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CC BY 4.0 · The Arab Journal of Interventional Radiology 2023; 07(01): 035-038
DOI: 10.1055/s-0043-1764199
Original Article

Accuracy of Electrocardiography-guided PICC in Atrial Fibrillation Patients

Ibraheem Aljediea 
1   Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
,
Mohammed Alshehri
1   Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
,
Khaled Alenazi
1   Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
,
Amr Mimesh
1   Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
,
Mustafa Fleet
1   Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
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Abstract

Objectives We conducted this study to review our experience performing electrocardiography-guided peripherally inserted central catheter insertion in patients with atrial fibrillation.

Materials and Methods This is a retrospective study of PICC insertions performed by interventional radiology technologists using electrocardiogram guidance in patients with atrial fibrillation. The study included 99 PICCs inserted using electrocardiography guidance in 79 patients diagnosed with atrial fibrillation. Chest X-ray is used to confirm tip position.

Results We reviewed all PICCs inserted in patients with atrial fibrillation using electrocardiography guidance between September 2017 and June 2022. The review process included success and malposition rates using X-ray correlation. Ninety-four out of 99 PICCs were successfully inserted, and 5 cases required repositioning.

Conclusion Our study suggests that electrocardiography navigation can be safely used for PICC insertion in patients with atrial fibrillation with high success rate.

Keywords

atrial fibrillation - echocardiography guided PICC - interventional radiology technologist - PICC


Publication History

Article published online:
11 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Dale M, Higgins A, Carolan-Rees G. Sherlock 3CG(®) tip confirmation system for placement of peripherally inserted central catheters: a NICE medical technology guidance. Appl Health Econ Health Policy 2016; 14 (01) 41-49
    CrossrefPubMedGoogle Scholar
  • 2 1 Recommendations | The Sherlock 3CG Tip Confirmation System for placement of peripherally inserted central catheters | Guidance | NICE. Accessed Feb 9, 2023, at: https://www.nice.org.uk/guidance/mtg24/chapter/1-Recommendations
  • 3 Lelkes V, Kumar A, Shukla PA, Contractor S, Rutan T. Analysis of the Sherlock II tip location system for inserting peripherally inserted central venous catheters. Clin Imaging 2013; 37 (05) 917-921
    CrossrefPubMedGoogle Scholar
  • 4 Mohammed AT. Successful implementation of electrocardiographic-guided peripherally inserted central catheter placement by a nurse-lead peripherally inserted central catheter placement team. AJIR 2018; 2: S25
    Google Scholar
  • 5 Yamagishi T, Ashida H, Igarashi T. et al. Clinical impact of the Sherlock 3CG® Tip Confirmation System for peripherally inserted central catheters. J Int Med Res 2018; 46 (12) 5176-5182
    CrossrefPubMedGoogle Scholar
  • 6 Barton A. Confirming PICC tip position during insertion with real-time information. Br J Nurs 2016; 25: S17-S21
    CrossrefPubMedGoogle Scholar
  • 7 Mack V, Nißler D, Kasikci D, Malouhi A, Aschenbach R, Teichgräber U. Magnetic tracking and electrocardiography-guided tip confirmation system versus fluoroscopy for placement of peripherally inserted central catheters: a randomized, noninferiority comparison. Cardiovasc Intervent Radiol 2020; 43 (12) 1891-1897
    CrossrefPubMedGoogle Scholar
  • 8 Tomaszewski KJ, Ferko N, Hollmann SS. et al. Time and resources of peripherally inserted central catheter insertion procedures: a comparison between blind insertion/chest X-ray and a real time tip navigation and confirmation system. Clinicoecon Outcomes Res 2017; 9: 115-125
    CrossrefPubMedGoogle Scholar
  • 9 Moureau NL, Dennis GL, Ames E, Severe R. Electrocardiogram (EKG) guided peripherally inserted central catheter placement and tip position: results of a trial to replace radiological confirmation. J Assoc Vasc Access 2010; 15: 8-14
    CrossrefGoogle Scholar
  • 10 Gao Y, Liu Y, Zhang H, Fang F, Song L. The safety and accuracy of ECG-guided PICC tip position verification applied in patients with atrial fibrillation. Ther Clin Risk Manag 2018; 14: 1075-1081
    CrossrefPubMedGoogle Scholar
  • 11 Dong H-M, Zhu Y-X, Yin X-X, Zhang X. Clinical significance of different atlas of intracavitary electrocardiogram for PICC localization in 961 cases. Ann Noninvasive Electrocardiol 2022; 27 (01) e12904
    CrossrefPubMedGoogle Scholar
  • 12 Zhao C, Zhu Y, Yin X, Zhang C, He Y, Gao J. ECG method for positioning the tip of peripherally inserted central catheters in patients with atrial fibrillation. Ann Noninvasive Electrocardiol 2022; 27 (03) e12931
    CrossrefPubMedGoogle Scholar
  • 13 Calabrese M, Montini L, Arlotta G. et al. A modified intracavitary electrocardiographic method for detecting the location of the tip of central venous catheters in atrial fibrillation patients. J Vasc Access 2019; 20 (05) 516-523
    CrossrefPubMedGoogle Scholar
  • 14 Alharbi AM, Alsuhaibani MA. Atrial fibrillation among adult Saudi patients with chronic heart failure: tertiary center experience. Int J Health Sci (Qassim) 2018; 12 (01) 64-68
    PubMedGoogle Scholar
  • 15 AlAmri A, AlShehri A, AlShammari R. et al. Prevalence of atrial fibrillation among Saudi patients who had stroke: a retrospective cross-sectional study at a university hospital. IJMDC 2022; 6: 333-339
    CrossrefGoogle Scholar
  • 16 Hecht HH. Potential variations of the right auricular and ventricular cavities in man. Am Heart J 1946; 32: 39-51
    CrossrefPubMedGoogle Scholar
  • 17 Hellerstein HK, Pritchard WH, Lewis RL. Recording of intracavity potentials through a single lumen, saline filled cardiac catheter. Proc Soc Exp Biol Med 1949; 71 (01) 58-60
    CrossrefPubMedGoogle Scholar
  • 18 Liu G, Hou W, Zhou C. et al. Meta-analysis of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement. J Vasc Access 2019; 20 (06) 577-582
    CrossrefPubMedGoogle Scholar