Palamà Z, Tricarico G, Scarà A, Robles AG, De Masi De Luca G, Nesti M, Romano S, Sciarra L. Late left ventricular summit premature ventricular contractions elimination with new TactiFlex irrigation technology. World J Cardiol 2026; 18(2): 111861 [DOI: 10.4330/wjc.v18.i2.111861]
Corresponding Author of This Article
Zefferino Palamà, MD, PhD, Research Fellow, Department of Cardiology, Casa di Cura Villa Verde, Via Golfo di Taranto, 22, Taranto 74121, Puglia, Italy. zefferino.palama@icloud.com
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Cardiac & Cardiovascular Systems
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Case Control Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 26, 2026 (publication date) through Feb 9, 2026
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Publication Name
World Journal of Cardiology
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1949-8462
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Palamà Z, Tricarico G, Scarà A, Robles AG, De Masi De Luca G, Nesti M, Romano S, Sciarra L. Late left ventricular summit premature ventricular contractions elimination with new TactiFlex irrigation technology. World J Cardiol 2026; 18(2): 111861 [DOI: 10.4330/wjc.v18.i2.111861]
World J Cardiol. Feb 26, 2026; 18(2): 111861 Published online Feb 26, 2026. doi: 10.4330/wjc.v18.i2.111861
Late left ventricular summit premature ventricular contractions elimination with new TactiFlex irrigation technology
Zefferino Palamà, Giuseppe Tricarico, Antonio Scarà, Antonio Gianluca Robles, Gabriele De Masi De Luca, Martina Nesti, Silvio Romano, Luigi Sciarra
Zefferino Palamà, Giuseppe Tricarico, Department of Cardiology, Casa di Cura Villa Verde, Taranto 74121, Puglia, Italy
Zefferino Palamà, Antonio Gianluca Robles, Gabriele De Masi De Luca, Silvio Romano, Luigi Sciarra, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila 67100, Italy
Antonio Scarà, Cardiology Unit, GVM Care and Research, San Carlo di Nancy Hospital, Rome 00100, Italy
Martina Nesti, Cardiology Unit, CNR, Pisa 52040, Tuscany, Italy
Author contributions: Palamà Z and Tricarico G performed the procedures and conceived the study by writing the first draft; Scarà A, Robles AG, De Masi De Luca G, and Nesti M analyzed data and completed the draft; Romano S and Sciarra L critically reviewed the paper.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki. Ethical review is not applicable.
Informed consent statement: Informed consent was obtained from all subjects involved in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data are available in the EP lab of the Cardiology Unit in Casa di Cura “VillaVerde”.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zefferino Palamà, MD, PhD, Research Fellow, Department of Cardiology, Casa di Cura Villa Verde, Via Golfo di Taranto, 22, Taranto 74121, Puglia, Italy. zefferino.palama@icloud.com
Received: July 21, 2025 Revised: August 1, 2025 Accepted: January 6, 2026 Published online: February 26, 2026 Processing time: 206 Days and 16.9 Hours
Abstract
BACKGROUND
Premature ventricular contractions (PVCs) originating from the left ventricular summit (LVS) could be challenging to ablate due to anatomical reasons.
AIM
To study the role of new irrigation technologies, like the TactiFlex catheter, could facilitate deeper radiofrequency (RF) penetration and thus increase success in the ablative treatment of this PVC subset.
METHODS
Three PVCs focus (left bundle branch block morphology, inferior axis on the frontal plane, early R/S transition in V1-V2) were accurately mapped with Ensite X omnipolar technology.
RESULTS
RF was delivered at mitroaortic continuity by TactiFlex catheter (4-9 lesions, max 35 W, 43 °C, 13 mL/minute, max 60 seconds, mean impedance drop 11.9 ± 1.7 ohms) with acute PVCs suppression but early recurrence in all cases. In one case, an anatomical approach in the posteroseptal right ventricular outflow tract was performed without acute success. After 6-10 hours, no PVCs/ventricular arrhythmias have been detected, and no arrhythmia recurrences in all 3 cases at a 180-day follow-up visit. These data were compared with a cohort of 10 patients with LVS PVCs with immediate disappearance treated with the same technology; the only difference, although not statistically significant, was in the greater drop in impedance (13.5 ± 2.1 ohms).
CONCLUSION
Late PVCs elimination could be due to the porous flexible distal tip design of the TactiFlex catheter that allows deeper RF penetration in the myocardium due to a greater adhesion of the saline irrigation system to tissue. It is reasonable to assume that this new technology makes lesions more transmural, determining a delayed lesion maturation, thus not limited to the duration of energy delivery.
Core Tip: Premature ventricular contractions from left ventricular summit could be challenging to ablate due to anatomical reasons. New irrigation technologies, like the TactiFlex catheter, could facilitate deeper radiofrequency penetration and thus increase success in the ablative treatment. Late premature ventricular contractions elimination could be due to the porous flexible distal tip design of the TactiFlex catheter that allows deeper radiofrequency penetration in the myocardium due to a greater adhesion of the saline irrigation system to tissue. It is reasonable to assume that this new technology makes lesions more transmu-ral, determining a delayed lesion maturation, thus not limited to the duration of energy delivery.
