Experiences with a new myocardial electrode for permanent cardiac pacing

The first experiences with a new myocardial sutureless screw-in electrode for cardiac pacing are reported. A brief description of the technique is given. The electrode can be inserted quickly and safely under direct vision through a small anterior thoracotomy using a special inserter tool. The heart can be brought under pacemaker control in less than 5 minutes. The technique was employed in 15 patients. Results to date are promising and it is suggested that this method should be resorted to in cases of unstable pacing or recurrent dislocation of an endocardial lead, or when there are difficulties in the proper positioning of an electrode transvenously. In Sweden endocardial electrodes for transvenous insertion predominate. In many countries, especially the U.S.A., there is extensive experience of epi- or myocardial pacing leads (2, 4, 5). Some authors consider epicardial pacemakers safer than endocardial pacemakers for permanent cardiac pacing (8). We have observed defective or unstable pacing with endocardial electrode in a high proportion of patients in our series early after the implantation and even after many years of perfect pacing. When there are problems with an endocardial lead an epi- or myocardial electrode can be used. This paper reports experiences with a new sutureless myocardial electrode (Medtronic model 6917).