Physiological sinus bradycardia with asymmetry generally does not require treatment, pathological sinus bradycardia with asymmetry is asymptomatic and should be treated, and a pacemaker should be installed as soon as possible if there are symptoms. 1. Healthy young people, athletes, sleep state and other physiological reasons can have sinus bradycardia with irregularities, generally without treatment. 2. Sinus bradycardia with arrhythmia caused by pathologic factors (e.g., hypothyroidism, acute inferior wall myocardial infarction, sinus node lesions, etc.) needs to be treated according to the situation. (1) If there are no obvious symptoms of bradycardia with arrhythmia, no treatment is needed for the time being and observation is sufficient; (2) If there are obvious symptoms of bradycardia with arrhythmia (e.g. palpitation, chest tightness, dizziness, blackout, syncope, etc.), pacemaker treatment is required as soon as possible; if pacemaker installation is not available, atropine or isoprenaline can be applied temporarily for maintenance treatment. Sinus bradycardia with arrhythmia is recommended to consult the hospital in time to clarify the cause of the disease and ask the doctor to guide the treatment.