Currently, dual-chamber (DDD) pacing is by far the most widely utilized pacing modality in clinical practice in many parts of the world, and its use is exhibiting an increasing trend. The study cohort consisted of 3932 consecutive patients who underwent de novo DDD pacemaker implantation between 1984 and 2014. Patients were followed up after pacemaker implantation up to 31st August 2016 or the time of death. Vital status was collected from the national death registration system. Observed survival was compared with expected survival based on the life expectancy tables published by Statistics Poland. Additionally, for inhabitants of Małopolska Province, who died between 1999 and 2015 the impact of premature mortality was measured with standard expected years of life lost. Mean follow-up was 6.5 ± 5.2 years after implant. Male sex and higher age were the only factors significantly associated with shorter survival time. There was a decreasing trend in standard expected years of life lost from 17.4 years in 1999 to 9 years in 2015 with average annual percentage change of -4%. Lead failure occurred in 4.2% of leads and 7.3% of patients. Independent predictors of lead failure were subclavian vein puncture, unipolar lead construction and younger age at the time of lead implantation. Permanent atrial fibrillation was noted in 19% of patients. Factors associated with the development of p ; ermanent atrial fibrillation were male gender, increasing age at implantation and history of atrial fibrillation prior to implant. Permanent atrial fibrillation increased hazard of death by nearly 1.5-fold, P < 0.001.