Present indications for a myocardial pacemaker electrode.

A myocardial electrode was implanted in 43 patients on special indications at a pacemaker centre, where the transvenous technique was used as the routine method for implantation of a stimulating electrode. The electrode was inserted through a small anterior thoracotomy or at open-heart surgery. The complications and deaths during the follow-up period of two-and-a-half years are reported. The results to date are quite satisfactory. Indications are suggested and the main advantages of a myocardial electrode in clinical use are discussed. The Medtronic myocardial electrode model 6917 should be resorted to as a very good alternative on failure of pacing with an endocardial lead. The hazards of thoracotomy must, however, be borne in mind. This approach should be used with restraint in very old patients and in patients with severe heart disease, particularly those with a recent myocardial infarction.