• Yi-Chia Wang, Chi-Hsiang Huang, Feng-Sheng Lin, Wen-Ying Lin, Shou-Zen Fan, Chih-Peng Lin, and Wei-Zen Sun.
• Department of Anesthesiology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan.
• J Surg Oncol. 2012 Jun 15; 105 (8): 848-51.

BackgroundProper tip position is a major determinant of totally implantable venous access device (TIVAD) outcome. The aim of this study is to analyze the potential utilization of intravenous electrocardiography (IV-ECG) to help inexperienced operators for TIVAD placement.Patients And MethodsThis is a retrospective, observational, uni-institutional study. 331 patients receiving TIVAD implantation from July 2008 to December 2008 were recruited. In IV-ECG group, IV-ECG was used to help decide catheter tip location and catheter length. In Landmark group, catheter length was decided by surface landmarks. Catheter tip position was confirmed by post-operative supine chest X-ray.ResultsThere were 153 patients in IV-ECG group, and 178 patients in Landmark group. No immediate reoperation due to catheter mal-position was noted in IV-ECG group, but it happened in eight patients in Landmark group. In IV-ECG group, 97.3% of the catheter tip located at proper position (within 2 cm from junction of right atrium and superior vena cava, as compared to 88.8% of the tip position in Landmark group was proper. The difference was statistically significant (P < 0.05). There was no complication associated with the use of IV-ECG.ConclusionIV-ECG is a safe and convenient method to help inexperienced operators placing TIVAD.Copyright © 2011 Wiley Periodicals, Inc.

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