Supraventricular and ventricular dysrhythmias, as well as conduction disturbances of varying severity are frequently observed in chronic obstructive pulmonary disease (COPD). The type of arrhythmia that occurs in patients with COPD is influenced by their clinical state. Co-existing coronary heart disease, severe blood gas abnormalities and medication may precipitate the rhythm disturbances. Particularly in patients with acute respiratory failure, the presence of arrhythmias is associated with poor prognosis. However, more studies are needed to assess the importance of cardiac arrhythmias in stable COPD patients and their value in predicting survival.