CTICasesPICC Line-Induced Ventricular Tachycardia
Imaging findings
Radiograph and CT show a right-sided peripherally inserted central catheter (PICC) with its tip positioned abnormally deep in the lower right atrium near the tricuspid valve. Arm abduction and adduction demonstrate significant catheter migration.
Key takeaways
PICC lines are prone to dynamic migration with arm movements. If the catheter tip is positioned too deep in the right atrium, it can physically contact and irritate the endocardium or tricuspid valve apparatus (referred to as 'atrial tickling'), triggering refractory ventricular tachycardia or atrial arrhythmias. Adjusting the line position is curative.
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