A Systematic Review of Design of Electrodes and Interfaces for Non-Contact and Capacitive Biomedical Measurements: Terminology, Electrical Model, and System Analysis.

With the advent of ubiquitous healthcare and advancements in textile industry, non-invasive wearable biomedical solutions are becoming an increasingly attractive alternative to in-hospital monitoring, allowing for timely diagnostics and prediction of severe medical conditions. Non-contact biopotential monitoring is particularly promising because non-contact biopotential electrodes can be applied over clothing or embedded in the material without almost any preparation. However, due to the intricacies of capacitive coupling they rely on, the design of such electrodes and their interface with the body plays a key role in achieving measurement repeatability and their widespread utilization in clinical-grade diagnostics. Based on exhaustive investigation of several decades of the literature on non-contact and capacitive biopotential electrodes and electric potential sensors, this study is intended to serve as a state-of-the-art overview of their historical development and design challenges, a collecting point for important research theories and development milestones, a starting point for anyone seeking for a soft head start into this research area, and a remedy for occasional misnomers and conceptual errors identified in the existing papers. The ultimate goal of this comprehensive analysis is to demystify phenomena of non-contact biopotential monitoring and capacitive coupling, systematically reconciliate terminological inconsistencies, and enhance accessibility to the most important findings for future research. To accomplish this, fundamental concepts are thoroughly revisited-from fundamentals of electrochemistry and working principles of capacitors and operational amplifiers to system stability and frequency-domain analysis. With the use of various mathematical tools (Laplace transform, phasors and Fourier analysis, and time-domain differential calculus), discussions on non-contact and capacitive biopotential electrodes, collected from the 1960s onward, are for the first time compiled into a unified, abstracted, bottom-up analysis. The laid-out inspection provides analytical explanation for various aspects of measurement results available in the referenced literature, but also serves an educative purpose by devising a methodological framework that can be easily applied to other similar research fields. Firstly, the differences and similarities between wet, dry, surface-contact, non-contact, capacitive, insulated, on-body, and off-body biopotential electrodes are clarified. For this purpose, equivalent electrical models of various non-invasive biopotential electrodes are analyzed and compared. As a result, a proposal for a revised classification of biopotential electrodes is given. Secondly, instead of using the concept of a purely capacitive biopotential electrode, a test is proposed for assessing the predominant coupling mechanism achieved with an electrode over an insulating layer. Thirdly, a fundamental model of a buffer active non-contact biopotential electrode and its interface with the body is built and generalized, and the proposed test is applied for analyzing the influence of voltage attenuation and phase shifts on signal morphology. Lastly, guidelines for designing the described electrode-body interfaces are proposed, along with a discussion on practical aspects of their implementation.