A flexible PVDF sensor for forcecardiography

Forcecardiography (FCG) uses force sensors to record the mechanical vibrations induced on the chest wall by cardiac and respiratory activities. FCG is usually performed via piezoelectric lead-zirconate titanate (PZT) sensors, which simultaneously record the very slow respiratory movements of the chest, the slow infrasonic vibrations due to emptying and filling of heart chambers, the faster infrasonic vibrations due to movements of heart valves, which are usually recorded via Seismocardiography (SCG), and the audible vibrations corresponding to heart sounds, commonly recorded via Phonocardiography (PCG). However, PZT sensors are not flexible and do not adapt very well to the deformations of soft tissues on the chest. This study presents a flexible FCG sensor based on a piezoelectric polyvinylidene fluoride (PVDF) transducer. The PVDF FCG sensor was compared with a well-assessed PZT FCG sensor, as well as with an electro-resistive respiratory band (ERB), an accelerometric SCG sensor, and an electronic stethoscope for PCG. Simultaneous recordings were acquired with these sensors and an electrocardiography (ECG) monitor from a cohort of 35 healthy subjects (16 males and 19 females). The PVDF sensor signals were compared in terms of morphology with those acquired simultaneously via the PZT sensor, the SCG sensor and the electronic stethoscope. Moreover, the estimation accuracies of PVDF and PZT sensors for inter-beat intervals (IBIs) and inter-breath intervals (IBrIs) were assessed against reference ECG and ERB measurements. The results of statistical analyses confirmed that the PVDF sensor provides FCG signals with very high similarity to those acquired via PZT sensors (median cross-correlation index of 0.96 across all subjects) as well as with SCG and PCG signals (median cross-correlation indices of 0.85 and 0.80, respectively). Moreover, the PVDF sensor provides very accurate estimates of IBIs, with R² > 0.99 and Bland–Altman limits of agreement (LoA) of [−5.30; 5.00] ms, and of IBrIs, with R² > 0.96 and LoA of [−0.510; 0.513] s. The flexibility of the PVDF sensor makes it more comfortable and ideal for wearable applications. Unlike PZT, PVDF is lead-free, which increases safety and biocompatibility for prolonged skin contact.