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Updated: Feb 10, 2026
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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
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Transcatheter electrosurgery in bipolar or monopolar modes
Jaffar M Khan1, Robert J Lederman1
1Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Summary
This study introduces bipolar radiofrequency wires for crossing lesions in chronic total occlusions (CTO). This novel approach offers potential for directed energy delivery in complex cardiovascular interventions.
Area of Science:
- Cardiovascular interventions
- Electrosurgery
- Minimally invasive procedures
Background:
- Transcatheter electrosurgery is gaining traction for procedures requiring tissue traversal or slicing.
- Existing techniques include transcaval access, transcatheter Glenn Shunt, LAMPOON, and BASILICA procedures.
- This study investigates a novel application of bipolar radiofrequency wires.
Discussion:
- Bipolar radiofrequency wires were utilized for the first time in humans to cross lesions in seven chronic total occlusion (CTO) cases.
- The bipolar configuration may offer directional charge delivery, potentially reducing the need for precise wire alignment.
- Theoretical concerns exist regarding tissue cutting efficacy due to charge concentration issues.
Key Insights:
- First human report of bipolar radiofrequency wires for lesion crossing in CTO.
- Demonstrates feasibility of bipolar RF wires in complex cardiovascular interventions.
- Highlights potential for improved directional energy delivery.
Outlook:
- Further research is needed to optimize bipolar radiofrequency wire technology for both lesion crossing and tissue cutting.
- Potential for enhanced safety and efficacy in complex transcatheter procedures.
- Exploration of bipolar configurations in other electrosurgical applications.
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