I don't know much about pacemakers, but I thought that a lot of them now had an inductive loop so you could charge the battery through the skin.
When I was young I saw, in a museum, a nuclear-powered pacemaker. I guess they were used before battery technology improved. The power source lasted quite a while. I'm not sure how it worked, exactly. I think nuclear batteries normally generate heat and use thermocouples to create electricity, but I don't know if that's how these worked.
Just to address a minor point, open heart surgery is not required to implant a pacemaker or defibrillator. The device itself is placed under the skin via a small incision, and the leads are passed through veins into the heart via catheters. Pacemakers implants are sometimes performed on an outpatient basis, and defibrillators typically involve just an overnight stay.
What are the engineering and design challenges in creating successful IoT devices? These devices are usually small, resource-constrained electronics designed to sense, collect, send, and/or interpret data. Some of the devices need to be smart enough to act upon data in real time, 24/7. Are the design challenges the same as with embedded systems, but with a little developer- and IT-skills added in? What do engineers need to know? Rick Merritt talks with two experts about the tools and best options for designing IoT devices in 2016. Specifically the guests will discuss sensors, security, and lessons from IoT deployments.