Synthesizing stealthy reprogramming attacks on cardiac devices

Nicola Paoletti, Zhihao Jiang, Md Ariful Islam, Houssam Abbas, Rahul Mangharam, Shan Lin, Zachary Gruber, Scott A. Smolka

Research output: Chapter in Book/Report/Conference proceedingConference contribution

2 Scopus citations

Abstract

An Implantable Cardioverter Defibrillator (ICD) is a medical device used for the detection of potentially fatal cardiac arrhythmias and their treatment through the delivery of electrical shocks intended to restore normal heart rhythm. An ICD reprogramming attack seeks to alter the device’s parameters to induce unnecessary therapy or prevent required therapy. In this paper, we present a formal approach for the synthesis of ICD reprogramming attacks that are both effective, i.e., lead to fundamental changes in the required therapy, and stealthy, i.e., are hard to detect. We focus on the discrimination algorithm underlying Boston Scientific devices (one of the principal ICD manufacturers) and formulate the synthesis problem as one of multi-objective optimization. Our solution technique is based on an Optimization Modulo Theories encoding of the problem and allows us to derive device parameters that are optimal with respect to the effectiveness-stealthiness tradeoff. Our method can be tailored to the patient’s current condition, and readily generalizes to new rhythms. To the best of our knowledge, our work is the first to derive systematic ICD reprogramming attacks designed to maximize therapy disruption while minimizing detection.

Original languageEnglish
Title of host publicationICCPS 2019 - Proceedings of the 2019 ACM/IEEE International Conference on Cyber-Physical Systems
EditorsGowri Sankar Ramachandran, Jorge Ortiz
PublisherAssociation for Computing Machinery, Inc
Pages13-22
Number of pages10
ISBN (Electronic)9781450362856
DOIs
StatePublished - Apr 16 2019
Event10th ACM/IEEE International Conference on Cyber-Physical Systems, ICCPS 2019, part of the 2019 CPS-IoT Week - Montreal, Canada
Duration: Apr 16 2019Apr 18 2019

Publication series

NameICCPS 2019 - Proceedings of the 2019 ACM/IEEE International Conference on Cyber-Physical Systems

Conference

Conference10th ACM/IEEE International Conference on Cyber-Physical Systems, ICCPS 2019, part of the 2019 CPS-IoT Week
CountryCanada
CityMontreal
Period04/16/1904/18/19

Keywords

  • Arrhythmia discrimination
  • Implantable Cardioverter Defibrillator
  • Medical device security
  • Model-based attack synthesis
  • Reprogramming attack

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  • Cite this

    Paoletti, N., Jiang, Z., Islam, M. A., Abbas, H., Mangharam, R., Lin, S., Gruber, Z., & Smolka, S. A. (2019). Synthesizing stealthy reprogramming attacks on cardiac devices. In G. S. Ramachandran, & J. Ortiz (Eds.), ICCPS 2019 - Proceedings of the 2019 ACM/IEEE International Conference on Cyber-Physical Systems (pp. 13-22). (ICCPS 2019 - Proceedings of the 2019 ACM/IEEE International Conference on Cyber-Physical Systems). Association for Computing Machinery, Inc. https://doi.org/10.1145/3302509.3311044