Vascular Interventional Radiologists (VIRs) frequently care for patients with high severity of illness, multiple comorbidities, and physiologic derangements. The incidence and prevalence of abnormal cardiac rhythms (dysrhythmias) in these patients is high, and these can quickly lead to hemodynamic instability, shock, and death. Therefore, VIRs should be skilled in the evaluation and management of common dysrhythmias. Here, we provide an overview of commonly encountered narrow-complex tachycardias, wide-complex tachycardias, and bradycardias, with emphasis on recognition, diagnosis of underlying etiologies, and initial pharmacologic or electrical treatment steps, with the understanding that advanced treatment and long-term management should be undertaken in conjunction with electrophysiology expertise.