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.

Calabrese, M., Montini, L., Arlotta, G., La Greca, A., Biasucci, D. G., Bevilacqua, F. C., Antoniucci, E., Scapigliati, A., Cavaliere, F., Pittiruti, M., A modified intracavitary electrocardiographic method for detecting the location of the tip of central venous catheters in atrial fibrillation patients, <<JOURNAL OF VASCULAR ACCESS>>, 2019; 20 (5): 516-523. [doi:10.1177/1129729818819422] [http://hdl.handle.net/10807/133579]

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

Calabrese, Maria;Montini, Luca;Arlotta, Gabriella;La Greca, Antonio;Bevilacqua, Francesca Chiara;Antoniucci, Enrica;Scapigliati, Andrea;Cavaliere, Franco;Pittiruti, Mauro
2019

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.
Inglese
Calabrese, M., Montini, L., Arlotta, G., La Greca, A., Biasucci, D. G., Bevilacqua, F. C., Antoniucci, E., Scapigliati, A., Cavaliere, F., Pittiruti, M., A modified intracavitary electrocardiographic method for detecting the location of the tip of central venous catheters in atrial fibrillation patients, <<JOURNAL OF VASCULAR ACCESS>>, 2019; 20 (5): 516-523. [doi:10.1177/1129729818819422] [http://hdl.handle.net/10807/133579]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/133579
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