Between April 1, 1965, and May 1, 1973, we inserted permanent transvenous pacemakers in 400 consecutive patients. Patients considered for this type of pacing were those with any episode of heart block and those with other types of bradyarnhythmias who had unexplained vertigo or syncope. There was one operative death and one instance in which the primary unit became infected. Problems with catheter dislocation, electrode fracture, and exit block were few and were easily corrected. We believe transvenous permanent pacing to be the best method of cardiac pacmaking in these patients. It is well tolerated by largely avoidable and easy to correct.