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, under stated parameter assumptions, 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, under these modeling assumptions EQS-HBC could, in principle, support 1 kSps, 16-bit equivalent continuous streaming at [Formula: see text] ([Formula: see text] more energy-efficient than RF) while remaining within safety standards and preserving [Formula: see text]-year lifetime, outlining design guidance for future implantable cardiac devices.