Concurrent lead impedance reduction in both leads of a dual-chamber pacemaker secondary to generator defect

Pacing malfunction can arise from structural integrity failure of the leads, and one of the main causes of lead integrity failure is insulation breach, which is recognized by low impedance. We present a rare case of decreased impedance in both right atrial (RA) and right ventricular (RV) leads of a dual chamber pacemaker due to generator failure with intact lead insulation. The removed device analysis revealed a bonding anomaly between the header and base can, leading to fluid ingress electronic circuitry damage that led to measured low impedances.