Recentry, therapies for arrhythmias have been extremely advanced by accumulation of electrophysiological knowledge, improvement of diagnostic technique, and development of antiarrhythmic drugs and devices(pacemakers, catheter ablation and implantable cardioverter-defibrillators). After the report of the CAST(Cardiac Arrhythmia Suppression Trial), the Sicilian Gambit was presented as new strategies of drug therapy. Now in the United States, three AHA guidelines were published. Besides in Japan 'the guidelines for antiarrhythmic drugs' based on the Sicilian Gambit was published. 'The guidelines for management of Atrial fibrillation' and 'the guidelines for antiarrhythmic devices' were also reported. Here, these guidelines are reviewed.