Transcatheter electrosurgery has emerging value in a range of other new procedures that require traversing tissue (transcaval access, transcatheter Glenn Shunt) or slicing tissue (LAMPOON slicing of the mitral valve and BASILICA slicing of the aortic valve). This is the first report of bipolar radiofrequency wires used to cross lesions in humans, reported here in seven re-entry CTO cases. The bipolar configuration may provide directionality to charge without need for wire alignment and advancement, but is theoretically disadvantageous for tissue "cutting" because of problems with charge concentration.
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