An endocardial apparatus for pacing four chambers of a heart, comprising: a power source housed in an implantable can, first, second and third leads having proximal and distal ends, each lead being electrically connected to the power source at its proximal end and extending into a
vein proximal the heart, the first lead connecting at its distal end to an
electrode that is in electrical contact with the
right atrium of the heart, the second lead connecting at its distal end to an
electrode that is in electrical contact with the right
ventricle of the heart, the third lead connecting at a point proximal its distal end to a first
electrode that is in electrical contact with the inside of the
coronary sinus and oriented so as to stimulate the
left atrium of the heart and connecting at its distal end to a second electrode that is in electrical contact with the inside of the great cardiac
vein and oriented so as to stimulate the left
ventricle of the heart. Devices are also disclosed for orienting and maintaining the position of the electrodes on the third lead.