Abstract: AIM:To explore the parameter optimization and adjustment in pacemaker-implanted patients with clinical symptoms. METHODS: According to the patients’ complaints such as palpitations, chest tightness and other symptoms, 138 cases were deemed as patients with clinical symptoms among the 324 pacemaker-implanted patients followed in the Outpatient Department. Of the 138 patients, 54 were implanted with dual-chamber pacemakers (DDD) and 84 with single-chamber pacemakers (VVI). Follow-up time varied from 1 day to 16 years after implantation. Based on the patients’ complaints, electrocardiographic (ECG) and pacemaker test results, we optimized or adjusted the parameters of the implanted pacemakers. Chest x-ray, dynamic electrocardiography (DCG) and ultrasound cardiography were performed when necessary. RESULTS: In patients with DDD, atrial pacing abnormalities were found in nine cases, ventricular pacing abnormalities in three cases, atrial sensing abnormalities in two cases, ventricular sensing abnormalities in five cases, and inappropriate working status in 28 cases. In patients with VVI, ventricular pacing abnormalities were found in ten cases, ventricular sensing abnormalities in seven cases and inappropriate working status in three cases. Altogether, atrial arrhythmia was found in 45 cases, ventricular arrhythmias in 12 cases, 3rd-degree atrioventricular block in two cases and long period R-R in three cases. CONCLUSION: Adjustment and optimization of the parameters of implanted pacemakers during the regular follow-up after pacemaker implantation can effectively ensure the safety of patients and prolong the battery life of the pacemakers, thus minimizing the patients' clinical symptoms.