The medical profession is conservative and changes slowly; and rightly so. With the lives of patients on the line, conservatism goes hand in hand with proven safety and efficacy. But with the current healthcare environment and the move towards managed care, large buying groups and government contracting, designers of implantable medical devices and other consumer products are facing pressures to reduce cost. In addition, they must reduce size, enhance performance and maintain a high level of reliability.

Life-critical cardiac rhythm management (CRM) products—implantable pacemakers and implantable cardioverter-defibrillators (ICDs), for example—are not immune to these pressures. Because these devices are implanted in the human body, reliability is paramount. A recall could have devastating effects, not only on the financial bottom lines of those involved, but also the lives of patients.

With all implantable medical devices, there are pressures to reduce size, increase functionality and extend battery life. These pressures all require improvements in the current packaging technology. To the patient, a small device is less intimidating and noticeable than a large one, the incision is smaller, the procedure is less obtrusive and the body heals more quickly.

With smaller electronics, more options can be fit into the package, allowing for features such as RF transceivers for wireless communication, advanced sensors to optimally time pacing and defibrillation shocks and backup systems in case the main system fails. While integrated circuits (ICs) have taken advantage of advances in dense packaging, such as die stacking, in most cases the discrete components remain unchanged. Market pressures are now forcing improvements in the current discrete packaging.