Continuous Monitoring in Implantable Cardiac Devices: Electro-Quasistatic Human Body Communication– Challenges and Opportunities

Cardiovascular diseases are the leading cause of global mortality, with millions of patients relying on implantable pacemakers. Finite battery energy fundamentally limits remote monitoring. Using open-source manufacturer longevity data we develop an energy-balance model to show a stringent ≈130 J/year communication budget, too low for continuous monitoring with conventional RF links. We investigate electro-quasistatic human body communication (EQS-HBC) as an alternative physical layer for pacemakers, combining a systematic review of implant-grade transceivers with a proof-of-concept channel feasibility study in a human-torso phantom. Our analyses indicate that EQS-HBC could, in principle, support 1 kSps, 16-bit equivalent continuous streaming at ≈ 2 μW (> 100× more energy-efficient than RF) while remaining within safety standards and preserving > 14 year lifetime, outlining design guidance for future implantable cardiac devices.