Out of 833 pacemakers implanted between 1979 and 1983, 228 were in patients aged over 80 years (137 aged 80-84, 79 85-89, and 12 90-93). Indication for cardiac stimulation was high-grade atrioventricular (av) block in 47%, sick sinus syndrome in 38%, low ventricular response in atrial fibrillation in 13% and hypersensitivity of the carotid sinus in 1%. An average follow-up period of 29.5 months (18-78 months), focusing special interest on quality of life, revealed that of the 199 patients (87%) who were independent at the time of implantation, 29 (15%) became dependent on social services during the follow-up and during the same period 49 (21%) were rehospitalized (88 hospitalizations) for reasons other than pacemaker problems. During the first year after implantation the mortality in the "paced" population was higher than in the general population of the same age groups; thereafter the survival curves run almost parallel. Mortality does not differ between persons paced for av block of for sinus node disease. We conclude that cardiac stimulation in patients aged over 80 years allows them to preserve their lifestyle and independence when compared to the general population, with the same rate of survival.