Among the dysionemias hyper- and hypokalemia are particularly important for clinical arrhythmogenesis. Disorders in sodium- and calcium concentrations, however, are relevant only in single cases. The impact of magnesium concentration disorders on cardiac rhythm is not yet totally elucidated. 2. In hypokalemia tachycardic arrhythmias are most important, while bradycardic and tachycardic arrhythmia can be caused by hyperkalemia. An important factor in arrhythmogenesis is the rate of development of hypo- or hyperkalemia. Hypokalemically-induced arrhythmia can be suppressed by potassium substitution. 3. Although the importance of a magnesium dysionemia for arrhythmogenesis has not been confirmed, magnesium can be used for the treatment of arrhythmias with good results. Besides an antiarrhythmic efficacy, an antifibrillatory activity is suggested in acute myocardial ischemia.