The present disclosure pertains to methods, devices and systems for detection of a lead-related condition in a medical electrical lead. In accordance with the disclosure, a physiological waveform interpreter module embedded within the lead functions to sense the occurrence of a cardiac event and to generate a minimal impact signal. In an example implementation, the physiological waveform interpreter module is disposed proximate to the sensing site or vicinity of cardiac signals. The physiological waveform interpreter module transmits the minimal impact signal that may include one or more predetermined properties to a remotely located lead monitoring module upon sensing a cardiac event. The lead monitoring module receives and processes the minimal impact signal to determine whether a cardiac depolarization has occurred and simultaneously verify the integrity of the transmission medium.