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Journal of Medical Systems, Vol. 26, No. 2, April 2002 ( C
2002)
Theory and Applications of Biotelemetry
Nihal Fatma G uler
1, 2
and Elif Derya

Ubeyli
1
In this study, biotelemetry and its evolution is explained in detail. Bioelectric and phys-
iological variables could be measured by biotelemetry systems. The development of a
biotelemetry system and its principal operation are presented. The components of a
biotelemetry system are explained. Biomedical data has been telemetered through ev-
ery mediumbetween two sites by using a variety of modulated energy forms. Designing
of the link between transmitter and receiver is described. Important factors in design-
ing a backpack or implanted telemeter are explained. The main features of implanted
biotelemetry units are determined. Single-channel and multichannel biotelemetry sys-
tems are dened. The types of telemetry, and a comparison thereof, are given. The
power sources of biotelemetry systems and features of different power sources are ex-
plained. A survey of biotelemetry applications on humans and animals is presented
and advantages of using biotelemetry systems are determined.
KEY WORDS: biotelemetry; remote monitoring; data gathering; implantable device; modulation;
telemetry types; single channel and multichannel biotelemetry.
INTRODUCTION
Biotelemetry is dened as transmitting biological or physiological data from a
remote locationtoa locationthat has the capability tointerpret the data andaffect de-
cision making. Biomedical telemetry is a special eld of biomedical instrumentation
that often permits transmission of biological information from an inaccessible loca-
tion to a remote monitoring site. When direct observation is impossible, biotelemetry
can be used to obtain a wide spectrum of environmental, physiological, and behav-
ioral data.
(1)
Biotelemetry includes the capability for monitoring humans andanimals
with minimum restraint and for providing a reproduction of the transmitted data. If
measurements and monitoring techniques are applied to restrained humans and an-
imals, stress of immobilization causes alterations of measured variables. According
to this concept, the advantage of biotelemetry is the measurement of physiological
1
Department of Electronic and Computer Education, Faculty of Technical Education, Gazi University,
06500 Teknikokullar, Ankara, Turkey.
2
To whom correspondence should be addressed; e-mail: fnguler@tef.gazi.edu.tr.
159
0148-5598/02/0400-0159/0 C
2002 Plenum Publishing Corporation
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variables in conscious, unrestrained humans and animals. The method of bioteleme-
try is offering wireless, restraint-free, simultaneous, long-term data gathering.
(24)
It is obvious that any quantity that could be measured was adaptable to
biotelemetry. Measurements that have been done in biotelemetry can be determined
in two categories:
1. Bioelectrical variables, such as ECG, EMG, and EEG.
2. Physiological variables that require transducers, such as blood pressure, gas-
trointestinal pressure, blood ow, and temperature. By using suitable trans-
ducers, telemetry can be employed for the measurement of a wide variety of
physiological variables.
(5, 6)
Biomedical telemetry like many other things began as a laboratory curiosity
but has evolved into a useful, reliable tool for data gathering. In 1903, Einthoven
transmitted electrocardiograms from a hospital to his laboratory. Immersion elec-
trodes were connected to a remote galvanometer directly by telephone lines. In this
instance, telephone lines were merely used as conductors for current produced by
biopotentials.
(5)
The use of wires in the transmission of biodata suited his purpose,
but a major advantage modern telemetry has is the elimination of wires. In 1921,
Winters transmitted heart sounds over a marine radio link. External transmitters of
various signals evolved as electronic methods evolved to produce small transmitters.
Later, several groups inserted small coils and electrodes into the skulls of animals
so alternating currents could be induced for a primitive form of telestimulation.
(6)
The transmission of signals from a subject was a technique that evolved slowly. In
1950s transistors were invented and then signals were transmitted fromthe body. En-
doradiosonde was one of the earliest biotelemetry units developed by Mackay and
Jacobson.
(5)
Since the invention of integrated circuit technology in 1958, contribu-
tions of microelectronics to biomedicine and health care have been enormous. Many
advanced diagnostic, therapeutic, and rehabilitative devices and systems would not
have been possible without these contributions. The circuits tested by Markevitch
showed that signals could be transmitted through the tissues of the body from quite
small coils placed within the body.
(7)
Miniature and micropower are two concepts
of modern biotelemetry design and construction. Improvements in these areas have
closely paralleled the evolution of semiconductor and microcircuit technologies. Re-
liable, stable integrated sensors and biotelemeters on microcircuit designs and im-
plementations are studied.
(27)
Biotelemetry is an important method for monitoring physiological variables by
providing a wireless link between the subject and the data collection equipment.
Biomedical data has been telemetered through every medium between two sites,
including air, space, water, and biologic tissue, by using a variety of modulated energy
forms like electromagnetic waves, light, and ultrasound. Physiological measurements
are frequently telemetered from a subject. This can be done by a transmitter carried
onabelt or inapocket. However, therearecases inwhichthetransmitter is swallowed
or surgically implanted in subject. The transmitting unit can be carried outside the
monitored subject as a backpack unit or can be implanted within the subjects body
after appropriate miniaturization and sealing against body uid. An implantable
biotelemetry unit is a device usually designed to sense a physiological event and
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Biotelemetry 161
transmit this information, at least over few centimeters of tissue, to an external
receiver.
(8, 9)
Although there had been examples of biotelemetry in the 1940s, they did not
receive much attention until the advent of the NASA space programs. Biotelemetry
is a specialized telemetry that NASAdeveloped for shuttle ights in which electronic
biomedical data taken fromastronauts is transformed into radio waves and sent back
to the ground. NASA has studied the design of advanced and reliable biomedical
sensors and biotelemetry devices.
(5, 10, 11)
THE COMPONENTS OF A BIOTELEMETRY SYSTEM
Size, cost, circuit complexity, power requirements (and operational lifetime),
transducers, nature of data to be transmitted, and performance dictate the design
of a telemeter. First of all, a simple system is described to illustrate the basic princi-
ples involved in telemetry. The stages in a typical biotelemetry system are shown in
Fig. 1.
(6)
Transmitter and Receiver
The stages of a typical biotelemetry systemcan be divided into functional blocks,
as shown in Fig. 2 for the transmitter and in Fig. 3 for the receiver.
(5)
Physiological
signals are obtained from the subject by means of appropriate transducers. Then,
signal is passed through a stage of amplication and processing circuits that include
generation of a subcarrier and modulation stage for transmission. The receiver con-
sists of a tuner to select transmitting frequency, a demodulator to separate the signal
from the carrier wave so as to display or record it.
The transmitter generates the carrier and modulates it. The receiver is capable
of receiving the transmitted signal and demodulating it to recover the information.
Fig. 1. Block diagram of a biotelemetry system.
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Fig. 2. Block diagram of a biotelemetry transmitter.
Information to be transmitted is impressed upon the carrier by a process known as
modulation. Amplitude-modulated (AM) and frequency-modulated (FM) carriers
have been used in biotelemetry. In an amplitude-modulated system, amplitude of the
carrier is caused to vary with the transmitted information. In a frequency-modulated
system, frequency of the carrier is caused to vary with the modulated signal.
In biotelemetry systems, the physiological signal is sometimes used to modu-
late a low frequency carrier, called a subcarrier. Radio frequency (RF) carrier of
the transmitter is then modulated by the subcarrier. If several physiological signals
are transmitted simultaneously, each signal is placed on a subcarrier of a different
frequency and all of the subcarriers are combined to simultaneously modulate the
RF carrier. This process of transmitting many channels of data on a single RF car-
rier is called frequency multiplexing. Frequency multiplexing is more efcient and
less expensive than employing a separate transmitter for each channel. At the re-
ceiver, a multiplexed RF carrier is rst demodulated to recover each of the separate
Fig. 3. Receiver storage display units.
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subcarriers and then demodulated to retrieve the original physiological signals.
(6)
In
describing this type of system, a designation is given in which the method of modu-
lating subcarriers is followed by the method of modulating RF carrier. For example,
a system in which subcarriers are frequency-modulated and RF carrier is amplitude-
modulated is designated as FM/AM. FM/FM designation means that both subcar-
riers and RF carrier are frequency modulated. Although FM/AM has been used in
biotelemetry, FM/FMsystems have been more popular because overall performance
expected of FM radio link is better.
(7)
Also, FM radio frequency oscillators are easy
to implement with a single transistor. FM/FM biotelemeters have been popular in
a variety of restraint-free monitoring studies. Most of the other approaches use a
technique known as pulse modulation, in which the transmission carrier is generated
in a series of short pulses. If the amplitude of the pulses is used to represent the trans-
mitted information, the method is called pulse amplitude modulation (PAM). If the
width (duration) of each pulse is varied according to the information, pulse width
modulation (PWM) or pulse duration modulation (PDM) system results. In pulse
position modulation (PPM), timing of a very narrow pulse is varied with respect to
a reference pulse. Other designations are pulse code modulation, (PCM) and pulse
interval modulation (PIM). In pulse code modulation, information is represented
by a sequence of coded pulses, which is accomplished by representing the signal in
discrete formin both time and amplitude. Pulse interval modulation uses the spacing
between constant width (length) pulses to transmit the data.
(12)
In all these systems,
the designations can be dened as PIM/FM, PWM/FM, and so on. As in amplitude-
and frequency-modulation systems, multiplexing of several channels of physiolog-
ical data can be accomplished in a pulse modulation system. However, instead of
frequency, time multiplexing is used. In time multiplexing, each of the physiological
signals is sampled and used to control either amplitude, width, or position of one
pulse, depending on the type of pulse modulation. If sampling rate is several times
the highest frequency component of each data signal, no loss of information results
from the sampling process. The signal transmitted at low power on the FM transmit-
ter is collected by the receiver and tuned to the correct frequency. The subcarrier is
removed fromRF carrier and then demodulated to reproduce a signal the amplitude
and frequency of which can be transformed back to the original data waveforms.
Later, this signal can be displayed or recorded on a chart and stored on tape for other
use.
(5, 13)
Antenna Tips
The distance the transmitted signal can be received is called as the range of
the system. The range of the system depends on power and frequency of the trans-
mitter, relative locations of transmitting and receiving antennas, and sensitivity of
the receiver. There are several important factors that telemetry users should be fa-
miliar with when using antennas. Some of these factors are as follows: (1) Keep
clear of the antenna when taking a bearing. (2) Do not stand within 1/2 wave-
length of the antenna elements. (3) Protect the antenna elements to prevent them
from getting bent out of shape. (4) Keep all metal objects from interfering with the
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antenna. In this way, confusion will be reduced and success rate in tracking will be
increased.
(14)
Transmitting devices built for patients must have light weight and be compact
to ensure adequate user comfort. This physical constraint on package volume means
that any built-in antenna must be electrically small, with correspondingly low ef-
ciency. Further problems appear as the telemeter is usually worn next to the skin
at chest or abdominal level, so the transmitting antenna is at extremely close prox-
imity to body tissue. In practice, the most important operational parameters for a
body-surfaceworn antenna used for biotelemetry are its radiation efciency and the
radiation pattern in the azimuthal plane. The analysis of electrically small antennas
under near-body proximity conditions has received little consideration. The use of
numerical electromagnetic modelling methods such as nite difference time domain
(FDTD) technique can provide a exible, more efcient alternative. Application of
FDTD to the analysis of body-surfacemounted radiators for use in 418 MHz ra-
dio biotelemetry systems have been explained. Numerical simulation of whole body
problems using suitable models enables a rapid determination of all critical param-
eters affecting close coupled antenna performance.
(8, 15)
Implantable Device
In some occasions, it is desirable to implant the telemetry transmitter or receiver
subcutaneously. The transmitter is swallowed or surgically implanted in the subject.
These systems allow monitoring and collecting data from conscious, freely moving
subjects. Conscious subjects provide data free from the effects of anesthesia. It has
been clearly shown in the literature that anesthetic agents can change blood pressure,
heart rate, peripheral vascular resistance, thermoregulation, gastrointestinal func-
tion, and other body functions. Comparing with the tethered animal model animals
instrumented with implanted telemetry are free of exit-site infections. Also, animals
instrumented with implanted telemetry are free of infections that result from exteri-
orizedcatheters andleadwires that are oftenrequiredwhenusing jacketedtelemetry.
In this situation, animals are free of stress and discomfort of carrying instrumentation
in tight-tting clothes. Once the telemetry device is implanted, data can be monitored
24 h per day without human intervention or contact while the animal remains in its
home cage. Highest quality data can be collected by implanted units.
(16)
The function
of the instrumented implant and the external system components are described.
(17)
However, there are some requirements for the usage of an implantable telemetry.
Implantable units must have relatively small size and be lightweight. Internal power
source has to be used for a long time. Miniaturization and long-term use of implant
electronic systems for medical applications have resulted in growing necessity for
an external powering system. Another requirement is encapsulation of the unit. Im-
plantable parts of the system must be encapsulated in a biocompatible material. The
outer case and any wiring must be impervious to body uids and moisture. For many
implantable electronic instruments, packaging is important. Requirements of pack-
aging materials, used in current techniques are as follows: (1) epoxy, silicone rubber,
and other polymeric material; (2) metal at-packs with resistive, electron beam, or
laser beam welding, or solder sealing; (3) pyrex and ceramic outer cases with epoxy
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Biotelemetry 165
or metal solder sealing. The unmet needs in packaging, as well as potentially useful
materials and techniques for packaging implantable electronic devices or systems for
use in chronic situations, are given. Problems of packaging solid state transducers
include the determination of the volume and weight of the packaging material.
(18)
The use of implantable units also restricts the distance of transmission of
the signal. Body uids and skin greatly attenuate the signal, and because of this
the implanted unit must be small. Therefore, the unit has little power and the range
of signal is quite restricted. This disadvantage has been overcome by picking up the
signal with a nearby antenna and retransmitting it. If applications involve monitoring
over relatively short distances then retransmission is not necessary.
(19)
Single Channel and Multichannel Biotelemetry Units
There are two types of biotelemetry units: single-channel and multichannel. In
general, more than one channel of physiological information is studied. The simplest
encoding can be used for telemetering a single channel of slow data. Pulse inter-
val modulation or pulse width modulation can be used for a single slow variable.
Telemetering a single channel of fast data requires quite different encoding because
the carrier must be continuously varied. Either its amplitude or its frequency may be
modulated.
(8)
Amultiple subject biotelemetry systemis composed of an implantable
system, which consists of a command receiver, a subject selection receiver, a con-
ditioner and a transmitter, and external systems, such as a power command signal
transmitter and a subject selection signal transmitter, as shown in Fig. 4.
(19)
As indi-
cated in Fig. 4, such a system is capable of accepting signals from a variety of sensors.
The function of the command receiver is to connect or disconnect the battery
to each implantable telemetry system on demand. Subject selection receiver is de-
signed for receiving the subject selection signal from an external subject selection
transmitter and then selecting a specic subject from the eight subjects and then
switching the power source to the selected subject. The conditioner circuit consists
of an 8-to-1 multiplexer, a comparator, a signal generator, and an 8-state ring counter.
In order to transmit the measured biological signals at low power, the transmitter
is designed for pulse width modulation, having high noise immunity and frequency
modulation (FM). The receiver system is for receiving, demodulating, and demulti-
plexing telemetry signals. This system enables one subject to be selected from eight
subjects, and the biological signals from seven implantable sensors to be obtained
sequentially using a synchronization gap.
(3)
The custom asynchronous digital mul-
tiplexer IC can combine the output signals from many digital sensors onto a single
pair of wires. A novel system architecture assures system startup as well as detection
and recovery from inactive sensing elements. Computer simulation of the system
architecture provides a verication of the digital logic design and an evaluation of
the system performance.
(20)
A CMOS integrated circuit for a noninvasive biological signal telemetry system
specied for use in medical and physiological studies of the inuence of weight-
lessness in space is presented. The system can monitor multichannel (4 channels
maximum) biological signals from multiple subjects (4 subjects maximum) in real
time by using time multiplexing.
(2123)
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Fig. 4. Block diagram of a multiple-subjects telemetry system.
TYPES OF TELEMETRY
Biomedical data has beentelemeteredthroughevery mediumbetweentwosites,
including air, space, water, and biologic tissue by using a variety of modulated energy
forms like electromagnetic waves, light, and ultrasound.
Radio Telemetry
In general, biotelemetry systems involve the use of radio transmission. A radio
frequency carrier is a high efciency sinusoidal signal propagated in the form of
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Biotelemetry 167
electromagnetic waves when applied to an appropriate transmitting antenna. Radio
telemetry is an excellent tool for gathering data on the biology of animals and their
interactions with the environment they inhabit.
(24)
The choice of operating frequency
has always been the subject of considerable controversy amongst researchers. Many
select the radio frequency at which they conduct their studies basing solely upon the
availability of equipment at hand or simply on tradition. Researchers are often not
fullyawareof theproximal impact of frequencychoiceonoverall systemperformance
and its ultimate impact upon the quality of the data that the study generates.
(25)
Infrared Telemetry
Infrared (IR) telemetry also has a very wide eld of application. The IR radia-
tion enables transmission of different physiological parameters frommoving subjects
like patients in intensive care units, wards, newborn babies in incubators and animals
in biological and hospital laboratories. In a typical IR biotelemetry system, the pa-
tient carries a battery-powered transmitter and one or more small arrays of infrared
light emitting diodes (IRLEDs) that send encoded data to remotely located photo-
detectorbased receivers.
(26)
IR radiation in information transmission is used in two ways: Narrow beam or
direct radiation and diffuse IR radiation. Diffuse IR radiation ll up almost homo-
geneously the room where the IR transmitter and receiver are located. The mobility
of the transmitter worn by the patient is complete within the room, without any re-
straint. The coverage of the room with IR radiation is based on reections from the
walls, ceiling, and oor. This is the reason for greater application of diffuse IR radia-
tion in biotelemetry than narrowbeamor direct IRradiation in biological parameter
measurements.
For analyzing an IR telemetry system and its feasibility in a room, it is impor-
tant to know the voltage amplitude and photoamplier output related to the noise
level voltage in any location at the room. At least one reection must occur on the
pathway between transmitter and receiver to realize a diffuse IR radiation. There
are two opposite types of reection. One is called specular (mirror-like) reection
and the other is reection from matt surface. In some large rooms there are some
locations where IR irradiance is not sufcient. This can happen in some corners with
dark background, close to the windows, or in very long rooms. A repeater can solve
such problems. The repeater consists of a sensitive enough IR receiver and trans-
mitter; the receiver is situated in a place where there is enough irradiation so that
pulses can be received. The efciency coefcient is the most important parameter
that enables the estimation of how large the room can be. Pulse frequency or pulse
time interval modulation is used for biopotential or some other biological signal
transmission.
(26, 27)
Ultrasonic Telemetry
Acoustic energy is the best available technique for marine shes to send a sig-
nal over a distance. Ultrasonic ranges 30100 kHz are above most animal auditory
ranges and are transmitted with low energy loss through seawater.
(28)
There is a
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denite need to reveal the daily activities of animals that range out of sight of an
underwater observer and to obtain information on behavior beyond release and
recapture sites. Ultrasonic telemetry appears to be well suited for such studies as
animals can be followed from boats or by other arrangements for up to several kilo-
meters distance.
(29)
Sound travels at a predictable speed through water. If a pulsed
signal is detected at a series of hydrophones at known positions, the position of the
sound source can be calculated from the differences in time taken for the sound to
reach each of the hydrophones successively more distant from the source. A number
of tracking systems based on this principle have been used to track sound-producing
animals as well as acoustically tagged individuals. Several transmitters may also be
tracked simultaneously using such techniques. Consideration of position-xing er-
rors associated with xed-array acoustic tracking techniques has generally centered
upon the consequences of inaccuracies in the timing of the arrival of the ultrasonic
pulse at each hydrophone.
(3035)
The simplest type of ultrasonic transmitter the pinger, which emits pulses of a
given ultrasonic frequency and repetition rate to transmitters with sensors for mon-
itoring swimming speed, tail-beat frequency, water depth, and water temperature.
Most pingers are augmented with a coded output that allows for recognition of in-
dividual animals.
(36)
Most acoustically telemetered eld data are interval-encoded.
Data can also be encoded in the duration of the ping, but power constraints usually
meanthat off-timeis abetter waytocarrysignal thanon-time,whichis minimized
for signaling. Most standard, available acoustic receiving equipment is designed to
decode data in this off-interval format. Receivers are usually set to ignore later pulses
in a blanking interval, typically 200300 ms.
(37)
COMPARISON OF TELEMETRY TYPES
Telemetry is an active process requiring energy output to send a signal over a dis-
tance. Electromagnetic energy, particularly at radio frequencies, is rapidly absorbed
as it passes through even a few centimeters of seawater. Thus, acoustic energy is the
best available technique for marine shes. Acoustic energy is transmitted with low
energy loss through seawater.
(28)
The use of modulated infrared (IR) light as an alternative to RF carriers in
biotelemetry systems has many advantages: man-made electrical impulse noise
causes interference in radio telemetry links.
(38)
In IR telemetry there is much less
man-made and natural interference noise. The space occupied by the transmitting
and receiving antennas is not required in IR telemetry. The transmitter worn by the
patient is more compact and does not require an inductive coil so that it can be re-
alized in surface-mount technology in a very small size.
(27)
When IR biotelemetry
systems are used for monitoring and locating hospital patients, there are no band-
width restrictions. Some reports suggest that RFtransmission causes electromagnetic
interference in medical devices such as cardiac pacemakers or infusion pumps.
(3944)
The possible effects of electromagnetic interference during wireless connectivity
are searched and no evidence was found of electromagnetic interference of IR
modems with any of the medical devices. Furthermore, IR modems showed similar
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Biotelemetry 169
performance to a wired systemeven in an electrically noisy environment. As a result,
IR wireless connectivity can be safely and effectively used in operating rooms.
(4548)
The disadvantages of IR biotelemetry are as the following: range of IR
biotelemetry is short and restricted to a single room. The short range is not par-
ticularly troublesome in medical telemetry, since patients are usually conned to
small rooms or wards. Diffuse IR biotelemetry system has difculties with multisys-
tem operation in the same room. Realization of a multisystem operation is not as
simple as in radio frequency telemetry. There are two possibilities: frequency multi-
plex and time division multiplex. Transmitters are difcult to separate by wavelength
division multiplex (frequency multiplex). It cannot be realized easily because of the
broad frequency response characteristics of photodiodes. In IR biotelemetry system
power consumption of transmitter is relatively high. Transmitter power consump-
tion may be kept to a minimum by operating the infrared light emitting diodes in a
pulsed mode with a favorable duty cycle. The pulse duration is usually set to just a
few microseconds, and pulse position modulation (PPM) is used to convey the data.
It is only necessary to transmit one IR pulse for each physiological signal or data
channel.
(26)
POWER SOURCES OF BIOTELEMETRY SYSTEMS
In many applications of short range biotelemetry, long operational life of the
remote unit is a prime requirement. Many different types of biotelemetry systems
featuring lowbattery drain have been developed over the years, but adequate battery
life can still be a problem.
(49)
Various environmental power sources have been investigated, such as light,
atomic radiation, radio waves, and biomechanical and biochemical energy convert-
ers. Biotelemetrysystems that donot activelyusetheir owninternal power totransmit
information have been described in the past and take two basic forms. RF-powered
devices could be considered one class since these derive their power from a base unit
transmitter and use the power to excite an internal low power transmitter broadcast-
ing telemetry data on another frequency. Another approach is to use the same RF
frequency for powering and transmission, but on a time-sharing basis. When prop-
erly designed, this technique eliminates the crosstalk between the powering circuit
and the signal circuit and only requires a single coil set for the implant. Two fac-
tors in RF-powered telemetry need to be considered: (1) the RF interference of the
signaleither on the transducer or on the biological systemand (2) the biological,
particularly the long term, effect of RF radiation on the subject.
(50)
Another class might be considered passive biotelemetry systems. A passive
telemetry system has been developed, operating according to the principle of the
impedance transformation of two inductively coupled coils. Signal-dependent mod-
ulation of the implanted coils load, which can be achieved with practically zero
power consumption, reduces the data transmission to the impedance measurement
of the external receiver coil.
(51, 52)
Long operating life of implantable electronic circuits can be obtained by using
low power transmission techniques. For example, pulse code modulation combined
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with remote switching systems to turn the circuit on only when monitoring is
necessary.
(53)
Asingle-transistor lowpower underdampedRFpulse positionmodula-
tor, with remote switching, for implantable biotelemetry units has been presented.
(54)
Inductive powering of implantable monitoring devices is a widely accepted so-
lution for replacing implanted batteries. Inductive powering is based on the magnetic
coupling between an internal coil and an external coil that is driven by an alternating
current.
(49, 55)
Both coils form a loosely coupled, coreless transformer. Parallel reso-
nance of the internal coil with a capacitor is most often used for higher link efciency.
This method demands technically skilled operators to tune constantly the power link
parameters. This becomes particularly important when the external systemmust also
be portable. Acceptable lifetimes for the external batteries can be obtained by a pre-
cise optimization of the power efciency of the inductive link. Inductive powering
system can be successfully developed for hospital use.
(56, 57)
APPLICATIONS OF BIOTELEMETRY
In the early days of human space ight, NASA used biotelemetry to provide
biomedical data from orbiting astronauts to medical personnel. Biomedical data
transmitted to earth from space included astronauts heart rate, body temperature,
ECG, and oxygen and carbon dioxide concentration. Telemetry was employed to
establish an understanding and to monitor health and well-being of the astronauts
while they were in orbit. So NASA has been involved in the development and ap-
plication of biotelemetry since the Agencys beginnings.
(5, 11, 58)
Because of the great
distance from the earth, systems and procedures were developed to support med-
ical operations in ight. All astronauts wore a biosensor harness, which provided
for transmitting critical physiological data back to the earth from the space craft
and lunar surface. This real-time telemetry was also available to monitor astronauts
in the event of illness in ight.
(58)
NASA had role in the development of space
ight animal habitats and monitoring hardware in 1970s. In response to this de-
velopment advanced biosensor and bioinstrumentation technologies were required.
Miniaturized, specic-application biosensors, biotelemetry, and noninvasive moni-
toring has become vital to the telemedicine industry. Sensors 2000! (S2K!) program
at NASA has implemented a variety of advanced biosensor and bioinstrumentation
technologies for space research and ground medical and surgical applications. For
these applications, miniaturized implantable biosensor to measure blood pH, ionic
sensors for Ca
+
, K
+
, and Na
+
, biophysical sensors for ow, pressure, and dimension,
and miniature high resolution CO
2
sensors, as well as advanced biotelemetry and
instrumentation and data systems, are developed.
(10, 59)
Advanced biosensors and biotelemetry systems are used in sensing a wide va-
riety of phenomena in the body and transmitting this information to receivers near
the body. These sensors can provide remote, continuous biomedical monitoring of
patient data. Continuous ambulatory monitoring of the condition of the mother and
fetus following in utero surgical repair of life-threatening congenital birth defects is
required by the University of California, Fetal Treatment Center (FTC).
(11)
In 1993,
Sensors 2000! established a relationship with FTC to adapt NASAs implantable
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Biotelemetry 171
biotelemetry devices to their monitoring needs of human fetus and its uterine
environment.
(60)
Sensors 2000! used NASAs technology to design a system that
could accurately measure intrauterine pressure changes, and the body temperature
and heart rate of the fetus.
(10)
A transmitting unit in a uterus monitors physiologi-
cal parameters and tranmits its reading to external equipment. The fully developed
transmitting unit, resembling a large pill, would be small enough to be implantable
by minimally invasive surgery.
(60)
A pressure/temperature pill transmitter is the rst
of a family of implantable and/or ingestible pill transmitters that will measure a
variety of physiological parameters. Other measurements will include pH, ions of
interest (Ca
+
, Na
+
, K
+
), heart rate, ECG, EEG, EMG, blood gases (O
2
, CO
2
), and
glucose. Testing had been done on a prototype pH pill transmitter similar in design
to the pressure/temperature device. The pill shape and small size of the transmitter,
its ultra-low power consumption, long life, and the powerful capabilities of its data
analysis software make this system unique. The portability of the system makes it
easily adaptable to any hospital setting and ideal for use in a home-based monitor-
ing environment. Applications of these pill transmitters are very common and go
beyond fetal surgery.
(61)
A complete biotelemetry system is designed for telemetry
of various physiological signals such as ECG, EEG, etc. The main advantage of this
biotelemetry system is that it provides an easy and practical way for long-term moni-
toring of various physiological signals from a patients body while maintaining a low
implementation cost.
(4)
An intraoral plaque pH measuring system has been developed incorporating
a hydrogen-ionselective eld effect transistor. The telemeter is a temperature-
compensated FMFM system utilizing voltage feedback to the input sensing
circuit.
(62)
A telemetry pill is proposed to investigate bladder pressure under normal
life circumstances. Extremely high compactness could be achieved using integrated
and hybrid technology. A 3-mm wide thick-lm substrate carries all electronics from
sensor totransmitter, including a dedicatedcontrol chipfor minimal power consump-
tion and is sealed by a micromachined package.
(63)
The use of telemetry to monitor
a swimmers rectal core temperature has been presented and measurements taken
from swimmers have been shown.
(64)
Progress in the development of an implantable
telemetry system for assessing blood oxygen saturation and hematocrit is described.
The key element of the system is an optical sensor, which employs optoelectronics
and on-chip signal processing electronics to measure light backscattered by blood.
(65)
Long-termmonitoringof central haemodynamics withimplantedmonitoringsystems
might be valuable in managing heart failure patients.
(66)
Emergency medical care has
become an important part of the overall health delivery system. In many areas am-
bulances and emergency rescue teams are equipped with telemetry equipment to
allow electrocardiograms and other physiological data to be transmitted to a nearby
hospital for interpretation.
(5, 67)
A compact, low power, implantable system for in vivo monitoring of oxygen
and glucose concentrations is developed. The telemetry instrumentation system
consists of two amperometric sensors: one oxygen and one glucose biosensor and
two potentiostats for biasing the sensors, an instrumentation amplier to subtract
and amplify sensor output signals, and a signal transmitter subunit to convert and
transmit glucose-dependent signal from the sensors to a remote data acquisition
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system.
(59, 68)
A system is designed to simultaneously acquire ECG and respiration
data and send them to a receiver over a telephone line. Respiration data is acquired
by measuring the transthoracic impedance between two electrodes.
(69)
The data
each FM-modulate subcarriers which then FM-modulate a carrier. The transmit-
ter is battery powered to assure patient safety. An electrohydraulic pulsatile blood
pump has been developed for implantation in the thoracic cavity. The system can
be used as a circulatory assist device or as an articial heart with modications.
Remote biotelemetry systems provide power, remote monitoring, and control.
(70)
A single-channel implantable microstimulator for functional neuromuscular stim-
ulation is developed. This device can be inserted into paralyzed muscle groups by
expulsion from a hypodermic needle, thus reducing the risk and discomfort associ-
ated with surgical placement. The device receives power and data from outside by
RF telemetry.
(9)
The walking (gait) analysis telemetry system (walking analyzer) consists of
miniature sensors/transmitters that are afxed directly over the leg muscle group
being studied. The muscle activity sensed by the electrodes is transmitted to a com-
puter by biotelemetry process. This system is used to determine the degree and
location of abnormal muscle activity and in prescribing treatment.
(71)
A system for
measuring force in both legs and crutches or cane, for the patient, during walking is
developed. A special sensor based on infrared radiation changes is realized for force
measurement in the crutches or cane. To extend patients free mobility, an infrared
telemetry system is applied.
(72, 73)
The most reliable operation of IR biotelemetry has been found in hospitals and
in biological laboratories.
(45)
An IRdiffuse telemetry systemis realized for ECGand
temperature transmission. The basic patient unit has an IR receiver and transmitter,
because biological data and signals have to be transmitted and commands and iden-
tication to the basic patient unit have to be received.
(27)
A wireless biotelemetry
system for the transfer of digital data through intact skin tissue has been devel-
oped to provide a safe and noninvasive communication between implanted medical
devices and outside of the body. The system utilizes two miniature infrared trans-
mitter/receiver modules. Data are transmitted through intact skin and subcutaneous
tissue on an infrared carrier signal. The systemhas been evaluated in human cadavers
and during in vivo implantation of articial hearts.
(2)
The infrared telemetry system
provides a reliable and effective way of performing continuous real-time ambula-
tory urodynamic monitoring in infants and young children. With the development of
more powerful telemetric data transmission technologies, such a method could be ex-
tended in the near future to a truly ambulatory urodynamic recording with real-time
on-line facilities, either at home or in the clinic, both for adults and for children.
(74)
A through-water ultrasonic data telemetry system burst-mode frequency shift
keying (FSK) is described. The system can be adapted for the transmission of data
from various sensors, but it has been designed principally for monitoring the res-
piratory rate, heart rate, temperature, and depth of a free-swimming diver over a
range of up to 300 m. This application requires the transmission of low rate digital
signals through water from a moving source to a receiver that is either stationary or
moving.
(75)
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Biotelemetry 173
Different biotelemetric applications are done ona wide variety of animal species
since 1950s. Information about wildlife biotelemetry activity with some historical
perspective are presented.
(76)
For many species, determination of habitat selection is
based on habitat-use data obtained through radio telemetry. The effects of habitat-
patch size, level of telemetry signal inhibition, and selection pattern are observed.
Monte Carlo simulations are used to assess the effect of habitat-dependent bias in
radio telemetry studies on the assessment of habitat selection. The characteristics
of habitat mosaics selected by animals can be studied in this way.
(77, 78)
Animals of
various species are used in biomedical researches, and some of the radio teleme-
try systems employed consist of implantable transmitter and receiver. Implantable
devices used to monitor various physiological parameters in mice, hamsters, rats,
rabbits, ferrets, dogs, cows, sheep, bears, and other species. Implant sites for pressure
telemetry can vary with the objectives of the study.
Implants that measure ECG have exible leads extending from the housing,
similar to those used in heart pacemakers. When measuring telemetered ECG, sens-
ing leads are placed under the skin at locations similar to the surface electrodes.
For EEG measurements, the transmitter leads can be connected to screw electrodes
or deep electrodes to monitor various sites within the brain. For EMG measure-
ments, the transmitter leads can be connected to ne-braided stainless steel wire to
be threaded through or buried in the muscle.
(7982)
Implants that measure tempera-
ture generally have a sensor imbedded in the electronics module. When measuring
core temperature, the device is often placed in the peritoneal cavity. Core body tem-
perature is a critical measure in studies of behavioral and physiological control of
metabolism and body temperature regulation.
(8386)
Activity measurements are de-
rived by the receiver and obtained by sensing changes in signal strength that occur as
the animal moves about its cage. Various biotelemetry systems have been developed
for small animals to record alterations in their autonomic and behavioral activity. The
major asset of telemetry method is the possibility of recording various parameters at
a time in the unrestrained, conscious animals. A wireless telemetry system to assess
heart rate, core temperature, and gross locomotor activity in freely moving rats while
performing a behavioral task. The telemetry system consists of a small implantable
transmitter, a receiver connected to a computer with data acquisition controlled by
a computer board and software package.
(8791)
Biotelemetry can be used for monitoring aquatic species in their natural envi-
ronment. Sustained direct observation of aquatic species is often impossible. Thus,
biotelemetry has become an increasingly important tool for studying the behavior
of shes. A combined acoustic and radio transmitting tag employing a dynamic con-
ductivity switch suitable for investigating the migratory behavior of diadromous sh
is described. The unique feature of the transmitter is its ability to sense the elec-
trical conductivity of the ambient water and therefore operate in the appropriate
signal mode. Under freshwater conditions the transmitter operates in radio mode, in
seawater it operates in acoustic mode.
(92)
Modern telemetry systems can gather many kinds of data, indicating which
animals are near telemetry receivers and what they are doing. Sharks were among
the rst marine animals to carry telemetry systems because of their size and the
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need to understand their interactions with humans. The examples show the parallel
progression of shark biology and acoustic biotelemetry illustrating that telemetry
systems are tools for gathering data.
(28)
Movement rates of sharks are oftenestimated
fromthe distance traveled by an animal over a certain time period, where the sharks
position is obtained from a telemetry device. This resultant speed is referred to as
rate of movement or point-to-point swimming speed. Instantaneous swimming speed
requires morecomplicatedandexpensivetransmitters tobeexternallyattached.
(29, 93)
Electromyographic (EMG) telemetry involves implantation of transmitters in
shthat relay muscular activity toaerial or submergedantennas andreceiver systems.
Muscular activity rates in free-swimming sh are used to describe upstream migra-
tions, spawning behavior, swimming performance and oxygen consumption, activity
associated with stressors such as temperature changes and metabolic rates and to
test bioenergetic models.
(9496)
Telemetered EMG signals indicate that muscle ac-
tivity varied signicantly for electrodes implanted at different longitudinal positions
along the sh. As a result, electrode placement is an important inuence affecting
the signals obtained from radio transmitters.
(97)
The monitoring of neural signals of
aquatic animals in the freely behaving condition is essential to understand the neu-
ral mechanism of their behavior. Underwater radio telemetry system is developed
to receive electroencephalographic (EEG) signals from the sh freely swimming in
freshwater areas. The system uses simple and generally available instrumentation
and is composed of a transmitter and a receiver. By using the system, EEG signals
are successfully received fromthe sh freely swimming in an outdoor pond.
(98)
Heart
rate telemetry has been utilized as a tool for the assessment of metabolic rate in wild
sh by a number of investigators. It is obvious that remote monitoring of heart rate
is a good indicator of physiological activity.
(99)
Animal movement and behavior is
remotely assessed within a wide range of environments characterized by water con-
ductivity and depth. The optimal mode of transmission is dependent upon ambient
conductivity and water depth and determined by the transmitters microprocessor
and sensing devices.
CONCLUSION
Biotelemetry systems have been used for about forty years and have become
a useful tool for obtaining bioelectrical and physiological data from humans and
animal species, and for monitoring these variables as well. Biomedical telemetry
is a special area of biomedical instrumentation that permits transmission of phys-
iologic information from an inaccessible location to a remote monitoring site. The
goal of biotelemetry include the capability for monitoring humans and animals with
minimum restraint and to provide faithful reproduction of the transmitted data.
Biotelemetry is a reliable tool for data gathering and with the invention of inte-
grated circuit technology in 1958 contributions of microelectronics to biomedicine
and health care have been enormous. Many advanced diagnostic, therapeutic, and
rehabilitative devices andsystems wouldnot have beenpossible without these contri-
butions. Miniature and micropower are two concepts of modern biotelemetry design
and construction. Improvements in these areas have closely paralleled the evolution
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Biotelemetry 175
of semiconductor and microcircuit technologies. Size, cost, circuit complexity, power
requirements (and operational lifetime), packaging, transducers, nature of data to
be transmitted, and performance are important in the design of a backpack or im-
planted biotelemetry unit. It seems likely that future development will be in the
further miniaturization and integration of biotelemeters and transducers, improved
power sources, and improved packaging. Techniques and applications of biotelemet-
ric methods continue to expand and seem to be limited only by the imagination of
the investigators using new technologies as they evolve. Since the rapid growth in
technology different applications of biotelemetry could be used for data gathering
from a remote location.
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