由于所患疾病、基础疾病和内环境紊乱等因素的影响，围术期心律失常并不少见，其可能会对患者生命安全或脏器功能造成不良影响。需要快速准确地识别并紧急处置恶性心律失常，正确处置症状性心律失常及其基础疾病和诱发因素。本文对常见的围术期心律失常的识别、处置进行阐述，包括恶性心律失常、高质量心肺复苏、电复律、起搏器、抗心律失常抢救用药以及注意事项等进行阐述。总之，围术期心律失常处置的紧急程度，取决于心律失常对血流动力学的影响，处置亦应考虑围术期因素的影响，如术后出血、缺氧等。

Peri-operative cardiac arrhythmias are not uncommon in patients with underlying diseases or internal environment disturbance, some of which might be fatal and induce organ dysfunction. A quick recognition and proper treatment for malignant cardiac arrhythmias or symptomatic arrhythmias and treatment for underlying diseases, would prevent patients from deteriorating. Recognition and treatment for common peri-operative cardiac arrhythmias are reviewed in detail, including high-quality cardiopulmonary resuscitation, electrical cardio-version, cardio-pacing, anti-arrhythmic medicines and some cautions during these managements. Most evidence-based recommendations come from recent international/domestic guidelines or expert consensus, for example, AHA or ESC CPR guidelines, supra-ventricular arrhythmia management guidelines, atrial fibrillation management guidelines, pre-operational evaluation in non-cardiac surgery, ventricular arrhythmias management guidelines and so on. As a conclusion, the emergency of peri-operative arrhythmias depends on its effect on hemodynamics, ie, how life-threatening it is. The effect of some peri-operative factors, such as post-surgery bleeding, hypoxemia and so on should be taken in account while treating peri-operative arrhythmias.