Active implantable devices Knowledge of the working principles and of the most important characteristics of cardiac pacemakers, implantable cardioverter/defibrillators, loop recorders, phrenic nerve stimulators, stimulators for reducing rigidity and tremor in subjects affected by Parkinson’s disease, urological stimulators, stimulators for gastro/entero-paresis, and cochlear implants. Capability of understanding in detail the functional characteristics of the presented devices and related safety issues. This course contributes in improving students’ learning capabilities, since students will be instructed to deepen the knowledge on each product by using specific requirements, user manuals, and information that can be found on web sites of producers of medical instrumentation. Medical images Knowledge on the physical principles of medical imaging. Knowledge of the structure and technology of the devices for medical imaging. Knowledge of the diagnostic potentialities of each device and of its intrinsic limitations. Knowledge of the criticalities of each device also in relation to its acquisition and maintenance. Considering a specific medical imaging device, the student will be able to detail the degree of technological development and the corresponding market segment of the device. Furthermore, using the acquired knowledge on the technology, regulations and device market, the student will be able to draft technical documents for buying imaging devices. This course contributes to the development of autonomous judgement during the laboratory assignments. This course contributes to improve communication skills, both written and oral, through laboratories. This course contributes to provide students with tools for continuous learning, requiring the consultancy of web sites of the main producers of imaging devices. This activity is aimed to illustrate how it is possible, through the internet, to obtain the documentation for a preliminary market analysis of the technological state-of-the-art.

Both modules Students must be familiar with physics and electronics. The knowledge of the Medical Device Directive 93/42 and of the 47/2007 directive is an important prerequisite. Moreover, students must be familiar with the working principles of devices for biopotential detection and electrical stimulation with low and high energy. Moreover, students are supposed to know how to solve simple electrical circuits, and, finally, they should be familiar with the physiology of the most important organs and systems of the human body.

Implantable active devices During the lessons the teacher will present in detail the working principles and features of the devices listed below. For each device, specific design issues will be discussed. The evaluation of the feasibility of a device based on the possibility of obtaining the necessary power trough available power sources will be carried out. Implant procedures of most devices will be presented through movies that will be discussed and explained. - Power sources for implantable active devices: description, workings, and main characteristics. - Remote powering through transcutaneous coupling. - Bidirectional telemetry. - Physiology of excitable tissues: intensity-duration curve and its parameters. - Cardiac stimulators: output circuit and typical waveforms of cardiac stimulation, the electrical model of the stimulation catheter, main functions of a cardiac stimulator, the NBG code and different pacing modalities, pacemaker functions oriented to diagnosis and follow-up, magnetic resonance compatibility. Analysis of selected parts of the user manual of a stimulator. Three-chamber stimulators (resynchronization therapy). - Implantable cardioverters/defibrillators: introduction, clinical need, design of the capacitor charging circuit, longevity of a device. Statistical detection of an event, ROC curves, detection parameters. Detection of ventricular fibrillation (VF), ventricular tachycardia (VT), and fast ventricular tachycardia (FVT). VF, VT, and FVT therapies. ATP therapies. Post shock pacing. - CRT-D: introduction, clinical need, positioning of the left ventricle stimulation lead, multipoint stimulation and parameter selection. - ICM (loop recorder): introduction, clinical need, dynamic threshold for R-wave detection, detected episodes, episode detection, holter function, episode log, longevity and power issues. - Phrenic nerve stimulator: introduction, clinical need, stimulation parameters, longevity evaluation. - Urological stimulators: introduction, clinical need, implant procedures of electrodes, electrical stimulation of hyper- and hypo-active bladder. Stimulation parameters. - Stimulators for pain control: introduction, clinical needs, implant procedures for intrathecal electrodes, stimulation parameters. - Implantable pumps: introduction, clinical need, different kinds of pumps, energy issues, working modalities. - Deep brain stimulators: introduction, clinical need, implant procedures of electrodes, stimulation parameters, closed loop stimulation. - Gastro/entero-stimulators: introduction, clinical need, implant procedures, stimulation parameters. How to exploit the EGEG signal to verify the effectiveness of stimulation. - Cochlear implants: introduction, clinical need, physiology of the auditory system, typical solution, implant techniques. Medical images The course describes the most widely used devices for medical imaging, starting from the physical principles upon which they are based on. Therefore, for each class of devices, the student will be first introduced to the properties of each kind of energy used to obtain the image. Secondly, the student will analyze the technologies that, taking advantage of each type of energy-matter interaction, allow the clinicians to perform diagnostic imaging. The main topics are: - Introduction to medical imaging (2 h) - Planar radiological devices (8 h) - Devices for computed tomography and tomosynthesis (8h) - Nuclear medicine, scintigraphy, PET and SPECT devices (8h) - Ultrasonography and Doppler flowmetry (8h) - Devices for magnetic resonance imaging (10h) - Diagnostic applications (2h) - Regulations and device dimensioning (4h)

Implantable active devices The course consists of frontal lectures during which students are exposed at the description of different devices and exercise sessions during which they are requested to solve practical problems. Implant procedures are presented and fully commented. Medical images The course is organized in frontal lessons, class exercises, and laboratory activities. The laboratories are four, involve groups of four students and are distributed during the course delivery. It is necessary to deliver a report of each lab assignment. The lab activities focus on supplementary analyses of the theoretical notions learned during the lessons, specifically for what concerns the regulations and the technological upgrades of the different medical imaging devices. The class exercises are aimed to analyze in more details some aspects of technological and energetic dimensioning of the studied imaging devices.

Implantable active devices The teacher will provide students with all the material presented during the course: handouts, user manuals, and other materials to deepen the knowledge. Medical images Slides provided by the teacher and recently published scientific papers on specific techniques. Book recommended: "Bioimmagini", Valli e Coppini, Collana di Ingegneria Biomedica, Pàtron Editore.

Exam: Written test; Computer-based written test in class using POLITO platform;

Implantable active devices The final exam aims at evaluating the student capability of solving exercises similar to those presented during the exercise sessions and to critically elaborate the theoretical concepts presented during the lessons. The exam is a written test composed by two different parts: the first part consists of ten closed-answer questions and the second one consists of three open questions. The first part lasts 10 minutes and corresponds up to 6 points that are obtained by multiplying by 6/10 the score obtained as follows: each right answer increases the score by 1 point, each wrong answer decreases the score by 0,5 points, each question without an answer does not modify the score. The second part lasts 45 minutes and corresponds up to 27 points, up to 9 points for each exercise. Students are required to be over the threshold of 5,5/10 points relative to the first part and 15/27 points relative to the second part. The final score is obtained by summing the results of the first and the second part. It is then possible to reach 33 points. If the final score is higher than 30.5 the exam is passed with Laude. During the exam students are not allowed to use handouts, textbooks or any other material. Medical images The final exam aims at evaluating the student capability of solving exercises similar to those presented during the exercise sessions and to critically elaborate the theoretical concepts presented during the lessons. The written exam consists of four open questions, each of which is evaluated up to 8 points. The exam lasts 60 minutes. The lab reports, which summarize the group project, corrected and discussed, are overall evaluated up to 6 points. The final mark is calculated summing the four better marks among the five marks (four questions and the lab reports score). If the final score is higher than 30.5 the exam is passed with Laude. During the exam students are not allowed to use handouts, textbooks or any other material.

In addition to the message sent by the online system, students with disabilities or Specific Learning Disorders (SLD) are invited to directly inform the professor in charge of the course about the special arrangements for the exam that have been agreed with the Special Needs Unit. The professor has to be informed at least one week before the beginning of the examination session in order to provide students with the most suitable arrangements for each specific type of exam.