Recently, peripherally inserted central venous catheters (PICCs) have been widely used for venous access. Advantages of a PICC over centrally inserted central catheters include the virtual elimination of the risk of pneumothorax, hemothorax, and arterial puncture, along with a reduced risk of bleeding. However, the PICC has associated risks. We present 2 cases of body position-dependent ventricular tachycardia related to PICCs. These events occurred in patients with no prior history of cardiac arrhythmia and were corrected by repositioning of the PICC. They serve to identify a potentially serious cardiac complication of the PICC that, to our knowledge, has not been described previously.

Arteriovenous fistula presents rarely with liver involvement. A 73-year-old man had new-onset ascites, hepatomegaly, and abnormal liver and renal function test results. An abdominal computed tomogram revealed a 7.6-cm internal iliac aneurysm but no other abnormality to account for his ascites. An aortogram demonstrated a 1.5-cm internal iliac arteriovenous fistula that subsequently was repaired, leading to resolution of his symptoms and laboratory abnormalities. High-output cardiac failure should be considered in the differential diagnosis of patients with new-onset massive ascites, hepatomegaly, and liver test abnormalities.

Arteriovenous fistula presents rarely with liver involvement. A 73-year-old man had new-onset ascites, hepatomegaly, and abnormal liver and renal function test results. An abdominal computed tomogram revealed a 7.6-cm internal iliac aneurysm but no other abnormality to account for his ascites. An aortogram demonstrated a 1.5-cm internal iliac arteriovenous fistula that subsequently was repaired, leading to resolution of his symptoms and labora-tory abnormalities. High-output cardiac failure should be considered in the differential diagnosis of patients with new-onset massive ascites, hepatomegaly, and liver test abnormalities.