OBJECTIVE: To evaluate the therapeutic efficacy of oxymatrine (Oxy) on arrhythmia and heart rate variability (HRV) in patients with coronary heart disease (CHD) by Holter electrocardiogram and HRV indexes. METHODS: One hundred and ten patients with CHD and frequent arrhythmia were randomly divided into the Oxy group and the propafenone group, 55 cases in each group. Changes of general conditions, 48 hrs Holter electrocardiogram, frequency of premature beats, P-R interval, R-R interval and 24 hrs HRV index in patients before and after treatment were evaluated. RESULTS: The amount of both atrial and ventricular premature beats decreased markedly in both groups (P < 0.01). Propafenone showed better effect in reducing atrial premature beats than that of Oxy (P < 0.05), while the two had similar effect on ventricular premature beats (P > 0.05). HRV was elevated in both groups after treatment (P < 0.01), but the effect of Oxy was superior to that of propafenone after treatment (P < 0.05). CONCLUSION: Oxymatrine could significantly improve HRV, and shows obvious effects on atrial and ventricular arrhythmia in patients with CHD.