A major advantage of modern telemetry is the elimination of the use of
wires.

The use of telemetry methods for sending signals from a living organism over
some distance to a receiver. Usually, biotelemetry is used for gathering data about the
physiology, behavior, or location of the organism. Generally, the signals are carried by
radio, light, or sound waves. Consequently, biotelemetry implies the absence of wires
between the subject and receiver.

Generally, biotelemetry techniques are necessary in situations when wires running

from a subject to a recorder would inhibit the subject's activity; when the proximity of an
investigator to a subject might alter the subject's behavior; and when the movements of
the subject and the duration of the monitoring make it impractical for the investigator to
remain within sight of the subject. Biotelemetry is widely used in medical fields to
monitor patients and research subjects, and now even to operate devices such as drug
delivery systems and prosthetics. Sensors and transmitters placed on or implanted in
animals are used to study physiology and behavior in the laboratory and to study the
movements, behavior, and physiology of wildlife species in their natural environments.

8
 Biotelemetry is an important technique for biomedical research and clinical
medicine. Perhaps cardiovascular research and treatment have benefited the most from
biotelemetry. Heart rate, blood flow, and blood pressure can be measured in ambulatory
subjects and transmitted to a remote receiver-recorder. Telemetry also has been used to
obtain data about local oxygen pressure on the surface of organs (for example, liver and
myocardium) and for studies of capillary exchange (that is, oxygen supply and
discharge). Biomedical research with telemetry includes measuring cardiovascular
performance during the weightlessness of space flight and portable monitoring of
radioactive indicators as they are dispersed through the body by the blood vessels.

Telemetry has been applied widely to animal research, for example, to record
electroencephalograms, heart rates, heart muscle contractions, and respiration, even from
sleeping mammals and birds. Telemetry and video recording have been combined in
research of the relationships between neural and cardiac activity and behavior.

There are usually two concerns associated with the use of biotelemetry: the
distance over which the signal can be received, and the size of the transmitter package.
Often, both of these concerns depend on the power source for the transmitter. Integrated
circuits and surface mount technology allow production of very small electronic circuitry
in transmitters, making batteries the largest part of the transmitter package.

1.1 History Of Biotelemetry

In the early days of human space flight, NASA utilized biotelemetry to provide
biomedical data from orbiting astronauts to medical personnel at the NASA Johnson
Space Center (Manned Space Flight enter in the early 1960's). Biomedical data
transmitted to Earth from space included astronaut's heart rate, body temperature, ECG,
oxygen (O2) and carbon dioxide (CO2) concentration. Further research and technology
from NASA was instrumental in driving both telemetry and telemedicine into civil health
care.

Distance medicine has been around for most of this century. In the early days,
doctors treated patients in remote locations via wireless radio and by sending diagnostic
samples through the mail. Today, communication is done digitally, and it's called
biotelemetry. On an extended space flight, the need to consult, diagnose and deliver
effective medical care when the doctor is far away from the patients is crucial. Scientists
are developing hardware and software to facilitate this process. Whether it's a case of
analyzing blood samples for medical diagnosis when a problem occurs during a three-
year voyage to Mars or installing a microchip inside the body to measure vital signs,
biotelemetry is revolutionizing medical care in space.

Historically, Linthoven, the originator of the electrocardiogram, as a means of

analysis of the electrical activity of the heart, transmitted electrocardiograms from a
hospital to his laboratory many miles away as early s 1903. The rather crude immersion
electrodes

9
Fig: 1.1 ECG measurement using immersion electrodes. Original Cambridge electrocardiograph
(1912) built for Sir Thomas Lewis. [2]

(see above picture), were connected to a remote galvanometer directly by telephone lines.
The telephone lines in this instance were merely used as conductors for the current
produced by the biopotentials.

1.2 Physiological and Technology Parameters

Any quantity that can be measured in the biomedical field is adaptable to
biotelemetry. The measurements are divided into two categories: bioelectrical and
physiological variables. Bioelectrical variables include measurements like ECG, EMG,
and EEG. Signals are obtained directly in the electric form. Physiological variables such
as temperature, blood pressure, blood flow, etc require some excitation or external
electrical parameters. Transducers are used for the conversion of physiological
parameters into an electrical signal. Parameters are measured as the variations of
resistance, capacitance, or inductance. Variations can be calibrated to represent pressure,
temperature, or blood flow. Base signal is modulated for transmission. And finally, this
signal is detected (demodulated) and converted back to its original form.

PCM technology offers significant advantages in the application of telemetry to

medical and physiological studies. The requirements for less complicated handling,
standardized system layout, improvement of weight, size and power supply by
commercial battery modules, as well as different wireless data links are met better by a
PCM encoder which was specially developed for physiological applications. The
advantages of PCM are illustrated by relating the experimental requirements to technical
specifications for the elements of a telemetry link.

1. Temperature by rectal or oral thermistor.

2. Respiration by impedance pneumograph.
3. Electrocardiograms by surface electrodes.
4. Indirect blood pressure by contact microphone and cuff.

10
 As the technology progressed, it became apparent that literally any quantity that
could be measured was adaptable to biotelemetry. Just as with hardwire systems,
measurements can be applied to two categories:
1. Bioelectrical variables, such as ECG, EMG, and EEG.
2. Physiological variables that require transducers, such as blood pressure,
gastrointestinal pressure, blood flow, and temperatures.

With the first category, a signal is obtained directly in electrical form, whereas the
second category requires a type of excitation, for the physiological parameters are
eventually measured as variations of resistance, inductance, or capacitance. The
differential signals obtained from these variations can be calibrated to represent pressure,
flow, temperature, and so on, since some physical relationships exist.

In a typical system, the appropriate analog signal (voltage, current, etc.) is

converted into a form or code capable of being transmitted. Currently, the most
widespread use of biotelemetry for bioelectric potential is in the transmission of the
electrocardiogram.

One example of ECG telemetry is the transmission of electrocardiograms from an

ambulance or site of an emergency to a hospital. Telemetry is also being used for
transmission of the electroencephalogram. Most applications have been involved with
experimental animals for research purposes. Telemetry of EEG signals has also been used
in studies of mentally disturbed children. The third type of bioelectric signal that can be
telemetered is the electromyogram. Telemetry can also be used in transmitting stimulus
signals to a patient or subject. For example, it is well known that an electrical impulse can
trigger the firing of nerves. Another example is the use of telemetry in the treatment of
“dropfoot,” which is one of the most common disabilities resulting from stroke. A
method for correcting “dropfoot” by transmitting a signal implanted electronic stimulator
has been used successfully at Rancho Los Amigos Hospital in Los Angeles.

11
 2. Types of Biotelemetry Systems

2.1 Single channel telemetry systems

A majority of the situations requiring monitoring of the patients by wireless
telemetry, parameter which is most commonly studied is the electrocardiogram. It is a
known that display of the ECG and cardiac rate gives sufficient information on the
loading of the cardio vascular system of the active subjects. Therefore, we shall first deal
with a single channel telemetry system suitable for transmission of electrocardiogram.

2.1.1 ECG Telemetry System

Figure below shows the block diagram of a single channel telemetry system
suitable for transmission of electrocardiogram. The Telemetry Transmitter which consists
of ECG amplifier, sub-carrier oscillator and a UHF transmitter along with dry cell
batteries. Telemetry Receiver, consisting of a high frequency unit and a demodulator, to
which an electrocardiograph can be connected to record, a cardioscope to display and a
magnetic tape recorder to store ECG. A. heart rate meter with an alarm facility can be
provided to monitor continuously beat-to-beat heart rate of the subject

Transmitter RF Amplifier

Demodulator Tape
Subcarrier Modulator
Recorder
ECG
Electrode
s
ECG Amplifier Heart rate monitor Graphic
Recorder

Battery Cardioscope

Fig: 2.1.1.1 Block diagram of a single channel telemetry system. [1]

Some ECG telemetry systems operate in the 450—470MHz band, which is well-
suited for transmission- within a hospital and has the advantage of having a large number
of channels available.

12
 Transmitter A block diagram of the transmitter is shown in Fig. 2.1.1.2. The
ECG signal, picked up by three fluid column electrodes attached to the patient’s chest is
amplified and used to frequency modulate a 1 kHz sub-carrier that in turn frequency-
modulates the UHF carrier The resulting signal is radiated by one of the electrode leads
(RL) which serves as the antenna. The input circuitry is protected against large,
amplitude pulses that may result during defibrillation.

Fig: 2.1.1.2 Block Diagram of ECG Telemetry Transmitter [1]

Receiver The receiver uses an omnidirectional receiving antenna which is a

quarter-wave monopole, mounted vertically over the ground plane of the receiver top
cover. This arrangement works well to pick up the randomly polarized signals transmitted
by moving patients. The receiver comprises an RF amplifier which provides a low noise
figure, RF filtering and image frequency rejection.

Fig: 2.1.1.3 Block diagram of high frequency section of ECG telemetry receiver. [1]

The 1 kHz subcarrier is demodulated to convert frequency-to-voltage to recover the

original ECG waveform.

13
Fig: 2.1.1.4 Schematic diagram of ECG demodulation and ‘inoperate’ circuits in ECG telemetry
receiver [1]

2.2 Temperature telemetry system

Systems for the transmission of alternating potentials representing such
parameters as ECG, EEG and EMG are relatively easy to construct. Telemetry system
‘which are sufficiently stable to telemetry direct current outputs from temperature,
pressure or other similar transducers continuously for long periods resent greater design
problems. In such cases, the information is conveyed as a modulation of the mark/space
ratio of a square wave. Heal (1974) described a temperature telemetry system based on
this principle and

Fig:2.2.1 Circuit diagram of a temperature telemetry system.[1]

the circuit is shown in Fig.2.2.1 The system is particularly well suited for use in medical
and biological research.

14
On the receiver side, a vertical dipole aerial is used which feeds an FM tuner, and whose
output, a 200Hz square wave, drives the demodulator. In the demodulator, the square
wave is amplified, positive dc restored and fed to a meter where it is integrated by the
mechanical inertia of the meter movement. Alternatively, it is filtered with simple RC
filter to eliminate high ripple content and obtain a smooth record on paper.

2.3 Multi channel wireless telemetry systems

Medical measuring problems often involve the simultaneous transmission of
several parameters. For this type of application, multi-channel telemetry system is
employed. Multi-channel telemetry is particularly useful in athletic training programs as
it offers the possibility of surveying simultaneously several physiological parameters of
the person monitored.

With appropriate preamplifiers, the multi-channel systems permit the transmission

of the following parameters simultaneously depending upon the number of channels
required, ECG and heart rate, respiration rate, temperature, intravascular and intra-cardiac
blood pressure.

In multichannel telemetry, the number of subcarriers used are the same as the
number of signals to be transmitted. Each channel therefore has its own modulator. The
RF unit—the same for all channels-converts the mixed frequencies into the transmission
band. Similarly, the receiver unit contains the RF unit and one demodulator for each
channel.

Pulse width modulation is better suited for multichannel biotelemetry systems.

Such systems are insensitive to carrier frequency shifts and have high noise immunity.
FM-FM system for similar use, though may have low power consumption and high base
line stability, they are more complicated and turn out to be more expensive. They can be
troubled by interference.

Fig: 2.3.1 Schematic diagram of FM-FM modulated radio telemetry transmitter for ECG and
respiration activity simultaneously.[1]

15
2.3.1 Obstetrical Telemetry System
There has been a great deal of interest to provide greater freedom of movement to
patients during labour while the patient is continuously monitored through a wireless
link. Thus, from a central location, it is possible to maintain a continuous surveillance of
cardiotocogram records for several ambulatory patients. In the delivery room, telemetry
reduces the encumbering instrumentation, cables at the bedside. Moreover, when an
emergency occurs, there is no loss of monitoring in the vital minutes during patient
transfer.

The patient carries a small pocket-sized transmitter which is designed to pick up

signals for foetal heart rate and uterine activity. The foetal heart rate is derived from
Foetal ECG which is obtained via a scalp electrode attached to the foetus after the
mother’s membranes are ruptured. Uterine activity is measured via an intra-uterine
pressure transducer. If only foetal ECG is measured, the patient herself can indicate
uterine activity or foetal movement by using a handheld pushbutton.

The receiver located away from the patient, is connected to a conventional

cardiotocograph. If the patient exceeds the effective transmission range or the electrode
has a poor contact, it is appropriately transmitted for corrective action.

Fig:2.3.1.1 Telemetry receiving system for monitoring foetal heart rate and urine contractions in
use .[1]

2.3.2 Telemetry in Operating Rooms

The use of telemetry in operating rooms seems to be particularly attractive as it
offers a means of achieving a high degree of patient safety from electric shock as well as
elimination of the hanging inter-connecting patient leads which are necessary in direct-
wired equipment. Normally. there are several parameters which are of interest in surgical
patient monitoring, most common being ECG, blood pressure, peripheral pulse and EEG.

16
 Basically, the signal encoding is based upon frequency modulation of 4
subcarriers centred at 2.2, 3.5, 5.0 and 7.5 kHz, respectively. The system is designed to
give a bandwidth of dc to 100 Hz at the 3 dB point and the discriminator provides 1.0 V
dc output for a 10% shift.. The transmitted signals are tuned by a FM tuner whose output
is fed into a fourth-channel discriminator which separates the sub- carriers through
filtering and demodulates each using a phase-locked loop. The demodulated signals are
displayed on an oscilloscope.

2.3.3 Sports Physiology Studies through Telemetry

Monitoring of pulmonary ventilation, heart rate and respiration rate is necessary
for a study of energy expenditure during physical work, particularly for sports such as
squash, handball, tennis and track, etc. The transmitter uses pulse duration modulation,
i.e., each channel is sampled sequentially and a pulse is generated, the width of which is
proportional to the amplitude of the corresponding signal. At the end of a frame, a
synchronisation gap is inserted to ensure that the receiving system locks correctly onto
the signal. Each channel is sampled 200 times a second. With each clock pulse, the
counter advances one step, making the gates to open sequentially. At the opening of a
particular gate, the corresponding physiological signal gets through to a comparator
where it is compared with the ramp. As soon as the ramp voltage exceeds the signal
voltage, the comparator changes state. Thus, the time required for the comparator to
change state would depend upon the amplitude of the signal. The counter and gates serve
as multiplexer.

Fig: 2.3.4 A three channel telemetry system to monitor the physiological data of a sprinter.[1]

17
 3. Wireless Radio Frequency (RF) telemetry
Wireless Radio Frequency (RF) telemetry offers a great advantage over other
telemetry methods by making use of a cheap and easily accessible transmission medium -
AIR. When properly installed, wireless systems are very reliable and require little, if any
maintenance. Using a license-free RF band eliminates the need for obtaining a site license
from the FCC.
 2.4GHz RF Band is License Free
 Reliable Spread-Spectrum Radios
 Channel-Hopping Algorithm
 Error Correction Protocol
 Automatic Re-Transmission on Error

3.1 Choice of Radio Carrier Frequency

In every country there are regulations restricting frequency and bandwidth to be
used for medical telemetry. Therefore, the permission to operate a particular telemetry
system needs to be obtained from the postal department of the country concerned. The
radio frequencies normally used for medical telemetry purposes are of the order of 37,
102, 153, 159, 220, 450 MHz. Transmitter is typically of 50mW at 50Ohms which can
give a transmission range of about 1.5 KM in the open flat country.

Radiowaves can travel through most non-conducting materials such as air wood,
and plaster with relative ease, However, they are hindered, blocked or reflected by most
conductive materials and by concrete because of the presence of reinforced steel.

18
Therefore, transmission may be lost or result in poor quality when a patient with a
telemetry transmitter moves in an environment with a concrete wall or behind a structural
column.

3.2 Spread-Spectrum Technology

Spread-Spectrum Technology uses more than one frequency to transmit data. The
radios choose from over 500 channels between 2.4000GHz and 2.4835GHz. This RF
band has been set aside specifically for the licensefree operation of spread-spectrum
radios.

3.3 Channel-Hopping
Spread-spectrum radios use channel-hopping technology to make use of the many
available channels. Radios will use one channel for only ¼ of a second before jumping to
another channel. This ensures that no one channel is ever occupied by one radio
preventing another from using the channel. Each radio may use a different channel-hop-
table thus allowing many radios to share the same RF band without interfering with one
another. If two foreign radios should happen to make use of the same channel, a collision
will be detected by both radios and they will each move onto a different channel and re-
send their data.

3.4 Error-Correction & Re-Transmission

The radios use a comprehensive error checking algorithm to ensure that the
transmitted data is indeed correct. If incorrect data was received, the receiver will instruct
the sender to re-send the data until it has been received correctly. Since all data is
transmitted in digital form there is no degradation in analog values when signal strength
decreases. Forward error correction algorithms ‘repair’ any questionable data on the fly.

3.5 Line of Site Dependence of Wireless Telemetry

As with any Radio Frequency (RF) system, the radio waves propagate best
through the air. Obstruction such as buildings, walls, hills, trees etc. pose a potential
hindrance to radio wave propagation (imagine your car radio going silent inside a tunnel).
The ideal system is one where all radio antennas are in direct line-of-sight with one
another. Although, radio waves may reflect off hard surfaces and find an alternate path
that is not line-of-sight.

In the ideal
system setup, both
antennas can see each
other without any
obstructions. This yields
the greatest transmission
distance and the most
reliable signal conditions.
Fig.3.5.1 [10] This is called line-of-sight
transmission.

19
 If there is a large
physical obstruction
between the two antennas,
the radio waves will be
blocked. No transmission
is possible in this case.

Fig. 3.5.2 [10]

In many cases
where there is no direct
line-of-sight path between
antennas, the RF signal
may still get through by
‘bouncing’ off buildings
or other solid structures.
Signal strength must be
taken into consideration
here to determine if there
is enough signal available
for reliable transmission.
Fig. 3.5.3 [10]

3.6 Antennas & Cables used

One of the most important components of any RF system is the antenna. This is
where the radio waves are sent on their way to the other radio. There are many different
types of antennas for different applications. Ideally antennas are located outdoors and
typically on a mast that clears all surrounding obstructions. Besides transmitting the radio
waves, antennas can also act as ‘radio wave amplifiers’. The cable that connects the
antenna with the radio is equally important. Unfortunately, all cable poses a ‘resistance’
to the RF signal thereby limiting the amount of signal being transmitted by the antenna.
Using low-loss coaxial cable and keeping this cable length short are two important
considerations.

20
3.6.1 Omni-Directional Antenna

An Omni-Directional antenna is a non-

directional antenna. It radiates equal amounts of
radio wave energy in a spherical pattern. Higher
gain antennas radiate in a 360° pattern that is
flattened on top and bottom and looks more like
a donut. These antennas are ideal for a host site
that has several remote sites located in various Fig. 3.6.1
directions.
3.6.2 Panel Antenna
A panel antenna is a directional
antenna that ‘focuses’ the radio wave
energy into a beam which is aimed out
the front of the antenna. Panel antennas
have a high gain for greater distance
transmissions and are great for a point- Fig.3.6.2
to-point RF system.

3.6.3 YAGI Antenna

A Yagi antenna is a highly
directional antenna that produces a
very narrow beam of radio waves.
These antennas provide the greatest
distance transmission and
obstruction penetration . Because of
the narrow RF beam they are more Fig. 3.6.3
difficult to align.

3.6.4 Antenna Polarization

All antennas have a direction of polarization. This means that
radio waves leaving an antenna are ‘oriented’ by the polarization
of the antenna. Radio waves can only be received by an antenna
of equal polarization. Directional antennas have a polarization
marking (vertical or horizontal) and a direction arrow to
indicate which way is UP. Omni-directional antennas can
be mounted in any orientation so long as ALL antennas in
the system are mounted the same way.

Fig 3.6.4

21
 4. Operation

Current radio monitoring systems keep thousands of patients under surveillance,

with limited scope. Biotelemetry systems consist of transmitter, simple telephone
modem, and central receiving station.

Central receiving station tunes into a transmitter, whose size may range from a
bracelet to a small pocket transistor. This tracking system can be used within the hospital
premises. Each patient is equipped with a pager sized personal monitoring as well as
alarm system. When the patient wearing the transmitter device—attached to his wrist,
chest, waist, etc-—leaves a specified range, periodic RF signals are sent to the modem.
The modem sends out an alert signal to both the patient and to the central monitoring
station. When the patient’s health condition becomes worse, emergency signals are
transmitted.

The mobile unit attached to the patient has an output of nearly 1W. Location of
the patient is derived from time- of-arrival calculations. The system uses spread spectrum
techniques operating in the RF band of 902-928 MHz to transmit signals of the patient’s
condition along with whereabouts. A network of receivers scattered throughout the
specified area picks up the signals with health condition of patient. Location is displayed
on a map at a central facility in the hospital treatment centre.

Fig . 4.1 Patient data monitor

Tracking is done by a spread spectrum system, using triangulation technique
based on time of arrival at various receivers, to locate the patient. This triangulation
technology is applied to locate the origins of all emergency signals sent and users with
personal two-way digital wireless communication devices.

22
4.1 Components
A basic biotelemetry system consists of.- besides a transmitter, simple modem,
and a central receiving station — the basic circuits like oscillators, amplifiers, power
supply, etc, usually present in a communication system. The earliest (1952) biotelemetry
transmitter was the ‘Endo radio-sonde.’ This pressure-sensing device was a ‘radio pill,’
winch had a volume less than 1 cm3 and could be swallowed by the patient. As it passed
through the gastro-intestinal tract, it measured the pressure at various points it
encountered. Such radio pills are available to measure temperature, pH, and enzyme
activity also.

4.2 Mobile unit

A mobile unit attached to the patient consists of a transmitter and a receiver.
(Refer to Fig.4.3.1) Bioelectrical signals are obtained directly from the patient while
physiological variables like temperature, pressure, or other parameters from the patient
are converted into electrical form using appropriate transducers. Signal conditioning
circuit is used to amplify, modulate and process the input received. It combines or relates
the output of two or more transducers. Even though the input it receives is an electrical
signal, signal conditioning circuit produces an output to satisfy the function and prepares
signals suitable for transmission. The physiological signal modulates a low-frequency
carrier, called a subcarrier, often in the audio-frequency range. The subcarrier in turn
modulates the RF signal to be propagated and sent to the antenna.

4.3 Modulation Systems

The modulation systems used in wireless telemetry for transmitting biomedical
signals makes use of two modulators .This means that a comparatively lower freq.
subcarrier is employed in addition to the VHF which finally transmits the signal from the
transmitter. The principle of double modulation gives better interference free
performance in transmission and reception of low frequency biological signals. The
submodulator can be a FM (freq modulation) system or PWM (Pulse Width modulation)
system, whereas the final modulator is practically always FM system.

Fig.4.3.1: Biotelemetry mobile unit [3]

23
 If several physiological signals are to be transmitted simultaneously, each signal
is placed on a subcarrier of a different frequency and all subcarriers are combined to
simultaneously modulate the RF carrier. This process of transmitting many channels of
data on a single RF carrier, called frequency multiplexing, is more efficient. The sub-
carrier is modulated either by AM (amplitude modulation) or FM (frequency
modulation). For reducing noise interference, FM is frequently used. The method of
modulating sub-carrier, followed by modulating the RF carrier, is termed as AM/FM or
FM/FM depending sub-carriers are frequency- modulated and the 1W carrier amplitude-
modulated, the method is designated as FM / AM. If both the subcarriers and the RF
carrier are frequency-modulated, it is designated as FM / FM.

4.3.1 Frequency Modulation:

In freq modulation, intelligence is transmitted

by varying the instantaneous freq in accordance
with the signal to be modulated on the wave, while
keeping the amplitude of the carrier wave constant.
The rate at which the instantaneous freq varies is
the modulating frequency. The magnitude to
which the carrier frequency varies away from the
center freq is called ‘Freq Deviation” and is
proportional to the amplitude of the modulating
signal. Usually, an FM signal is produced by
controlling the freq of an oscillator by the
Amplitude of the modulating voltage. For example The frequency of oscillation in most
oscillators depends on a particular value of capacitance. If the modulation signal can be
applied in such a way that it changes value of capacitance, frequency of oscillation will
change in accordance with the amplitude of the modulating signal.

4.3.2 Pulse Width Modulation

Pulse width modulation
method offers the advantage that it is
less perceptive to distortion and noise.
Fig.4.3.2 shows a typical pulse width
modulator. In practice the negative
edge of the square wave is varied in
rhythm with the ECG signal.
Therefore, only this edge contains
information of interest. The ratio P : Q
(see Fig.4.3.2.2) represents the
momentary amplitude of the ECG.

Fig.4.3.2.1: Pulse width modulator.[1]

24
Pulses generated by astable multivibrator (symmetrical 1000Hz)

Fig. 4.3.2.2: Variation of pulse width with amplitude of the input signal.[1]

The amplitude or even the frequency variation of the the P: Q ratio and
consequently on the ECG signal. The signal output from this modulator is fed to a normal
speech transmitter, usually via an attenuator, to make it suitable to the input level of the
transmitter.

Modulation schemes are used depending not only on the noise interference, but
also on size of the unit, its complexity, location, and other operational aspects. The
receiver circuit uses RF tuner to select the transmitted frequency of the base station. The
signal is demodulated though demodulator and sent to the processor. The processor
enables necessary action depending on the command given to it from the base station.
Both transmitter and receiver circuits function as a modem. Control feedback
incorporates a control system to enable automatic control of the stimulus, the transducers,
or any other part of the instrument system. Tins system comprises a loop in which output
from the signal conditioning equipment or signal received is used to control the operation
of the system.

4.4 Working Principle

To illustrate the basic principles involved in telemetry, a simple system is
described. The stages of a typical biotelemetry system can be broken down into
functional blocks, as shown in the Fig.4.4.1 for transmitter and Fig.4.4.2 for the receiver.
Physiological signals are obtained from the subject by means of appropriate transducers.
The signal is then passed through a stage of amplification and processing circuits that
include generation of a sub carrier and a modulation stage for transmission.

25
 Direct
biopotentia
l
Amplifie
Subject r
Transducer
Processo
r

Exciter Modulator

Carrier
Fig.4.4.1: Block Diagram of a Biotelemetry Transmitter [2]

The receiver (Fig.4.4.2) consists of a tuner to select the transmitting frequency, a

demodulator to separate the signal from the carrier wave, and a means of displaying or
recording the signal..

Chart Recorder
Tuner Demodulator or Oscilloscope

Tape
Recorder

Fig.4.4.2:Receiver-storage-display unit [2]

It receives the multiplexed RF carrier emitted by the patient’s transmitter, as
shown in Fig .4.4.2. The tuner has a tuning circuit. When the circuit is tuned to receive
signals, the appropriate signal is selected and the unwanted signals are rejected. The
multiplexed RF carrier is demodulated to recover the individual sub-carriers. Sub-carriers
are then demodulated to reproduce original physiological signals emitted by the patient.
A recorder records physiological signals for future reference. Signals can be stored on
any secondary media like tape, magnetic discs etc. Display system used can be CRT or
computer monitor, chart etc.

26
 5. Implantable units

Fig. 5.1: Different Telemetry Components

It was mentioned previously that sometimes it is desirable to implant the

telemetry transmitter or receiver subcutaneously. The implanted transmitter is especially
useful in animal studies, where the equipment must be protected from the animal. The
implanted receiver has been used with patients for stimulation of nerves.The life of the
unit depends on how long the battery can supply the necessary current.

A partial implant is a good example of a system used for the monitoring of the
electroencephalogram where the electrodes have been implanted into the brain and the
telemetry unit is implanted within and on top of the skull. This type of unit needs a
protective helmet. The use of implantable units also restricts the distance of transmission
of the signal. The body fluids and the skin greatly attenuate the signal and because the
unit must be small to be implanted, therefore has little power, the range of signal is quite
restricted, often to just a few feet. This disadvantage has been overcome by picking up
the signal with a nearby antenna and retransmitting it. However, with the plastic potting
compounds and plastic materials available today, encapsulation is easily possible. Silicon
encapsulation is commonly used.

Mercury and silver-oxide primary batteries have been used extensively and, more
recently, lithium batteries have found many applications. For field work with free-
roaming animals, the power requirements are quite different from those needed in a

27
closed laboratory cage. Requirements range from an electrical capacity of 20 mA-hr to
1000 mA-hr.

Fig. 5.2: Single channel implantable transmitter for blood pressure. [2]
In simple terms the complete implantable telemetry transmitter system consists of
the transducer(s), the leads from the transducer(s) to the transmitter, the transmitter unit
itself, and the power source. The transducers are implanted surgically in the position
required for a particular measurement, such as in the aorta or other artery for blood
pressure. Fig.5.3 shows a typical pressure transducer implantation in a dog. The
transmitters and power units have to be placed in a suitable body cavity close to the under
surface of the skin and situated so that they give no physical or psychological disturbance
to the animal. An antenna loop is also part of the transmitter.

Fig. 5.3 Transducer implanted in the aorta [2]

A basic unit is shown in Figure 5.1. This is a single-channel blood pressure

transmitter. The module at the top contains the signal conditioning circuitry and RF

28
transmitter. The second module contains a 200-mA-hour lithium power source and a 1.7-
MHz RF switch for turning the system on and off remotely.

Fig. 5.4: Cut-away single channel temperature transmitter. [2]

Fig. 5.4 is a cutaway view of a single-channel temperature transmitter. A 1.35-V

battery is contained inside the antenna loop at the top. Besides, one of the three hybrid
packages is shown open. Fig. 5.5 shows array of all parts of the complete system. The top
unit in the figure is the, 6 Telemetry Demodulator. It has six main channels and is
designed to work with the 88 to 108-MHz receiver shown immediately below it. The
receiver is modified to accept both continuous FM and pulsed-RF-mode telemetry
signals. An inductive power control wand for turning the implant on and off is shown on
the bottom right side. Below the wand there is an external recharging transmitter.

A cutaway view of an inductively-powered multichannel telemetry system is

shown in Fig.5.6. Sensor leads and compensation components are shown on the right.
Power and antenna leads are shown on the left. I the center, one of three hybrid packets is
shown open. It contains six sensor input amplifiers, an eight-channel multiplexer, an
analog-to-PWM converted and a 1O-kHz clock and binary counter. Finally, there are
systems with only partial implantations. Refer again to Fig.5.3, a pressure transducer is
shown implanted in the aorta of a dog. In that particular system, the lead from the
transducer brought Out through the dog’s back and connected to a telemetry transducer
external to the body of the dog. This type of preparation is achieved b having the dog
wear a jacket. Prior to surgery, dogs are trained to wear jackets continuously so that they
get used to them. After the surgical it plantation of the transducer and after the chest wall
is healed, the jacket put back on the dog. It is made of strong nylon mesh so that it is
comfortable and permits air circulation, but cannot easily be bitten into by the dog. The
lead that comes out of the dog’s back from the transducer is plugged into an external
telemetry transmitter which is kept in a pocket of the jacket. The transmitter can be
removed when not in use. Another pocket, on the opposite side of the jacket, is available
for other equipment.

29
 Fig.5.5: Complete implantable telemetry system. [2]

Fig. 5.6: Cut-away multi-channel telemetry system [2].

30
 For example, in an experiment concerned with the effect of the hormone,
norepinephrine, on blood pressure, a small chemical pump was placed in the other pocket
to inject norepinephrine into the blood stream at various rates. The effect on the blood
pressure of the dog was observed and recorded by the use of the telemetry system. The
system is the same as that shown in Fig.5.2 A photograph of a dog wearing a jacket with
the telemetry transmitter in the pocket is shown in Fig.5.5.

Fig.5.7: Jacket for partially implanted telemetry system. [2]

31
 6. Applications
There are many instances in which it is necessary to monitor physiological events
from a distance. Typical applications include the following:

1. Radio-frequency transmissions for monitoring astronauts in space.

2. Patient monitoring where freedom of movement is desired, such as in obtaining an
exercise electrocardiogram. In this instance, the requirement of trailing wires is
both cumbersome and dangerous.
3. Patient monitoring in an ambulance and in other locations away from the hospital.
4. Collection of medical data from a home or office.
5. Research on unrestrained, unanesthetized animals in their natural habitat.
6. Use of telephone links for transmission of electrocardiograms or other medical
data.
7. Special internal techniques, such as tracing acidity or pressure through the
gastrointestinal tract.
8. Isolation of an electrically susceptible patient (see Chapter 16) from power-line-
operated ECG equipment to protect him from accidental shock.

These applications have indicated the need for systems that can adapt existing methods of
measuring physiological ‘variables to a method of transmission of resulting data. This is
the branch of biomedical instrumentation known as
biomedical telemetry or biotelemetry.

6.1 Equipments Used in Biotelemetry

Some of the equipments used for the applications of biotelemetry are:
a.) Imagers: Xray, MRI, Ultrasound
b.) Sensors, transmitters: surgical instruments, analyzers
c.)Microsatellites: multipurpose, regional coverage, steerable beams

6.2 Applications of telemetry in patient care

There are a limited number of situations in which telemetry is practical in the
diagnosis and treatment of hospital patients. Most involve measurement of the
electrocardiogram. Some common applications are described below.

6.2.1. Telemetry of ECGs from Extended Coronary Care patients

Cardiac patients must often be observed for rhythm disturbances for a period of
time following intensive coronary care. Such patients are generally allowed a certain
amount of mobility. To make monitoring possible, some hospitals have extended
coronary-care units equipped with patient-monitoring systems that include telemetry.
In this arrangement, each patient has FCC electrodes taped securely to his chest. The
electrodes are connected to a small transmitter unit that also contains the signal-
conditioning equipment.

32
 Fig.6.2.1.1: ECG Telemetry transmitter: (a)Hewlett-Packard type 78100A in hospital use.
(b)Electrode placement for telemetered ECG [2]

The transmitter unit is fastened to a special belt worn around the patient’s waist. Fig. 6.1
shows typical units. Batteries for powering the signal- conditioning equipment and

33
transmitter are also included in the transmitter package. These batteries must be replaced
periodically.

A telemetry receiver for each monitored patient is usually included as part of the
monitoring system. The output of each receiver is connected to one of the ECG channels
of the patient monitor. A potential problem in the use of telemetry with free-roaming
patients concerns being able to locate a patient in case his alarm should sound. Telemetry
equipment has no provision for indicating the location of a transmitter.

6.2.2 Telemetry for ECG Measurements During Exercise

For certain cardiac abnormalities, such as ischemic coronary artery disease,
diagnostic procedures require measurement of the electrocardiogram while the patient is
exercising, usually on a treadmill or a set of steps. Although such measurements can be
made with direct-wire connections from the patient to nearby instrumentation, the
connecting cables are frequently in the way and may interfere with the performance of
the patient. For this reason, telemetry is often used in conjunction with exercise FCC
measurements. Two-way voice transmission is normally used in conjunction with the
telemetry to Facilitate identification of the telemetered information and to provide
instructions for treatment. Through the use of such equipment, ECGs can be interpreted
and treatment begun before the patient arrives at the hospital.

One type of system in use is illustrated in Fig.6.2.2.1, 2, 3. The coronary

observation display console on the receiving end of the system in the hospital is
illustrated in Fig.6.2.2.4.

The portable unit carried in the ambulance or paramedic vehicle has a nominal
output of 12 W RF. It can transmit on any different channels. These are the eight
approved MED frequencies ant EMS or public safety dispatch channels. The Federal
Communication Commission (FCC) has set up rules and regulations concerning the
“Special Emergency Radio Service” (see the Bibliography) in which MED frequencies
are defined.

Fig.6.2.2.1: Emergency medical care system, portable transmitter nit.[2]

34
 Fig.6.2.3: Emergency medical care system, transmitter unit in use.[2]

Fig.6.2.4: Emergency medical care system, hospital console.[2]

6.3 Monitoring physiological functions of mammals

The Biotelemetry System monitors physiological functions of mammals onboard
the Spacelab. Each unit can monitor one animal for one to four physiological parameters.
It consists of three basic parts:
A) the implantable sensor and transmitter within the animal;
B) the antenna/receiving system
C) the data-handling system onboard the Spacelab.

35
 Fig.6.3 Block diagram representation

Sensor data are telemetered to antennae within selected rodent cages and primate
cages. A pulse interval modulated FM radio signal is received from each animal cage
being monitored. The animal ECG rate is up to 320 samples/second. Data can be stored
or down linked to Earth by radio transmission in real time or near-real time. .

6.4 Implantable Biotelemetry System for Preterm Labor and Foetal

Monitoring

Foetal Treatment Center (FTC) at UC San Francisco has developed a

revolutionary surgical procedure to treat foetuses suffering from diaphragmatic hernia, a
condition in which a hole in the diaphragm allows internal organs to shift from the
abdominal cavity into the chest cavity. The FTC first used traditional hysterotomy
surgery to correct this anomaly. They recently developed a minimally invasive procedure
using endoscopic techniques, called "FETENDO." Accurate monitoring of uterine
contractions in the postoperative period is critical to develop medications that can inhibit
the progression of preterm labor.

36
 7. Benefits of Biotelemetry

Scientists foresees a revolution in global health care delivery through the

application of telecommunications, computer, and microelectronic and nanoelectronic
technologies to support revolutionary improvements in such delivery. NASA promotes,
develops and uses advanced technologies to deliver health care that benefits space flight
and enhances health care for everyone.

That development continues. Researchers are working on biotelemetry

applications that support U.S. astronauts aboard the Russian Mir space station and the
ISS. NASA also has used its expertise in telemedicine and telecommunications to provide
assistance to disaster-stricken areas of the world and to aid in the application of space-
based technologies to terrestrial medical care.

7.1 Futuristic approach

The existing worldwide wireless infrastructure could be a spring-board for the
development of system-level architecture for vital transmission from patients and also for
detecting their position. It wou1d include cellular telephony, two-way paging, and data
packet networks. RE monitoring device can be as small as a bracelet or about the size of
pager- The second-generation units would comprise small computers, exchanging data
packets using radio communications with a central database system. .

Computerised database systems would control communication with the transmitters and
maintain pertinent information about the patients being tracked. The transmitter would be
equipped with a broad-based tool for monitoring vital signals as pulse rate and blood
pressure. A hypothetical third-generation system, as soon as it detects even paltry
malfunction, would send to the patient an audible alarm or other warning signal.

37
 8. Limitations

The system has inherent limitations. Movement of patient is restricted. If the

patient goes beyond the range of system, his ECG cannot be monitored. Research is in
progress for upgrades. Practical systems are being developed to build on existing
technology and public infrastructure.

A consortium of private companies, national laboratories, universities, and end-

users such as hospitals, healthcare centers, non-profit organisations, etc would be the best
to explore the alternatives. The consortium could study the feasibility of such systems,
communication and interface standards, methods of improving the communication
infrastructure in the locale, and human aspects such as which types of patients would be
candidates for these systems. Legal changes, ethics, social impacts and safeguards, etc are
the other issues to be considered. Economic considerations such as cost to the society in
comparison with outlays for the existing system, size of the market, number of patients
qualifying as system users, etc need to be examined. A demonstration system could be
developed and tried out on patients.

38
 9. Conclusion

Use of biotelemetric techniques in medical science will bring out a sea-change

with improvements in patient care and treatment. Since the technology uses the existing
communication infrastructure, it is easy to realise and implement biotelemetry without
much effort and cost.

Biotelemetry will enable patients to move and perform their daily chores without
any worry or mental stress of the unpredictable attack due to their body disorders.
Patients who need continuous monitoring can wear a biotelemetry device which sends the
vita signals to the base (hospital). There is a need to create interest in this field and
initiate research activities.

Another imp area of biotelemetry is conservation of rear species of birds and

animals. There living condition, mortality rate n movements can be remotely monitored
for appropriate conservation steps. This can also help in understanding the behavior of
certain birds, animals, aquatic animals for the benefit of the mankind.

This technique can open new vistas for development of new techniques and
understanding for the good of human kind. Nanotechnology is becoming increasingly
supportive in biotelemetry especially because of large strides made in nanotechnology in
recent times

39
 Bibliography
1. Mr R S Khandpur- Handbook of BMI, Third edition.
2. M/S Leslie Cromwell, Weibell and Pfeiffer-Biomedical Instrumentation and
measurements, Second edition.
3. Electronics for you – March 2000
4. www.biotelemetry.com
5. The national academics press
http://books.nap.edu/openbook.php?record_id=6066&page=12
6. NCBI-Pubmed.com
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&lis
t_uids=7047072&dopt=Citation
7. Biomedical Instrumentation And Measurements by Cromwell
8. M. Steyaert, S. Gogaert, T. Van Nuland, and W. Sansen, “A low-power
portable telemetry system for eight-channel EMG measurements,” in
Proc. Annu. Int. IEEE-EMBS Conf., vol. 13, 1991, pp. 1711–1712.
9. hthtetry.html http://www.datafilter.com/mc/sensors2000biotelem
10. http://www.hq.nasa.gov/office/olmsa/aeromed/index.html
11. http://www.paho.org/english/DPImag/Number5/article2.htm
13. www.biomedical-engineering-online.com/ articles/browse.asp

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