You only live twice...unless you're Roger Moore

Sir Roger Moore's famously dry wit doesn't desert him, even as he contemplates how he has faced death and undergone numerous medical procedures.

'There are bits of me in specimen jars all over the world,' he says. 'I just hope there'll be enough of me left to put in my coffin when I die.'

He has battled fictional foes in Sixties TV series The Saint, in The Persuaders of the Seventies, and later as the star of seven James Bond movies. Offscreen, he has had to fight for his life several times.

He came close to death as a small boy in the pre-antibiotics era after contracting double pneumonia. Suffering prostate cancer in 1993, he faced his mortality and made life-changing decisions as a result. And four years ago he was diagnosed with a lethally slow heartbeat after collapsing on stage in New York.

'I was told I could die at any time and that I must have a life-saving cardiac pacemaker inserted the very next day,' says Sir Roger, who turns 80 in October.

He blacked out without warning during his star turn in the Morecambe and Wise tribute show, The Play What I Wrote, on Broadway, in May 2003.

'It was a matinee performance and I was dressed as Marie Antoinette escaping from the Bastille. We were doing a song and dance number.

'I went to say my line at the end of the dance and then I thought: "Where's the air gone"? I heard a bang, which was my head hitting the stage as I fell headfirst, but luckily my skull was protected by the huge wig I was wearing.

'As I came round, I was in a dreamlike state for several minutes. The curtain came down and my wife, who'd sat through all my performances in the show, rushed backstage. At first the audience thought it was part of the show.

'After some water, I began to feel better and decided to go on with the show. I felt very brave and got an extra cheer as I went back on.'

Although he jokes about it now, by not getting immediate treatment he was unwittingly putting his life in danger. He didn't realise his heart had stopped for several seconds. Fortunately, Sir Roger's fourth wife, Kristina Tholstrup, insisted on calling paramedics. 'After the show, they came clattering into my dressing room, put an oxygen mask on me and carried me down to an ambulance.'

ECG tests, which show how electrical signals travel through the heart, established Sir Roger was suffering from bradycardia, or an abnormally slow heart rhythm - below 60 beats a minute. The condition prevents the body getting enough oxygen and nutrients to function properly.

It is more common in older people when the body's natural pacemaker cells may stop working properly.

Symptoms can include dizziness, fatigue and shortness of breath. But Sir Roger had none of them and the first time he realised something was wrong was when he fainted.

Barring a couple of mysterious blackouts as a child - known as syncope and probably the result of a drop in blood pressure - he had never fainted before.

Sitting in hospital in New York having been told his heart was beating perilously slowly, he took a phone call from his Californian heart specialist who had alarming news. 'I said I had been planning to leave the U.S. and he warned me that I must not get on a plane as I could die at any time.'

He was transferred to the Beth Israel Medical Centre where the next day an artificial cardiac pacemaker was fitted under his skin just below the collarbone.

When the pacemaker detects that the wearer's heart rate has fallen, it sends an electrical signal, prompting the heart to contract. With the need to avoid a general anaesthesia in heart patients, the pacemaker is usually inserted under a local anaesthetic that has an amnesiac effect.

Sir Roger was almost 76 at the time and recalls feeling groggy. 'Kristina said that the theatre sister wanted my autograph. I was woozy and in no position to argue.

'She may have had me signing a will for all I knew. I felt tired and anxious but not petrified, although my cardiologist's warning that I could drop dead at any time was still ringing in my ears.'

That night, in his role as goodwill ambassador to Unicef, he went ahead with a planned speech. 'I was able to tell the audience that as I left hospital, the cardiologist handed me a cheque for $10,000 for the charity's work, as he had been so moved by what I'd told him of the way so many children live.'

Not long after, Sir Roger bumped into Sir Elton John, who also has a cardiac pacemaker. 'I told Elton I'd had a zip fastener put into mine so they could change the batteries.' Elton countered with an even bigger boast. 'He said he had a diamond-studded zip on his.'

Joking aside, the device is usually changed for the most up-to-date model when the batteries run out, after between five and seven years.

Without one, Sir Roger is unlikely to have survived more than two years as there is no other reliable treatment for his condition. 'I was told that if I'd had this 30-odd years ago, I would have died. That is a sobering thought.

'We're very lucky with the medical advances we have now. I remember what life was like preantibiotics. Aged five, (in 1932) I had double pneumonia and was too sick to be moved to hospital.'

Antibiotics such as penicillin were not commonly used until the early-1940s, and bacterial pneumonia had a mortality rate of 82 per cent. Beset by pain, fever and breathing difficulties, Roger, the only child of London policeman George Moore and his wife Lillian, was in an alarming condition.

'My father sold his motorbike to pay the doctor's fees. After five days, the doctor took him aside and said: "I shall come back tomorrow. Prepare your wife to sign a death certificate". The next morning, after a fitful night, my parents woke to hear me singing Jesus Wants Me For A Sunbeam.'

In his 30s, Sir Roger endured the first of three operations to remove kidney stones, formed when the minerals found in urine crystallise.

'The pain was excruciating. You feel as if you're being kicked in the back and the testicles at the same time.'

These days, kidney stones can be broken up non-surgically using shockwave treatment, but this was not available at the time Sir Roger's appeared. 'I was opened up both sides and have large scars.'

He has had no recurrence for 20 years. 'I was told to drink lots of water and avoid strawberries, spinach and chocolate.'

In 1993, a tumour of the prostate was diagnosed. He says he suffered many of the usual symptoms, including an urgent need to urinate.

He had surgery to remove the prostate, which commonly requires the urethra to be stitched to the bladder to allow for the flow of urine.

'It changed the way I looked at life,' he says. 'You will have noticed that my domestic arrangements changed after that.'

He is referring to the end of his marriage to his third wife, Luisa Mattioli, the mother of his three children, Deborah, 47, Geoffrey, 41, and Christian, 37. They divorced in 1996 and he began a relationship with Kristina, marrying her in 2002.

They lead a healthy life in Geneva, Switzerland, and have taken up Nordic pole walking, which is said to use 90 per cent of the body's skeletal muscles ( compared to 35 per cent when swimming, 70 per cent when running).

'I am my wife's dog. She takes me for long walks. Walking with poles makes you swing your arms up to your shoulders, which is good for the heart and circulation.'

Now, as well as his other charitable work, Sir Roger is a patron of STARS, which offers information and support on syncope - the mysterious blackouts he suffered - and reflex anoxic seizures, the latter mostly experienced by children, whose heart and lungs stop for up to 30 seconds.

'I was horrified to discover how often both conditions are misdiagnosed,' he says.

It is thought that 30 per cent of syncope attacks are treated as epilepsy. 'I was lucky that I was in the U.S. where a speedy diagnosis of the underlying cause was made. Otherwise I might not be here today.'

Dr Mike Gammage, consultant cardiologist, says: 'Some sufferers need medication or a pacemaker. Others can benefit from drinking more water, taking salt and wearing support stockings to help return blood to the heart.'

Sir Roger has used his celebrity muscle to lobby for more attention to be given to the condition. 'When I joined STARS, and knowing that Tony Blair had suffered from tachycardia (fast heart beat), I wrote to him. I got a handwritten reply saying he thought it was a very worthwhile organisation.

'I am lucky enough to have faced death and yet be in rude health. I hope my celebrity, or perhaps that should be my notoriety, can help others.'

For the blackouts checklist and more information call STARS on + 44 1789 450564 or go to www.stars.org.uk.