CN111714113A

CN111714113A - Implanted medical device for sensing electrocardiosignals

Info

Publication number: CN111714113A
Application number: CN202010364412.9A
Authority: CN
Inventors: 洪峰; 平利川
Original assignee: Suzhou Wushuang Medical Equipment Co ltd
Current assignee: Suzhou Wushuang Medical Equipment Co ltd
Priority date: 2020-04-30
Filing date: 2020-04-30
Publication date: 2020-09-29

Abstract

An implantable medical device capable of sensing cardiac electrical signals is disclosed. The housing of the implantable medical device is composed of a metal shell and a material shell through which an electromagnetic signal can pass. The implantable medical device has a microprocessor function, a telemetry function, a memory function, an interface function, a communication function, and a display function. By arranging the antenna and the sensor inside the material shell through which the electromagnetic signal can pass, the length of the implanted medical equipment is shortened, and meanwhile, the influence of the metal shell on the transmission signal strength of the antenna is reduced.

Description

Implanted medical device for sensing electrocardiosignals

Technical Field

The invention is applicable to the field of implantable medical equipment, and relates to a method for sensing and transmitting signals by arranging an antenna and a sensor in a partial shell of the implantable medical equipment.

Background

Implantable heart monitors (ICMs) on the market are available for short or long term implantation into a patient. Some implantable medical devices may be used to chronically monitor physiological signals of a patient, such as implantable hemodynamic monitors, implantable cardiac monitors (sometimes referred to as implantable loop recorders or electrocardiograph monitors), implantable blood chemistry monitors, implantable pressure monitors, and the like. Other implantable devices may be configured to provide a therapy in conjunction with or separate from monitoring of physiological signals.

Improvements in medical device technology have enabled implantable devices to be made smaller, which facilitates minimally invasive surgery to implant the device and improves patient comfort. However, the reduction in device size results in limited space available for batteries, telemetry communication modules, and other device components that support important device functions.

Currently, the telemetry communication of the ICM is generally realized through an antenna, and the housing of the ICM is usually a conductive metal housing, and the metal housing may have a large influence on the transmission of signals by the antenna. In the ICM, which is common in the market, the antenna communication module is usually located outside the housing of the hybrid circuit of the mounting body as an electrical feedthrough assembly and is electrically connected to the housing of the hybrid circuit of the mounting body. This greatly increases the length of the ICM. Accordingly, there is a need for the following implantable medical devices: such as by implanting an implantable medical device in which the telemetric communication module is disposed inside the housing, while the strength of the antenna signal transmission is increased by altering a portion of the housing material.

Disclosure of Invention

The invention discloses an implanted medical device (implant), which consists of an antenna, a substrate, a hybrid circuit, a metal shell and a material shell through which an electromagnetic signal can pass; the metal shell and the material shell which can be penetrated by the electromagnetic signal jointly form a shell of the implanted medical equipment, the two shells divide the shell into two parts in the direction of the longer length of the implant body, the two shells respectively form the edge structure of the shell in the length direction of the shell, the antenna, the substrate and the hybrid circuit form a combined structure, the combined structure is packaged in the shell, and the antenna is arranged in the material shell which can be penetrated by the electromagnetic signal.

Since the metal case interferes with the strength of the signal transmitted by the antenna, in order to reduce this interference, the antenna is prevented from being mounted in the metal case. Half of the shell of the implanted medical equipment is a metal shell, and the other half of the shell is a material shell through which electromagnetic signals can pass. Because the metal can influence the effect of antenna transmission signal, and the material shell that can supply the electromagnetism signal to pass is lower to antenna signal interference degree, can reach better signal transmission effect.

The implanted medical device comprises a sensor which is an optical sensor consisting of a light source and a detector.

The sensor of the optical sensor is arranged in a material shell which can be penetrated by an electromagnetic signal, and a light source of the optical sensor can shine through the material shell which can be penetrated by the electromagnetic signal.

The composite structure of the implanted medical equipment is divided into three layers, a substrate is arranged in the middle layer of the composite structure, a battery is arranged at the bottom layer of the composite structure, one or more electronic devices are arranged at the upper layer of the composite structure, the electronic devices are arranged in the shell and are not connected to the substrate, and each electronic device comprises a capacitor, a transistor, a hybrid circuit, a sensor, a light source, a detector, an accelerometer, a signal processor and the like.

The antenna of the implanted medical device is positioned in the middle of the hybrid circuit and is communicated with the hybrid circuit.

The antenna of the implanted medical equipment is positioned in the same plane, and the shape of the antenna is any one of a bow shape, a plurality of continuous bow shapes, a vertical Z shape, a plurality of continuous Z shapes, a trapezoid shape, a plurality of continuous trapezoid shapes, a W shape, a plurality of continuous W shapes, an S shape and a plurality of continuous S shapes, or the combination of a plurality of shapes.

The antenna and sensor of the implanted medical device of the present invention are located inside a material housing through which the electromagnetic signal can pass. The antenna is arranged in the middle of the medical equipment hybrid circuit instead of being packaged as an independent feed-through assembly, so that the space for connecting the implanted medical equipment antenna and the hybrid circuit is saved, the length of an implant body is shortened, the occupied space of the medical equipment in the human body is reduced, the implantation difficulty is simplified, the side effect of the implant body in the human body is reduced, and a good implantation effect is achieved. The reduction of the overall volume of the device also reduces the manufacturing cost of the product.

The implanted medical equipment comprises an electrode column, and the electrode column is electrically connected with the hybrid circuit through a metal elastic sheet.

The shape of the electrode post on the implanted medical equipment substrate is stepped column, cylinder, rectangular column, stepped rectangular column, semi-cylinder or stepped semi-cylinder, and the electrode post fixes the substrate to the shell of the equipment.

The substrate of the implanted medical device may take any suitable shape or combination of shapes. The substrate takes a shape or combination of shapes that is complementary to the shape of the housing such that the substrate is sealed to the housing and provides a low profile shape to the sealed package.

The substrate of the implanted medical device is a single unitary substrate or a plurality of substrates joined together.

The base plate material of the implanted medical equipment is one or more of polymer, ceramic or inorganic material, the inorganic material is one or more of glass, quartz, silicon dioxide, sapphire and silicon carbide, and the metal shell comprises the same material or combination of materials of the base plate.

The housing of the implanted medical device is a biocompatible material such that the package is implanted within the body of a patient and one or more coatings or layers are disposed on the outer surface of the housing to provide biocompatibility.

The electronics of the implanted medical device include one or more light sources, including any suitable light source or combination of light sources, including any circuit components capable of emitting light in response to an applied voltage or current, light emitting diodes, laser diodes, vertical cavity surface emitting lasers, organic LEDs printed directly on the surface, nano-emitters, and the like.

The light source of the implanted medical device emits one or more components of one or more discrete wavelengths or a cluster of broadband emitters spanning a wide range of wavelengths. The light source is an encapsulated light source. The light source is a bare semiconductor die. The light source is adapted to emit light of any suitable wavelength or wavelengths. The light source emits at least one of infrared light, near-infrared light, visible light, and UV light.

The detector of the implanted medical device comprises any suitable detector adapted for detecting light emitted by the light source, one or more photodiodes, photoresistors or photoresistors, phototransistors, photovoltaic cells, charge coupled devices, avalanche detectors, or the like.

The detector of the implanted medical device is adapted to detect any desired wavelength or wavelengths, the detector detecting one or more of infrared, near infrared, visible and UV light.

According to the invention, the base plate is arranged in the implanted medical equipment, the hybrid circuit board is arranged on the base plate, and the battery is arranged below the base plate, so that the connection between the battery and the hybrid circuit is easier, a larger placing space is reserved for the battery, the larger battery can store more electric energy, the more electric energy prolongs the service life of the implant, and the risk of the implant that the service life of the medical equipment is shorter due to the smaller battery amount is reduced.

Drawings

FIG. 1 is a schematic illustration of an implanted medical device and its relative position within a human body.

Fig. 2 is a schematic structural view of an implanted medical device.

Fig. 3 is a coaxial schematic of the metal housing, internal structure and material housing structure through which the electromagnetic signal can pass of the implanted medical device.

Fig. 4 is a second embodiment of the relative placement of the antenna and sensor of the implanted medical device of fig. 3.

Fig. 5 is a third embodiment of the relative positioning of the antenna and sensor of the implanted medical device of fig. 3.

Fig. 6 is a fourth embodiment of the relative positioning of the antenna and sensor of the implanted medical device of fig. 3.

Fig. 7 is a cross-sectional view of the implantable medical device of fig. 2.

Fig. 8 is a schematic diagram of another antenna configuration of an implantable medical device.

Fig. 9 is a functional block diagram of an implanted medical device.

The optical sensors shown in fig. 2 and 3 are identical; fig. 2, 4, 5 and 6 differ in that: the optical sensor is placed at a different relative position to the antenna and at a different orientation from the optical sensor, and the optical sensor is placed transversely in the same orientation in fig. 2, 4 and 5, except that the optical sensor is placed at a relative position to the antenna 212, the optical sensor is placed in the middle of the antenna 212 in fig. 2, and the antenna is placed at both sides of the antenna 212 in fig. 4 and 5. The orientation of the optical sensor and its position with the antenna 212 in fig. 6 is different from the rest of the figures, the optical sensor shown in fig. 6 being placed longitudinally at one end of the antenna.

Detailed Description

The invention is described in detail below with reference to the accompanying drawings, which illustrate an embodiment of an Implantable Cardiac Monitor (ICM) as an example of a method for sensing or treating cardiac electrical signals by an implantable medical device. It is only used as a preferred technical solution for those skilled in the art to understand the present invention, and does not limit the protection scope of the present invention, and it is obvious that the technical solution of the present invention can also be applied to Implantable Cardiac Defibrillators (ICDs), implantable Cardiac pacemakers (cardioc pacemakers), leadless implantable Cardiac pacemakers, Subcutaneous Implantable Cardiac Defibrillators (SICDs) and hearing implanters, such as cochlear implants, neurostimulators (such as spinal cord stimulators, brain or deep brain stimulators, peripheral neurostimulators, vagus stimulators, occipital neurostimulators, subcutaneous stimulators, etc.), gastric stimulators, ventricular assist devices, and various tissues, organs and neurostimulators or sensors, etc.

FIG. 1 is a schematic illustration of an implanted medical device and its relative position within a human body. The medical device ICM100 is implanted in a subcutaneous region of a human body 101. If the medical device is an ICD or pacemaker, the implant site is an atrium or ventricle within the heart, and the determination of a particular implant site is related to the number of medical devices implanted. The types of implantation are classified according to the number of implanted medical devices: single-cavity, double-cavity and three-cavity types. If the implantation type is a single-cavity implantation type, the implantation position is the right ventricle; if the double-chamber implantation type is adopted, one is implanted in the right atrium and the right ventricle respectively; if the three-cavity implantation type is adopted, the right ventricle, the right atrium and the left ventricle are implanted one by one. The ICM has sensing function to the human body electrocardiosignal and has no treatment function; while ICDs have not only a sensing function but also a therapeutic function on cardiac electrical signals. The ICM is typically implanted using a syringe, and in the clinic, a scalpel, syringe, and ICM are mated. When the device leaves a factory, the scalpel, the ICM and the injector are matched for use. Before injection, a small opening is cut at an implantation part by an operating knife, then the implant ICM is placed into an injector, the injector is inserted into the implantation part of a human body 101, the ICM is gently pushed towards the skin surface under the skin with proper force after insertion, when the ICM is completely pushed into the subcutaneous tissue, the injector is rotated with proper force, so that the direction of the injector is turned over by 180 degrees, then the injector is gently pulled out, and finally the wound is sutured. The implantable medical device 100 is capable of remote communication with an external device 102, which may be a programmer or remote follow-up. Since the external device generally has functions of telemetry, display, processor, etc., the electrocardiographic signal parameters stored in the implantable medical device 100 can be read and processed by the external device, and meanwhile, the parameters of the implant 100 can be managed and controlled by the external device.

Fig. 2 is a schematic structural view of an implanted medical device. To reduce this interference, the antenna 212 is prevented from being mounted within the metal housing 214, since the metal housing 214 interferes with the strength of the signal transmitted by the antenna 212. The shell of the implanted medical equipment consists of two parts: a metal shell 214 and a material housing 202 through which electromagnetic signals can pass. The metal shell 214 is conductive to provide a ground electrode for encapsulation as is known in the art. The housing may also be a biocompatible material such that the package can be implanted into the patient's body. For example, one or more coatings or layers may be disposed on the outer surface of the housing to provide biocompatibility. The metal shell 214 serves as an electrode for sensing electrocardiosignals, and the antenna and the sensor can be packaged in the material shell 202 through which electromagnetic signals can pass. The two-part shell divides the shell into two parts in the direction of the longer side of the implant, and forms the partial structure of the shell in the length direction of the shell. In an actual process, the width of the two-part housing can be properly adjusted according to actual requirements. Because the interference degree of the material shell which can be penetrated by the electromagnetic signal to the antenna signal is lower, the equipment can achieve better signal transmission effect. ICM1101 is comprised of antenna 212, substrate 206, hybrid circuit 204, metal housing 214, material housing 202 through which electromagnetic signals may pass, and electronics. The antenna 212 is arranged in the middle of the hybrid circuit of the medical equipment instead of being packaged as an independent feed-through assembly, so that the space for connecting the implanted medical equipment antenna and the hybrid circuit is saved, the length of an implant is shortened, the occupied space of the medical equipment in a human body is reduced, the implantation difficulty is simplified, the side effect of the implant in the human body is reduced, and a good implantation effect is achieved. The reduction of the overall volume of the device also reduces the manufacturing cost of the product. The antenna is positioned in the same plane, and the shape of the antenna is any one of a bow shape, a plurality of continuous bow shapes, a vertical Z shape, a plurality of continuous Z shapes, a trapezoid shape, a plurality of continuous trapezoid shapes, a W shape, a plurality of continuous W shapes, an S shape and a plurality of continuous S shapes, or the combination of a plurality of shapes. The electronics of the implanted medical device may include one or more light sources. The light source may comprise any suitable light source or combination of light sources. The electronics of the implanted medical device may include one or more light sources. The light source may comprise any suitable light source or combination of light sources. For example, the light source may include any circuit component capable of emitting light in response to an applied voltage or current, such as a Light Emitting Diode (LED), a laser diode, a Vertical Cavity Surface Emitting Laser (VCSEL), an organic LED printed directly on a surface, a nano-emitter, and the like. The light source of the implanted medical device may be one or more components that emit one or more discrete wavelengths or a cluster of broadband emitters that span a wide range of wavelengths. The light source may be an encapsulated light source. The light source may be a bare semiconductor die. The light source may be adapted to emit light of any suitable wavelength or wavelengths. The light source may emit at least one of infrared light, near-infrared light, visible light, and UV light. The detector of the implanted medical device may comprise any suitable detector adapted for detecting light emitted by the light source, e.g. one or more photodiodes, photoresistors or photoresistors, phototransistors, photovoltaic cells, charge coupled devices, avalanche detectors, etc. In one or more embodiments, the light source can also be utilized as a detector. Any suitable number of detectors may be packaged inside each light source. The detector may be adapted to detect any desired wavelength or wavelengths, one or more of infrared, near infrared, visible and UV light may be detected.

Fig. 3 is a coaxial schematic of the metal housing, internal structure and material housing structure through which the electromagnetic signal can pass of the implanted medical device. The composite structure implanted inside the medical device housing is divided into three layers, the upper layer being provided with one or more electronic devices that may be provided inside the housing and not connected to the substrate 206. The electronic devices may include capacitors, transistors, hybrid circuits, sensors, light sources, detectors, accelerometers, signal processors, and the like. The middle layer of the combined structure is provided with a substrate, and the bottom layer is provided with a battery. An electrode column is arranged on a substrate implanted with the medical equipment and is electrically connected with the hybrid circuit through a metal elastic sheet. The shape of the electrode post 304 on the substrate 206, which secures the substrate to the housing of the device, is stepped cylindrical, rectangular cylindrical, stepped rectangular cylindrical, semi-cylindrical, or stepped semi-cylindrical. Substrate 206 may take any suitable shape or combination of shapes. The substrate may take a shape or combination of shapes that is complementary to the shape of the housing such that the substrate 206 may be sealed to the housing and provide a low profile shape to the sealed package. Substrate 206 may be a single unitary substrate or multiple substrates joined together. The substrate 206 is made of one or more of metal, polymer, ceramic, or inorganic material. The inorganic material may be one or more of glass, quartz, silica, sapphire, silicon carbide, and the metal housing may comprise the same material or a combination of materials as the substrate. The present invention provides a base plate 206 within the implantable medical device, and mounts and secures other structural modules on the base plate 206. Electrode posts 304 are disposed on both sides of the substrate of the implanted medical device and electrically connected to the metal spring 302 of the circuit board, and current flows in from one side of the electrode posts 304 and flows out from the other side. The composite structure is secured to the housing of the medical device by electrode posts 304. Hybrid circuit board 204 sets up on base plate 206, sets up battery 306 below base plate 206 simultaneously, has reserved great place the space for battery 306, and great battery 306 can store more electric energy, and more electric energy extension implant's working life has reduced the implant because the battery volume is less leads to the short risk of medical equipment life.

The internal assembly of the implanted medical device 100 also includes a sensor, which in accordance with the present invention is an optical sensor, comprising two parts, a light source 208 and a detector 210. The optical sensor is disposed within a material housing through which an electromagnetic signal can pass. The light source 208 is capable of shining through the material housing 202 through which the electromagnetic signal can pass. Optical sensors may be employed in IMDs as physiological sensors, and such optical sensors may be used, for example, to detect changes in levels of metabolites in the blood (e.g., oxygen saturation levels or blood glucose levels). A typical optical sensor may comprise one or more light sources and one or more detectors adapted for detecting light emitted by the light sources and modulated by, for example, a body fluid or tissue measurement volume. In order to ensure that the sensor works properly, it must be ensured that the optical signal is able to penetrate the housing of the medical device, i.e. the material housing through which the electromagnetic signal passes must be able to transmit the optical signal. The detector 210 may be electrically connected to electrodes provided on the carrier. One or more of the light sources 208 and one or more of the detectors may be disposed on a first major surface of the substrate facing the interior of the housing. The sealed package may be implanted into any suitable location within a patient and utilized for detecting a physiological condition of the patient.

Fig. 4 is a second embodiment of the relative placement of the antenna and sensor of the implanted medical device of fig. 3. Fig. 5 is a third embodiment of the relative positioning of the antenna and sensor of the implanted medical device of fig. 3. Fig. 6 is a fourth embodiment of the relative positioning of the antenna and sensor of the implanted medical device of fig. 3. Since the antenna 212 and the optical sensor (including 208 and 210) need to be placed inside the material housing 202 through which the electromagnetic signal can pass, the space utilization of the substrate 206 inside the portion of the material housing 202 through which the electromagnetic signal can pass should be improved as much as possible when placing the antenna 212 and the optical sensor, considering that the length of the antenna 212 needs to be as long as possible. The antenna 212 and sensors of the implanted medical device 100 may be placed according to the embodiments shown in fig. 4, 5 and 6, in addition to the positions shown in fig. 2 or 3. In practice, the sensor may be placed at any suitable location on the antenna. Meanwhile, the optical sensor can rotate at any angle. The optical sensors shown in fig. 2 or 3 are placed laterally in the middle of the antenna 212, and the optical sensors shown in fig. 4 and 5 are placed laterally on the sides of the antenna 212, respectively. The antenna shown in fig. 6 is positioned longitudinally to the side of the antenna 212. The optical sensor shown in fig. 6 is placed longitudinally on the side of the antenna. The placement shown in fig. 6 can increase the lateral width of the optical sensor, and reduce the occupied space to a certain extent, thereby providing a larger space for the antenna.

Fig. 7 is a cross-sectional view of the implantable medical device of fig. 2. The combined structure of the implanted medical device 100 is divided into three layers, the upper layer provided with the hybrid circuit 204, the antenna 212 and the optical sensors (208 and 210), the middle layer provided with the substrate 206 and the bottom layer provided with the battery 306. Hybrid circuit board 204 sets up on base plate 206, sets up battery 306 below base plate 206 simultaneously, can simplify the degree of difficulty that battery 306 and hybrid circuit 204 are connected, has reserved great parking space for battery 306 simultaneously, and great battery 306 can store more electric energy, and the working life of more electric energy extension implant has reduced the implant and has leaded to the shorter risk of medical equipment life because the battery volume is less. The antenna 212 is mounted in the middle of the two hybrid circuit boards 204 and is connected to the hybrid circuit 204. Thereby saved the space of switch-on, shortened the length of implant 100 to reduce the occupation space of implant 100 in human 101, simplified the implantation degree of difficulty, also reduced the side effect of implant in the human body simultaneously, reached good implantation effect, simultaneously, the reduction of equipment whole volume has also reduced the manufacturing cost of product.

Fig. 8 is a schematic diagram of another antenna configuration of an implantable medical device. The implantable medical device housing of the present invention comprises two portions, a metal housing 214 and a material housing 202 through which an electromagnetic signal can pass, which divide the housing into two portions in the direction of the longer side of the implant. The antenna 212 is encapsulated on the substrate 206 inside the material housing 202 through which the electromagnetic signal can pass. Since the length of the antenna affects the strength of the signal transmitted by the antenna, and the longer the length of the antenna, the better the signal is transmitted, the antenna should be designed as long as possible. The antenna of the present invention is located in the middle of the hybrid circuit board 204 and is encased in a material housing 214 through which the electromagnetic signal passes. The antenna 212 of the implantable medical device of the present invention may be a two-dimensional structure as well as a three-dimensional structure. The shape of the antenna with the two-dimensional structure may be any one of a bow shape, a vertical Z shape, a plurality of continuous Z shapes, a trapezoid shape, a plurality of continuous trapezoid shapes, a W shape, a plurality of continuous W shapes, an S shape, a plurality of continuous S shapes, or a combination of several shapes, besides the plurality of continuous bow shapes shown in fig. 3. The three-dimensional structure of the antenna needs to ensure that the longitudinal height of the antenna is lower than the height of the hybrid circuit board 204.

Fig. 9 is a functional block diagram of an implanted medical device. The implantable medical device ICM100 has six functions: microprocessor function 902, telemetry function 904, memory function 906, interface function 908, communication function 910, and display function 912. Generally, ICM100 is also capable of communicating 910 via telemetry 904 by connecting with external device 102, both of which collectively function as a user interface. Microprocessor function 902 of the ICM refers to the ICM's ability to autonomously process sensed cardiac electrical signals. After the cardiac electrical signal sensing and processing, the ICM stores the cardiac electrical signal through the memory 906, the storage time period is set by a chip in the ICM, and the cardiac electrical signal parameters recorded in the time period can be traced back through the shift register at the later time, so that the corresponding data can be searched and read. If the ICD is used, the microprocessor function not only comprises the function of sensing electrocardiosignals, but also has the function of diagnosing and treating diseases according to the sensed electrocardiosignals. The exertion of the ICM function can be realized through two modes, one mode is that the ICM organism can be independently regulated and controlled, and manual triggering and control are not needed. Another is telemetry 904 and control via external device 102. The external programming of the ICM is typically a programmer, patient assistant, or other device capable of commanding it or sensing its internal signals. Telemetry 904 between the ICM and external device 102 may be by one or more of wired communication, bluetooth, WIFI, LTE, or CDMA, etc. wireless communication networks. While the ICM needs to have interface functionality 908, for example, the ICD needs to implement far-field telemetry monitoring and control via a Bluetooth interface, a wireless interface, or a wired interface, the ICM has at least one of these interface functionalities.

Claims

1. An implanted medical device, characterized in that the implanted medical device is composed of an antenna, a substrate, a hybrid circuit, a metal housing, and a material housing through which an electromagnetic signal can pass; the metal shell and the material shell which can be penetrated by the electromagnetic signal jointly form a shell of the implanted medical equipment, the two shells divide the shell into two parts in the direction of the longer length of the implant body, the two shells respectively form the edge structure of the shell in the length direction of the shell, the antenna, the substrate and the hybrid circuit form a combined structure, the combined structure is packaged in the shell, and the antenna is arranged in the material shell which can be penetrated by the electromagnetic signal.

2. The implantable medical device of claim 1, wherein the implantable medical device comprises a sensor, the sensor being an optical sensor, the optical sensor comprising a light source and a detector.

3. The implantable medical device of claim 2, wherein the sensor of the optical sensor is disposed within a material housing through which the electromagnetic signal is transmittable, and wherein the light source of the optical sensor is illuminable through the material housing through which the electromagnetic signal is transmittable.

4. The implantable medical device of claim 3, wherein the composite structure of said implantable medical device is divided into three layers, the middle layer of said composite structure is provided with a substrate, the bottom layer is provided with a battery, the upper layer is provided with one or more electronic devices, said electronic devices are provided within the housing and not connected to the substrate, the electronic devices comprise capacitors, transistors, hybrid circuits, sensors, light sources, detectors, accelerometers, signal processors, and the like.

5. The implantable medical device of claim 4, wherein the antenna of the implantable medical device is located intermediate to and in communication with the hybrid circuit.

6. The implantable medical device of claim 5, wherein the antennas of the implantable medical device are located in the same plane, and the antennas are in any one of a bow shape, a plurality of consecutive bow shapes, a vertical Z shape, a plurality of consecutive Z shapes, a trapezoid shape, a plurality of consecutive trapezoid shapes, a W shape, a plurality of consecutive W shapes, an S shape, a plurality of consecutive S shapes, or a combination thereof.

7. The implantable medical device of claim 6, wherein the implantable medical device comprises an electrode post electrically connected to the hybrid circuit by a metal dome.

8. The implantable medical device of claim 7, wherein the electrode posts on the substrate of the implantable medical device are stepped cylindrical, rectangular cylindrical, stepped rectangular cylindrical, semi-cylindrical, or stepped semi-cylindrical, the electrode posts securing the substrate to the housing of the device.

9. The implantable medical device of claim 8, wherein the substrate of the implantable medical device is in any suitable shape or combination of shapes. The substrate takes a shape or combination of shapes that is complementary to the shape of the housing such that the substrate is sealed to the housing and provides a low profile shape to the sealed package.

10. The implantable medical device of claim 9, wherein the substrate of the implantable medical device is a single unitary substrate or a plurality of substrates joined together.

11. The implantable medical device of claim 9, wherein the substrate of the implantable medical device is made of one or more of a polymer, a ceramic, or an inorganic material, the inorganic material is one or more of glass, quartz, silica, sapphire, and silicon carbide, and the metal housing comprises the same material or a combination of materials as the substrate.

12. The implantable medical device of claim 1, wherein the housing of the implantable medical device is a biocompatible material such that the encapsulation is implanted within the patient's body, and one or more coatings or layers are disposed on an outer surface of the housing to provide biocompatibility.

13. The implantable medical device of claim 2, wherein the electronics of the implantable medical device comprise one or more light sources comprising any suitable light source or combination of light sources including any circuit component capable of emitting light in response to an applied voltage or current, light emitting diodes, laser diodes, vertical cavity surface emitting lasers, organic LEDs printed directly on a surface, nano-emitters, and the like.

14. The implantable medical device of claim 13, wherein the light source of the implantable medical device emits one or more components of one or more discrete wavelengths or a cluster of broadband emitters spanning a wide range of wavelengths. The light source is an encapsulated light source. The light source is a bare semiconductor die. The light source is adapted to emit light of any suitable wavelength or wavelengths. The light source emits at least one of infrared light, near-infrared light, visible light, and UV light.

15. The implantable medical device of claim 14, wherein the detector of the implantable medical device comprises any suitable detector adapted to detect light emitted by the light source, one or more photodiodes, photoresistors or photoresistors, phototransistors, photovoltaic cells, charge coupled devices, avalanche detectors, or the like.

16. The implantable medical device of claim 15, wherein the detector of the implantable medical device is adapted to detect any desired wavelength or wavelengths, the detector detecting one or more of infrared, near infrared, visible, and UV light.