Measurement of hemodynamic parameters such as stroke volume (SV) via impedance cardiography (ICG) is an easy, non-invasive and inexpensive way to assess the health status of the heart. We present a possibility to use this technology for monitoring risk patients at home. The IMPACT Shirt (IMPedAnce Cardiography Textile) has been developed with integrated textile electrodes and textile wiring, as well as with portable miniaturized hardware. Several textile materials were characterized in vitro and in vivo to analyze their performance with regard to washability, and electrical characteristics such as skin-electrode impedance, capacitive coupling and subjective tactile feeling. The small lightweight hardware measures ECG and ICG continuously and transmits wireless data via Bluetooth to a mobile phone (Android) or PC for further analysis. A lithium polymer battery supplies the circuit and can be charged via a micro-USB. Results of a proof-of-concept trial show excellent agreement between SV assessed by a commercial device and the developed system. The IMPACT Shirt allows monitoring of SV and ECG on a daily basis at the patient's home.

Impedance cardiography is a simple and inexpensive method to acquire data on hemodynamic parameters. This study analyzes the influence of four dynamic physiological sources (aortic expansion, heart contraction, lung perfusion and erythrocyte orientation) on the impedance signal using a model of the human thorax with a high temporal resolution (125 Hz) based on human MRI data. Simulations of electromagnetic fields were conducted using the finite element method. The ICG signal caused by these sources shows very good agreement with the measured signals (r = 0.89). Standard algorithms can be used to extract characteristic points to calculate left ventricular ejection time and stroke volume (SV). In the presented model, the calculated SV equals the implemented left ventricular volume change of the heart. It is shown that impedance changes due to lung perfusion and heart contraction compensate themselves, and that erythrocyte orientation together with the aortic impedance basically form the ICG signal while taking its characteristic morphology from the aortic signal. The model is robust to conductivity changes of tissues and organ displacements. In addition, it reflects the multi-frequency behavior of the thoracic impedance.

Athletes need a balanced body composition in order to achieve maximum performance. Especially dehydration reduces power and endurance during physical exercise. Monitoring the body composition, with a focus on body fluid, may help to avoid reduction in performance and other health problems. For this, a potential measurement method is bioimpedance spectroscopy (BIS). BIS is a simple, non-invasive measurement method that allows to determine different body compartments (body fluid, fat, fat-free mass). However, because many physiological changes occur during physical exercise that can influence impedance measurements and distort results, it cannot be assumed that the BIS data are related to body fluid loss alone. To confirm that BIS can detect body fluid loss due to physical exercise, finite element (FE) simulations were done. Besides impedance, also the current density contribution during a BIS measurement was modeled to evaluate the influence of certain tissues on BIS measurements. Simulations were done using CST EM Studio (Computer Simulation Technology, Germany) and the Visible Human Data Set (National Library of Medicine, USA). In addition to the simulations, BIS measurements were also made on athletes. Comparison between the measured bioimpedance data and simulation data, as well as body weight loss during sport, indicates that BIS measurements are sensitive enough to monitor body fluid loss during physical exercise.