The intrathoracic subclavian venous technique for pacemaker implantation may be associated with serious complications. Axillary vein puncture tends to reduce lead implantation complications such as pneumothorax and lead crush, but clinical adoption is not widely acknowledged, especially in China, although this approach has been proposed for 20 years. The major concern is the learning curve for axillary vein puncture and its success rate. The investigators try to prove that the success rate of axillary vein puncture is non-inferior to subclavian vein puncture, hence to promote the clinical application of axillary vein puncture to reduce pacemaker implantation complications.

Inclusion Criteria:

• Patients with indication of pacemaker or ICD implantation
• Personally signed and dated informed consent document

Exclusion Criteria:

• Accompanied with malignant disease or other disease, which cause life expectancy < 1 year.
• Anatomical variation of axillary vein or subclavian vein, unable to puncture.
• Poor compliance for follow-up.
• Patients with any condition which, in the investigator's judgment, not suitable for enrollment.