Pericardioscopic implantation of electrodes for myocardial electrocardiostimulation.

Endocardial placement of electrodes for myocardial electrostimulation is a standard procedure. In the past, myocardial electrode placement was not performed routinely mainly because of the trauma of surgical access to the heart. We have developed for the first time an endoscopic approach. It is based on the use of a rigid endoscope with a diameter of 20 mm, which is introduced via a subxyphoideal skin incision into the pericardium. A sutureless, screw-in electrode is positioned via the endoscope. 129 patients were treated successfully without method-related lethality. An advantage especially for our large country is the possibility of performing this procedure in distant hospitals without the need of X-ray facilities. The equipment can be carried in an attaché case. Further developments could include two-chamber ECS using disposable kits ready for on-the-spot use.