Remote health-care monitoring systems communicate biomedical information (e.g. Electrocardiogram (ECG)) over insecure networks. Protection of the integrity, authentication and confidentiality of the medical data is a challenging issue. This chapter proposed an encryption process having a 4-round five steps -encryption structure includes: the random pixel insertion, row separation, substitution of each separated row, row combination and rotation. Accuracy and security analysis of proposed method for 2D ECG encryption is evaluated on MIT-BIH arrhythmia database.