Advanced writing and research, MSc Smart Systems Integration

A review of inductive-link-based implantable sensors for biomedical

applications
Constantino Migulez Pea, Muhammad Faizan, Heriot-Watt University

Abstract
The interest in development of implantable devices based on MEMS has grown rapidly over the last decade due to better
performance, reliability and longevity of an implant. The limiting factor in achieving long term sensing applications is the
communication and powering of an implant. Conventional sensors use wires for communication and battery as a power
backup but wires can lead to surgical complications and infections whereas the battery can induce chemical toxicity in
surrounding cells. This report reviews a wireless telemetry system employing inductive link coupling technique for
powering as well as communication with an implant. This technique has proven to be more efficient and reliable than
conventional techniques. It not only minimizes the threats to the host body but also reduces the overall size of an
implantable device which is one of the most critical parameter in designing of implants such as cardiovascular implants.
Inductive link is established by electromagnetic coupling of two coils that are used for wireless data and power
transmission from the external unit to the implanted unit. Adverse effects of EM wave absorption on biological tissues
and signal power are also reviewed, which can be solved by the proper selection of transmission frequency of the system.

1. Introduction

Implantable medical devices have revolutionized the course of medical field. Now a days, they are
considered as a solution to many medical problems. Implants or Bio MEMS devices are miniaturized
devices planted inside the living body used to replace or act as a fraction of or the whole biological
structure. These devices are also used for the continuous monitoring and reporting of different biological
variables of the human body. One of the most important features is self-sustainability of implantable device
for the intended duration of application. After implantation, a device has to survive harsh biological
environment of the host body, communicate with the outside world and harvest power for its necessary
functionalities.

One of the biggest challenges faced by an implantable device is to ensure a reliable bi-directional
communication between the implanted device and the external unit while harvesting power for sensing
operations. Conventional sensors use wires for communication with an external unit and batteries for
powering of circuitry but wires are main source of surgical complications such as infection, breakage and
immobility whereas batteries have limited lifetime, large size and can cause chemical toxicity in
surrounding tissues. In order to reduce the shortcomings of wired implants, extensive research has been
done in implementation of wireless Radio Frequency (RF) telemetry for communication between an
implant and an external unit. However, wireless communication requires more power to sustain a reliable
communication link due to electromagnetic wave absorption through biological tissues, which further
increases the need to find a reliable way of powering an implant.

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The best way to power an implant is to harvest energy from the ambient environment in which it resides.
Implants powered by harvested energy have longer lifetime, small size and better biocompatibility with
surrounding tissues than the conventional devices. There are two types of energies that can be harvested:
energy harvested from human body and energy harvested from biological environment, as shown in Figure
1. Types of energy that can be scavenged from human body includes kinetic energy (body motion) and
thermal energy (body temperature) which are generated by human activities such as walking, running and
sleeping but the size of kinetic and thermoelectric transducers is large, resulting in overall increase in the
size of an implant whereas the energies such as infrared, solar and electromagnetic energy which can be
scavenged from the ambient biological environment are considered as highly efficient and a permanent
replacement of batteries as a primary source of power for an implanted device. These energies are abundant
in nature and can easily be converted into useable electrical energy. The most efficient way to power an
implant is to wirelessly transmit electromagnetic energy through inductive link. . By using this technique,
implantable devices powered by RF radiation energy, scavenge the same electromagnetic wave energy that
was once used for communication only. The same circuitry of implantable device used for communication
will be used to harvest this energy. This significantly reduces the size and weight of an implant which is
one of the most critical parameters in designing the implantable devices.

This review outlines different components of telemetry system used for wireless communication and
powering of implantable sensor simultaneously. This technique eliminates the requirement for internal
power storage and wirings, and consequently, all the disadvantages mentioned above. Powering an implant
through inductive coupling is relatively a new topic of research. It has shown promising results in
biomedical applications where the battery of implant cannot be changed. It works on the principle of
mutual induction where external coil is electromagnetically coupled with the coil embedded under the skin.
An implantable system consists of two modules, an internal unit (implant) which resides inside the host
body and an external unit which is located outside the body, as shown in Figure 2. The main function of
external unit is to wirelessly transmit and receive information to and from the implant and deliver power to
implant through inductive coupling. An inductive link consists of two closely spaced primary and
secondary coils. Primary coil is a part of external unit which is placed outside the body and secondary coil
is mounted on an internal unit (implant). Usually these units are placed only few millimeters apart
separated by a thin layer of skin. An inductive link is established by generating a variable magnetic field
around the primary coil by means of an alternating current (AC). This changing magnetic field, through the
barrier of skin induces an electromotive force (EMF) in the secondary coil, resulting in generation of
alternating current (AC) in it. Rectifier is used to convert induced alternating current (AC) into direct
current (DC) by means of different topologies of diodes such as full wave rectification and half wave
rectification, depending upon the application of an implantable device. Voltage regulator is used to regulate
the exceeding voltage and protect the implant from overshooting. Direct current (DC) is passed through the
regulator, which normalizes the variations in the power supply and provides stable voltage to different parts
of sensors for necessary sensing operations. By using this technique, power from an external unit is
wirelessly transferred to an implanted unit through the body tissues. Typically, different types of magnetic
field modulations are used to utilize the same inductive link for data transfer. Data signal is impinged onto
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the same carrier signal used to power an implant and the signal variations such as amplitude, frequency and
phase variations are detected and interpreted by an implant. An implant is a fully automated electronic
system which contains biological, mechanical and optical components used to detect, collect and convert
biological parameters into electrical signals. These electrical signals are then modulated and sent to the
external unit where they are recorded and analyzed.

Figure 1

I.

Figure 2

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2. Challenges
2.1. Communication with the implant

In order to ensure the proper functionality of an implantable device, the external unit should be in contact
with the device at all times. The external device sends necessary instructions to the implant, where they are
processed by the interfaced circuitry and forwarded to the sensor which performs necessary functions.
Conventional implantable devices use transcutaneous wire for communication with external unit. Although
wired communication provides high throughput and greater reliability, it poses serious health hazards. The
wire not only restricts patient mobility but also causes many surgical complications and infections. It
increases the physiological response in the surrounding tissues resulting in the degradation of device
sensing capabilities. In some applications, ultrasonic waves are used for communication with implant but it
suffers from low efficiency. Novel approach to tackle this problem is to use inductive coupling in order to
wirelessly transmit and receive information. Special attention must be given while selecting the frequency
of communication because low frequency requires bigger antenna which increase the size of implant
whereas if high frequency is used for communication then EM wave absorption increases, resulting toxicity
in surrounding cells.

2.2. Powering of the device

Powering of implant is one of the most limiting factor in achieving long term sensing applications.
Permanent sensing requires more power for consistent monitoring of biological variables of the host body.
Extensive research has been carried out to find a permanent and safe solution to power an implant.
Currently, implants are powered by three ways: permanent battery, rechargeable battery and external power
source. Battery as a power source poses serious threats to human body. Firstly, the battery is large and
heavy and makes an implant unreliable. Secondly, they have limited lifetime and chemical side effects.
Permanent batteries require expensive surgeries to replace the discharged batteries whereas rechargeable
batteries require connectors and wires attached to human body which lead to wound infections. Powering
implant via wireless external source is highly effective and it significantly reduces the size of an implant by
utilizing same system components for communication as well as for powering of an implant but patient has
to follow strict protocols to keep implant functional.

3. Description of an inductive link powered sensor system

There are many different possible ways to implement inductive link based biomedical sensors, however, all
of them consist of at least two units: a sensor unit which is placed inside the body and senses biological
parameters and an external unit, which when placed near the skin, communicates with the implanted
device, remotely powering through the resonant inductive link.[1]

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In a resonant inductive link, energy is wirelessly transferred within two axially aligned coils which are
tuned to resonate at the same frequency. This configuration operates as an air core transformer where one
of the coils is placed inside the human body, called secondary, while the other coil is located inside the
external transceiver, the primary, which operates near the skin.[2] Since both of the implanted and the
external units contain either the primary of secondary coil of the inductive link, they are also called primary
and secondary units, referring to the external and internal device respectively.[3]

The primary unit generates an alternating magnetic fields, when it is approximated to a place outside the
body and near the spot where the secondary unit is implanted, it induces a electromotive force across the
coil of the secondary unit, which is used to wirelessly power the implanted sensor by transmitting energy
through the bodys tissues. By using this technique it is possible to transmit data from the external unit to
the implanted device (downlink transmission) and from the implant to the external unit (uplink
transmission).[4]

Regarding communication with the implant, there are two types of implementations, one is using
bidirectional communication, both downlink and uplink transmission, or uplink transmission only from the
implant to the external unit.[5]

Figure 3 Schematic representation of an inductive link performing bidirectional communication [3]

In many designs of inductive link implanted sensors, downlink transmission is performed by amplitude
modulation of the current in the primary coil, this is called amplitude shift keying (ASK), which requires
simple circuitry. Uplink communication is achieved by using Load Shift Keying modulation (LSK) [6],
systems using LSK are commonly called backscatter systems because this modulation technique is based in
the impedance change of the secondary that is reflected back to the primary when the secondary unit is
excited, being detected as a change in the flowing current through the coil. Consequently, the implanted
unit has the lowest power consumption, making this type of implementation optimal for the design of low
invasive implantable sensors. [3] [1] 6][7]

The communication is set up in half duplex transmission, which means that communications takes place
only in one direction at a certain moment: either signal from the external unit to the implanted sensor or
from the implanted unit to the exterior is sent at the same instant. The implanted module remains idle until

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it receives a pure carrier signal from the external device, when this happens, it transmits back the sensed
parameters to the exterior by the coupled inductive link.[8][9]

3.1.Modulation techniques

Most of the telemetry systems for biomedical implantable devices use frequency modulation (FM) for
transmission of signals. The main advantage of FM modulation in coupled telemetry is that the signal
transmission is not affected by the movement of the antennas, making FM an optimal modulation for
transmission of analog signals for RF implantable sensors. There several FM modulation types suitable for
these applications, these include amplitude shift keying (ASK), frequency shift keying (FSK) and phase
shift keying (PSK).[6][4]

Amplitude Shift Key modulation (ASK) is the most efficient digital modulation in terms of power but it is
susceptible to noise. FSK modulation is not as efficient as ASK modulation but it is much less susceptible
to noise. FSK achieves high performances a simpler circuit design than ASK. By selecting a proper
modulation index and an acceptable signal to noise ratio (SNR), it is possible to achieve an excellent
transmission of data using FSK.[2][6]

Load shift keying (LSK) is a form of ASK modulation which is also called reflectance modulation, it
allows the remote delivery of power and communication through the same inductive link. The inductive
link has basically the same configuration as a transformer made of a coupled pair of flat inductors with an
inner air core. The working principle of LSK relies on the impedance reflection property of the coupled
inductors, by which any change on the secondary is reflected back in the primary as an impedance change.
The modulating circuit makes the input digital signal to power the secondary circuit, which load is reflected
back on the primary inductor as changes in voltage amplitude, this signal can be decoded to recover data.
By this means, it is possible to achieve a reliable transmission of data using LSK.[6] [10]

LSK modulation can be generated by a transistor in parallel with the capacitor of the LC resonant circuit of
the implantable circuit (Figure 4). When the transistor turns on, the capacitor is short circuited and the
reflected impedance changes. When the transistor is turned off, the voltage in the LC circuit increases,
while this happens it is not possible to draw any power from it, this means that a large capacitor is required
to store the energy necessary to feed the sensor while the LC circuit charges until the required level
voltage.[11]

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Figure 4Simple data transmitter [11]

3.2.External module or primary unit of the inductive link

The external module normally consists of two subsystems; the reader, which communicates with the
implanted device and a unit that forwards the acquired data to another device, which can be a computer,
tablet or similar. There are many different possible implementations for the external device depending of
the needs of the application, for example it can be a handheld unit with a USB port to connect it to a
computer, or it can be a wearable unit with a Bluetooth module to forward the sensed data wirelessly to a
smartphone or computer. [7]

The elements that the external module contains are a processing unit, which can be a microcontroller or a
FPGA [8], which decode the received signals from the implanted device, and code the data for forwarding
it to a computer for further processing; an oscillator, transmitter inductor with LC resonating circuit, a
power amplifier and an envelope detector.[6]

The power amplifiers that are typically used to drive the inductive link at the primary coil in biomedical RF
sensors are class E power amplifiers because of their high efficiency, near 100%. The design of the power
amplifier is primary conditioned by the quality factor in the load network, Ql. The power at the output
increases proportionally with Ql, consequently, the election of a suitable quality factor implies finding a
balance between bandwidth, which decreases as Ql increases and the harmonic content at the output, which
is higher at lower values of Ql. Due to the fact that the resonant inductive link has the dual purpose of both
powering the implanted device and providing a mean for data communication, from the external device to
the implanted sensor, high values for Ql are not suitable for this purposes.[2][12]

Figure 5 Schematic of a typical class E power amplifier.[2]

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The election of the inductance for the primary coil depends of the chosen value for the quality factor and
the total resistance seen at the output of the amplifier (Figure 5), of which comprises Rl, the primary
inductor, as part of it. The design of the primary coil is affected by several parameters: the quality factor,
Ql, which should be lower than 5 since it is a limitation on the L1/R ratio; the value of Rl, which should be
much greater than R in order maximize power transfer and the current in the primary; and both the mutual
inductance and frequency of operation, which should be large enough to induce the required voltage at the
secondary.[2][12]

The following figure shows a schematic description of the inductive link where the primary inductor is
noted as L1 and the secondary as L2, L1 is in series with R1 and V1, forming the thevenin equivalent
circuit of the power amplifier represented in Figure 5.[13]

Figure 6 Schematic description of an inductive link.[13]

3.3.Internal module or secondary unit of the inductive link

This unit contains a resonant circuit that increases the efficiency of the power transfer between the two
coils, the energy inserted in the primary circuit generates oscillation in the resonant circuit until it is
transmitted to the secondary [11].

As shown in Figure 6, the secondary coil L2 is drawn by R2. C2 is a resonant capacitor that drives the
secondary circuit in resonance and also maximizes the power transfer and therefore, the link efficiency. C2
need to have a fixed value in order for L2 to resonate at a frequency , this value is determined by 2 =
1
. A matching network is implemented in order adapt the impedances of R2 (the resistance of the coil)
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and Rl, (the load resistance corresponding to elements of the sensor circuit); this network can be purely
capacitive, and ideally, it would not dissipate any active power as it presents no resistive
component.[13][14]

There are two types of circuit configurations used on the secondary circuit, a parallel or series
configuration, both of them can be configured to maximize power transfer efficiency. The main difference
between both configurations is the connection to the power amplifier, either with a parallel resonator as it
can be seen on Figure 5 or a series resonator, shown in Figure 8.
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Figure 7 Typical series resonant coupling circuit.[11]

Figure 8 AC model of typical series resonant.[11]

Both circuits have similar behavior with some differences; for example, the parallel resonator requires a
high output resistance at the driving circuit, behaving as a current source in order to optimize the quality
factor of the resonator. In the case of a series resonator, a low output resistance is required at the output of
the driving circuit.[11] For specific quality and low coupling factors which translates into low efficiency
links; a series configuration requires a much larger secondary inductance to maximize the efficiency of the
link. A large secondary inductor is a limitating factor in the design of the implantable unit.[15] Therefore,
low power links are usually implemented in biomedical implantable sensors, utilizing a parallel resonance
in the secondary circuit.[2][16]

The circuit below shows an example of a secondary unit comprising a resonant circuit in series, a rectifier,
a voltage regulator and a low pass filter. The capacitor Cp is resonating at the frequency of operation of the
primary coil, behaving as a source of AC voltage to the rest of the network. A full wave rectifying stage
followed by a low pass filter, converts the signal into DC voltage. The LT1521 is a voltage regulator
employed to supply a regulated voltage to the sensor.

Figure 9 Schematic diagram of the inductive powering secondary unit of the system.[2]

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4. Other design considerations

4.1.Inductor design

Another important aspect on the design of inductive link biosensors is the election of the inductors that
compose the inductive link, which greatly affect to both the performane of the system and the confort of the
patient.[13]

The most common types of inductors are Litz-wire coild, CMOS inductors, printed spiral coils and MEMS
inductors. Litz-wire inductors are composed by many insolated thin fibers; this type of inductors
experiment reduced resistive losses in comparison with solid wire inductors, however they become noisier
at high frequencies, around 1MHz.
Integrated circuit spiral inductors are another type of components where both the coils and circuitry are
integrated in the same chip. These components are built using CMOS fabrication and they have maximum
quality factors at high frequencies near the GHz range; making these devices not suitable for inductive
links that operate within the MHz range. MEMS inductors are fabricated using surface micromachining
technology, they have less inductor resistance than CMOS devices, and therefore higher quality factors but
with lower inductance values than CMOS. The last option is printed spiral coils, fabricated using printed
circuit board methods, they can be implemented on flexible substrates using a multi layer approach that
enables miniaturization and achieving quality factors up of 50 in the MHz range.[13][17]

4.2.Power transmission efficiency

It is vital to keep as low as possible then transmission energy levels in an implanted device while
maintaining a reliable connection since the radiation intensity cannot exceed certain safety levels and the
constraints for energy consumption related to device miniaturization, hence, link efficiency takes special
importance in the design of this type of biosensors.[18][19]

The efficiency in an inductive link is measured by the ratio of the dissipated power on the load to the total
dissipated power in the system.[13] The most significant losses on these systems are seen on the voltage
regulators of the primary and the secondary units, as well as the load conditions and possible misalignments
of the inductive link during long term operation of the implanted device. There can be several of
performance issues related to different types of misalignments, such as variations of coil spacing, lateral or
angular misalignments.[2][18]

In the case of variation of the coil spacing, the mutual inductance is inversely proportional to the distance
between the coils, and therefore the output voltage at the secondary, which proportionally decreases with
the distance between them (Figure 10). In the same manner, if the coils are laterally displaced between each
other; remaining parallel to each other while their centers are displaced a distance d in the horizontal axis
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and the vertical distance is kept constant, the output voltage decreases proportionally to the displacement d
between the centers of both coil (Figure 11). Lastly, in the case of angular misalignment, both coils remain
centered to each other but with tilted planes forming an angle of angular displacement. As increases
from 0 to 90, mutual induction decreases leading to a linear voltage drop at the output. When is 90, the
coefficient of mutual induction is zero and so is the output voltage (Figure 12).[2]

Figure 10 Effect of variation of coil spacing between transmitter and receiver coils.[2]

Figure 11 Effect of the variation of lateral misalignment ( ) between the transmitter and the
receiver coils.[2]

Figure 12 Illustration of angular misalignment () between the transmitter and the receiver coils.[2]

4.3.Degradation of RF due to biological environment

The human body behaves as a conductor when exposed to radio frequency waves, therefore it is not an
ideal medium of transmission. Different tissues within the body have different impedances and dielectric
constants. Therefore, every frequency is affected in different forms and with various severities depending
on the electrical characteristics of the diverse organic tissues which conform the human body.[20][19]

The radiofrequency waves that travel across the body experiment losses, destruction of radiation patters or
frequency shifts. The human body is mostly water with high ionic content, the liquids within the body
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cause attenuation on the RF waves while the skeletal tissue reflect and diffract some specific frequencies. If
the wavelength is much greater than the cross section of the body which it is travelling trought, the body
does not cause any significant effect on the signal, on the opposite hand, for higher frequencies, the wave
experiments scattering effects introduced by the human body. The frequency limit for this phenomenon to
happen is considered to be around 4GHz.[20]

The human body presents a high overall conductivity, different tissues such as fat, muscle and bones have
different conductivity values which condition the amount of attenuation that an electromagnetic wave
crossing them undergoes. Conductivity destroys electromagnetic radiation since the free electrons that exist
in the tissues will always move to the lowest energy levels to reorganize themselves so the field of the
incoming wave is cancelled out. In order effectively characterize the body as reliable communication link,
it is a requirement to consider the specific bioimpedances of the tissues for a particular wavelength.[20]

4.4.Effects of the electromagnetic radiation on the human body

The electromagnetic waves generated by RF implanted sensors can dissipate in the living tissues, causing
damages which can be irreversible. Therefore, when designing an implantable wireless sensor it is of vital
importance to guarantee that its operation within the human body will not cause harmful radiations by
fulfilling the safety levels and standards for human exposure to electromagnetic radiation. [8]

According to the IEEE C95.1 standard for safety levels of human maximum permissible exposure to RF
electromagnetic fields; radio frequency exposure of human body tissues can cause adverse effects on health
when it leads to a temperature increase in a localized area within the body at temperatures above 43 C. The
increase of temperature above this threshold, which irreversibly damages living tissues, is considered for a
power density of 20 mW/cm[20]. The frequency range most widely used in biomedical telemetry
applications located between 100KHz and 3GHz, for these frequencies there are standardized restrictions in
terms of specific absorption rates (SAR).[8] The IEEE C95.1 standard considers that the exposure to
radiation originated from an implanted RF implant is partial body exposure within an uncontrolled
environment, in this case the whole body average SAR provisions during localized exposure should not be
violated. The admissible SAR values for the whole body must be under the 0.08W/Kg limit, while the
value for the spatial peak of the average SAR for any tissue of 1 g of mass defined in cubes, should not
exceed 1.6 W/Kg with the exceptions of wrists, ankles, hands and feet, where it should be less than
4W/Kg.[20]

However, despite of the standardization of safe levels of RF electromagnetic radiation, there is still
controversy among the scientific community about the actual safety of these levels, and a demand for
further research as there is a concern about the differences between the experimental and real scenarios and
a necessity for continuous improvement of these devices.[21]

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5. Conclusions

Inductive link coupling is a preferred technique for wireless transmission of data and power due to its
efficiency, reliability and low cost. This paper reviews different components of RF telemetry system which
are used to deliver power wirelessly through skin barrier and establishes a bi-directional communication
link between the implanted device and the outside world. Table 1 summarizes the pros and cons of
different energy harvesting techniques that can be used to power an implant. In comparison with all the
sources listed in table 3, inductive links deliver maximum power and data rate. By reducing the size of an
implant, physiological response of body can be reduced, resulting in overall improvement in the sensing
efficiency of the device. As this technique requires both coils to be placed very close the skin surface,
research has been carried out to improve the range of communication between the both units resulting in
better mobility of patient.
..

Table 1[3]

6. References

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[17] K. M. Silay, C. Dehollain, and M. Declercq, Inductive power link for a wireless cortical implant with
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