Arrhythmias are more common in the elderly and in many situations are of prognostic importance. The incidence of arrhythmias in the elderly is increasing, most likely due to enhanced longevity. Alterations in heart rate and rhythm may occur because of age-related change within the heart. Elderly people are more likely to experience co-morbid health problems, intercurrent illness and adverse drug reactions, all of which may result in arrhythmias. Falls are a common problem in elderly people; an arrhythmic cause should always be considered.