ECG method for positioning the tip of peripherally inserted central catheters in patients with atrial fibrillation

Annals of noninvasive electrocardiology: the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc

article

Conghui Zhao MM¹  Yuxin Zhu PhD²  Xinxin Yin BD²  Congcong Zhang BD²  Yingxia He BD¹  Jingfang Gao BD² 

[1] Department of Oncology, Shijiazhuang People’s Hospital;Department of Central Venous Catheter Clinic, Shijiazhuang People’s Hospital

关键词: atrial fibrillation;    electrocardiogram;    patients;    PICC;    tip positioning;   

DOI  :  10.1111/anec.12931

来源: Wiley

【 摘 要 】

Objective To observe the changes of F waves on electrocardiograms (ECGs) in patients with persistent atrial fibrillation during the insertion of a peripherally inserted central catheter (PICC), and to analyze the application effect of the ECG method (through F wave changes) for guiding PICC tip positioning. Methods Seventy-two patients who met the inclusion criteria and needed a PICC catheter were selected as the research subjects. We observed waveforms in the ECGs when the tip of the catheter reached a predetermined position. The chest X-ray results were used as the gold standard to calculate the sensitivity and specificity, and judge the safety and accuracy of ECG-guided PICC tip positioning in patients with atrial fibrillation. Results Of the 72 patients, there was no significant difference between the ECG method and chest X-ray results (χ 2 = 0.2, p > 0.05). Sixty-one patients had F wave changes on ECG and 10 had no obvious changes (X-ray results confirmed that five patients had a tip position that was too shallow, two had ectopic tip positions, and three were located in the correct place). The sensitivity of the method was 95.7% and the specificity was 80%. Conclusion As the ECG baselines of patients with persistent atrial fibrillation were difficult to judge and the F wave was irregular, we found that the F wave was significantly higher than before catheter insertion and fell back while withdrawing the catheter, so the catheter should be fed until the F wave significantly increased as the correct position of the catheter tip.

【 授权许可】

Unknown