Background It is well known that increased cumulative ventricular pacing proportion (CumVP％) is one of the most important causes for adverse cardiovascular events. Therefore, how to reduce CumVP％ has been a treatment issue in recent years. This study aimed to investigate the effects of different pacing algorithms on CumVP％ in patients with pacemakers.Methods Pacemakers with three pacing algorithms, i.e., conventional dual chamber rate adaptive pacing (DDDR),search atrioventricular conduction plus (SAV+) and managed ventricular pacing (MVP), were implanted in 42 patients including 41 with bradycardia arrhythmias and one with ventricular tachycardia. Pacemakers were programmed to work in conventional DDDR, SAV+ and MVP during the follow-up periods of the first, the second and the third month. In each pacing algorithm, the time percentages of four pacing and sense status including atrial sense-ventricular sense (AS-VS),atrial sense-ventricular pacing (AS-VP), atrial pacing-ventricular sense (AP-VS) and atrial pacing-ventricular pacing(AP-VP) were calculated. Cumulative ventricular pacing proportions were compared in the three pacing algorithms in the first, the second and the third month postoperatively.Results In the DDDR algorithm AS-VS, AS-VP, AP-VS and AP-VP were 2.4％, 52.3％, 2.5％ and 42.8％ respectively,while in SAV+ they were 19.3％, 34.9％, 33.9％ and 12.0％, in MVP they were 38.9％, 13.2％, 41.6％ and 6.4％. In the above the DDDR, SAV+ and MVP algorithms, cumulative ventricular pacing proportions were 95.1％, 46.9％ and 19.6％,respectively (P＜0.05) and the percentages of CumVP％ ＜40％ in patients were 0, 23.8％ and 95.2.0％ (P＜0.05).Conclusions Compared with the conventional DDDR algorithm, both SAV+ and MVP significantly reduced the CumVP％, especially the MVP algorithm. Patients may benefit from MVP algorithm due to reduced CumVP％.