In the light of possible restriction of the number of pacemaker implantations in Switzerland and missing local data on this topic, we aimed to evaluate if the pacemaker indications in a tertiary Swiss hospital are in accordance with current guidelines of the European Society of Cardiology (ESC). We included all 309 pacemakers implanted between the 1st of January 2018 and the 15th of March 2019. CRT pacemakers were excluded. Mean age of the patients was 78.3 years (standard deviation 10.2 years). Class I indication was present in 90.6%, class IIa in 3.6%, class IIb in 3.6%, and class III in 2.2%. Based on these results, it is unlikely that a prespecified restriction of annual pacemaker implantations will prevent volume expansion. On the contrary, these measures may even result in withholding indicated therapy for symptomatic patients.