Objective To compare the effect of dual chamber high pressure PICC (peripherally inserted central catheter) and femoral vein CVC(central venous catheter)catheterization in patients with IV class heart failure. Methods From January to December 2016, 61 patients with congestive heart failure in the sitting position were selected from our hospital. According to the convenient sampling method, they were randomly divided into the study group (31 cases) and the control group(n=30). The study group were treated with high pressure PICC tube, the control group underwent femoral vein catheterization. Two groups of patients with the success rate of catheterization, catheter tip location, complications, indwelling catheter days and related clinical indicators of patient satisfaction were observed. Results The successful rate of intubation in the study group was 93.55% (29 cases), higher than that of the control group (25 cases)(P<0.05), and the incidence of complications in the study group was lower than that of the control group(P<0.05)(83.33%). Conclusion Treatment for patients with heart failure IV be in sitting position under high pressure PICC intubation, may improve the success rate of catheterization, reduce the incidence of complications, improve patient satisfaction, and be the first choice when the rescue of patients with venous channel.