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Wireless body sensor network (WBSN) has gained significant interests as an important infrastructure for the realtime biomedical healthcare system, while the security of the sensitive health information becomes one of the main challenges. Due to the crucial constraints of low power in the sensors, traditional security mechanisms and key distribution schemes are not suitable for WBSN. In this paper, we investigate a novel energy-efficient approach, BodyKey, that can generate and distribute the cryptographic keys using the electrocardiograph (ECG) biometrics in WBSN. The proposed BodyKey represents the biometric features as ordered set, and deals with the biometric variations using a new fuzzy construction with set reconciliation. In this way, only limited necessary information needs to be communicated for key agreement, and the total energy consumption for key distribution can thus be reduced. The proposed approach has been implemented and evaluated on the public domain PTB diagnostic set database with 290 subjects. Experimental results and security analysis for accuracy performance, energy consumption and security property show that BodyKey is a promising and practical key distribution scheme for secure communications in WBSN.