Compared to regular ventricular leads, single-pass VDD leads have two additional floating electrodes proximal to the ventricular tip, which enables them to detect atrial signals. Because of the latter, VDD leads are thicker than ventricular leads, which could affect ventricular pacing. The purpose of the present study was to compare ventricular pacing of a steroid-eluting single-pass VDD lead (CapSure VDD, Medtronic; n = 107) with the same steroid-eluting regular lead (CapSure SP, Medtronic; n = 39) implanted in the ventricle; both leads were connected to the same types of pacemakers. At implantation, pacing thresholds were measured at 0.5-ms pulse duration and impedance by means with the PSA. At discharge, as well as after 1 and 3 months, pulse duration thresholds were determined at 2.5 V pulse amplitude and impedance by telemetry. At implantation, pacing thresholds and impedance were not different in the VDD (0.38 +/- 0.16 V; 691 +/- 122 omega) and ventricular lead group (0.44 +/- 0.17 V; 648 +/- 150 omega). During follow-ups, no differences in pulse duration threshold were detected between the two groups neither at discharge (VDD = 0.05 +/- 0.03 ms; ventricular 0.05 +/- 0.02 ms), nor after 1 (VDD = 0.05 +/- 0.02 ms; ventricular 0.08 +/- 0.07 ms) and 3 months (VDD = 0.06 +/- 0.03 ms; ventricular 0.09 +/- 0.10 ms). There were also no significant differences for impedance at discharge (VDD = 675 +/- 113 omega; ventricular = 594 +/- 113 omega), after 1 (VDD = 678 +/- 131 omega; ventricular = 627 +/- 112 omega) and 3 months (VDD = 652 +/- 99 omega; ventricular = 628 +/- 105 omega). Pacing thresholds and impedance were neither significantly different at implantation nor during follow-ups between patients with steroid-eluting VDD leads and patients with an equivalent ventricular lead indicating that the thicker VDD lead does not affect ventricular pacing.