If an atrial lead has dislodged into the ventricle and is sensing the QRS, what action should be taken?

The correct action is to program the device to VVI mode. This decision is based on the need to ensure appropriate pacing and sensing capabilities when there is an issue with the atrial lead.

When an atrial lead dislodges into the ventricle and begins sensing the QRS complex, it can lead to potentially inappropriate behavior from the device. It may trigger the pacing output at inappropriate times, which can create interference with the heart's normal rhythm and lead to complications such as tachycardia. In VVI mode, the device is set to sense and pace only from the ventricle, eliminating the interference caused by the inappropriate sensing of atrial activity and allowing for reliable ventricular pacing.

This choice is advantageous as it helps maintain hemodynamic stability while a proper plan for lead repositioning may be arranged. Other options, such as programming the device to DDD mode, would not be suitable because having a dislodged lead sensing the QRS can cause dual-chamber pacing inappropriately, leading to further complications. Simply leaving the device on its current setting would not address the sensing issue, and surgical repositioning of the lead, while necessary in the long term, is invasive and not immediately required when a safe pacing strategy can