You're not thinking like a modern *aaS company. I'm waiting for subscription-based pacemakers. $9.95/mo for up to 60 beats per minute or $19.95 for unlimited heartbeats. Sign up for a year now and get an additional 3 months free :)
"We hope this message finds you with your beats still strong and rhythmic. It is with a heavy heart (pun fully intended) that we, at PulsarTech, your trusted provider of the world's first Internet-connected pacemaker, announce the discontinuation of our heartbeat-as-a-service (HaaS) platform. Yes, it’s time to say goodbye to those sweet, life-sustaining firmware updates and cloud-synced palpitations."
I'm hoping that in this hypothetical there is an OpenHeart group that shared software and build scripts for self-hosting the heartbeat cadence functionality.
It's not the pacemaker malware you want to worry about, it's the pacemaker ransomware!