Evidence map›Paper›PMID 42346629›Full record

ReviewJournal of personalized medicine2026

An Individualized Right-to-Left Tunneling "Bail-Out" for Complex ICD Upgrade in a Pacemaker-Dependent Patient: A Case Report and Literature Review.

Dimitrios A Vrachatis, Konstantinos A Papathanasiou, Sotiria G Giotaki, Christos Piperis, Maria S Kousta, Ioannis Anagnostopoulos, Christos Karavasilis, Gerasimos Deftereos, Georgios Giannopoulos, Sotirios Patsilinakos and 2 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of personalized medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Dimitrios A VrachatisElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0002-2385-5365
Konstantinos A PapathanasiouElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0003-0123-2615
Sotiria G GiotakiElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Christos PiperisElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0009-0000-8293-7283
Maria S KoustaElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0001-9355-400X
Ioannis AnagnostopoulosElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0002-3062-360X
Christos KaravasilisElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Gerasimos DeftereosElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Georgios GiannopoulosThird Department of Cardiology, Aristotle University of Thessaloniki, "Hippokration" General Hospital, 546 42 Thessaloniki, Greece.
Sotirios PatsilinakosElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Gerasimos SiasosThird Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 115 28 Athens, Greece.
Spyridon DeftereosElectrophysiology and Pacing Department, Eugenideio Clinic, National and Kapodistrian University of Athens, 115 28 Athens, Greece.ORCID 0000-0001-9611-5002

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Inadequate vein access is a frequent obstacle during cardiac implantable electronic device (CIED) upgrade procedures; thus, bail-out strategies are employed. A 71-year-old male with dilated cardiomyopathy bearing a 7-year-old right-sided dual-chamber pacemaker was scheduled for upgrade to an implantable cardioverter defibrillator. The case presented two main challenges-first, pacemaker dependency, and second, an occluded right subclavian vein. In a shared decision-making approach, the decision was made to "abandon" the right-sided ventricular lead in situ, reposition the right-sided atrial lead by tunneling over the sternum into the left pectoral area, and implant a new left-sided defibrillator lead. During the 2-year follow-up our patient remained clinically stable and the CIED fully functional. Herein, beyond case presentation we also elaborate on individualized alternative treatment strategies for patients with venous access site occlusion in a literature review.

Indexed as

over the sternum tunnelingpacemaker dependenceright-sided cardiac implantable electronic deviceupgrade

Identifiers

PMID42346629
PMCPMC13302732

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.