Twenty-two patients with symptomatic atrioventricular block were treated with permanently implanted transvenous pacemakers. The pacemaker was relatively simple to implant; only local anesthesia was required, and there were no hospital deaths. One late death occurred in a patient with severe coronary artery disease, and there was one failure of the system due to perforation of the ventricle. Interruption of pacing occurred nine times in six patients due to dislocation of the catheter tip or pulse generator problems. No deaths resulted and adequate pacing was reinstituted by minor procedures in all of the patients except one who had resumed normal atrioventricular conduction. Nineteen of the patients at the time of this report are alive, free of syncopal attacks, and paced with an adequate ventricular rate.