Robbin George RN VA-BC
I think this is very much a physician preference. We have asked our cardiologists and they prefer no picc on the same side as a pacemaker unless it has been in place for at least 6 weeks (one even prefers 12 weeks).
I think the contraindication to placing a picc on the opposite extremity solely comes from the fear of a possible CRBSI with potential contamination of the new pacer and I am just guessing here as a couple of our docs have casually mentioned this. I have had a couple of docs state they do not want the picc wire touching the pacer wires - nearly impossible since they both reside in the SVC - when they become this picky, I refer them to IR so they can be done under flouro.
We have placed picc lines in opposite extremities in patients that have had their old pacer removed and a new placed, we also prefer to wait until the old is out as well. Sometimes we do have the difficulty of threading the picc where the old pacer was and I must say that every time we get an order in this particular patient population, we cross our fingers and hold our breath until the line goes beyond the subclavian area.