Vitatron transvenous leads are implantable and designed to be used alongside pulse generators as part of a cardiac pacing system. Contraindications may occur when a patient is suffering from tricuspid valvular disease as they also may for those with mechanical tricuspid heart valves using endocardial ventricular leads. In absence of a right atrial appendage, a passive fixation atrial lead might be able to be contraindicated. If a single dose of 1.0 mg dexamethasone sodium phosphate can be contraindicated, do not use steroid eluting leads. An implanted lead directly forms low-resistant current paths to the myocardium so it is best during lead implantation and later testing to use only equipment powered by batteries. Any line-powered equipment in use must be grounded correctly to reduce the risk of possible electric shock for either the patient or the physician.