If electrode displacement is suspected in a pacemaker, what should be checked next?

When electrode displacement is suspected in a pacemaker, checking the integrity of lead placement is crucial. The leads are the wires that connect the pacemaker to the heart and ensure proper electrical signals are delivered to stimulate the heart. If there is a displacement, it means that the leads are not correctly positioned, which can lead to ineffective pacing and potentially result in inadequate heart function.

Verifying the integrity of lead placement involves assessing if the leads are securely anchored to the heart muscle and ensuring they are in the correct anatomical position. This is vital for ensuring that the pacing is effective and that the pacemaker functions as intended. If the leads have moved, it may lead to reduced pacing thresholds or failure to capture the heart, meaning that the heart does not respond to the pacemaker's signals.

In contrast, while checking the pacemaker firmware, programming, or the patient's blood pressure may be important in other circumstances, they do not directly address the issue of lead displacement, which disrupts the fundamental operation of the pacemaker. Therefore, verifying lead placement is the immediate step to troubleshoot the suspected problem of electrode displacement.