Atrial arrhythmias are commonly encountered by the primary care clinician. They are usually asymptomatic or have only minor symptoms, unless the ventricular rate becomes very rapid. The challenges for the clinician are to recognize the benign from the more severe arrhythmias, to identify and treat the precipitating cause, to control the symptoms that concern the patient, and to prevent any complications. There are new medicinal and nonmedicinal treatments available that offer greater likelihood of acute and long-term success in the treatment, and sometimes cure, of the original arrhythmias.