Electrocardiogram (ECG) Guided Peripherally Inserted Central Catheter (PICC) Placement

A Study of Electrocardiogram (ECG) Guidance for Placement of Peripherally Inserted Central Catheters (PICC)

This study is designed to obtain information for design purposes on use of an ECG guided monitoring system to aid in the correct placement of PICC lines.

There is no formal study hypothesis.

PICC line placement is a common procedure, made more difficult by the need to ensure that catheter tip placement is in an acceptable location, typically the superior vena cava (SVC), and ideally at the junction of the SVC and right atrium. Tip location is determined at present by chest X-ray, which is performed after the procedure. If the tip location is incorrect, additional procedures and/or X-rays are needed until proper placement is ensured.

Use of an electrode placed inside the catheter during insertion has been reported to provide identifiable changes in the p-wave sufficient to guide placement. This study is designed to collect ECG and catheter depth information during routine PICC placement procedures, and to correlate these ECG changes to tip location as determined by contrast enhanced fluoroscopy.

Inclusion Criteria:

• Require Power PICC placement as standard care
• Signed informed consent

Exclusion Criteria:

• Has an intracardiac device
• Does not have normal sinus rhythm
• Has known abnormality of central venous system
• Plasma creatinine >=1.5 mg/dL
• Pregnancy
• Allergy or prior reaction to contrast material