Abstract Electronic visual prostheses, or biomimetic eyes, have shown the feasibility of restoring functional vision in the blind through electrical pulses to initiate neural responses artificially. However, existing visual prostheses predominantly use wired connections or electromagnetic waves for powering and data telemetry, which raises safety concerns or couples inefficiently to miniaturized implant units. Here, we present a flexible ultrasound-induced retinal stimulating piezo-array that can offer an alternative wireless artificial retinal prosthesis approach for evoking visual percepts in blind individuals. The device integrates a two-dimensional piezo-array with 32-pixel stimulating electrodes in a flexible printed circuit board. Each piezo-element can be ultrasonically and individually activated, thus, spatially reconfigurable electronic patterns can be dynamically applied via programmable ultrasound beamlines. As a proof of concept, we demonstrate the ultrasound-induced pattern reconstruction in ex vivo murine retinal tissue, showing the potential of this approach to restore functional, life-enhancing vision in people living with blindness. 

/pdf/flexible-ultrasound-induced-retinal-stimulating-piezo-arrays-14n8cc8l.pdf

Flexible ultrasound-induced retinal stimulating piezo-arrays for biomimetic visual prostheses

Cybersecurity: The need for data and patient safety with cardiac implantable electronic devices

Emerging Ultrasonic Bioelectronics for Personalized Healthcare

Are implanted electronic devices hackable

Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is an important part of patient follow-up. The increasing number of patients with CIEDs and the recent pandemic pose several challenges for already limited device clinic resources. This review focuses on recent evolutions in RM and identifies future needs to improve RM. RM has been associated with multiple clinical benefits, including improved survival, early detection of actionable events, reduction in inappropriate shocks, longer battery lives, and more efficient healthcare utilization. The survival benefit was driven by studies using alert-based continuous RM with daily transmissions and fast reaction times. Patients report a high satisfaction rate without significant differences in quality of life between RM and in-office follow-up. The increasing workload, due to the increasing number of CIEDs implanted with daily remote transmissions, results in several challenges for the future of RM. RM requires appropriate reimbursement for RM device clinics to optimize patient/staff ratios, including sufficient non-clinical and administrative support. Universal alert programming and data processing may minimize inter-manufacturer differences, improve the signal-to-noise ratio, and allow the development of standard operating protocols and workflows. In the future, programming by remote control and true remote programming may further improve remote CIED management, patient quality of life, and device clinic workflows. RM should be considered standard of care in management of patients with CIEDs. The clinical benefits of RM can be maximized by an alert-based continuous RM model. Adapted healthcare policies are required to keep RM manageable for the future. 

/pdf/remote-patient-monitoring-what-have-we-learned-and-where-are-30tv37d5.pdf

Remote Patient Monitoring: What Have We Learned and Where Are We Going?

In August 2016, Muddy Waters LLC released a short-sell report outlining potential cybersecurity vulnerabilities in several St. Jude Medical (now Abbott) pacemaker models following a demonstration of a "crash attack" and a "battery drain attack" by vulnerability research firm MedSec. 1 The motivation behind the release of this report does not appear to have been focused on patient safety; rather than inform Abbott or the US Food and Drug Administration (FDA) directly, the information was released to the public sector. 2 This event was followed by a safety communication issued by the FDA in January of 2017 describing the vulnerabilities and informing the public of a software patch. 3 Shortly after, the FDA issued a warning letter to Abbott in April of 2017. In response to these events, Abbott released a firmware upgrade with enhanced cybersecurity. Installation of this firmware upgrade is non-invasive and takes a few minutes to complete. During the installation procedure the pacemaker may temporarily change its pacing mode, leaving open the possibility that patients may become symptomatic during the upgrade. 4

Pacemaker Cybersecurity: Local Experience With a Firmware Upgrade.

Close-coupled pacing to identify the “functional” substrate of ventricular tachycardia: Long-term outcomes of the paced electrogram feature analysis technique

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Pacemaker Cybersecurity: Local Experience With a Firmware Upgrade.

Close-coupled pacing to identify the “functional” substrate of ventricular tachycardia: Long-term outcomes of the paced electrogram feature analysis technique