Background: Transvenous lead (TVL)implantation in patients with a septal defect can result in complications. With the advent of the transvenous septal occlusions(TVSO) risks can be minimized. The purpose of this study is to evaluate the outcomes of transvenous lead implants after device closure of a septal defect. Methods: IRB approved multi-center review. Data collected included:cardiac diagnosis, indication and complications of septal closure,indication, initial and long-term follow up of leads. Results: We identified 11 patients who underwent TVSO followed by implantation of TVL(s). Eleven TVSOs (9 atrial, 1 ventricular and 1 both) were placed. Median age was 13 years (range 4-21.) No complications resulted [median 60 months (range 2-153).] Leads were implanted: same stay (6), < 3 months later (2) or > 3 months (3.). Indication for device: [pacer (7) / ICD (4)] was complete atrio-ventricular block (5), sinus node dysfunction (2) and aborted sudden death (4). No complications occurred with leads [average 44 months (range 5-84).] No significant difference were noted in thresholds (average: Atrium; implant = 0.5 V at 0.4 ms, follow up = 0.6V at 0.4 ms, Ventricle; implant = 0.6 V at 0.5 ms, follow-up 0.9 V at 0.5 ms.) Conclusion: Implantation of TVL can be successfully performed after TVSO. TVL can be implanted during the same hospital stay as TVSO is performed. Acute and chronic thresholds are not affected by septal occlusion device placement in short-term follow-up. A large study with long term follow up is warranted to evaluate lead and device longevity.