Clinical Significance of Ventricular Premature Beats in an Outpatient Population

¹ Lahey Clinic Foundation and Harvard School of Public Health, Boston

The mortality of all outpatients who had ventrucular premature beats (VPB) during a routine electrocardiogram (ECG) taken at the Lahey Clinic in 1967 was compared to that of a carefully selected control group. Those clinical and electrocardiographic factors within the VPB group which might influence mortality were also examined. Follow-up, averaging 3 years, was achieved in more than 99 percent of patients. Mortality was 17.1 percent in the VPB group and 10.7 percent in the control grouop (P 0.01). The following conclusions were made: 1) By far the most important determinants of prognosis in ambulatory patients with or without VPB are their age and underlying cardiac status. 2) In patients with heart disease the presence of VPB in a standard ECG is associated with a small but statistically significant increase in mortality. 3) In the absence of clinical heart disease and in the presence of a normal ECG, VPB appear to have little effect on mortality. 4) In both VPB and control groups, patients with certain clinical features (history of myocardial infarction or angina) and electrocardiographic abnormalities (myocardial infarction patterns, left ventricular hypertrophy, and bundle branch block) have a particularly high mortality.