Long-term relative survival in patients with premature ventricular complexes but structurally normal hearts

Studies on the prognostic implications of premature ventricular complexes (PVCs) in patients without structural heart disease have shown conflicting results. It has been suggested that these patients may have a favorable mid-term prognosis, but their long-term prognosis is largely unknown.

The purpose of this study was to investigate the long-term relative survival in PVC patients without structural heart disease.

In this observational cohort study, we consecutively included patients who received a PVC diagnosis and met the inclusion criteria at three major hospitals in Stockholm between 2010 and 2016. All patients had normal results on echocardiogram and stress test and no history of structural heart disease. The expected survival from the age-, sex, and calendar year-matched Swedish population was obtained from the Human Mortality Database. Relative survival was calculated using the Ederer II method. Relative survival is a method to assess disease-specific survival without the need for cause-of-death information.

A total of 790 PVC patients were included. The median age was 59 years, and 57% were women. Of these, 183 (23%) patients had more than 10.000 PVCs per day, and 84 (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 91% vs. 82%, respectively). The relative survival at 1, 5, 10, and 12 years was 100%, 104%, 109%, and 112%, respectively. There was no difference in relative survival based on the number of PVCs per day. The median follow-up time was 10 years (maximum 14 years).

In PVC patients without structural heart disease, long-term survival was excellent, exceeding the expected survival of the general population. These results support the notion that many PVC patients without structural heart disease may be given a reassuring message.

Observed vs expected survival.