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A modification of the technique for placing a permanent epicardial electrode to the atrium is described. It results in long-term atrial pacing and low sensing thresholds. The method requires meticulous surgical technique but is reliable, safe, and free from serious or long-term complications.

The unique concept of an atrioventricular electrode is presented. This transvenous electrode is incorporated into one body and has the mechanical advantages of double fixation and atrial or ventricular sensing or pacing. With the "extension wire principle," it can be used for diagnostic or therapeutic purposes, short- or long-term pacing. The optimal pacemaker setting can be adjusted according to the individual needs of the patient and can easily be converted to a permanent system. This atrioventricular electrode was used for long-term atrial pacing in 4 patients with tachyarrhythmia syndrome. There were no electrode-related complications. Atrial pacing was maintained in all patients. The longest follow-up period was 2 1/2 years.