Dual-chamber pacing is commonly used as a pacing mode maintaining at-rioventricular synchrony. However, traditional technique for atrial J lead implantation is relatively time-consuming and not easy to get optimal sites for both atrial and ventricular leads, especially for less-experienced operators. We developed a new "push technique" for atrial J lead implantation.

This study included sixty-two consecutive patients (26 males 36 females, 55±10 years, 56 patients received DDD and 6 received AAI pacemakers) from Jan. 1992 through Dec. 1996. Atrial J leads were implanted using a "push technique", that is, simply advancing a straightened lead while holding the stylet in the pacing lead at the junction of the superior vena cava and the right atrium. We evaluated the early and long-term result of atrial J lead implantation by the "push technique".

1) Atrial leads were successfully inserted by the first or second trial of the "push technique" in the 62 patients (100%). The sensed P wave amplitude was 3.1±1.0 mV, pacing threshold 0.6±0.2 V at the pulse width of 0.5 ms, impedance 547.4±118.5 ohms at 5 V. 2) During follow-up of 28.1±15.7 months, significant changes in the pacing parameters and the dislodgement of atrial leads were not seen.

The early and long-term result of atrial J lead implantation by the "push technique" was excellent. This "push technique" can be used as an easy alternative technique for atrial J lead implantation.