The present invention includes devices and methods for pacing contact, lead, conduit or other medical fixture placement in tissues or organs. The invention features an articulating multiple suction foot device, comprising an inner vacuum conduit and foot slidingly contained within an outer vacuum conduit and foot, with the inner vacuum conduit and foot configured to extend beyond the outer vacuum suction foot, and to be further articulated once extended; as well as a separate tissue or waste removal vacuum assembly that extends within the inner vacuum conduit to the inner vacuum foot to remove cut tissue prior to its advancement beyond the outer vacuum suction foot. The device is configured to permit the placement foot, such as a suction foot, to articulate to a desired position with respect to the target tissue, while the pacing contact, lead, fluid conduit or other medical fixture is releasably attached to the placement foot to permit it to be released from the placement foot after stabilization on the target tissue site.