A wireless communications system optimizes performance by dividing communications functionality between a wireless pacemaker and a wireless monitoring base station according to the design constraints imposed by the system elements. Typical design constraints include high frequency operation, low pacemaker power consumption, reasonable range, high data rate, minimal RF radiation of internal circuitry, small pacemaker antenna system, simple pacemaker RF circuit design, high reliability, low pacemaker cost, and use of existing pacemaker construction methodologies.