How do you fix low impedance or an insulation break?

The correct approach to addressing low impedance or an insulation break is to replace the compromised lead. This action is necessary because a low impedance or insulation break typically indicates that there is a significant issue with the lead’s integrity, potentially compromising the effectiveness of pacing and creating safety concerns.

When replacing the lead, it is critical to correctly cap the old lead to prevent any electrical interference while placing a new lead at a site that is adequately distanced from the previous one, typically around 1 cm. This allows for a clear pathway for pacing signals without interference from the defective lead, ensuring reliable device performance.

Alternative methods, such as increasing the pacing current or adjusting sensitivity settings, do not address the fundamental problem of lead insulation integrity. Reprogramming the device to higher voltages could provide a temporary solution but would not resolve the underlying issue of lead function and might lead to further complications. Thus, lead replacement stands out as the most effective and appropriate solution in such scenarios.