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In this work, the potential of load adaptation for enhanced back-off efficiency in RF power amplifiers (PAs) is investigated through a 0.13-mum silicon-on-insulator (SOI) CMOS fabrication technology. To this aim, the first CMOS PA with fully integrated reconfigurable output matching network is presented. The PA delivers a 24-dBm maximum output power while operating at 2.4 GHz and 2-V supply voltage. A significant efficiency improvement of up to 34% is achieved through load adaptation, peak efficiency being as high as 65%. Linear operation is also demonstrated under two-tone excitation, since a 16-dBm output power is attained while complying with a -40-dBc IM3 specification.