A medical quality electrocardiogram (ECG) signal is necessary for permanent monitoring, and an accurate heart examination can be obtained from instrumented underwear only if it is equipped with high-quality, flexible, textile-based electrodes guaranteeing low contact resistance with the skin. The main objective of this article is to develop reliable and washable ECG monitoring underwear able to record and wirelessly send an ECG signal in real time to a smart phone and further to a cloud. The article focuses on textile electrode design and production guaranteeing optimal contact impedance. Therefore, different types of textile fabrics were coated with modified poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) in order to develop and manufacture reliable and washable textile electrodes assembled to female underwear (bras), by sewing using commercially available conductive yarns. Washability tests of connected underwear containing textile electrodes and conductive threads were carried out up to 50 washing cycles. The influence of standardized washing cycles on the quality of ECG signals and the electrical properties of the textile electrodes were investigated and characterized.

In this paper, the washability of wearable textronic (textile-electronic) devices has been studied. Two different approaches aiming at designing, producing, and testing robust washable and reliable smart textile systems are presented. The common point of the two approaches is the use of flexible conductive PCB in order to interface the miniaturized rigid (traditional) electronic devices to conductive threads and tracks within the textile flexible fabric and to connect them to antenna, textile electrodes, sensors, actuators, etc. The first approach consists in the use of TPU films (thermoplastic polyurethane) that are deposited by the press under controlled temperature and pressure parameters in order to protect the conductive thread and electrical contacts. The washability of conductive threads and contact resistances between flexible PCB and conductive threads are tested. The second approach is focused on the protection of the whole system—composed of a rigid electronic device, flexible PCB, and textile substrate—by a barrier made of latex. Three types of prototypes were realized and washed. Their reliabilities are studied.

E-textiles is a new hybrid field developed with the help of the integration of electronic components into our daily usage of textile products. These wearable e-textiles provide user-defined applications as well as normal textile clothing. The medical field is one of the major leading areas where these new hybrid products are being implemented, and relatively mature products can be observed in the laboratory as well as in commercial markets. These products are developed for continuous patient monitoring in large-scale hospital centers as well as for customized patient requirements. Meanwhile, these products are also being used for complex medical treatments and the replacement of conventional methods. This review manuscript contains a basic overview of e-textile systems, their components, applications, and usages in the field of medical innovations. E-textile systems, integrated into customized products for medical needs, are discussed with their proposed properties and limitations. Finally, some recommendations to enhance the e-textile system’s integration into the medical field are argued.

Reliability and washability are major hurdles facing the e-textile industry nowadays. The main fear behind the product’s rejection is the inability to ensure its projected life span. The durability of e-textiles is based on an approximate lifetime of both the electronics and textiles integrated into the product. A detailed analysis of the wash process and the possibility of predicting product behavior are key factors for new standards implementation. This manuscript is focused on the washability issues of different types of woven, knitted, and embroidered, textile-based ECG electrodes. These electrodes are used without the addition of any ionic gel to the skin to reduce impedance. They were subjected to up to 50 wash cycles with two different types of wash processes, and changes in surface resistance, as well as the quality of ECG waves, were observed To investigate the wash damages in detail, the proposed mechanical (Martindale and Pilling box) and chemical test methods were investigated. The electrodes which increased resistance after washing showed the same trend in the proposed test methods. Copper-based electrodes suffered the most severe damage and increased resistance, as was also visible in an SEM analysis. These proposed test methods can be used to predict robustness behavior without washing.

A development of washable PEDOT:PSS (poly(3,4-ethylenedioxythiophene) polystyrene sulfonate) polyamide textile-based electrodes is an interesting alternative to the traditional Ag/AgCl disposable electrodes, usually used in clinical practice, helping to improve medical assessment and treatment before apparition or progress of patients’ cardiovascular symptoms. This study was conducted in order to determine whether physical properties of PEDOT:PSS had a significant impact on the coated electrode’s electrocardiogram (ECG) signal quality, particularly after 50 washing cycles in a domestic laundry machine. Tests performed, included the comparison of two PEDOT:PSS solutions, in term of viscosity with emphasis on wetting tests, including surface tension and contact angle measurements. In addition, polyamide textile fabrics were used as substrate to make thirty electrodes and to characterize the amount of PEDOT:PSS absorbed as a function of time. The results showed that surface tension of PEDOT:PSS had a significant impact on the wetting of polyamide textile fabric and consequently on the absorbed amount. In fact, lower values of surface tension of the solution lead to low values contact angles between PEDOT:PSS and textile fabric (good wettability). Before washing, no significant difference has been observed among signal-to-noise ratios measured (SNR) for coated electrodes by the two PEDOT:PSS solutions. However, after 50 washing cycles, SNR decreased strongly for electrodes coated by the solution that had low viscosity, since it contained less solid contents. That was confirmed by scanning electron microscopy images (SEM) and also by analyzing the color change of electrodes based on the calculation of CIELAB color space coordinates. Moreover, spectral power density of recorded ECG signals has been computed and presented. All cardiac waves were still visible in the ECG signals after 50 washing cycles. Furthermore, an experienced cardiologist considered that all the ECG signals acquired were acceptable. Accordingly, our newly developed polyamide textile-based electrodes seem to be suitable for long-term monitoring. The study also provided new insights into the better choice of PEDOT:PSS formulation as a function of a specific process in order to manufacture cheaper electrodes faster.