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Marcia DeRuiter
PICC and pacemakers or defibs

Does anyone have any info on placing or d'cing Picc lines when you have pacer or defib lines going down the svc together?  I thought I had once read an article and seen an x-ray that showed the lines enterwined, which means that when you pull the Picc the other wires might be moved.

Thank you 

mariebf
There was a latest poster on

There was a latest poster on the pacemaker and picc in AVA conference in Arizona, recently. Remember the pacer wires are embedded into the cardiac muscle( within the atrium and ventricle) in order to pace the heart beat, while the picc cath tip is in the SVC, the wires will not enterwine.

IV Team from MDAnderson Hospital

MarB

lynncrni
There is the possibility of
There is the possibility of fracturing the pacer wires when discontinuing a CVC **if** the two are connected by thrombus bridging between the two **and** you do not stop CVC removal if you feel resistance. There is not a lot of information published about this but I thought I had come across one case study a few years ago. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

smarison
SO does this mean we can
SO does this mean we can actually place a Picc on the same side as a pacemaker?  I have always avoided that in past.  Susan
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Raquelhoag@gmail.com's picture
When I first learned how to
When I first learned how to insert PICCs over 10 yrs ago, we brought this issue up with our Cardiologists at that time and they had informed us that as long as the Pacemaker wasn't newly inserted, it should be fine...of course, we avoid it whenever possible.

 As Marie mentioned the poster presentation at AVA, the pacer wires are embedded into the cardiac muscle. The only problem we have sometimes is visualizing the PICC tip if the pacer wires are super-imposed.
I've kept data of our PICC outcomes for the past 7 yrs and we have not had any problems removing PICCs on pacemaker sides. 

Raquel M. Hoag, RN, BSN, CRNI
Washington Hospital, Fremont, CA

Raquel M. Hoag, BSN, RN, PHN, VA-BC

AshleyM
Our cardiovascular surgeons
Our cardiovascular surgeons have us remove all central lines before a pacemaker or defibrilator is implanted and we avoid central lines in those patients until they are well healed.  We also try to avoid placing PICCs  on the same side as pacemakers but on the patients we have done same side we have been fortunate and not had any difficulties with insertion or removal.
Gilda Taylor
Are there any references

Are there any references stating that it is not a good practice to place picc lines on the same side as defibrillators in patients? Or in patient's with pacemakers? Or is it the length of time pacemaker in place--- is it okay after pacemaker in for a length of time to place a picc line?

Thank You

afruitloop
My experience is the same as

My experience is the same as the others who have responded.  Pacer wires will eventually become covered with fibrin, etc.  During this period, having a PICC (which is also becoming covered) dwelling in the same vessel may, as Lynn said, cause the two to become connected.  Check with your physician, offering this explanation on fibrin encapsulation and he may agree.  My team avoided running the two together for 30 days.  I will add quite successfully!

Cheryl Kelley RN BSN, VA-BC

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