The present invention provides for transesophageal implantation of cardiac electrodes (102) and (104) for pacing and/or defibrillation The electronic module (110) could be implanted in the abdomen or thorax using a transesophageal, transgatric, thoracoscopic or open surgical approach In another aspect, the invention provides for transesophageal delivery of other cardiac therapies including ablation, phototherapy, radiation therapy and implantation or injection of therapeutic substances into the heart The transesophageal approach takes advantage of the proximity between the esophagus and the chambers of the heart, allowing surgical access to the heart with very low morbidity and risk of complications.