Rheumatic fever and rheumatic hart disease are still highly prevalent in many parts of the world including Egypt. In different studies, RF was associated with different types of arrhythmias either with or without evidence of underlying carditis by indefinite mechanism. So this study aimed to detect and to delineate the arrhythmogenic pattern of rheumatic fever (acute and chronic and after treatment) through arrhythmia screen among ninety-six patient suffering from rheumatic fever compared to fifty healthy children. They all had thorough clinical examination, CBC, ESR, CRP, ASO, TSH, T4, CXR, ECG, ECHO and Holter was done to 5 patients. Our results showed higher incidence of different arrhythmias; ES 10.4 %, AF 11.5%, SVT 11.5%, SV 18.8%, VES 2.1% and VT, 3.1%. AF was highly associated with rheumatic valve disease, while; JET, VT and EAT were highly associated with rheumatic activity however there was no evidence of underlying carditis.