I Can See Health

Remember [new] in one second! Lu Chen got the patient’s medical record. This was a 24-year-old female patient.

"Lu Chen, this patient is a nurse from the orthopedics department of our hospital." Fan Zhiping said.

Lu Chen nodded and continued reading.

The patient has had recurring symptoms of palpitations in the past month.

It was especially severe at night. After being admitted to the hospital, an electrocardiogram was performed, which showed that ventricular premature ejaculation occurred frequently.

"We did a 24-hour dynamic electrocardiogram on the patient." Fan Zhiping, "It showed that she had more than 30,000 ventricular premature beats in 24 hours! And it was a multi-source ventricular premature syndrome, and occasionally there were short bursts of ventricular tachycardia. attack."

Lu Chen raised his eyebrows slightly, "So you performed radiofrequency ablation on the patient?"

"Yeah." Fan Zhiping nodded, and then sighed, "Our department performed radiofrequency ablation on her ourselves, but during the operation we found that the origin of her ventricular adenoma was very weird. I ablated it for three hours, but it was still the same. The origin of ventricular tachycardia was not found..."

After hearing Fan Zhiping's description, Lu Chen almost understood the patient's medical history.

For patients with a particularly high number of ventricular premature births, which also affects their daily life, they must try ablation surgery.

What's more, the patient is young, and if ventricular tachycardia continues, it may lead to heart failure or even cardiomyopathy in the long run.

The difficulty of this patient's surgery is to find the "origin point" of ventricular tachycardia!

Lu Chen looked at the patient's electrocardiogram.

After studying it carefully for a while, I found out that this electrocardiogram was different.

"Brother Fan, how did you diagnose this electrocardiogram?" Lu Chen asked.

Fan Zhiping asked doubtfully: "Isn't this ventricular tachycardia originating from the left ventricular outflow tract?"

"Nothing else?"

Fan Zhiping frowned, "No more."

When Lu Chen heard this, he didn't say much.

This electrocardiogram is extremely complex. On the surface, it appears to be just a multi-source, frequent ventricular tachycardia. However, if you look deeper, you will find more origins are yet to come!

…

At this moment, Li Yao spoke up.

"Director Yin, prepare for surgery!"

"Okay." Yin Chao looked serious.

Their department performed three or four hours of surgery but could not find the origin.

Although Professor Li Yao's electrophysiology technology is superb, Yin Chao still felt that it would take at least two hours.

Soon, the patient was pushed into the operating room.

Li Yao took Lu Chen into the operation room.

On the side, Yin Chao sighed slightly, Professor Li Yao really still let his students be assistants!

…

Intervention indoors.

Wash hands, disinfect, anesthetize...

These routine operations are all done by Lu Chen.

Yin Chao couldn't help but think that maybe Lu Chen would just do these ordinary operations and leave the intervention room when it was time for puncture and ablation.

But as the operation continued, Yin Chao knew that he was wrong.

After Lu Chen was anesthetized, he directly started the electrophysiological examination, including mapping, ablation, etc.

"This...sigh..." Yin Chao has given up completely now.

…

At this time, Lu Chen held the electrophysiological examination catheter in his hand and slowly entered the punctured catheter.

A twenty-year-old female patient wanted to have good blood vessel conditions, so Lu Chen's puncture operation went very smoothly.

This stunned everyone outside.

This technique and speed should definitely not come from a student!

There is absolutely no other person with this skill in Fengm County!

"Fan Zhiping, didn't you work in the 8th District of the Cardiology Department of Beijing Second Hospital?" Yin Chao asked subconsciously, "Does this Dr. Lu Chen have such strong electrophysiological interventional capabilities?"

Unexpectedly, Fan Zhiping also had a look of surprise on his face at this time. He shook his head slowly: "Director, when I was in the eighth district of my heart, Dr. Lu Chen hadn't started learning electrophysiological intervention yet..."

"Ah?" Yin Chao was startled suddenly, and then turned back to look at Fan Zhiping, "He, he didn't know anything before? In just this year, his surgical ability has become so strong?"

"Yeah." Fan Zhiping nodded slightly.

But Yin Chao still found it a bit unbelievable. Fan Zhiping must have remembered it wrong. He didn't think that anyone could improve the ability of interventional surgery to this extent within a year!

…

At this moment, Li Yao walked out of the intervention room.

"Li Yao, what are you..." Yin Chao was stunned. The operation was still going on. Why did the surgeon come out?

"I'll make room for you!" Li Yao glanced at Yin Chao, "If you don't make room, how will the doctors in your department learn?"

"This..." Yin Chao was suddenly startled, and then said, "Professor Li, aren't you the chief surgeon?"

"I never said I was!" Li Yao pointed at Lu Chen who intervened in the room, "He is."

"But..." Yin Chao looked into the intervention room, "Your student hasn't graduated yet... This is a bit unruly, right? The most important thing is that he doesn't have a certificate. Without an intervention certificate, he can't perform surgery!"

Hearing this, Li Yao smiled.

Maybe Lu Chen lacks other things, but he lacks the certificate the most!

"He has a certificate!" Li Yao smiled, "An interventional certificate issued by the Chinese Electrophysiology Society."

"Ah?" Yin Chao swallowed and glanced at Lu Chen who stepped into the room.

Does this student have a certificate?

Moreover, it is the most valuable electrophysiology interventional certificate issued by the Chinese Electrophysiology Society.

If the person in front of him was not Professor Li Yao, Yin Chao would really suspect that others were making fun of him.

…

But since the conversation had come to this point, Yin Chao did not hesitate and winked at Fan Zhiping.

Fan Zhiping understood and immediately changed into surgical clothes and lead clothes and walked into the interventional room.

In the interventional room.

Lu Chen was carrying out the steps of ECG mapping and ablation.

This is also the most difficult and most important part of the entire electrophysiological surgery!

Fan Zhiping came to Lu Chen.

Lu Chen also noticed him.

"Lu Chen, come and be your assistant." Fan Zhiping said slowly, and there was still a trace of disbelief in his voice.

He watched Lu Chen's operation from a close distance and could see the skillful technique.

However, the technique is secondary now.

Being able to find the origin of ventricular tachycardia is the most important thing!

Otherwise, no matter how skillful the operation is, it will be in vain.

…

Just then, Fan Zhiping noticed that the place where Lu Chen was ablated seemed to be a little wrong!

"Lu Chen, why are you ablating here?" Fan Zhiping said slowly.

Lu Chen glanced at Fan Zhiping, then retracted his gaze, and said without pausing his hands.

"Brother Fan, look carefully at the patient's electrocardiogram. The chest lead transition of ventricular premature beats is above the transition of sinus rhythm chest lead, indicating that ventricular premature beats may come from the left ventricular outflow tract."

"Another point, the R wave duration/QRS wave duration of V1\u003e50%, the R wave amplitude/S wave amplitude of V1\u003e30%, coincidentally, also suggests that it may come from the left ventricular outflow tract; the I lead is a negative wave, indicating that the frontal vector starts from the left to the right, and it may come from the left coronary sinus ostium."

"Of course, it may also be a ventricular premature beat at the junction of the left and right sinus ostiums of the left ventricular outflow tract, or at the AMC, or at the epicardium of the great cardiac vein at the top of the ventricle. The lower wall is also high R, but the chest lead shape does not match the transition."

...

Fan Zhiping didn't feel it was sharp.

Lu Chen could see so many things from an electrocardiogram!

Lu Chen's current state reminded Fan Zhiping of the scene when he interpreted the electrocardiogram in the WeChat group before.

He is really worthy of being called "Professor Lu"!

Lu Chen finally said: "Personally, the origin of this patient's ventricular tachycardia is left ventricular outflow tract (left coronary sinus ostium) ventricular premature beats \u003e right ventricular outflow tract anterior compartment ventricular premature beats \u003e pulmonary artery trunk ventricular premature beats, left ventricular outflow tract left and right sinus ostium junction or AMC or great cardiac vein ventricular premature beats."

"I don't know if you covered these parts during the three hours of surgery?"

Fan Zhiping touched the back of his head awkwardly, "Really not..."

...

Outside the intervention room.

Lu Chen's words were clearly heard by everyone.

Yin Chao showed a look of astonishment on his face.

Lu Chen's analysis was easy to understand and even exceeded his understanding.

Is this the electrophysiological intervention ability that a student can have?