Dynamic Path Gain Compensation for Enhancing Intracardiac Communication in Leadless Pacemakers

Leadless pacemakers (LCPs) have emerged as a viable solution to mitigate the side effects associated with traditional pacing leads. Nevertheless, the absence of suitable intracardiac communication methods restricts most LCPs to single-chamber pacing. Galvanic conductive communication (GCC) offers a promising approach for achieving intracardiac communication in multichamber LCPs. However, impedance mismatch between the receiver and myocardium during the cardiac cycle can lead to a reduction in path gain, thereby affecting communication stability. This article proposed a dynamic compensation method to reduce impedance mismatch and enhance communication stability. We developed a simplified LCP system with dynamic path gain compensation and validated it on an ex vivo porcine heart dynamic experimental platform. The results demonstrated a path gain improvement of 9.23 dB and a reduction in path gain variation from 3.95 to 0.3 dB. Additionally, the bit error rate (BER) decreased by over 50% across various transmission rates, with the most significant improvement observed at 5 kbps, where it decreased by 82.7%. These findings provide a high-reliability solution for intracardiac communication and establish a foundation for future multichamber sequential pacing applications in LCPs.