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@article{204881,
        author = {Harsh Bhaskar and Dr Lubna Luxmi Dhirani},
        title = {Securing Pacemakers in the Internet of Medical Things: Lightweight Cryptography and Mitigation of Cybersecurity Vulnerabilities},
        journal = {International Journal of Innovative Research in Technology},
        year = {2026},
        volume = {13},
        number = {1},
        pages = {4059-4064},
        issn = {2349-6002},
        url = {https://ijirt.org/article?manuscript=204881},
        abstract = {Pacemakers are life-saving implantable medical devices that increasingly form part of the In- ternet of Medical Things (IoMT), enabling continuous remote monitoring and adaptive therapy. At the same time, their wireless connectivity exposes them to critical cybersecurity risks, including spoofing, replay, denial-of-service, and unauthorized reprogramming, any of which could directly compromise patient safety. [1, 2] Recent recalls and security analyses have shown that attackers can abuse unprotected communication channels to drain batteries, alter therapy parameters, or trig- ger inappropriate shocks. [2, 6] This paper examines these vulnerabilities and evaluates a set of lightweight cryptographic protocols—Elliptic Curve Cryptography (ECC), SPECK, SIMON, and Hummingbird—as practical mitigation strategies for resource-constrained pacemakers.
Using a MATLAB-based simulation framework, we emulate cardiac electrical activity under bradycardia (< 60 bpm), normal sinus rhythm (60–100 bpm), and tachycardia (> 120 bpm) and insert inline encryption between ECG signal processing and wireless telemetry. For each protocol, we quantify encryption time, energy overhead, ECG signal integrity, and resistance to spoofing and replay attacks. The results indicate that ECC and SPECK offer the most attractive trade-off between security and performance, delivering up to a 90% reduction in spoofing success rate with only 3– 4.5% additional energy consumption and less than 10 ms added latency. All four protocols preserve accurate R-peak detection and do not distort clinically relevant ECG features, demonstrating compatibility with real-time pacing demands. Taken together, these findings support the use of lightweight cryptography as a viable path toward secure-by-design pacemakers in the IoMT ecosystem. [6]},
        keywords = {Pacemaker security, Internet of Medical Things, lightweight cryptography, ECC, SPECK, SIMON, Hummingbird, ECG simulation.},
        month = {June},
        }