Ultra-low power system for atrioventricular synchronization using leadless pacemakers

Leadless cardiac pacemakers (LCP) are the cutting-edge technology of cardiac rhythm management (CRM), reducing complication risks and treatment invasivity. Current leadless cardiac pacemakers can only pace a single location of the heart, limiting their use to a small fraction of the bradycardia patient population. A dual-chamber system of synchronized leadless cardiac pacemakers is required to cover the major part of bradycardia patients. The power consumption relating the synchronization of pacemaker nodes is one of the major technological challenges preventing the rise of dual-chamber leadless cardiac pacemaker systems. Intra-body communication (IBC) is considered a suitable technology for leadless cardiac pacemaker applications, in terms of both power and size optimization. In this work, we suggest a power-optimized method for atrioventricular synchronization (AVS). First, we estimated the channel loss for intra-cardiac intra-body communication signals using quasi-static simulations. This was an essential study to define the specification limits of intra-body communication transceivers for atrioventricular synchronization. We then designed a superregenerative receiver (SRR) in 0.18 μm CMOS technology. The power consumption of the superregenerative receiver circuit was further optimized using a communication strategy for the atrioventricular synchronization application, achieving levels of power consumption as low as 340 nW. This study showed the feasibility of atelemetry-based synchronization of dual-chamber leadless cardiac pacemaker systems while minimizing the impact on the device's longevity.