Guidewire‐guided electrocardiogram for positioning the catheter tip of upper arm port in breast cancer patients

Abstract

Intracavitary electrocardiogram (ECG) is a reliable and safe method for real‐time, confirming the tip of central venous access devices. Saline and guidewire are the most commonly used as an intracavitary electrode for introducing ECGs. However, little information about the ECG technique using for the catheter tip of arm port. We aimed to explore the effects of guidewire‐guided ECG approach for locating the catheter tip of the upper arm port in breast cancer patients. We performed a prospective single‐center study, 36 patients with breast cancer were enrolled. Thirty‐six upper arm ports were implanted using a guidewire guided ECG approach, to evaluate the accuracy of the catheter tip position, the operation time, and the stability of the ECG waveform. The ECG‐based tip location was compared with post‐procedural tip location by chest X‐ray. We found that all the upper arm ports implantation were successful in this study. The tip was located at the lower 1/3 superior vena cava or cava‐atrial junction in 35 cases and the upper right atrium in one case. The average operation time of the ECG was 269.25 ± 52.79 second, (range: 190‐345 seconds). The correct rate of the catheter tip position was 97.22%. All the ECG waveform was stable and easy to read. In conclusion, the guidewire‐guided ECG technique is valid and accurate for locating the upper arm port catheter tip; it is also convenient.