Updated data on permanent cardiac pacing in Malaysia is presented. Over the past 3 1/2 years (1976-1980), 75 patients underwent insertion of pacemakers giving an annual incidence of about 20 cases as compared with a total of 21 cases in the previous 8 years (1968-1977). Many of the features reported in an earlier paper in 1977 viz mode of presentation, age and sex distribution and indications for pacing remain unchanged. Over this period only 4 patients required lead replacement. Since concentrating mainly on the use of epicardial leads implanted via a subxiphoid approach, complications have been remarkably low. The problem of availability of pacemakers has been averted. Cost remains a major consideration when recommending one pacemaker in preference over another. The details concerning clinical features, indications for pacing, complications and other problems encountered in the management of these patients are discussed.
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