Abstract
The ability to remotely reprogram a cardiac implantable electronic device (CIED) and the ability to remotely install software or firmware updates would reduce the need for in-office visits and could provide a mechanism to rapidly deploy important software or firmware updates. The challenges of implementing remote reprogramming of cardiac implantable electronic devices are no longer technical. Using asymmetric cryptography, sophisticated end-to-end secure communication protocols and hardware accelerators, the resources required to identify and take advantage of a cybersecurity vulnerability of a single CIED would be very significant and likely well beyond the gain that an intruder would deem worthwhile.
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