Multimodal, Porous, Starfish-Like Soft Wearable Bioelectronic Systems for Motion-Artifact-Resilient, Real-Time and High-Accuracy Cardiac Monitoring - Project Summary Heart disease is the leading cause of death in the U.S., accounting for ~655,000 deaths annually and over $219 billion in healthcare costs each year. Continuous ambulatory monitoring with wearable devices is vital for early detection, prevention of life-threatening events, and reducing healthcare burdens. However, existing heart mon- itors face three critical limitations: (1) they primarily focus on cardiac electrical activity via electrocardiography (ECG) and lack the ability to assess mechanical function (e.g., seismocardiography, SCG and gyrocardiography, GCG), restricting diagnostic depth and overall accuracy; (2) they perform reliably at rest but are prone to motion artifacts, limiting their utility during daily activities; and (3) they are typically made from nonporous materials with poor long-term biocompatibility, often leading to discomfort, skin irritation, inflammation, and even infections over long-term wear, reducing user adherence. Together, these limitations hinder reliable, continuous cardiac moni- toring throughout daily life—an essential feature given that cardiac events can occur unpredictably at any time. To address the challenges, this project aims to develop multimodal, porous, starfish-like, soft wearable systems for high-fidelity recordings of cardiac electrical (five-electrode ECG) and mechanical (SCG and GCG) biosignals even during motion, enabling real-time, continuous, reliable monitoring of heart conditions across daily activities. The device features a pentaradial, starfish-like configuration with five free-standing arms, each equipped with sensing elements (electrodes and accelerometer-gyroscopes) at its tips (sensing pads), all connected to a cen- tral electronic hub. This device configuration minimizes mechanical coupling at the system level, ensuring high- fidelity cardiac biosignal acquisition during motion when combined with signal compensation and machine learn- ing (ML)-driven data processing. The five-electrode recording configuration enables 7-channel ECG data collec- tion, while SCG and GCG offer complementary mechanical insights, providing a holistic view of cardiac function and enhancing diagnostic accuracy. ML algorithms on smartphones will process the data in real time, enabling timely and accurate heart condition diagnosis. Our innovative multifunctional porous soft materials will serve as the skin-interfaced device substrate, ensuring long-term biocompatibility and user comfort. Atrial fibrillation (AFib) will be used as the disease model to validate our approach. During our preliminary studies, we have developed the proposed device using polyimide as substrates and initially verify its ability to record high-fidelity cardiac electrical and mechanical signals during motion and to improve heart disease diagnostic accuracy using three cardiac signal types as inputs for ML models. Building on this promising foundation, we aim to fully achieve our research objectives through two specific aims: (i) develop multimodal, starfish-like wearable cardiac monitors with our innovative multifunctional porous materials and evaluate their performance on 20 healthy individuals during motion and over 7-day wear; and (ii) evaluate the device on 20 AFib patients during motion and over 7- day wear and investigate heart disease diagnosis using multimodal cardiac signals as inputs for ML models.
