Twenty-five subjects from a cohort of 62 asymptomatic, apparently healthy subjects incidentally discovered to have frequent and complex ventricular ectopy were studied with cardiac catheterization and coronary angiography. Fourteen had normal coronary arteries, five noncritical coronary artery disease (less than 50% luminal narrowing), and six significant coronary artery disease (greater than or equal to 50% luminal narrowing). Slightly elevated left ventricular end diastolic pressures were found in all subject subgroups. Characteristics of the ventricular ectopy detected by maximal exercise testing or 24-hour Holter ambulatory electrocardiography did not differentiate those subjects with coronary artery disease from those with normal coronary arteries. This study documents that a minority of apparently healthy subjects with frequent and complex ventricular arrhythmia have significant coronary artery disease and supports a conservative approach to the management of such patients.