Abstract: Objective: To study the clinical features of severe bradyarrhythmias in elderly patients.Methods: The clinical data,electrocardiogram,static and dynamic electrocardiogram,classification of arrhythmia and therapy of 74 elderly patients with severe bradyarrhythmias were retrospectively analyzed.Results: Of the 74 cases,39 cases presented sick sinus syndrom,26 cases(35.14%) high degree atrioventricular block and 9 cases atrial fibrillation with long RR interval.Syncope occurred in 32 cases,near syncope in 17 cases and dizziness in 15 cases.Thirty-five cases were observed >3 seconds long RR intervals by dynamic and static electrocardiogram and 31 cases had a heart rate of <40 times/minute on daytime.Parmanent cardiac pacing therapy was applied to all the cases and some patients received antiarrhythmial therapy.Conclusions: Severe bradyarrhythmias usually leads to severe symptoms in elderly patients.Static and dynamic electrocardiogram is of great value in distinguishing the cause of syncope and obtaining the change of heart rate and rhythm.Parmanent cardiac pacing combined with antiarrhythmial therapy is efficient in treatment of bradycardia with tachyarrhyarrhythmias.