This review is devoted to analysis of the world experience of perioperative care in patients with high risk of development and aggravation of heart rhythm and conduction disturbances. There was given the definition of the arrhythmia, their modern classification, described the mechanisms of formation and causes of long duration. Special attention is paid to the problem of perioperative arrhythmias in oncosurgery, which is characterized by the extent and traumatic interventions in reflexogenic zones in patients with nutritive deficiency, hypovolaemia, anemia, electrolyte imbalance. The problem of interaction of antiarrhythmic drugs with anaesthetics, possible complications and ways of correction of hemodynamically significant bradycardia with the help of drugs (atropine, sympathomimetics) and drug-free (transesophageal (TEECS) and invasive cardiac stimulation) methods. Describes approaches to the diagnosis and prediction of the risk of the arrhythmia development with the help of the analysis of Holter ECG results with e of heart rhythm variability (HRV) assessment.