To investigate the success rate of implanting shorter pacing leads, the post-operative complication rate after implanting shorter leads and relative factors to assess surplus lengths of the right ventricalar or right atrial leads.

Eligible patients were recruited from patients receiving pacemaker implant between May 2016 and February 2017 in Zhongshan Hospital and were randomized to conventional-lead group and shorter-lead group. The patients in conventional-lead group were implanted with normal length leads and patients in shorter-lead group were implanted with shorter length leads. The complications were recorded at 1, 3, 6 months after implantation. The success rate of implanting pacemaker, the complication rates and the surplus lengths of right ventricalar or right atrial leads in different venous paths were compared between groups. Meanwhile, the correlation between these parameters before implanting and the surplus lengths of the right ventricalar or right atrial leads were analyzed.

The success rate of implanting pacemaker was separately 100% in both of the two groups. There was no significant difference in the post-operative complication rates between groups. When choosing left subclavian vein approach, the surplus length of the right atrial lead and right ventricular lead in shorter-lead group and conventional-lead group separately had statistically significant differences[ (13.8±2.8) cm vs. (20.9±3.9) cm, P<0.001, (12.1±3.0) cm vs. (17.8±3.8) cm, P<0.001]. When choosing either right subclavian vein approach or cephalic vein approach, the surplus length of the right atrial were significantly shorter than conventional-lead group. And the rate of coiling leads into the pocket at once in shorter-lead group was higher than in the conventional-lead group (90.8% vs. 68.1%, P<0.001) . The surplus length of the right atrial lead was negative correlated to the age, height, weight, aortic dimension and was associated with different venous paths. The surplus length of the right ventricle lead was negative correlated to height, weight, aortic dimension, left atrial diameter and left ventricular diameter and was associated with different venous paths in shorter-lead group. In multivariate Cox linear regression analysis, we observed that the surplus length of the right atrial lead was negative correlated to the age and weight and no factors associated with the surplus length of the right ventricle lead was detected.

It is reliable and safe to implant shorter-leads pacemaker in Chinese through either left or right subclavian vein, which reduce the complexity and saved operation time. The surplus lengths can be predicted before implanting through the height, weigh, left atrial, left ventricular diameters and different venous path.

Pacemaker leads; Feasibility; Short