Gullo Giuseppe, Qanadli Salah D
Department of Diagnostic and Interventional Radiology, Cardiothoracic and Vascular Unit, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.
Front Cardiovasc Med. 2022 May 6;9:765935. doi: 10.3389/fcvm.2022.765935. eCollection 2022.
Intracavitary electrocardiography is an accurate guidance technique for peripherally inserted central catheters (PICC) tip location that is spreading widely among providers using non x-ray-based facilities. The principle behind this technology relies on the transmission of the electrocardiographic signal at the tip of the catheter and its use as an internal mobile electrode, allowing the system to identify the cavo-atrial junction (CAJ) through internal P-wave amplitude modulations. The gain in popularity of intracavitary electrography and its large diffusion have led manufacturers to offer various devices with heterogeneous properties, among which clinician who place PICCs have to choose. It is therefore important to understand differences between available techniques and devices. The potential impact might not only affect availability and costs but also the clinical impact through advantages and limitations regarding electric signal transmission PICC selection. Current perspectives on intracavitary electrocardiography will also be discussed, to give the reader a global view of the management of electrocardiographically guided PICCs, especially in an environment without x-ray support.
腔内心电图是一种用于外周静脉中心静脉导管（PICC）尖端定位的精确引导技术，在使用非X射线设备的医疗机构中广泛应用。该技术的原理基于导管尖端心电图信号的传输，并将其用作内部移动电极，使系统能够通过内部P波振幅调制来识别腔房交界处（CAJ）。腔内心电图的普及及其广泛应用促使制造商提供了各种性能各异的设备，放置PICC的临床医生必须从中进行选择。因此，了解现有技术和设备之间的差异非常重要。潜在影响不仅可能涉及可用性和成本，还可能通过电信号传输、PICC选择的优缺点对临床产生影响。本文还将讨论腔内心电图的当前观点，以便读者全面了解心电图引导下PICC的管理，特别是在没有X射线支持的环境中。
