Clinical study of intravascular electrocardiogram for central venous catheter placement

Abstract

A method for placing the central venous catheter using intravascular electrocardiography (ECG) was studied. For the connection of central venous catheter and ECG chest lead, a connecting tube adaptor with alligator clip was devised, which was sterile and disposable. The stable intravascular ECG could be easily recorded by filling the tube adaptor and central venous catheter with heparinized saline. The intravascular ECG derived from the central venous catheter was characteristic in wave form. As the catheter tip approached to the right atrium, the amplitude of negative P-wave showed a gradual increase. At the junction of the superior vena cava and the right atrium W-shaped P-wave was inscribed. Within the cavity of the right atrium the amplitude of the P-wave almost exceeded that of QRS complex. When the catheter tip was positioned in an inappropriate way, such as jugular vein or peripheral vein, the characteristic wave form did not appear and no chest rentogenography was required for confirming it.