Introduction: Myocardial remodeling in arterial hypertension (AH) is a factor contributing to the development of contractile dysfunction, arrhythmias and symptomatic heart failure. The aim of the work is to clarify the features of arrhythmic syndrome in elderly patients with hypertension with different types of myocardial remodeling. Materials and methods. 176 patients (mean age 69.2 ± 3.6 years) with grade 1-2 hypertension, stage 2, high risk were examined. The duration of the disease is 15.1 ± 3.4 years. Holter monitoring of ECG and blood pressure was carried out by Cardiotechnika-04-AD-3(M) recorders (St. Petersburg, Russia). Echocardiography was performed on a Vivid-3 (GE) device. The mass index of the left ventricular myocardium (LV) and the relative thickness of the LV wall were calculated. Based on these indicators, the geometric model of LV was evaluated. Results. It was found that 18.2% had eccentric hypertrophy, 19.9% had concentric hypertrophy, 28.4% had concentric remodeling, and 33.5% had normal LV geometry. Arrhythmic syndrome was detected in 69.9% of patients. Supraventricular extrasystole was registered in 40.7%, ventricular in 17.1%, a combination of ventricular and supraventricular extrasystole in 19.5%, paroxysmal form of atrial fibrillation in 22.7%. Discussions. A comparable number of ventricular and supraventricular arrhythmias were observed in patients with NGLV. Ventricular ES was most common in EHLV, supraventricular rhythm disturbances were found with CHLV and CRLV. Atrial fibrillation occurred more often than with all other types of remodeling. With NGLV, a significant correlation between arrhythmia and SBP (g= 0.33), LV dimensions (g= 0.32) and left atrium (g= 0.35) is revealed. A high positive correlation (r=0.70) with LV size and DBP value (r=0.36) was revealed in EHLV. There was a high positive correlation between the presence of arrhythmia and the thickness of the interventricular septum (g=0.51). The most common symptoms of chronic heart failure occur in elderly patients with EHLV and CHLV. Conclusion. The isolation of the heart of elderly patients with hypertension of persons with different types of remodeling (NGLV, EHLV, CHLV, CRLV) makes it possible to better predict such possible consequences of hypertension as the development of arrhythmic syndrome and chronic heart failure.