Analysis of P-wave Morphology Changes and Related Influencing Factors during PICC Catheterization in Tumor Patients Using Intracavitary Electrocardiographic Monitoring Localization Technology

Abstract

Objective To explore the changes in P-wave morphology during peripherally inserted central catheter (PICC) placement under intracavitary electrocardiographic (ECG) monitoring and analyze the related influencing factors. Methods A total of 180 patients who underwent PICC procedures at a tertiary cancer hospital in Shandong Province from December 2025 to May 2026 were selected as the study subjects. All patients underwent catheterization guided by intracavitary ECG monitoring, and their ECG monitor's lead II was observed to record characteristic high-spike P-waves, double-peaked P-waves, and the extraction rate and positioning accuracy of bidirectional P-waves. Univariate analysis of variance (ANOVA) and multivariate linear regression analysis were used to investigate the influencing factors of intracavitary ECG P-waves. Results All 180 patients completed PICC placement, and intracavitary ECG monitoring was performed after catheterization. The results indicated that the top two factors affecting intracavitary ECG P-wave changes were characteristic high-spike P-waves and bidirectional P-waves in lead II, accounting for 93.87% and 85% respectively. Univariate ANOVA revealed that patient height, gender, baseline P-wave amplitude, and catheterization site were associated with changes in intracavitary ECG P-waves (P < 0.05); multivariate linear regression analysis showed that patient baseline P-wave amplitude and catheterization site had significant effects on intracavitary ECG P-waves (P < 0.05). Conclusion The application of intracavitary ECG monitoring for PICC placement can reduce radiation hazards, is safe, low-cost, and holds positive significance and broad application prospects.