System-level design and integration of next generation wireless implantable medical devices: A review and future research directions

Next-generation wirelessly enabled implantable electronic medical devices demand simultaneous improvements in wireless communication, power autonomy, biocompatibility, and long-term reliability, yet current literature addresses these aspects in isolation, creating critical gaps in cross-disciplinary integration. This review systematically analyzes recent advances in implantable medical device (IMD) antennas, sensors, wireless power transfer (WPT) schemes, and biocompatible materials to clarify how these components interact under realistic in-body environments. Using a comparative and mechanism-oriented evaluation framework, the paper identifies unresolved challenges including limited miniaturization without performance degradation, unstable in-tissue communication links, material–tissue mismatch effects, and insufficient guidelines for co-optimizing power efficiency, safety, and data rate. The review uniquely consolidates therapeutic, diagnostic, and continuous-monitoring perspectives to map how device geometry, electromagnetic behavior, material properties, and energy delivery constraints jointly influence IMD performance. By synthesizing design rules, benchmarking emerging bioresorbable and soft-tissue-compatible materials, and evaluating system-level trade-offs, this work provides a unified understanding of where current technologies fall short and outlines concrete research directions for highly reliable, wirelessly powered IMDs in future healthcare systems.