“…Our initial use of the transvenous pacemaker resulted in the rehabilitation of elderly patients without the mortality or morbidity that attended implantation of pacemakers by thoracotomy. With continued improvements in the electronic circuits, the indications for transvenous pacemaker insertions have expanded considerably (8)(9)(10)(11). The purpose of this paper is to present our current indications for permanent pacemaker therapy, to describe the complications attending the use of these implantable devices, and to outline the course of management that has evolved in the Division of Cardiovascular Surgery of the Toronto General Hospital.…”