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Ventricular ectopy in children without known heart disease. OBJECTIVE: To describe the presentation and clinical course of patients with ventricular ectopy (VE) without known heart disease seen at a single institution. STUDY DESIGN: Patients with VE were identified from the cardiology database. Patients with known hemodynamically significant heart disease or systemic diseases were excluded. RESULTS: A total of 219 patients constitute the study population, with 59% male and median age of diagnosis 11.3 years. A total of 138 patients had follow-up data. Median duration of follow-up was 3.1 years (n = 138, range 0-21 years) for a total of 587 patient-years. Simple VE was found in 83%, and 17% had ventricular tachycardia. Most patients were asymptomatic at presentation (77%) At presentation, echocardiograms were performed in 164 patients, with 98% normal. Of the 36 patients with sequential echocardiograms, 32 (88%) remained normal, 3 (9%) had abnormal echocardiograms which normalized, and 1 (3%) had progressive left ventricular dysfunction. On sequential Holter data (n = 48), 54% showed stable or decreased VE, 40% showed resolution, and 6% showed worsening. No cases of death or resuscitated sudden death occurred. CONCLUSIONS: Most patients were asymptomatic. There were rare cases of progression of VE and development of left ventricular dysfunction but the majority had stable findings. No deaths occurred.