Pulse decompensation is when the heart rate is greater than the pulse rate. The rhythm of the pulse reflects the rhythm of the heart. In normal people, the pulse rhythm is regular, but in those with sinus arrhythmia, the pulse rhythm may change with breathing. It increases during inspiration and slows down during expiration. Patients with various arrhythmias can affect the pulse rhythm, such as those with atrial fibrillation whose pulse rhythm is absolutely irregular. Atrial fibrillation (AF), this arrhythmia can have “three inconsistencies”, i.e., inconsistent heart sounds, inconsistent fast and slow, and inconsistent with the pulse (pulse off-rhythm). The treatment can be propranolol (insulin), verapamil (isoptin), cardiac glycosides such as cetiran and other drugs. First, arrhythmia with normal heart rate (heart rate between 60~100 beats per minute, irregular heart rhythm) can be seen in the following three cases: 1. Sinus arrhythmia, which can be of the following two types: (1) respiratory sinus arrhythmia, after the patient holds his breath and activity, the heart rhythm can become neat, but the heart rate accelerates during inspiration and slows down during expiration. (2) Non-respiratory sinus arrhythmia, in which the patient’s heart rate is fast or slow independent of breathing. These patients do not need to be treated, or only need to remove the cause of the disease. 2, atrial fibrillation (atrial fibrillation) This arrhythmia can have “three inconsistencies”, that is, inconsistent heart sound strength, inconsistent fast and slow, and inconsistent with the pulse (pulse off-leak). Treatment can use propranolol (Jinan), verapamil (Isoptin), cardiac glycosides such as Sidilan and other drugs. 3. Pre-phase contraction (premature beat) The number of pre-phase contraction can be reduced or disappeared in normal people after activity; but the number of pre-phase contraction increases in patients with organic heart disease, the first heart sound is enhanced, the second heart sound is weakened, and the pulse is off. Treatment may include propranolol, verapamil, phenytoin sodium (dalantin), lidocaine and acetaminophen iodofurone. Second, arrhythmias with a slow heart rate (heart rate below 40 beats per minute) can have both neat and irregular heart rhythms. Sinus bradycardia: the heart rate is less than 40~60 beats/minute, the intensity of the first heart sound is equal, the heart rate can be accelerated after activity, and the heart beat is consistent with the jugular vein beat. Treatment can be done with atropine, ephedrine and isoproterenol. 2.Complete atrioventricular block: heart rate is less than 40 times/minute, the first heart sound may be of unequal intensity, there are tapping sounds, the heart rate does not increase after activity, and the jugular venous pulsation is not related to the heart rate. The treatment is the same as sinus bradycardia, and a pacemaker can be installed if necessary.