Leadless Pacemakers: Past, Present, and Future—A Review of Antennas and Wireless Power and Data Telemetry

The leadless cardiac pacemaker is a revolutionary device for bradycardia patients. It is a single-component, capsule-type implantable medical device that corrects the heart's electrical function when the heart rate falls below the standard value of 60 beats per minute. The remote monitoring feature enables the leadless pacemaker to monitor bradycardia patients’ heart health, and it is only possible due to the ultra-compact antenna of the implantable leadless pacemaker's biotelemetry system. This article reviews the leadless pacemaker's antennas for biotelemetry and power telemetry systems, the importance of intra-cardiac communication for dual-chamber leadless pacemakers, and future requirements of leadless pacemaker antennas. Considering the real-time device architecture, some crucial aspects of antenna design in the simulator are given by briefing the research conducted to date. Furthermore, experimental verification of the antenna's functioning in the cardiac environment is also provided by summarizing different approaches used by previous studies. Dual-chamber leadless pacing communication and the requirement of leadless pacemaker antennas in 5G/6G IoT healthcare environment are also briefly discussed.