A comprehensive cardiac pacing and ICD survey of the Asian Pacific region, Middle East, South America, and Canada was undertaken for calendar year 1997. Thirteen countries in the Asian Pacific region contributed to the survey. There were also two countries from the Middle East, three from South America, and Canada. Accurate numbers of new implants and replacements were obtained for cardiac pacemakers. In the Asian Pacific region, Japan with almost 20,000 implants, had the largest number of pacemaker implants, but Australia had the highest implant rate with 345 new implants per million population. However, Canada and Uruguay had higher new implant rates per million. The major indication for implantation of a cardiac pacemaker was high degree atrioventricular block. There was a high incidence of single chamber ventricular pacing in the developing countries of Asia. Only a few countries used substantial numbers of single lead VDD and AAIR pacing systems. Pacing leads were predominantly transvenous, bipolar, passive fixation, and steroid eluting. Active-fixation leads were also used in the atrium. With ICD use, Australia had the highest new implant rate per million population. The major indications were sudden death and ventricular arrhythmias. A group of enthusiastic survey coordinators has now been established. It is hoped to continue physician and country recruitment, particularly in the Middle East and South American regions to establish a fully global experience of cardiac pacing and ICD use.