Long-term survival in patients with premature ventricular complexes and no structural heart disease

Premature ventricular complexes (PVCs) are common and can cause concerns in both patients and their caregivers. In patients with structural heart disease, PVCs are associated with worse clinical outcomes. However, in patients without such disease, the prognostic implications of PVCs are more uncertain.

In this observational cohort study, we included patients who were diagnosed with PVCs at three major hospitals in Stockholm between 2010 and 2016. All included patients had normal results on echocardiography and stress test, and no history of structural heart disease. The expected survival from the age-matched, sex-matched and calendar year-matched Swedish population was obtained from the Human Mortality Database. Relative survival was estimated using the Ederer II method.

A total of 803 PVC patients were included. Median age was 59 years, and 57% were women. In all, 185 (23%) patients had more than 10 000 PVCs per day and 86 (11%) had more than 20 000 PVCs per day. The observed survival was greater than the expected survival at 1, 5, 10 and 12 years (100% vs 99%, 97% vs 94%, 93% vs 86% and 90% vs 82%, respectively). The relative survival at 1, 5, 10 and 12 years was 100%, 104%, 109% and 111%, respectively. The median follow-up time was 10 years (maximum 14 years).

PVC patients without structural heart disease had a favourable long-term survival, exceeding the expected survival of the general population. These results suggest that most PVC patients without structural heart disease may be given a reassuring message.