Ventricular tachycardia resulting from central venous catheter tip migration due to arm position changes: Report of two cases

Abstract

This case report and the investigation of the cadaver suggest that when the central venous catheter is placed near the tricuspid valve with the arm abducted, serious ventricular arrhythmias can result should the arm position change and move the catheter tip into the right ventricle. Earlier investigations of the placement of CVP catheters via peripheral veins did not describe this migration or arrhythmia problem. For surgical cases in which arm position will be altered after insertion of the catheter, we recommend that placement of the catheter be in the superior vena cava. In patients with sudden onset of ventricular arrhythmias, migration of the central venous catheter into the ventricle should be included in the differential diagnosis.