Polymer-derived ceramics (PDC) have recently gained increased interest in the field of bioceramics. Among PDC's, carbon-rich silicon oxycarbide ceramics (SiOC) possess good combined electrical and mechanical properties. Their durability in aggressive environments and proposed cytocompatibility makes them an attractive material for fabrication of bio-MEMS devices such as pacemaker electrodes. The aim of the present study is to demonstrate the remarkable mechanical and electrical properties, biological response of PDCs modified with titanium (Ti) and their potential for application as pacemaker electrodes. Therefore, a new type of SiOC modified with Ti fillers was synthesized via PDC route using a Pt-catalyzed hydrosilylation reaction. Preceramic green bodies were pyrolyzed at 1000 degrees C under an argon atmosphere to achieve amorphous ceramics. Electrical and mechanical characterization of SiCxO2(1-x)/TiOxCy ceramics revealed a maximum electrical conductivity of 10 S cm(-1) and a flexural strength of maximal 1 GPa, which is acceptable for pacemaker applications. Ti incorporation is found to be beneficial for enhancing the electrical conductivity of SiOC ceramics and the conductivity values were increased with Ti doping and reached a maximum for the composition with 30 wt % Ti precursor. Cytocompatibility was demonstrated for the PDC SiOC ceramics as well as SiOC ceramics modified with Ti fillers. Cytocompatibility was also demonstrated for SiTiOC20 electrodes under pacing conditions by monitoring of cells in an in vitro 3D environment. Collectively, these data demonstrate the great potential of polymer-derived SiOC ceramics to be used as pacemaker electrodes.