30-10-2020 | By Robin Mitchell
Recently, Dr Mohamad implanted the first Bluetooth-enabled heart defibrillator in a patient with success. What do implanted defibrillators do, what makes this achievement important, and what repercussions can be expected from wirelessly controlled medical devices?
An implantable defibrillator is a device that is implanted into the human body and has electrodes attached to various points around the heart to perform different functions, including monitoring, cardioversion, defibrillation, and pacing. Under normal conditions, the implanted defibrillation only monitors heart pulses, but if arrhythmias start (i.e. missed beats, too fast, or too slow), then the defibrillator can take action to correct this with the use of small electric pulses. If, however, fibrillation occurs (i.e. fluttering of the heart), then the unit can provide larger shocks to help reset the hearts rhythmic pattern. Another device similar to an implantable defibrillator is the pacemaker; these are also implanted just under the skin with electrodes connected to the heart, but these are mainly used for arrhythmia only.
While many medical devices such as defibrillators and pacemakers have been implanted in the past few decades, history was recently made with the implantation of the first Bluetooth-enabled device. Dr Mohamad Sinno, a cardiac electrophysiologist, implanted a Bluetooth heart defibrillator into a patient at Edgewood hospital. The defibrillator, called Abbott Gallant, allows for doctors and patients to access and monitor the implanted device and retrieve historic data. The use of such data not only provides doctors with better insight into the patient, but the patient can reduce hospital visits as well as improve their survivability. The use of two-way authentication prevents remote access by unauthorised parties, and the success of the implantation now sees 50 patients in the queue for the Bluetooth-enabled implant.
The ability to remotely monitor implanted devices not only allows patients to track their health, but it can also be used to track the health of the device, including battery life and failures. However, the use of implanted medical devices should no be done so lightly, and security must be the highest priority in any implanted device.
Implanted devices such as those that merely monitor heart rate or oxygen content in the blood are rather benign in nature; thus, an attacker gaining access may not be able to do much if at all. However, those that can affect the body, such as an insulin dispenser or heart defibrillator, carry large risk as they can potentially be used to incapacitate the patient, or worse cause death. But causing physical harm to the patient is just one way in which criminals can perform malicious acts. Implanted devices can, in theory, be used to track individuals by looking for emitted Bluetooth signals. Another method in which criminals can take advantage of such devices is through computation theft (such as when IoT devices are forced to either perform DDoS attacks or mine cryptocurrency). However, medical devices are more likely to be unique platforms with much less processing power than a standard IoT device. Either way, security is an incredibly important factor in implanted medical devices and must be the prime focus, even before the medical function.
Implanted medical devices can provide live information regarding the human body, and if this data can be streamed to a smartphone (as is with the new Bluetooth-enabled heart defibrillator), then this data could easily be fed into a portable AI doctor. Such a system would allow for medical data to be examined over long periods as well as provide predictive medical deductions. For example, an AI doctor on a smartphone with access to patient heart data may be able to predict heart attacks before they occur, and this could provide patients with precious moments to call an ambulance or seek medical help. The same system is could even able to call an ambulance automatically and use location data to provide the emergency services with the precise location of the patient. The same system can also be ideal for treatment whereby doctors can prescribe different medications and observe the medical data over the following weeks.