Abstract: A medical device is configured to deliver a cardiac pacing pulse having a pacing pulse amplitude for delivery to an electrode terminal of the medical device. The medical device is configured to pull a latching current by an internal adjustable load of the medical device coupled to a low side of a high side switch of a high voltage output circuit of the medical device to hold the high side switch in a conducting state during a first portion of the cardiac pacing pulse in some examples. The medical device may be configured to pull a holding current to hold the high side switch in a conducting state during a second portion of the cardiac pacing pulse. The holding current may be less than the latching current.