Ventricular ectopy: significance and management. Ventricular ectopy is a normal variant of cardiac rhythm, and its significance in an individual is related to cardiac risk factors and the presence or absence of heart disease. Although there is good evidence in many forms of heart disease that complex VEBs indicate a high risk of death, treatment of asymptomatic VEBs with antiarrhythmic drugs has not been shown to improve survival and may be hazardous. Treatment should be directed at the underlying heart disease. Those with heart disease and severe symptoms resulting from VEBs will often require electrophysiological assessment as to specific antiarrhythmic therapy. Those without heart disease can usually be managed by reassurance and do not require antiarrhythmic drugs. 