A simple angiographic technique (right ventricular apexangiography) for positioning permanent transvenous pacemakers is described. With this technique, electrode failure occurred in only five (3%) of 186 patients followed for more than two years, as compared to an average failure rate of 23% in 11 reported series. Right ventricular apexangiography should be particularly useful in those patients in whom problems arise during insertion of a permanent transvenous electrode catheter.