Premature ventricular complexes (PVCs) that are frequently noted, although they may be benign, are commonly associated with structural heart disease and serve as a trigger for sustained ventricular arrhythmias. Although it has not been documented that chronic PVCs can impair cardiac systolic function, there have been reports of improved function with the abatement of PVCs. Our objective in this study was to determine the association between frequent PVCs and left ventricular systolic function over long-term follow-up. We reviewed all ambulatory electrocardiographic monitor data at our medical center during a 1-year interval. Patients with at least 1000 PVCs per 24 hours and 2 consecutive echocardiograms (>3 months apart) were selected for analysis of left ventricular systolic function. The primary end-point was a change in left ventricular ejection fraction (LVEF) in relation to PVC frequency. Results were analyzed adjusting for covariates. Thirty-seven patients, 27% of whom had structural heart disease, had ≥1000 PVC/24 hours, LVEF ≥ 40% (mean age, 61 years; male, 62%; mean LVEF, 52.7%), and follow-up echocardiograms. PVC frequency (8559/24 hours) was not significantly associated with change in LVEF over a mean follow-up of 40 months. Additionally, confounders such as diabetes, hypertension, coronary artery disease, and medications had no correlation with the primary end-point. Our data suggest that PVC burden observed in our study over approximately 3 years is not associated with a reduction in LVEF during follow-up in patients with baseline normal or mildly reduced systolic function.