In the rapidly evolving landscape of continuous electrocardiogram (ECG) monitoring systems, there is a heightened demand for non-invasive sensors capable of measuring ECGs and detecting heart rate variability (HRV) in diverse populations, ranging from cardiovascular patients to sports enthusiasts. Challenges like device accuracy, patient privacy, signal noise, and long-term safety impede the use of wearable devices in clinical practice. This scoping review aims to assess the performance and safety of novel multi-channel, sensor-based biopotential wearable devices in adults. A comprehensive search strategy was employed on four databases, resulting in 143 records and the inclusion of 12 relevant studies. Most studies focused on healthy adult subjects (n = 6), with some examining controlled groups with atrial fibrillation (AF) (n = 3), long QT syndrome (n = 1), and sleep apnea (n = 1). The investigated bio-sensor devices included chest-worn belts (n = 2), wrist bands (n = 2), adhesive chest strips (n = 2), and wearable textile smart clothes (n = 4). The primary objective of the included studies was to evaluate device performance in terms of accuracy, signal quality, comparability, and visual assessment of ECGs. Safety findings, reported in five articles, indicated no major side effects for long-term/continuous monitoring, with only minor instances of skin irritation. Looking forward, there are ample opportunities to enhance and test these technologies across various physical activity intensities and clinical conditions.

Recent advances in hemodynamic monitoring have seen the advent of non-invasive methods which offer ease of application and improve patient comfort. Bioimpedance Analysis or BIA is one of the currently employed non-invasive techniques for hemodynamic monitoring. Impedance Cardiography (ICG), one of the implementations of BIA, is widely used as a non-invasive procedure for estimating hemodynamic parameters such as stroke volume (SV) and cardiac output (CO). Even though BIA is not a new diagnostic technique, it has failed to gain consensus as a reliable measure of hemodynamic parameters. Several devices have emerged for estimating CO using ICG which are based on evolving methodologies and techniques to calculate SV. However, the calculations are generally dependent on the electrode configurations (whole body, segmental or localised) as well as the accuracy of different techniques in tracking blood flow changes. Blood volume changes, concentration of red blood cells, pulsatile velocity profile and ambient temperature contribute to the overall conductivity of blood and hence its impedance response during flow. There is a growing interest in investigating limbs for localised BIA to estimate hemodynamic parameters such as pulse wave velocity. As such, this paper summarises the current state of hemodynamic monitoring through BIA in terms of different configurations and devices in the market. The conductivity of blood flow has been emphasized with contributions from both volume and velocity changes during flow. Recommendations for using BIA in hemodynamic monitoring have been mentioned highlighting the suitable range of frequencies (1 kHz–1 MHz) as well as safety considerations for a BIA setup. Finally, current challenges in using BIA such as geometry assumption and inaccuracies have been discussed while mentioning potential advantages of a multi-frequency analysis to cover all the major contributors to blood’s impedance response during flow.

We present a simple-structured strain sensor based on a low-cost ionic liquid. The ionic liquid was made of sodium chloride/propylene glycol solution and was embedded in a linear microfluidic channel fabricated using Ecoflex. The proposed sensor is capable of measuring strain up to 100% with excellent repeatability. The highest gauge factor is obtained as 6.19 under direct current excitation and 3.40 under alternating current excitation at 1 kHz. The sensor shows negligible hysteresis and overshoot, and survived 10,000 rapid stretch-release cycles of a 100% peak strain with a minor deviation in the response signal. The sensor can be mounted to different locations on the human body and suits a variety of applications in the field of motion detection, human–machine interface and healthcare monitoring.

Electrocardiography (ECG) is widely used in clinical practice, for example to diagnose coronary artery disease or the cause of chest pain during a stress test, while the patient is running on a treadmill. Ambulatory ECG monitoring is used for long term recording of ECG signals, while the patient carries out his/her daily activities. Artefacts in ECG are caused by the patient’s movement, moving cables, interference from outside sources, electromyography (EMG) interference and electrical contact from elsewhere on the body. Most of these artefacts can be minimized by using proper electrode design and ECG circuitry. However, artefacts due to subject’s movement are hard to identify and eliminate and can be easily mistaken for symptoms of arrhythmia and the physiological effects of exercise, leading to misdiagnosis and false alarms. This study provides an overview of various ambulatory ECG measurement systems and electrode topologies used for ECG sensing. The challenges associated with ambulatory ECG monitoring and the techniques used to overcome those challenges have also been discussed in this paper.

Recent advancement in wearable and robot-assisted healthcare technology gives rise to the demand for smart interfaces that allow more efficient human-machine interaction. In this paper, a hydrogel-based soft sensor for subtle touch detection is proposed. Adopting the working principle of a biomedical imaging technology known as electrical impedance tomography (EIT), the sensor produces images that display the electrical conductivity distribution of its sensitive region to enable touch detection. The sensor was made from a natural gelatin hydrogel whose electrical conductivity is considerably less than that of human skin. The low conductivity of the sensor enabled a touch-detection mechanism based on a novel short-circuiting approach, which resulted in the reconstructed images being predominantly affected by the electrical contact between the sensor and fingertips, rather than the conventionally used piezoresistive response of the sensing material. The experimental results indicated that the proposed sensor was promising for detecting subtle contacts without the necessity of exerting a noticeable force on the sensor.

This paper improves the accuracy of quantification in the arterial diameter-dependent impedance variance by altering the electrode configuration. The finite element analysis was implemented with a 3D human wrist fragment using ANSYS Electronics Desktop, containing fat, muscle, and a blood-filled radial artery. Then, the skin layer and bones were stepwise added, helping to understand the dielectric response of multi-tissues and blood flow from 1 kHz to 1 MHz, the current distribution throughout the wrist, and the optimisation of electrode configurations for arterial pulse sensing. Moreover, a low-cost wrist phantom was fabricated, containing two components: the surrounding tissue simulant (20 wt % gelatine power and 0.017 M sodium chloride (NaCl) solution) and the blood simulant (0.08 M NaCl solution). The blood-filled artery was constricted using a desktop injection pump, and the impedance change was measured by the Multi-frequency Impedance Analyser (MFIA). The simulation revealed the promising capabilities of band electrodes to generate a more uniform current distribution than the traditional spot electrodes. Both simulation and phantom experimental results indicated that a longer spacing between current-carrying (CC) electrodes with shorter spacing between pick-up (PU) electrodes in the middle could sense a more uniform electric field, engendering a more accurate arterial diameter estimation. This work provided an improved electrode configuration for more accurate arterial diameter estimation from the numerical simulation and tissue phantom perspectives.