Danish Randomized Trial on Leadless vs Transvenous Pacing

Inclusion Criteria: * First time pacemaker implantation on class I or II ESC recommendations for AVB with an expected amount of right ventricular pacing \>80% of the time, * Age 75 years or older * Intact sinus node function * Expected survival more than 12 months based on clinical evaluation * Able to provide informed consent Exclusion criteria: * Persistent or previous cardiac implantable electronic device i.e., pacemaker, ICD, or CRT. * Persistent, or chronic atrial fibrillation * Reversible AVB * Transient AVB due to ongoing ischemia * Heart failure NYHA class III-IV * Heart failure with branch block and indication for CRT implantation, irrespective of NYHA class * Indication for primary or secondary prophylactic ICD implantation * Acute myocardial infarction (AMI) within 3 months * Severe chronic pulmonary disease with pulmonal hypertension limiting exercise capacity * Expected survival \< 12 months based on clinical evaluation * Performing high intensity sport * Participation in another trial with experimental treatment * Contraindication against device implantation (e.g., concurrent infection) * Failure to provide informed consent