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In this paper, wireless telemetry using the near-field coupling technique with round-wire coils for an implanted cardiac microstimulator is presented. The proposed system possesses an external powering amplifier and an internal bidirectional microstimulator. The energy of the microstimulator is provided by a rectifier that can efficiently charge a rechargeable device. A fully integrated regulator and a charge pump circuit are included to generate a stable, low-voltage, and high-potential supply voltage, respectively. A miniature digital processor includes a phase-shift-keying (PSK) demodulator to decode the transmission data and a self-protective system controller to operate the entire system. To acquire the cardiac signal, a low-voltage and low-power monitoring analog front end (MAFE) performs immediate threshold detection and data conversion. In addition, the pacing circuit, which consists of a pulse generator (PG) and its digital-to-analog (D/A) controller, is responsible for stimulating heart tissue. The chip was fabricated by Taiwan Semiconductor Manufacturing Company (TSMC) with 0.35-μm complementary metal-oxide semiconductor technology to perform the monitoring and pacing functions with inductively powered communication. Using a model with lead and heart tissue on measurement, a -5-V pulse at a stimulating frequency of 60 beats per minute (bpm) is delivered while only consuming 31.5 μW of power.