Introduction To follow up for cardiac pacing in 921 patients in 28 years.  Methods Patients data pacemaker numbers and model surgical procedures and complications were compared in two patient groups before and after year 1990. Results 921 pacemakers were implanted in 774 patients (man 444woman 330) VVI pacing 83.4 physiological pacing16.4 and other 1.31 (anti-tachycardia and bi-ventricle pacing). After 1991 more patients were found with organic heart diseases for pacemaker implantation and the percentage of III atrioventricular block (AVB) decreased II AVB sick sinus syndrome (SSS) and atrial fibrillation (Af) with AVB increased leads implanted through cephalic (17.7) or subclavicular vein (82.3) a significant decline in major complications (early failure of battery life leads dislocation and pocket infection etc) (P＜0.05). The operation related death rate was 0.41. 146 patients had pulse generators replaced for 197 times. The reason toreplace included end of battery life (77.7) pacemaker mal-function (3.8) and complications (18.5).  Conclusions The pacemaker number and physiological pacing increased steadily after 1991. Leads implanted switched from cephalic vein to subclavian vein. The indication for pacing was expanded from bradycardia to tachycardia and other diseases. There are less complications and operation related death.
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