Postural Ventricular Tachycardia from Peripherally Inserted Central Catheter Line Placed Using Tip Confirmation System

We report a striking and florid case and immediate emergency management of ‘postural’ ventricular tachycardia likely caused by the mis-confirmed tip of a peripherally inserted central cannula (PICC) placed via a Tip Confirmation System (TCS). Cardiac arrythmia is a known complication of PICC insertion, however the literature does not include a case of arrythmia where a TCS was utilized for insertion to our knowledge. This case highlights the importance of a thorough history and clinical exam in allowing for prompt diagnosis and treatment of arrythmias caused by PICCs – despite reassuring radiographic and TCS confirmation of tip placement.