Two hundred thirty-five men among 2,035 survivors of myocardial infarction (11.5%) had one or more ventricular premature beats (VPB) in their resting base-line electrocardiogram. During a three-year follow-up period, deaths were about twice as frequent in those with any VPB (21.7%) as in those with none (11.4%) among the placebo-treated patients in the nationwide Coronary Drug Project. Excess long-term risk of death, including sudden death, was associated with the frequency of VPB, with VPB in pairs or runs, and possibly with early-cycle VPB. The excess risk with these VPB characteristics was independent of the risk associated with other electrocardiographic and clinical characteristics.