What testing confirms lead integrity during pacing lead assessment?

• A. Visual inspection alone is sufficient.
• B. Impedance testing and pacing threshold assessment confirm lead integrity.
• C. Lead integrity is not routinely checked.
• D. Battery status alone confirms lead performance.

Answer: (B)

Testing lead integrity hinges on the electrical performance of the lead, specifically impedance and pacing threshold. Impedance testing measures the resistance of the lead circuit; normal impedance suggests the conductor and insulation are intact, while sudden changes indicate issues such as a fracture or insulation break. Pacing threshold assessment shows the minimum energy needed to consistently capture the myocardium; a stable, low threshold signals good lead-tissue contact and function, whereas increasing thresholds or loss of capture point to problems like lead displacement, insulation wear, or maturation of tissue at the tip. Together, these measurements provide a practical, functional check of the lead's integrity. Visual inspection alone may miss internal damage, and battery status doesn't reflect lead performance, so impedance and threshold testing are the key tools used during pacing lead assessment.