Abstract: Objective To assess the feasibility and safety of using the modified active fixation pacing leads model to pace the
right ventricular outflow tract septum. Methods A total of 136 patients undergoing artificial heart pacemaker implantation
with active fixation pacing leads were randomized into two groups to receive conventional right ventricular outflow tract
pacing (CRVOTP) or modified right ventricular outflow tract pacing (MRVOTP). The electrode lead wire core was modeled in
a double-curved three-dimensional shape in CRVOTP group and in a J-shaped bend in MRVOTP group before fixation at the
right ventricular outflow tract septum. Results Right ventricular outflow tract septum pacing was achieved successfully in all
the patients. None of patients experienced serious complications. No significant differences were found between the two
groups in the number of times of electrode fixation, pacing thresholds, impedance, R wave height or QRS wave width during
the operation, but MRVOTP was associated with a reduced time of X -ray exposure and operation (P<0.05) due to the
convenience in electrode modeling and in passing the leads through the tricuspid annulus and the direct access to the right
ventricular outflow tract septum. Postoperative follow-up of the patients showed no incidence of active fixation pacing lead
dislocation and comparable pacing thresholds of the ventricular electrodes, impedance, R wave height and QRS wave width
between the two groups. Conclusion Using the modified active fixation pacing leads model to pace the right ventricular
outflow tract septum can reduce the time of X -ray exposure and operation with a low probability of lead damage.