A modified intracavitary electrocardiographic method for detecting the location of the tip of central venous catheters in atrial fibrillation patients

Luca Montini, Antonio La Greca, Andrea Scapigliati, Franco Cavaliere, Maria Calabrese, Gabriella Arlotta, Francesca Chiara Bevilacqua, Maria Enrica Antoniucci, Mauro Pittiruti

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: The intracavitary electrocardiographic method is recommended for assessing the location of the tip of central venous catheter when there is an identifiable P wave. Previous reports suggested that intracavitary electrocardiographic method might also be applied to patients with atrial fibrillation, considering the so-called f waves as a surrogate of the P wave. Methods: We studied 18 atrial fibrillation patients requiring simultaneously a central venous catheter and a trans-esophageal echocardiography. An intracavitary electrocardiographic trace was recorded with the catheter tip in three different positions defined by trans-esophageal echocardiography imaging: in the superior vena cava, 2 cm above the cavo-atrial junction; at the cavo-atrial junction; and in the right atrium, 2 cm below the cavo-atrial junction. Three different criteria of measurement of the f wave pattern in the TQ tract were used: the mean height of f waves (method A); the height of the highest f wave (method B); the difference between the highest positive peak and the lowest negative peak (method C). Results: There were no complications. With the tip placed at the cavo-atrial junction, the mean value of the f waves was significantly higher than in the other two positions. All three methods were effective in discriminating the tip position at the cavo-atrial junction, though method B proved to be the most accurate. Conclusion: A modified intracavitary electrocardiographic technique can be safely used for detecting the location of the tip of central venous catheters in atrial fibrillation patients: the highest activity of the f waves is an accurate indicator of the location of the tip at the cavo-atrial junction.
Original languageEnglish
Pages (from-to)516-523
Number of pages8
JournalJOURNAL OF VASCULAR ACCESS
Volume20
DOIs
Publication statusPublished - 2019

Keywords

  • Atrial fibrillation
  • Nephrology
  • Surgery
  • cavo-atrial junction
  • central venous catheter
  • intracavitary electrocardiographic method
  • tip location
  • trans-esophageal echocardiography

Fingerprint

Dive into the research topics of 'A modified intracavitary electrocardiographic method for detecting the location of the tip of central venous catheters in atrial fibrillation patients'. Together they form a unique fingerprint.

Cite this