The records of all 380 adult patients receiving cardiac pacemakers at West Virginia University in the 15-year period ending January 1, 1977, were reviewed. The five-year survival rate was 58 per cent and the 10 year, 38 per cent with a median survival of 74 months. Life expectancy approached life-table curves if the mortality during the initial year was ignored. Although the younger patients lived the longest, their expected survival was reduced more than in the older patients. The need for a pacemaker in a young person implies serious life-shortening consequences. Unlike reports in the literature, patients with sinoatrial disease fared worse than those with A-V block.