The implantation of special electrodes is indicated by right ventricular dilatation and especially by electrode displacement. For this purpose the MIP 2000 has been used with good results. It is the electrode preferred currently, but it may be replaced in future by the screw electrode which is now being clinically tested. Because of the danger of uncontrolled ventricular perforation the indication for operative myocardial implantation of pacemaker electrodes should be restricted especially in cases of myogenic dilatation of the heart.