MODULE – 2

Heart and Cardiovascular System

Heart is considered as a 2-stage pump – arranged in parallel with blood passing through pumps
in a serial sequence.

Right Heart acts as a pump that supplies blood to rest of the system

Circulatory path for blood flow through the lungs Pulmonary Circulation

Circulatory system that supplies oxygen and nutrients to cells of body System circulation

Engineering point of view

Systemic circulation is a highly resistive circuit with large pressure gradient between arteries
and veins

Pump forming the left heart may be considered as pressure pump.

Pulmonary circulation is a low resistance circuit with small pressure difference between arteries
and veins – Right heart is a volume pump

Muscle contraction of left heart is larger and so greater pressures are required for systemic
circulation

Volume of blood delivered per unit time by the two sides is the same

Pumping action is performed by contraction of heart muscles surrounding each chamber of
heart.

Muscles receive their own blood supply from coronary arteries – surrounding the heart like a
crown.

Arteries and veins are flexible and can control blood circulation by their own muscular action
and their own valve and receptor system.

The Cardiovascular System

1

Blood enters heart on right side through 2 main veins:

Superior Vena cava – which leads from the body’s upper extremities and

Inferior Vena Cava –Leading from the organs and extremities below the heart

Incoming blood fills the storage chamber – Right atrium

In addition to the 2 main veins, coronary sinus also empties the right atrium

When right atrium is full – it contracts and forces blood through tricuspid valve into right
ventricle – it then contracts to pump the blood into pulmonary circulation system

When ventricular pressure > Atrial pressure Tricuspid valve closes and pressure in ventricle
forces the semi lunar pulmonary valve to open  Causing blood to flow into pulmonary artery
that divides into two lungs

In alveoli of lungs, exchange takes place.

RBC are recharged with oxygen and give up their carbon dioxide

Pulmonary arteries divide many times into smaller and smaller arteries – which becomes
arterioles with small cross section

Arterioles supply blood into alveolar capillaries – Exchange of oxygen and carbon dioxide
takes place here

On other side of lungs – capillaries feed into tiny veins or venules – Combines to form larger
veins – Combines until all oxygenated blood is returned to heart via pulmonary vein.

Cardiovascular Circulation

2

Blood enters left atrium from pulmonary vein – then pumped through mitral or bicuspid valve,
into left ventricle by contraction of atrial muscles

When left ventricular muscles contract – Pressure produced by contraction mechanically closes
mitral valve.

Build-up of pressure in ventricle forces the aortic valve to open – Causes the blood to rush from
ventricle into aorta

Heart’s pumping cycle divided into 2 major parts:

Systole – Period of contraction of heart muscles at which the blood is pumped into
pulmonary artery and aorta

Diastole – Period of dilation of heart cavities as they fill with blood.

Once blood has been pumped to arterial system – Heart relaxes – pressure in the chamber
decreases – Outlet valves close – After a short time, the inlet valve opens again to restart the
diastole and initiate a new cycle in heart

After passing through many divisions of arteries – Blood reaches the main organs – Brain &
extremities

Last stage of arterial system- Gradual decrease in cross section and increase in the number of
arteries until smallest type (Arterioles) is reached

Arterioles feed into the capillaries – where oxygen is supplied to cells and carbon dioxide is
received from cells

Capillaries join into venules – which becomes smaller veins, then large veins and at last forms
superior and inferior vena cava.

Blood supply to heart is from the aorta through the coronary arteries into a capillary system to
cardiac veins.

Blood returns to heart chambers through coronary sinus.

Heart beats at an average rate of about 75 beats per minute in a normal adult

Heart rate increases when a person stands up and decreases when he sits down – Range varies
from 60 to 85

Heart rate is higher in women and generally decreases with age

In an infant – heart rate may be as high as 140 beats per minute

Heart pumps about 5 litres of blood per minute

At any given time, 75to 80% of blood volume is in the veins and about 20% in arteries

Systolic (Maximum) blood pressure – Range of 95 to 140 mm Hg, with 120 mm Hg being
average

Normal diastolic blood pressure (lowest pressure between beats) – Range from 60 to 90 mm
Hg, Average value of 80mm Hg

3
Electrocardiography (ECG)

Graphic recording or display of the time variant voltages produced by myocardium during
cardiac cycle.

P, Q, R, S and T wave reflects the rhythmic electrical depolarization and repolarization of
myocardium due to contractions of atria and ventricles.

Used to clinically diagnose various diseases and conditions associated with heart.

Block Diagram of ECG Machine

Lead Selector Switch

The potentials picked up by the patient electrodes are taken to the lead selector switch. Here
the electrodes are selected two by two according to the lead program.

Preamplifier

The signal from lead selector switch given to preamplifier.

A preamplifier is an electronic amplifier which prepares an electronic signal for further
amplification or processing.

It is usually 3 or 4 stage dual input unbalanced output differential amplifier.

4

Power Amplifier

It is a push pull differential amplifier.

Single ended output from preamplifier is given to power amplifier.

Another input is from frequency selective network.

Output is single ended

The output of the power amplifier is fed to the pen motor which deflects the writing arm
of the paper.

Frequency selective network is an R-C network, which provides necessary damping of the
pen and is pre-set by the manufacturer.

Auxiliary Circuits

The auxiliary circuits provide a 1 mV calibration signal and automatic blocking of the
amplifier during change in the position of the lead switch.

It also includes a speed control circuit for the chart driver motor

Standby mode is provided on ECG – Stylus moves in response to input signals but paper is
stationary Allows the operator to adjust position and baseline position controls without
wasting paper.

Analysis of ECG Signals

The recording of electrical activity associated with the functioning of the heart is known as
electrocardiogram.

It’s a quasi-periodical, rhythmically repeating signal synchronized by the function of the heart,
which act as a generator of bioelectric events.

This generated signal can be described by means of an electric dipole. i.e. pole consisting of
positive and negative pair of charge.

P wave – Base line or Isopotential line  Depolarization of auricles

QRS Wave – Repolarization of atria and depolarization of ventricles
T wave – Ventricular Repolarization

5
Normal values for an ECG signal

Amplitude:

Duration

Normal value of heart rate varies from 60 to 100 beats per minute

Slower rate than normal Bradycardia (Slow heart)

Faster rate than normal  Tachycardia (Fast heart)

Then, the doctor would see if cycles are evenly spaced – if not it is arrhythmia

If P-R interval > 0.2 sec  Blockage of AV node

If one or more of the basic feature is missing – Heart block may be indicated

Position of the heart within thoracic region of body as well as position of body itself influences
the “electrical axis” of the heart

Electrical axis – Line along which the greatest electromotive force is developed at a given
instant during the cardiac cycle

It shifts continuously through a repeatable pattern during every cardiac cycle.

Under pathological conditions, several changes may occur in ECG

Altered paths of excitation in the heart

Changed origin of waves

Altered relationship (sequences) of features

Changed magnitudes of one or more features

Differing durations of waves or intervals

6

Electrocardiograph is the instrument tool used fir diagnostics of cardiac disorders

But arrhythmias cannot be diagnosed using ECG – for which angiography and
echocardiography can provide the information not available in ECG.

Electrodes and Leads

To record ECG, a number of electrodes (usually 5) are affixed to the body of the patient

Electrodes are connected to the ECG machine by the same number of electrical wires

Electrodes to which the connection is made – Leads

For recording of ECG, 2 electrodes or one electrode and an interconnected group of electrodes
are selected and connected to the input of recording amplifier

Lead – Particular group of electrodes

Electrode – Individual lead wire as well as physical connection to the body of patient

Voltage generated by the pumping action of heart is a vector whose magnitude as well as
spatial orientation changes with time

ECG signal is measured from electrodes applied to surface of the body – Waveform is
dependent on the placement of electrodes

Some of the segments disappear and some may appear clearly. For this reason – normal ECG
uses usually 12 different leads to ensure that no information is missed.

Electrodes

Einthoven found it advantageous to record the ECG from electrodes placed vertically as well
as horizontally on the body
7

In early times, patients were made to place both arms and one leg into earthenware crocks used
as immersion electrodes

Left leg was selected - as it terminates vertically below the heart

With the introduction of electronic amplifier – an additional ground reference was required

Free right leg was used for that purpose

Chest electrode was introduced later – Normally suction type. Others are plate electrodes.

ECG Lead Configurations

To record ECG 12 electrodes connected to the body of the patient.

Electrodes connected to ECG machine using wires called leads.

Leads are electrodes which measure the difference in electrical potential between either:
1. Two different points on the body (bipolar leads)
2. One point on the body and a virtual reference point with zero electrical potential, located
in the centre of the heart (unipolar leads)
Classification
1. Standard Limb Leads or Bipolar Leads or Einthoven Leads : I, II & III
2. Augmented Limb Leads (Unipolar): aVR, aVL & aVF
3. Precordial Leads: V1- V6

Standard Limb Leads or Bipolar Limb Leads or Einthoven Leads : I, II & III

Standard Limb Leads are used to display a graph of the potential difference recorded between
two limbs at a time.

In these leads, one limb carries a positive electrode and the other limb, a negative one.

The three limb electrodes, I, II and III form a triangle (Einthoven’s Equilateral Triangle), at
the right arm (RA), left arm (LA) and left leg (LL).

8

Called as bipolar because each lead data is recorded from 2 electrodes and third electrode is
not connected

In each of the 3 lead positions – R wave is positive

Einthoven told that any given instant of cardiac cycle, electrical activity is a 2D vector

ECG measured from any one of the three basic limb leads is a time variant single dimensional
component of the vector

Einthoven made the assumption that heart (origin of the vector) is near the centre of an
equilateral triangle.

Apexes of triangle are right and left shoulder and crotch (part where legs join together)

Assumption – ECG potential at shoulders are same as the wrists. Potential at crotch slightly
differ from that at either ankle.

Einthoven Triangle

9
• Sides of the triangle represent the lines along which 3 projections of ECG vector are measured.
• Einthoven showed that the instantaneous voltage measured from any one of the 3 limb lead
position is approximately equal to algebraic sum of other two.
• Or vector sum of projections on all three lines is equal to zero.
• For the statements to be true, polarity of lead II measurement must be reversed.
• Lead II produces greatest R wave potential = Sum of R wave amplitudes of leads I and II

Unipolar Limb Leads

• Introduced by Wilson in 1944
• ECG is recorded between a single exploratory electrode and the central terminal, which has a
potential corresponding to centre of the body
• Central terminal is obtained by connecting the 3 active limb electrodes together through
resistors of equal size
• Potential at the connection point corresponds to average of potentials at the 3 electrodes
• Unipolar limb leads  One of the limb electrode is used as an exploratory electrode as well
as electrode contributing to the central terminal
• It results in an ECG signal with small amplitude
• Augmented unipolar limb leads or Averaging leads  Limb electrode used as an exploratory
electrode is not used for the central terminal – Increases the amplitude of ECG signal
• Leads – aVR, aVL and aVF (F for foot)

Augmented Unipolar Limb Leads

10
Unipolar Chest or Precordial Leads

Single chest electrode is sequentially placed on each of the pre-designated positions of chest

Chest positions are called precordial unipolar leads, and is designated as
 
 .

All three active limb electrodes are used to obtain central potential while a separate chest
electrode is used as exploratory electrode

V1 = Fourth intercostal space, at right internal margin

V2 = Fourth intercostal space, at left internal margin
V3 = Midway between V2 and V4
V4 = Fifth intercostal space at mid-clavicular line
V5 = Same level as V4, on anterior axillary line
V6 = Same level as V4, on mid axillary line

11
 ECG Recording Principles

Connecting wires of the patient electrodes originate at the end of a patient cable and the other
end which plus into ECG recorder

Wires from the electrodes connect to the lead selector switch – Also selects the resistors
necessary for unipolar leads

Push button allows us to insert a standardization voltage of 1mV to calibrate the recorder

From the lead selector switch, ECG signal goes to a preamplifier – differential amplifier with
high CMRR

AC coupling is used to avoid problems with small dc voltages that may arise due to
polarization of electrodes

Preamplifier also provides a switch to set the gain

Preamplifier is followed by a dc amplifier called pen amplifier - Provides the power to drive
pen motor that records actual ECG trace.

Input of the pen amplifier can be accessed separately – with a special input jack at the rear side
of ECG recorder – Can be used to record the output of other devices such as Electromotograph
(Recording of Achilles Reflex)

Position Control on the pen amplifier – Possible to center the pen on recording paper

Modern ECG recorders uses heat sensitive paper and pen is an electrically heated stylus

Beside recording stylus – there is a marker stylus Actuated by a push button and allows the
operator to mark the lead being recorded at margin of ECG

Power switch has three positions

ON – Power to amplifier turned on, but paper drive is not running

RUN – Starts the paper driver

OFF – Turns off
12
Input Circuit of Modern ECG machine

To increase the input impedance and to reduce the effect of variations in electrode impedance
– Buffer amplifier is used for each patient lead

Transistors in the amplifiers are protected by a network of resistors and neon lamps from over
voltages that may occur when ECG is used during surgery in combination with high frequency
devices for cutting etc.

Modern ECG devices do not connect right leg of patient

Involves a summing network to obtain the sum of voltages from all electrodes and a
driving amplifier – Output of which is connected to right leg

Arrangement is to force the reference connection at the right leg of the patient to
assume a voltage equal to sum of voltages at other leads

Increases the CMRR of the system and reduces interference

13
Blood Pressure

It is an indicator of the working of cardiovascular system

Typical pressure values

Arterial system – 30 to 300 mm Hg

Venous System – 5 to 15 mm Hg

Pulmonary System – 6 to 25 mm Hg

Measurement of Blood Pressure

The systolic pressure is the maximum pressure in an artery at the moment when the heart is
beating and pumping blood through the body.

The diastolic pressure is the lowest pressure in an artery in the moments between beats when
the heart is resting.

If either one is raised, it means you have high blood pressure (hypertension).

Blood pressure measurement can be classified in to
1. Indirect
2. Direct

Direct Methods

Provides continuous and more reliable information about vascular pressure from probes or
transducers inserted directly into blood stream

Equipments are complex, causes disturbance to patients

If blood pressure readings are not taken at heart level – they should be compensated to
correspond to readings at heart level

Eg- If reading is taken at h mm below heart level, the reading is high due to weight of column
of blood h mm high (weight = ℎ)

For Hg,  = 13.6 / ; For blood,  = 1.055/
.

Ratio = . = 12.9
(   !" # $ !!)

Equivalent reading at heart level = %.&

If the manometer is above heart level, add the correction; if below, subtract the correction.
Direct Methods for monitoring Blood Pressure

Used when high degree of accuracy, dynamic response and continuous monitoring is required.

Used to measure the pressure in deep regions inaccessible by indirect means

Catheter or needle type probe is inserted through a vein or artery in area of interest

2 types of probe can be used
14

Catheter type probe – Probe in which sensor is mounted on the tip of the probe and
pressure exerted on this is converted into proportional electrical signals

Fluid filled catheter systems - Transmits the pressure exerted on the fluid filled column
to an external transducer – transducer converts exerted pressure to electrical signals –
It is then amplified and displayed or recorded
Indirect Methods for BP measurement
1. Auscultatory

Uses sphygmomanometer with a stethoscope.

Auscultatory comes from the Latin word “listening”.
2. Oscillometric

Method was first demonstrated in 1876

Involves the observation of oscillations in the sphygmomanometer cuff pressure
which are caused by the oscillations of blood flow, i.e., the pulse.
3. Ultrasonic
Indirect Method for Blood Pressure Measurement

Indirect measurement is done by the use of a cuff over the limb containing the artery

Technique was introduced by Riva-Rocci for the determination of systolic and diastolic
pressures

Initially, pressure in the cuff is raised to a level well above the systolic pressure so that flow
of blood is completely terminated

Pressure in the cuff is then released at a particular rate

When it reaches a level, which is below systolic pressure – Brief flow occurs

If the cuff pressure is allowed to fall further, just below diastolic pressure – flow becomes
normal.

Simple equipment, Very little discomfort, Less informative and Intermittent

Indirect method is also somewhat subjective, and often fails when the blood pressure is very
low (as would be the case when a patient is in shock).

15

Problem is to determine the exact instant at which artery just opens and when it is fully opened.

Method given by Kortkoff and based on sounds produced by flow changes is the method
normally used in conventional sphygmomanometers.

Sound first appears when cuff pressure falls just below systolic pressure.

Sound disappears or change its character at just below diastolic pressure

Sounds are picked up by using a microphone placed over an artery distal to the cuff

Sphygmomanometric technique is an ausculatory technique

It depends upon operator recognizing the occurrence and disappearance of Kortkoff sounds
with variation in cuff pressure.
DIFFERENTIAL AUSCULTATORY METHOD

Non-invasive method for accurately measuring blood pressure

Special cuff mounted sensor consisting of a pair of pressure sensitive elements is used

16

High frequency pulses are created
each time, the intra-arterial pressure
exceeds the cuff pressure

As long as cuff pressure exceeds
pressure in artery – artery is closed and
no pulse is generated

As soon as intra-arterial pressure
rises to a value which exceed cut off
pressure for a short time – artery opens
and a pulse is created

Once artery is open – Blood flows
though it giving rise to low frequency
pressure wave signal – Lasts till the arterial pressure again drops below the cuff pressure.

Each time artery opens, a signal is generated

Signal consists of slowly rising, low
frequency component (0.5-5Hz) with a fast pulse
(10-80Hz) superimposed on it

Signal denoted as A is transmitted from
artery to both sensor and air bag in cuff.

Due to air bag characteristics, high frequency
component is highly attenuated leaving only the
low frequency component

Only low frequency signal is transmitted to
side of sensor

Diastolic pressure – Value at which differential signal disappears

Differential sensor subtracts signal B from signal A – Cancelling out pressure wave
component and motion artefact signals.

17
Oscillometric Measurement Method

Advantages over auscultatory method

Not a sound based technique – Environmental noise levels does not affect
measurement

Does not require a microphone or transducer in the cuff – Placement of cuff is not
as critical as in Auscultatory method

Disadvantage of oscillometric as well as auscultatory

Excessive movement or vibration during measurement can cause inaccurate
readings or fail to obtain any reading at all

18
 Principle

An occluding cuff deflates
from a level above systolic
pressure

Artery walls begin to vibrate
or oscillate as the blood flows
turbulently through partially
occluded artery and

Vibrations will be sensed in
transducer system monitoring
cuff pressure

As the cuff pressure decreases, oscillations increase to a maximum amplitude and then
decreases until the cuff fully deflates and blood flows returns to normal

Cuff pressure at the point of maximum oscillations corresponds to the mean arterial pressure

Point above the mean pressure at which oscillation begin to rapidly increase in amplitude
Correlates with diastolic pressure

Method is based on oscillometric pulses (pressure pulses) generated in cuff during inflation and
deflation.

19

Blood pressure is usually determined by the application of mathematical criteria to the locus
or envelope formed by plotting a characteristic called oscillometric pulse index against
baseline cuff pressure.

Baseline cuff pressure at which the envelope peak (Maximum height) is regarded as Mean
Arterial Pressure (MAP)

Height based and slope based criteria is used to determine systolic and diastolic pressures.
Ultrasonic Doppler Shift Method

Based on ultrasonic detection of arterial wall motion

Doppler frequency can be expressed as:
2
$
∆( =
)*

∆( =Doppler frequency in Hz


$ = Velocity of object in m/s

)* = Carrier wavelength in m

For BP measurement, brachial artery is the object from where ultrasound gets reflected.

Arterial movement produces Doppler frequency shift.

*
)* =
(*

)* = Wavelength of carrier frequency in medium


* = Velocity of carrier frequency in medium (1480 m/sec in water)

(* = Carrier frequency in medium (2MHz)
1480
)* = = 0.74 × 10/ 
2 × 10

Doppler frequency is expressed as
2
$
∆( = = 2.7 × 10
$ 012)
0.74 × 10/

∆( varies directly with target velocity i.e. motion of brachial artery.

To measure BP, Doppler frequency shift due to snapping action of artery must be known

Arterial movement with opening and closing of artery is 5 X 10/ m assuming that snapping
action occurs in 0.1s(∆)

Arterial wall velocity is
∆3 5 × 10/

$ = = = 50 × 10/ /45
∆ 0.1

Artery motion Doppler frequency is
20
 ∆( 2.7 - 10
$ 2.7 - 10 - 50 - 10 13512

Instruments making use of ultrasonic Doppler shift principle for measurement of BP are based
on the detection of frequency shift due to back scattering from moving blood particles

BP measurement instrument

Filters out the high frequency reflections and

Senses the low frequency refractions originating from movement of relatively slow
moving arterial wall
Major Subsystems in Blood pressure monitor

Power Supply block

Converts incoming ac line voltage to several filtered and regulated dc voltages required
for pneumatic sub system

It is for inflating the occlusive cuff around the patient’s arm.

Control Subsystem

Signals turn on the transmitter in the RF and audio sub system – Generating a 2MHz
carrier – Given to the transducer located in the cuff

Transducer converts the RF energy into ultrasonic vibrations which pass into the
patient’s arms

Cuff pressure is monitored by the control sub system and when the pressure reaches
the pre set, further inflation of cuff stops

Audio circuit in the RF and audio sub system – Enabled by control subsystem signals
 Audio signals representing any Doppler frequency shift is thus able to enter the
control sub system logic
21

Control sub system signals the pneumatic sub system to bleed off cuff pressure at a
rate determined by pre-set bleed rate.

As long as brachial artery remains occluded, returned RF is same as that of transmitted
frequency

Till that point, there are no audio signals entering the control sub system

At systolic pressure – Occluded artery snaps open and arterial blood flow starts

Artery motion results in a Doppler shift in the returning ultrasonic vibrations

The signal is recognized as systolic by control sub system logic

Four valid artery returns must be recognized to accurately fix the systole

Pulses more than 125 msec wide or occurring more frequently than every 250 msec are rejected
by control sub system logic

Upper limit on patient’s heart rate – 240 bpm

Lower limit on patient’s heart rate – 24 bpm

At diastolic pressure, cuff pressure equals or slightly exceeds arterial wall pressure – Wall
snapping stops and Doppler shift is not seen in received RF signal.

Occlusive cuff is placed on the arm with an ultrasonic transducer on the arm over the brachial
artery

Cuff is inflated first to above systolic pressure and then deflated at a specific rate

Low energy ultrasonic beam at a frequency of 2MHz is transmitted into the arm

Portion of ultrasound i.e. reflected by the arterial wall shifts in frequency when wall of artery
moves

22

Above systolic, vessel remains closed – due to pressure in occluding cuff and the monitor
signals are not received.

As the cuff pressure falls to point where it is just overcome by brachial artery pressure – Artery
walls snap open

Opening wall movement – Corresponds to the occurrence of first Kortkoff sound – produces
a Doppler shift which is interpreted by logic in the instrument as Systolic and is displayed

With each subsequent pulse, similar frequency shift is produced until at the diastolic pressure,
artery is no longer occluded

Rapid motion suddenly disappears and Doppler shift becomes relatively small

Instrument notes the sudden diminution in the amplitude of Doppler shift and cuff pressure at
this point is displayed as diastolic pressure.

Doppler shift principle provides reliable BP measurements in severe hypertension states –
where no other indirect method of measurement is feasible.

Measurement of Blood Flow

An adequate supply of blood is necessary for all organs of the body.

Inadequate supply of blood is the cause for various diseases

Therefore, the ability to measure blood flow in vessel that supplies blood for a particular organ
would be adequate for diagnosing diseases.

Rate of flow of a liquid or gas in a pipe is expressed as the volume of the substance that passes
through pipe in a given unit of time.

Blood flow meters used in clinical and research applications are based on one of the following
physical properties:

Electromagnetic Induction

Ultrasonic transmission or reflection

Thermal Convection

Radiographic principles
Magnetic Blood Flow Meters

Based on the principle of magnetic induction

When an electrical conductor is moved through a magnetic field, a voltage is induced in the
conductor proportional to the velocity of motion.

Same principle can be applied when the moving conductor is a column of conductive fluid that
flows through a tube located in magnetic field

Permanent magnet or electromagnet positioned around blood vessel generates a magnetic field
perpendicular to direction of blood flow

23

Voltage induced in the moving blood column is measured with stationary electrodes located
on opposite sides of the blood vessel and perpendicular to the direction of magnetic field.
:;
5 = 6 7 × 8 . 39


where B = Magnetic Flux Density; L= length between electrodes and

u = Instantaneous velocity of blood

Slip on or C-type is applied by squeezing an excised blood vessel together and slipping it
through the slot of the probe.

Cannula Type Transducer

Blood flows through a plastic cannula around which magnet is arranged.

Contacts penetrate the walls of cannula

24

Type of transducer requires that blood vessel is cut and its end is slipped over the
cannula

Extracorpeal blood flow probe

Used in dialyzers

Magnetic blood flow meters
measure the mean blood velocity

Magnetic blood flow transducers
are also manufactured as
catheter-tip transducers

Electromagnet is located inside the catheter and it has electrodes at the outside

Output voltage of a magnetic blood flow transducer is very small – typically in the order of
micro volts

In early times, blood flow meters a constant magnetic field was used

Causes difficulties with electrode polarization and amplifier drift

To overcome this, all magnetic blood flow meters uses electromagnets that are driven by
alternating currents

But it creates another problem – Change of magnetic field causes transducer to act like a
transformer and induces error voltages that exceeds the signal levels by several magnitudes

For recovering the signal in the presence of error voltage, amplifiers with large dynamic range
and phase sensitive detectors have to be used.

To minimize the problem, several
different waveforms have been used
for magnetic current.

With sinusoidal magnetic current, the
induced voltage is also sinusoidal but
90 degrees out of phase with flow
signal

If magnetic current is in the form of
square wave – Induced voltage should
be zero once the spikes from polarity
reversal have passed.

Oscillator – Drives the magnet and provides a control signal for the gate

Operates at a frequency between 60 and 400 Hz

Use of gated detectors makes the polarity of output signal reverse when the flow of direction
reverses

Frequency response of the system is enough to allow the recording of flow pulses – Mean or
average flow can be derived by using LPF

25
Magnetic Blood Flow Meter with different channels

Ultrasonic Blood Flow Meters

A beam of ultrasonic energy is used to measure the velocity of flowing blood.

Blood cells in the fluid reflects ultrasound signal with a shift in ultrasonic frequency due to its
movement

Transit time velocity meter

Pulsed beam is directed through a blood vessel at a shallow angle and its transit time
is then measured

When blood flows in the direction of energy transmitted – Transit time is shortened

If it flows in opposite direction – Transit time is lengthened.

26

The transit-time ultrasonic flow meter is an
instrument designed for measuring the volume flow
rate in clean liquids or gases.

It consists of a pair of ultrasonic transducers
mounted along an axis aligned at an angle _ with
respect to the fluid-flow axis.

Each transducer consists of a transmitter–receiver pair, with the transmitter emitting ultrasonic
energy which travels across to the receiver on the opposite side of the pipe.

These ultrasonic elements are normally piezoelectric oscillators.

Fluid flowing in the pipe causes a time difference between the transit times of the beams
travelling upstream and downstream, and measurement of this difference allows the flow
velocity to be calculated.

The typical magnitude of this time difference is 100 ns in a total transit time of 100 μs, and
high-precision electronics are therefore needed to measure it.
<=4>?5
=
@?37=?
5A=B
<
=
 C 74 D

t = Transit Time

D = Distance between the transducers

c = Sound velocity

u = Blood Flow velocity
Doppler-shift Flow-Velocity Meters

Non-invasive technique to measure blood velocity in a particular vessel from the surface of
the body.
27

It is based on the analysis of echo signals from the erythrocytes in the vascular structures.

Because of the Doppler effect, the frequency of these echo signals changes relative to the
frequency which the probe transmits.

Doppler frequency shift is a measure of the size and direction of the flow velocity
Principle of Ultrasonic Doppler Shift Flow Velocity Meter

Incident ultrasound is scattered by the blood cells and the scattered wave is received by second
transducer

Frequency shift due to moving scatterers is proportional to the velocity of scatterers

Frequency shift due to moving scatterer is proportional to velocity

Change in frequency occurs when

Ultrasound arrives at scatterer

Ultrasound leaves the scatterer

If the blood is moving towards the transmitter, the apparent frequency f1 is given by
@ F G cos D
( = ( E K
@
f = Transmitted Frequency
C = Velocity of sound in blood
D = Angle of inclination of the incident wave to the direction of blood flow
v = Velocity of Blood cells

Assume incident and scattered radiations are both inclined at D to the direction of flow
@
(% = ( E K
@ L G cos D

Resultant Doppler shift is given by

28
 @
∆( ( F (% ( F ( E K
@ L G cos D

Therefore,
@ F G cos D @
∆( ( F(E KE K
@ @ L G cos D
0@ F G cos D
∆( ( M1 F N
0@ L G cos D

Since C >> v
2(G cos D ∆( . @
∆( ⇒G
@ 2( cos D

Equation is the basis for measuring blood velocity

Depending on application – either a signal proportional to average instantaneous velocity or
signal proportional to peak instantaneous velocity may be required.
Block Diagram of Ultrasonic Blood Flow Meters

Piezo-electric crystal A is electrically excited to generate ultrasonic waves, which enter the
blood.

Ultrasound scattered from the moving blood cells excites the receiver crystal.

Electrical signal received at B consists of a large amplitude excitation frequency component,
which is directly coupled from the transmitter to the receiver, plus a very small amplitude
Doppler-shifted component scattered from the blood cells.

Detector produces a sum of the difference of the frequencies at D

Low-pass filter selects the difference frequency, resulting in audio frequencies at E.

Each time the audio wave crosses the zero axis, a pulse appears at G.

The filtered output level at H will be proportional to the blood velocity.

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Oscillator operating at a frequency of several MHz – Excites a piezoelectric transducer

Transducer is coupled to the wall of an exposed blood vessel

Sends an ultrasonic beam with a frequency F into flowing blood

Small part of transmitted energy is scattered back and is received by a second transducer
arranged opposite to the first one

Scattering occurs mainly as a result of moving blood cells – Reflected signal has a different
frequency due to Doppler effect

Frequency is either F+FD or F-FD -- Depending on direction of flow

Doppler frequency FD is directly proportional to velocity of flowing blood

Fraction of transmitted ultrasonic energy however reaches 2nd transducer directly – with
frequency being unchanged

After amplification of composite signal – Doppler frequency can be obtained at the output of
detector as the difference between direct and scattered signal components

Doppler frequency is typically in low audio frequency range

Due to velocity profile of flowing blood – Doppler frequency is not a pure sine wave

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