The present invention includes devices and methods for lead, conduit or other medical fixture placement in tissues or organs. 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 lead, 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. In a preferred embodiment, the invention features an articulating dual suction foot device, an inner lead conduit or guide and foot contained within an outer lead conduit or guide and foot, with the inner conduit or guide configured to extend from the outer conduit or guide, and to be further articulated once extended.