SHERLOCK 3CG™ Diamond Tip Confirmation System

Inclusion Criteria:

• Male or female, ≥ 21 years of age with altered cardiac rhythm (no recognizable P-waveon standard ECG) with diagnosis of specific arrhythmia type or identification ofpacemaker driven rhythms as defined below:

1. Atrial fibrillation with history of diagnosis per 12-lead ECG in medical recordor diagnosed via bedside telemetry by study team RN at assessment, or
2. All other arrhythmias (including but not limited to atrial flutter, PAC, PVC,PJC, tachycardia, AV Block, BB Block) with history of diagnosis per 12-lead ECGin medical record or diagnosed via bedside telemetry by cardiac unit RN atassessment, or retrospectively by site cardiologist, or
3. Pacemaker driven rhythm with temporary or permanent pacemaker device in place;

• Subject requires PICC placement as part of standard of care;
• Subject or Legally Authorized Representative (LAR) has signed an Informed Consent Form (ICF).

Exclusion Criteria:

• Subject has a contraindication to PICC placement as listed in the Instructions for Use (IFU) to include:

1. The presence of bacteremia or septicemia (known or suspected),
2. The patient's body size is insufficient to accommodate the size of the implanteddevice,
3. The patient is known or is suspected to be allergic to materials contained in thedevice,
4. Past irradiation of prospective insertion site,
5. Previous episodes of venous thrombosis or vascular surgical procedures at theprospective placement site,
6. Local tissue factors will prevent proper device stabilization and/or access;

• Subjects who previously had a PICC in place and require a PICC exchange;
• Subject has presence of active resting tremor (i.e. Parkinson's, Multiple Sclerosis,etc.) deemed by Investigator to have potential impact on procedure accuracy;
• Subjects who are pregnant or think they may be pregnant.