Abstract： Objective To investigate the risk factors influencing the occurrence of cardiac arrhythmia following pulmonary heart disease in elderly patients. Methods Totally 80 cardiac arrhythmia and 28 non-cardiac arrhythmia in elderly patients with pulmonary heart disease cases were analyzed. Results Eighty cases were complicated with cardiac arrhythmias with the incidence of 74.1%. The logistic regression analysis indicated that concomitant disease, hypoxemia, heart failure, lung infection, Acid-base inbalance, electrolyte disturbance were significant risk factors (P ＜ 0.05 ). Conclusions Cardiac arrhythmia in elderly patients with pulmonary heart disease should be strengthened. Early diagnosis and treatment must be addressed according to the risk factors.