An implantable medical device or some other ambulatory medical device, such as a pacer, defibrillator, or other cardiac rhythm management device can include an electrical energy delivery circuit, such as including an integrated circuit comprising a first electrostimulation output terminal, a can terminal, and a switch control output. The ambulatory or implantable device can include at least two switches in series, each including a respective substrate electrically separate from the integrated circuit, and from each other, the switches configured to controllably isolate a conductive housing of the implantable medical device from the can terminal of the integrated circuit, such as in response to the switch control output.