Ventricular arrhythmias are often recorded in individuals without structural heart disease. The application of the current recommendations on the management of such patients in real practice has a number of limitations of objective and subjective nature. Therefore, further studies aimed at clarifying the indications for the use of various treatment methods are relevant. Objects — the aim of the research was to study the immediate results of different approaches to the treatment of frequent ventricular extrasystole (VE) and/or ventricular tachycardia (VT) in patients without structural heart disease. Material and methods. 85 patients (21 men and 64 women, mean age 44 [32; 56] years) with ventricular arrhythmias and without structural heart disease were included in the study. The mean number of VAs per day was 15 251 [8979; 23642], unstable VT was registered in 26 patients, stable VT — in 5 patients. The further treatment tactics was chosen taking into accounts the preferences of the patient: 27 (32%) patients preferred the RFA, 37 (43%) — antiarrhythmic therapy (AAT), 21 (25%) — case follow-up. At Baseline and after 1 month follow-up, was performed holter monitoring of the electrocardiogram and evaluation quality of life (QoL) using the SF-36. Results. RFA and AAT results were comparable (p>0.1): after 1 month, the criteria for a positive ant arrhythmic effect were in 74.1% of patients in the RFA group, in 67.6% of patients in the AAT group and in 38.1% of the follow-up group. The baseline QoL of patients in the RFA and AAT subgroups was not statistically significant. At the same time, QoLs of persons who chose case follow-up were significantly higher compared to patients from the RFA and AAT groups (p=0.033). After 1 month after effective RFA, the improvement of QoLs was statistically significant. In case of ineffectiveness of the procedure, on the contrary, a decrease in the average score on the scale of mental health was revealed (p=0.034). In the AAT subgroup, a positive effect was most often achieved with the 1C class antiarrhythmic drug — ethacyzin (69.7%), and side effects were less likely to occur with treatment with β-blockers (8.5%). After 1 month in patients with effective therapy, the indicators of QoL significantly improved, and when AAT ineffective, they were not statistically significant. In the case follow-up group at 1 month, none of the QoL indicators changed significantly. However, in 8 patients with a spontaneous decrease in the number of VE, there was a significant increase in the average score on the mental health scale (p=0.024). Conclusion. In patients with ventricular arrhythmias without structural heart disease, it is advisable to evaluate the QL for choosing the optimal tactics of treatment. In patients with a high level of QoL immediate treatment is not indicated. The nearest results of AAT and RFA in idiopathic ventricular arrhythmias are comparable. A positive result of antiarrhythmic therapy or RFA is accompanied by an improvement in QoL indicators that correspond to “mental health”. IC class antiarrhythmic drug ethacyzin in this group of patients is the most effective antiarrhythmic drug (the effectiveness of 69.7% of cases with a frequency of side effects of 16.7%).