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Remember [new] in one second! "What's going on? The patient in operating room No. 3 seems to have resumed premature ventricular contractions?"

What happened to Lu Chen was immediately known to the audience.

Even some students who didn't know much about electrophysiology surgery also saw that Lu Chen's ablation seemed to have failed? !

At the same time, the operating speed of several other students in the operating room also caught up with Lu Chen.

After performing puncture and mapping, they were all ready to start the discharge ablation operation.

Among them, Yu Hewei's surgery progressed the fastest.

He has completed a third of the ablation procedure.

In the classroom, everyone was whispering again.

"It seems that the one who does it the fastest is not necessarily the best! Our competition is not about who can do it in the shortest time!"

"Hey, young man, you still don't have enough experience!"

"However, have you noticed that this patient's arrhythmia seems to be different!"

…

Inside the catheter room.

Lu Chen stared closely at the patient's ECG monitor.

"Continue the ablation discharge!"

Since one discharge ablation was not enough, Lu Chen performed a continuous discharge operation.

But what Lu Chen didn't expect was that after several attempts, the patient's sinus rhythm could only be maintained for a short period of time.

After the ablation discharge was withdrawn, the patient's premature ventricular contractions quickly recovered!

At this time, Lu Chen fell into an endless loop.

He looked through the patient's case information again.

"That's right, it's the right ventricle!"

The patient's electrocardiogram clearly showed that premature ventricular contractions originated from the right ventricle.

He is now ablating the right ventricular outflow tract, which has a certain therapeutic effect, but the ablation effect cannot be maintained!

"Why is this?" Lu Chen stopped what he was doing, his eyes flickered, and he began to recall countless simulation trainings in his mind, trying to find out the reason.

…

Off-site demonstration classroom.

"Oh, I really didn't expect that there is a difficult case!"

Director Wan Jingshui of the third ward in the heart smiled and looked at the big screen. He touched his chin and was extremely interested in Lu Chen in the third operating room.

"Director, I think there is nothing wrong with Lu Chen's ablation operation!" Fang Ruzhang sat next to Wan Jingshui with a puzzled look in his eyes, "But why did it fail in the end?"

Wan Jingshui grinned, "So, you young people are very skilled in surgical operations, but you still have too little clinical experience!"

"Director, do you know the reason for the failure?" Fang Ruzhang was slightly startled.

Wan Jingshui smiled and nodded, "Lu Chen melted in the wrong place."

"The position is wrong?" Fang Ruzhang scratched the back of his head, looked at the big screen again, and said doubtfully, "I also looked at the patient's electrocardiogram, and the ventricular atrial fibrillation originates from the right ventricle. That's right!"

Through electrocardiogram, the origin of premature ventricular syndrome is easier to determine.

Originating from right ventricular premature beats, the chest leads conform to the left bundle branch block pattern. The main wave direction of the qrs waveform is upward in leads v5 and i, and the main wave direction in lead v1 is downward or in an obvious rs shape. Its r wave is often larger than Fat, the time limit is greater than 30ms.

Originating from premature left ventricular contractions, the opposite is true.

After hearing Fang Ruzhang's words, Wan Jingshui shook his head slightly and smiled, "You are right, the ventricle originates from the right ventricular outflow tract, but have you ignored that the heart is a three-dimensional structure? After ablating the right ventricle of the endocardium, Finally, Shizao still exists, should we consider other possibilities?”

"Three-dimensional structure?" Fang Ruzhang frowned and murmured, "Director, do you mean that the origin of ventricular premature ejaculation is inside the heart? That is, in the middle of the intima and adventitia?"

The heart is divided into the endocardium and the epicardium, with a layer of myocardial tissue in between.

In most surgeries, doctors place the catheter lab into the blood vessels and ablate the lining of the heart.

"A child can be taught." Wan Jingshui nodded with a smile, "This kind of early origin is relatively rare!"

However, upon hearing this, Fang Ruzhang's frown deepened, "Director, how can we dissolve the origin point inside the heart?"

"Haha, it's difficult! Lu Chen's case seems to be probably going to fail. The surgeon should be ready to take over." Wan Jingshui turned to stare at the big screen and shook his head slightly, "This can only be due to bad luck. , if it were any other four cases, Lu Chen might have completed the operation."

Yao Jie on the side also heard the conversation between the two. She bit her lip lightly, clasped her hands together, and kept praying to Lu Chen in her heart.

"Senior brother, you can definitely do it!"

…

Inside the catheter room.

After calming down, Lu Chen gradually realized the problem.

After all, he had tried most surgical operations in the systematic surgical simulation room.

"First of all, I want to make it clear that my ablation is effective, which proves that the ablation site is generally correct, at least there is not much deviation!"

"But the effect of ablation cannot be maintained. This only shows that the origin of ventricular premature disease is deeper and farther from the endocardial ablation point!"

Lu Chen lowered his head and looked at the patient on the operating table, feeling no joy at all in figuring out the crux of the problem.

Because he realized a problem, the origin of ventricular cystitis is deep, so how can we "reach" this lesion?

The lesion is between the intima and adventitia, or closer to the adventitia!

"Perhaps, only by performing epicardial ablation can this patient's ventricular premature disease be completely eliminated!" Lu Chen thought to himself, "But, how can my catheter reach the epicardium when it is in the blood vessel?"

Time passed by minute by minute.

Lu Chen seemed to have given up. He just stared at the ECG monitor without making any other movements.

In the other four operating rooms, everyone's surgical operations are coming to an end.

"Student No. 3, do you want to end the assessment?"

In operating room No. 3, the surgeon stood beside Lu Chen for the first time.

As long as he saw Lu Chen nodding, he would immediately take over the operation.

However, the surgeon in charge was also sighing for Lu Chen.

This is really bad luck!

Anyone who chooses this patient will end up with the word "failure".

Patients with this type of ventricular premature origin are very rare.

Generally speaking, ventricular premature ejaculation is terminated after intimal ablation.

"Classmate, you don't need to worry." The surgeon reminded, "This operation is more difficult than expected. Even I have to report it to the director of the department now to decide the next treatment plan."

Lu Chen paused, then shook his head slightly, "I don't want to give up yet."

"Okay, UU Reading www.uukanshu.net I will give you the last five minutes to think. If there is no next step, the assessment will be deemed to be over!"

…

Outside the catheter room, all the students from the other four operating rooms came out.

When they saw Lu Chen still in the operating room, they couldn't help but feel surprised, confused, and some even had a hint of schadenfreude.

"Xiao Fang, it seems that Lu Chen has given up!" Looking at Lu Chen who had not moved in the catheterization room for a long time, Wan Jingshui shook his head regretfully.

"Oh, what a pity!" Fang Ruzhang lamented, "Lu Chen has always been ranked second. Without this accident, he will definitely pass this assessment!"

On the big screen in the demonstration classroom, everyone saw that the surgeon in charge of operating room No. 3 had come out.

"Okay, the assessment is over, let's go back too!"

Wan Jingshui stood up and prepared to return to the department.

But just as everyone was about to leave the demonstration classroom, someone shouted loudly: "Operating room three, operating room three, why did the operation start again?!"