Resilient Control Under Side-Channel Compromise for IoMT Devices

As Internet of Medical Things (IoMT) ecosystems expand, life-critical devices become increasingly vulnerable to microarchitectural leakage attacks that enable adversaries to evade conventional digital authentication mechanisms. Exploiting timing and cache leakage allows adversaries to extract credentials and issue cryptographically valid commands with physiologically unsafe parameters, a systemic weakness we define as the verified attacker problem. This work introduces a dual-layer physiological and side-channel defense architecture that maintains patient safety even under credential compromise. At the perception layer, single-lead 1D electrocardiogram (ECG) telemetry is restored using a 1D Denoising Autoencoder (1D-DAE) to counteract hardware perturbation proxies: actuation jitter, cache eviction block erasures, and password verification timing interference. The 1D-DAE maintains high signal reconstruction fidelity (PSNR≈29.1–36.7dB, SSIM≈0.81–0.89), stabilizing diagnostic classification accuracy above 90% across all perturbation conditions. At the actuation layer, a Control Barrier Function (CBF) filter enforces physical safe-set invariance, instantly projecting a malicious pacing command injection (ureq=300BPM) down to a safe 140BPM bound using real-time Quadratic Programming (QP). Hardware profiling yields an end-to-end execution latency of 2.09ms and a low 7.2mJ energy footprint per cycle, confirming real-time feasibility for continuous 360Hz telemetry monitoring and safe closed-loop pacing.