Developing a wearable medical device requires more than integrating electronics into a flexible patch. It demands a balance between signal quality, usability, manufacturability and clinical workflow. That challenge was central to the collaboration between Quad Industries and Pilotfish in the development of a next-generation ECG monitoring solution for EP Solutions. The project combined printed electronics, human-centered engineering and iterative development cycles to move from concept to a validated and scalable solution. For Quad Industries, this project illustrates how printed electronics can enable complex medical wearables that need both high technical performance and practical usability in clinical environments.
The clinical context behind the innovation
Cardiac rhythm disorders affect millions of patients worldwide. In therapies such as cardiac resynchronisation therapy, catheter ablation and pacemaker treatment, understanding how electrical activation spreads through the heart is essential for making better treatment decisions. One of the challenges in cardiac resynchronisation therapy is that a substantial share of patients still does not respond optimally, often because better spatial insight into the heart’s electrical activity is needed.
To improve outcomes, clinicians need access to high-quality data on cardiac activation pathways. That requires a solution capable of high-density electrode acquisition, full-torso coverage, reproducible positioning between patients, and low, consistent contact impedance. At the same time, the system also needs to remain practical in busy clinical settings where long setup times, poor anatomical fit and workflow disruption can limit adoption.
The challenge: turning a complex sensing concept into a clinically usable solution
From the start, this project asked for more than a functional patch. The hardware architecture had to support a large number of traces, defibrillation protection, radiopaque electrode markings, geometrical constraints, large patch sizes and robust soft-to-hard interfacing. These are exactly the kinds of challenges where wearable product development becomes technically demanding very quickly. On top of that, larger patch sizes also increase production complexity and create additional usability risks during application.
The challenge was therefore twofold. First, the solution had to perform technically at a high level. Second, it had to work smoothly in real-world use. In a clinical environment, even a technically strong system can fall short if it is too slow to apply, difficult to position or too dependent on operator experience. Pilotfish’s material makes that clear: technologies using hundreds of electrodes often face practical barriers related to time, fit, cost, reproducibility and workflow feasibility.
Collaboration between Quad Industries and Pilotfish
To address the hardware challenges of such a complex wearable system, printed electronics became a key enabling technology.
Quad Industries contributed its expertise as a printed electronics manufacturer with extensive experience in flexible electronics and smart patches. Their role focused on translating demanding product requirements into a technically feasible hardware architecture that could support large electrode arrays while maintaining flexibility and integration.
Printed electronics offered several advantages for this application:
- flexible electrode arrays that adapt to body contours
- integration of many traces within a compact architecture
- improved scalability for larger patch formats
- reduced need for fragmented electrode setups
Rather than relying on multiple discrete electrodes and complex cabling, the printed electronics approach allowed the development team to move toward a more integrated sensing architecture.
At the same time, Pilotfish contributed its expertise in Human Factors Engineering, focusing on usability and real-world application. Their human-centered design approach ensured that the solution would not only work technically, but also remain practical for nurses and clinicians operating in demanding clinical environments.
This multidisciplinary collaboration allowed both partners to address the full scope of challenges involved in advanced wearable development.
Solving the key development challenges
A key strength of the project was its iterative development approach.
Instead of committing to one concept early in the process, multiple design directions were explored and evaluated against criteria such as anatomical coverage, application speed, connector ergonomics and production feasibility.
Challenge 1: Managing patch complexity
The wearable patch needed to support a large number of traces, defibrillation protection, radiopaque electrode markings and robust soft-to-hard interfacing. Printed electronics made it possible to integrate these elements into a flexible architecture while maintaining system reliability and scalability.
Challenge 2: Ensuring good fit across anatomies
Human anatomy varies significantly between patients. Early testing showed that anatomical protrusions could reduce patch contact and affect signal quality. Geometry refinements, improved tab positioning and iterative testing across different body types helped ensure better surface contact and more stable measurements.
Challenge 3: Improving positioning consistency
Accurate placement across the torso is essential for reliable cardiac mapping. The design therefore incorporated anatomical references, visual markers and clear application guidance to improve reproducibility across users and patients.
Challenge 4: Making technology intuitive
The development process also focused on making the solution intuitive to use. Improvements in liner visibility, clearer peeling sequences and better visual cues helped reduce user errors and improve confidence during application.
The result: A robust and market-ready direction for advanced ECG monitoring
The collaboration resulted in a robust and validated direction for an advanced ECG monitoring solution.
The final system demonstrated several important improvements:
- fast application times of less than 10 minutes
- reliable anatomical coverage across a wide range of patients
- improved placement consistency and reduced user errors
- strong signal quality through stable electrode contact
- scalable patch architecture supported by printed electronics
Two patch sizes were sufficient to fit more than 95% of both male and female patients, helping simplify logistics while maintaining anatomical adaptability.
Beyond the technical results, the project demonstrates the importance of combining printed electronics expertise with usability-driven product development. For Quad Industries, the collaboration highlights how printed electronics can support complex medical wearable solutions from early concept stages through to validated product directions.
By integrating flexible electronics with a structured engineering process and human-centered design, the project shows how advanced sensing technologies can be transformed into solutions that are both technically sophisticated and ready for real clinical use.
Looking for a printed electronics partner for advanced wearable development?
Quad Industries supports medtech innovators in developing smart patches and flexible electronic solutions for advanced healthcare applications. From ECG monitoring systems to next-generation wearable devices, we help transform complex ideas into scalable printed electronics architectures that are ready for real-world deployment.
