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A review on antennas for biomedical implants used for IoT based health care

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DOI: 10.1108/SR-01-2019-0020

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A review on antennas for biomedical implants
used for IoT based health care
Kasturi Sudam Patil and Elizabeth Rufus
School of Electronics Engineering, Vellore Institute of Technology, Vellore, India

Abstract
Purpose – The paper aims to focus on implantable antenna sensors used for biomedical applications. Communication in implantable medical
devices (IMDs) is beneficial for continuous monitoring of health. The ability to communicate with exterior equipment is an important aspect of IMD.
Thus, the design of an implantable antenna for integration into IMD is important.
Design/methodology/approach – In this review, recent developments in IMDs, three types of antenna sensors, which are recommended by researchers
for biomedical implants are considered. In this review, design requirements, different types of their antenna, parameters and characteristics in medical
implants communication system (MICS) and industrial, scientific and medical (ISM) bands are summarized here. Also, overall current progress in
development of implantable antenna sensor, its challenges and the importance of human body characteristics are described.
Findings – This article give information about the requirements of implantable antenna sensor designs, types of antennas useful to design
implantable devices and their characteristics in MICS and ISM bands. Recent advancement in implantable devices has led to an improvement in
human health.
Originality/value – The paper provides useful information on implantable antennas design for biomedical application. The designing of such
antennas needs to meet requirements such as compact size, patients’ safety, communication ability and biocompatibility.
Keywords Capsule antenna, Circular antenna, Dual band antenna, Implantable antenna sensor, Implantable medical devices (IMDs),
MICS and ISM bands, Microwave sensors
Paper type Literature review

1. Introduction bandwidth and sufficient radiation efficiency and has to address


patient safety (Kim et al., 2010; Kaur et al., 2015; Gabriel et al.,
In recent years, microwave sensors have played an important 1996). Several research works in the direction of designing
role in IMD; the first implantable electronic biomedical device antenna for medical implants have been carried out in the
was the cardiac pacemaker (Greatbatch and Homes, 1991). ISM band for biometry. Recently, MICS has specified
Now, several defibrillators and drug delivery systems are being 402-405 MHz for this purpose to minimize interference with
widely used. Considering the population growth and the public other services (Aleef et al., 2017; Herth et al., 2017; Asili, 2015;
consciousness about health, the IMDs have become a growing Asili et al., 2012; Jung, 2016; Huang et al., 2013; Scarpello,
technology. It is used for monitoring the human body 2011; Asili, 2015; Emami-Nejad and Mir, 2017; Yilmaz et al.,
temperature (Scanlon et al., 1997), implantable defibrillators, 2008; Yang et al., 2016; Bahrami et al., 2015). This means that
pacemakers (Wessels, 2002) continuous glucose monitoring the wavelength is nearly 74 cm, which has a direct relation
(Yilmaz et al., 2008), heart failure detection (Chow et al., with the antenna dimensions. This indicates a need to
2009), etc. The aim of the IMD is to continuously monitor the miniaturize the microwave antenna which conforms to the
various activities inside the human body and send information human body. Rules and regulations related to all frequency
to a receiver outside the body (Soontornpipit et al., 2004). bands used to design implantable antennas are given [CEPT/
Therefore, IMDs require microwave sensors for the application ERC 70-03, (1997); http://itu.int/home; Annex 12 (1997)].
of wireless communication from inside the host (human body) A review of several works with regard to implantable
to the device outside (Kim and Rahmat-Samii, 2004). These antennas which have been carried out in this field during the
microwave sensors are implantable antennas; IMDs with a past few years have been read and summarized in this paper.
miniature antenna are called a radio frequency (RF)-linked First, the requirements of the miniaturized implantable
IMD. The design of such sensors has lots of challenges because antenna have been discussed and second, the review of the
of the lossy tissues in the human body (Soontornpipit et al., methods for fulfilling the requirements, based on the literature
2005; Gosalia et al., 2005). An implantable antenna has certain survey, are consolidated.
features/characteristics such as small size, wide operating
2. Design requirements of implantable antenna
The current issue and full text archive of this journal is available on
Emerald Insight at: www.emeraldinsight.com/0260-2288.htm The antennas used inside the body need to satisfy many
conditions unlike traditional antennas which operate in free
space. The implantable antenna should meet the requirements

Sensor Review
© Emerald Publishing Limited [ISSN 0260-2288] Received 24 January 2019
[DOI 10.1108/SR-01-2019-0020] Accepted 15 May 2019
Antennas for biomedical implants Sensor Review
Kasturi Sudam Patil and Elizabeth Rufus

of efficiency and patient’s comfort. So, these antennas must hypodermic biosensor biosensors are connected to RF
have sufficient gain and high bandwidth. It is also preferred to transmitter outside the human body. A drawback of this system
have a multiband operation to reduce power conservation. is the replacement of the glucose sensor after every two-three
Many antennas with a single feed have been suggested in days, bulky RF unit, frequent battery replacement of RF unit,
literature, which offers low efficiency, as they suffer from the long response time required for sensor, etc. Karacolak et al.
loss of baluns, but the antennas with dual feeds have the (2008) developed a system which monitors glucose levels in the
advantages of common mode rejection, negligible material human body continuously. Hence, it improved the quality of
coupling effect, negligible noise and superior linearity. lives of patients suffering from diabetes. For antenna
 Permittivity of dielectric substrate and superstrate is very simulation, particle swarm optimization algorithm and a
important because this helps to minimize the antenna combined finite element-boundary integral technique is used.
dimensions. The relation between permittivity and In (Sánchez-Fernández et al., 2010) designed antenna, which
dimension of the antenna is inverse. Thus, high consisted of multilayer configuration and radiating element and
permittivity will shorten the wavelength and hence the feedline, was situated at a different level. Hence, size reduction
antenna dimensions. occurs because of an independent line that feeds radiating
 Planar structure is preferred for implantable antenna, as it elements by electromagnetic coupling. Duan et al. (2012)
is conformal to the surface of the body. The microstrip proposed differential feed dual band antenna which is easily
antennas are planar structures which have the connects with differential circuitries, and eliminates loss
disadvantage of having a narrow bandwidth (BW) and this occuring in it because of matching circuit and balun this kind
poses a challenge to the design of implantable antennas. of antenna is used in application like neuro-microsystem. Liu
 The length of current path is also important which can be et al. (2012) adopted a small dual-band implantable antenna
done by incorporating slots in the patch. Stacking is one for biomedical application. Xu et al. (2012) designed a dual-
way to increase the length of the current path. band planar inverted-F antenna (PIFA) by adding an open-end
 Impedance matching is yet another important aspect. The slot in a ground plane which is helpful to enhance the BW for
imaginary part of impedance can be offset by using telemetry communication . Kiourti et al. (2014) proposed an
appropriate capacitance or inductive loading at the design on-body repeater. It receives signals from the IMD and
frequency band. In addition to loading, the split-ring retransmits it to the control device. The goal of a repeater is to
resonator (SRR) can be incorporated. extend the telemetry range of the IMD by receiving weak
 Specific absorption rate (SAR) has to be limited to signals from IMD and retransmitting it to an exterior device. In
preserve patient safety, based on the IEEE regulations and case of high frequency, ISM band permits for small, designed
guidelines. and efficient antennas, which are suitable for on-body usage.
 Biocompatibility is an important factor to be considered. The advantage of this configuration is it provides patient’s
The designed antenna has to be coated with safety against electromagnetic field (EM), eliminates EM
biocompatible materials such as macor, alumina and interference and helps increase lifetime of IMD. Xu and Guo
polydimethylsiloxane (PDMS) as mentioned in literature. (2014) developed miniaturized dual band antenna for
This may have an effect on the antenna performance, implantable wireless communication. Size reduction of
which needs to be studied. antenna and dual band antenna operation is achieved by
 In the present status, implantable antenna works as a adapting an off-centre feeding dipole and bending the spiral
transmitter in most of the cases. Ensuring far field dipole and printing it on to sides of substrate, respectively.
communication is a requirement of design of Implantable Impedance matching is an important task and with help of
antennas. inductive loop, it is achieved in this paper, for both upper and
lower bands (Xu and Guo, 2014). Duan et al. (2014) proposed
an antenna with dual band capacity at MICS and ISM bands.
3. Survey of dual band antennas The proposed system consists of two modes, the sleep and
This section enumerates few of the dual band antennas which wake-up modes. When data transmission is required in MICS,
have been proposed by researchers for biomedical applications. a wake-up signal via ISM band can be sent to the implantable
The research on implantable antenna for medical application is device to wake up the implantable system in a normal
in the MICS, medical device radio communication services condition, when the implant is in a sleep mode. This type of
(MedRadio) and ISM bands of operation (Karacolak et al., antenna, connected with transmitter with differential output,
2008; Sánchez-Fernández et al., 2010; Duan et al., 2012; Liu also reduces the loss produced by matching circuit and balun
et al., 2012; Xu et al., 2012; Kiourti et al., 2014; Xu and Guo, (Duan et al., 2014). Liu et al. (2016) developed differential feed
2014; Duan et al., 2014; Liu et al., 2016; Lei and Guo, 2014; dual band antenna, and it is used for near-field biotelemetry
Cho and Yoo, 2016; Liu et al., 2014; Dhun and Xu, 2017; application. Shorting pin and symmetric meandered strip are
Akbarpour1 and Chamaani1, 2017; Blauert and Kiourti, techniques used for differential feed antenna to integrate into
2018). In the table, the dual-band antenna fabricated by differential RF front-end without balun and matching circuit.
different researchers is summarized. It also describes the Lei and Guo (2014) designed differentially fed dual band
antenna type, antenna parameters and percentage bandwidth. implantable antenna. To achieve size reduction of this antenna,
« r indicates dielectric constant, tand is tangent loss and h is the shorting strip is implemented (Lei and Guo, 2014). Cho
thickness of the respective substrate. achieved large-size reduction of implantable antenna by
Table I provides information about dual band antennas. shorting pin and open-end slot on a ground plane, and it is used
Considering previous research work, for glucose monitoring for wireless biotelemetry (Cho and Yoo, 2016). Dhun and Xu
Antennas for biomedical implants Sensor Review
Kasturi Sudam Patil and Elizabeth Rufus

Table I Dual band antenna


Ref. No. Antenna type Antenna parameters (%) Bandwidth
(Karacolak et al., 2008) Meandered/serpentine patch antenna Size = 1265.6 mm 3
35.3% at MICS band
Substrate-Rogers RO3210 7.1% at ISM band
« r = 10.2 , tand = 0.003, h = 0.635 mm
(Sánchez-Fernández Strip patch antenna Size = 1375.4 mm3 Very narrow band width
et al., 2010) substrate-ARLON 1000
« r = 10.2, tand = not specified, h = 1.27 mm
(Duan et al., 2012) Differentially fed spiral antenna Size = 480.6 mm3 7.3% at 433.9 MHz
Substrate-Rogers 6010 5.4% at 542.4 MHz
« r =10.2, tand = 0.0023, h = 0.635 mm
(Liu et al., 2012) Spiral microstrip patch antenna and planar Size = 691.5 mm3 13% at MICS band
inverted antenna Substrate-Roger 3010 4.4% at ISM band
« r = 10.2, tand = 0.0023, h = 1.37 mm
(Xu et al., 2012) P shaped antenna with two meander strips Size = 468.1 mm3 52.6% at 356 MHz to
Substrate-Rogers 3010 610 MHz
« r = 10.2, tand = 0.0035, h = 0.635 mm 4.4% at 2.42 to 2.53 GHz
(Kiourti et al., 2014) Triangular patch antennas Antenna 1: Size = 399 mm3 20.2% at MedRadio
Substrate-Rogers RO 3210 band
« r = 10.2, tand = 0.003, h = 0.635 mm 20.1% at ISM band
Antenna 2: Size = 6720 mm3
Substrate FR4
« r = 4.4, tand = 0.02, h = 1.6mm
(Xu and Guo, 2014) Spiral dipole antenna Size= 67.8 mm3 47.5% at MICS band
Substrate-Rogers 3010 31.6% at ISM band
« r = 10.2, tand = 0.035, h = 0.635 mm
(Duan et al., 2014) PIFA antenna Size= 179.0 mm3 49.5% at 321 MHz to
Substrate-Rogers RO3010 532 MHz
« r = 10.2, tand = 0.0035, h = 10.2 mm 24.1% at 2.15 GHz to
2.74GHz
(Liu et al., 2016) Symmetric meandered strip antenna Size = 642.6 mm3 7.4% at 389 MHz to
Substrate-Rogers 3010 419 MHz
« r = 10.2, tand = 0.0023, h = 0.635 mm 6.6% at 2395 MHz to
2563 MHz
(Lei and Guo, 2014) Differentially fed meandered and L-shaped Size = 308.6 mm3 7.9% at 403.5 MHz
antenna Substrate-Rogers 3010 6.1% at 2.44 GHz
« r = 10.2, tand = 0.0035, h = 0.635 mm
(Cho and Yoo, 2016) Symmetric PIFA antenna Size = 31.5 mm3 21.8% at MICS Band
Substrate-Rogers 6010 8.6% at ISM Band
« r = 10.2, tand = 0.0035, h = 0.25 mm
(Liu et al., 2014) Differentially fed symmetric P shaped antenna Size = 642.62 mm3 7.4% at 389 to 419 MHz
Substrate-Rogers 3010 6.6% at 2395 to
« r =10.2, tand = 0.0023, h = 0.635 mm 2363 MHz
(dhun and Xu, 2017) Conformal L-striped antenna Size =76.2mm3 16.2% at 1.4 GHz
Substrate - Rogers 3010 34.8% at 2.45 GHz
« r = 10.2, tand = 0.0035, h = 0.635 mm
(Akbarpour1 and PIFA antenna Size = 2788.5 mm3 5.9% at MICS band
Chamaani1, 2017) Substrate FR4 and RO 4003 1.2% at ISM band
« r = 4 and 3.37, respectively, h = 1.6 mm and
0.5mm, respectively
(Blauert and Kiourti, E-shaped patch antenna Size = 91.44 mm3 Not specified
2018) Substrate-Rogers 3010
« r = 10.2, tand = 0.0035, h = 0.635 mm

(2017) proposed an antenna structure which consists of two coupled loop antenna, and with the help of lumped capacitors,
identical orthogonal strips with each one of them connected miniaturization is achieved. Blauert and Kiourti (2018)
with one conformal L-strip (Dhun and Xu, 2017). Akbarpour1 proposed an E-shaped patch antenna; coupling slots line the
and Chamaani1 (2017) designed the dual-band electrically microstrip feed is useful for adequate matching between
Antennas for biomedical implants Sensor Review
Kasturi Sudam Patil and Elizabeth Rufus

microstrip feed and the interior patch. It presents finite element direct contact (Xu et al., 2015). Li et al. (2016) designed
simulation of the reflection coefficient with the help of a genetic broadband and CP implantable antenna for biomedical
algorithm (Blauert and Kiourti, 2018). telemetry. A cross-shaped slot with unequal-length arms is
inserted in the ground plane of an antenna. Hence, the
4. Survey of circular polarized antennas proposed antenna improves impedance BW and axial-ratio BW
without any backward radiation (Li et al., 2016). Further Liu
For wireless applications, reduction in multipath and low bit- et al., developed a single feed, wide beam-width CP
error rates are designed and can be achieved by circular implantable antenna, its application is real-time glucose
polarization. Also, implantable antenna should maintain a fixed monitoring. Four C-shaped slots and complementary split-ring
orientation towards the receiver. But because of the posture resonator (CSRR), loading the radiation patch, are helpful for
movement and common human tissue activity, it is difficult. To size reduction of the antenna (Liu et al., 2017). Zhang et al.
eliminate these issues, circular polarized (CP) antennas would (2017) achieved miniaturization by loading stub and
be the best solution. It has an inherent immunity to time- meandering slots for designing an antenna structure; this
varying orientation of the transmitter and the receiver. Thus, it method achieved great size reduction of antenna. Liu et al.
offers better mobility, reduction of multipath, improvement of (2018) developed CP antenna used for far-field wireless power
lower bit-error rates and link stability (Liu et al., 2014; Liu transmission. For designing a compact CP antenna, various
et al., 2014; Xu et al., 2015; Li et al., 2016; Liu et al., 2017; techniques are used, such as stub loading and capacitive
Zhang et al., 2017; Liu et al., 2018). In Table II CP antennas, coupling among the stub (Liu et al., 2018).
its parameters and percentage BW are given.
Liu et al. (2014) developed capacitive-loaded, CP microstrip
patch antenna. In this proposed antenna, capacitive loading is
5. Survey of capsule antennas
helpful to achieve better impedance and capacitive coupling Implanting a medical devices inside the human body for
used for effective size reduction (Liu et al., 2014). Guo et al. diagnosis process is recent advances in micro-electrochemical
proposed a multilayer axial-mode helical antenna; it is used for system. Swallowable electronic radio-telemetry capsule was
wireless capsule endoscope applications. This antenna is firstly developed in 1957. It is used to measure pressure and
composited in three open loops at different layers, connected temperature (Mackay and Jacobson, 1957). It can transmit
with the help of holes. It forms an axial-mode helical structure detailed information in real-time, grow heat stroke among the
to generate traveling wave radiation. In this process, high athletes, while transmitting information to the receiver it
relative dielectric constant is used to miniaturize the antenna simultaneously monitoring body temperature (Visser et al.,
size. This high data rate ingestible capsule endoscope system 2007). The approximate size of the capsule is 11  26 mm and
(Liu et al., 2014). Xu et al. (2015) used the concept of slow the antennas are an integral part. Generally, the orientation of
wave by loading the patches. The radiated loop antenna is used the capsule is random. But, the challenges are the
to achieve miniaturization. An implantable antenna is helpful establishment of a continuous robust communication link for
for communication with the equipment outside the human biomedical telemetry and developing a stable and secure
body. Hence, patients can be monitored remotely without communication link for capsule devices. Various antenna

Table II CP antennas
Ref. No. Antenna type Antenna parameters (%) Bandwidth
(Liu et al., 2014) Single-fed microstrip patch antenna (capacitive Size = 127 mm 3
7.74% at 2.36 GHz to
loading) Substrate-Rogers 3010 2.55 GHz
« r = 10.2, tand = 0.003, h = 0.635 mm
(Liu et al., 2014) Circular patch antenna (capacitive loading) Size = 361.89 mm3 26% at 2.4 GHz to 2.48 GHz
Substrate-Roger RO3010
« r = 10.2, tand = 0.0022, h = 0.635 mm
(Xu et al., 2015) Square loop (LC loading) Size = 214.6 mm3 29.4% at 709 MHz to 954 MHz
Substrate - Rogers 3010 27.8% at 737 MHz to 975 MHz
« r = 10.2, tand = 0.0035, h = 0.635 mm
(Li et al., 2016) Single fed patch antenna Size = 127mm3 14.03% at 2.32 GHz to 2.67
Substrate-Rogers 3010 GHz
« r = 10.2, tand = 0.003, h = not specified
(Liu et al., 2017) Conventional square patch and C-shaped patch Size = 91.75 mm3 13% at 2.31 GHz to 2.63 GHz
antenna Substrate-Rogers 3210
« r =10.2, tand = 0.003, h = 0.635 mm
(Zhang et al., 2017) Square patch antenna Size = 285.75 mm3 10.6% at 865 MHz to 962 MHz
Substrate-Rogers 3010
« r = 10.2, tand = 0.0035, h = 0.635 mm
(Liu et al., 2018) Square patch meandered antenna Size = 153.67 mm3 17% at 828 MHz to 982 MHz
Substrate-Roger 3010
« r = 10.2, tand = Not specified, h = 0.635 mm
Antennas for biomedical implants Sensor Review
Kasturi Sudam Patil and Elizabeth Rufus

Table III Capsule antenna


Ref. No. Antenna type Frequency of operation Antenna parameters Gain
(Izdebski et al., 2009) Multilayer spiral meandered 1.4 GHz Size = 286 mm 2
–26dB
dipole antenna Substrate-Polyethylene « r = 2.2,
tand = Not specified, h = 0.127 mm
(Merli et al., 2011) Multilayer helical antenna 401-406 MHz Size-321 mm2 –28.8 dB
2.4-2.5 GHz Substrate – Roger TMM10 (alumina), copper –18.5 dB
metallization, PEEK (Polyetheretherketones)
« r of copper = 9.2, tand = 0.0022, h = 35 m m
« r of PEEK = 3.2, tand = 0.01
(Mahe et al., 2012) Microstrip and meandered 434 MHz Size = 119 mm2 –33dB
antenna Substrate FR4
« r = 4.4, tand = 0.0035, h = 1.58 mm
(Psathas et al., 2013) Microstrip antenna 402 MHz Size = 240 mm2 –29.64 dB
Substrate-Rogers RT/Duroid 5880,
« r = 2.2, tand = Not specified, h = 0.127 mm
(Liu et al., 2014) CSRRantenna 2.45 GHz Size = 286 mm2 –32dB
Substrate-Rogers 3010
« r = 10.2, tand = 0.0022, h = 0.635 mm
(Alrawashdeh et al., Asymmetric dipole antenna 401-406 MHz, 433.1-434.8 MHz, Size = 75 mm2 –25dB
2015) 868-868.5 MHz, 902.8-928 MHz Substrate-Polymide
and 2.45 GHz « r = Not specified, tand = Not specified
h = 0.0254 mm
(Xu et al., 2015) Asymmetric dipole fed 402 MHz Size = 264 mm2 –37dB
Substrate-Rogers 3010
« r = 10.2, tand = 0.0035 , h = 0.635 mm
(Nikolayev et al., Microstrip antenna 434 MHz Size = 119 mm2 –33.4dB
2017) It consists three substrates
1. Rogers ULTRALAM 3850 HT,
« r = 2.9, tand = 0.002, h= 9 m m
2. Rogers XT/Duroid
« r = 3.23 tand = 0.0035, h= Not specified
3. DuPont Pyralux AP (polymide)
« r = 3.4 , tand = 0.002, h= Not specified
(Faerber et al., 2018) Multilayer helical with 433 MHz Size = 300 mm2 –23dB
meandered shape antenna Substrate-Not specified
« r = Not specified , tand = Not specified
Thickness of substrate = Not specified

designs have been designed and developed in the literature for human body with the help of the RF link. CP receiver antenna
capsule antenna, which includes multilayer spiral, multilayer designed with orthogonal dipoles provide polarization diversity
helical, dipole antennas and CSRR. Antenna performance can and reduced size, to fit into personal digital assignment
be measured with the help of matching radiation patterns, link (Izdebski et al., 2009). Rajagopalan (2012) compared inverted
budgeting and characterizing the wireless medical telemetry conical helical antenna and conformal meandered offset dipole
services (WMTS). The WMTS and ISM bands are used for antenna CMODA and characterized their performance
performance evaluation (Rajagopalan, 2012). evaluation. The author developed a link budget and established
Table III lists a few of the antenna types, their operating reliable communication link for indoor communication for
frequency and the capsule antenna. The motivation behind biotelemetry applications (Rajagopalan, 2012). Merli et al.
designing such antenna is improving transmission range of (2011) discussed design procedure, realization and
antenna inside a human body. But, there are difficulties such as measurement of conformal antenna, which are used for
low radiation efficiency, strong coupling to lossy, dispersive implantable telemetry applications. Mahe et al. (2012)
biological tissue and antenna impedance detuning. Capsule designed a flexible, compact antenna using various
antenna also considered for animal biotelemetry (Nikolayev miniaturization techniques. Feasibility of these kind of
et al., 2017). antennas are dependent on the good quality link from pill
Izdebski et al. (2009) investigate the conformal antenna for embedding conformal antenna to a receiver (Mahe et al.,
the ingestible biotelemetric capsule system. This system has the 2012). Psathas et al. (2013) proposed an antenna type for
ability to provide real-time biological information from the ingestible capsule endoscopy in the Medical
Antennas for biomedical implants Sensor Review
Kasturi Sudam Patil and Elizabeth Rufus

Radiocommunication (MedRadio) band. The antenna consists References


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pp. 1160-1163. ac.in

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