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Summary Steroid eluting leads introduced in 1983have been shown in a series of 51 atrial and 73ventricular leads (Med­ tronic 4503and 4003)to offer no significant benefit in terms of sensing or pacing in either chamberat implant. All leads were tested non-invasively at follow-up using the patients' implanted generator (Pacesetter 283,285, Bio­ tronik Diplos 04, OS, Medtronic 7005).In short term follow-up significantly larger P waves were seen 3.16 ± 2.16 vs 1.97 ± 0.97mVin comparisons madewith presently available Medtronicstandard atrial leads. Both short and long term atrial thresholds were highly significantly improved 1.10 ± 0.55 vs 1.65 ± 0.94 V and 0.93 ± 0.09 vs 1.07 ± 0.28 V respectively. Short, medium and long term ventricular thresholds were also were significantly improved 0.90 ± OvsO.96 ± 0.13V, 0.91 ± 0.07vs 1.19 ± 0.47 V and 0.97 ± 0.2 vs 1.07 ± 0.29V. Existence of sinus node disease does not appear to influence atrial sensing in the short and medium term. In conclusion, the addi­ tion of steroid-elution to electrode design is an important advance in pacing technology and offers the possibi­ lity of safe long term pacing at 2.5 V output or even lower and permits maintenance of P wave detection in the short and medium term which is the period of greatest atrial sensing problems.