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Two groups of patients present with dysrhythmias: asymptomatic patients with incidental rhythm changes and patients with symptomatic rhythm changes. Incidental dysrhythmias may relate to the symptoms, but are the result of a noncardiac problem and do not worsen the immediate outcome. Usually, these patients have normal or near normal vital signs. Patients with incidental dysrhythmias, or who are asymptomatic, rarely require field rhythm‐directed treatment. Those with incidental dysrhythmias typically require treatment of any underlying acute condition (e.g., analgesia for pain or IV fluids for hypovolemia).

Example: A 67‐year‐old male patient with a history of “extra heart beats” transported for an isolated ankle injury displays a sinus tachycardia (from pain) and occasional premature ventricular complexes, but no other symptoms or abnormalities on physical examination. He requires splinting and analgesia, not antidysrhythmics. This should not be confused with dysrhythmias with symptoms, such as tachycardia or bradycardia associated with chest pain, weakness, breathing difficulties, or syncope.