I Can See Health

   Chapter 409 Rejection

  Lu Chen didn't care too much about what people thought.

   In the Kyoto electrophysiology training class, he paid more attention to the teaching of the old professor.

   These are the top electrophysiology experts all over the country.

  For example, the one who taught everyone today is Yang Feng, an electrophysiologist from the Cardiology Department of Kyoto University School of Medicine.

  Yang Feng, he is currently one of the authoritative experts in the field of electrophysiology in China.

   Lu Chen’s Cardiology Instructor who applied for the Kyoto University School of Medicine was Yang Feng.

  Lu Chen vaguely remembered the scene when Professor Yang Feng gave him an interview.

   Professor Jia Bo, who is a judge at the Electrophysiology Society, is only a student of Professor Yang Feng.

At this moment, Yang Feng stood on the podium with a stern expression, looked around at the people below, and then slowly said, "When the pacemaker is embedded in the subcutaneous tissue in front of the pectoralis major, the prototype of the single-electrode pacemaker is close to the chest. It is in front of the major muscle, so it is easy to be affected by the muscle potential, and there are three kinds of manifestations. Do you know which three?"

Among the    professors, there was no sound.

   Everyone frowned, some people had some thoughts in their hearts, but they were not sure.

   At this moment, Min Xiaobo suddenly raised his hand.

   "You answer." Yang Feng pointed at Min Xiaobo.

Min Xiaobo immediately stood up and said, "The first is that the pacemaker should be inhibited from sending out pacing pulses, which is relatively common. Second, ventricular pacing is triggered, and the ventricular tracking frequency is less than the programmed high frequency limit. Three...I haven't thought of it yet."

   Yang Feng's expression remained the same, still cold, "Okay, sit down, does anyone know the third type?"

  Min Xiaobo touched the back of his head and sat down helplessly.

   There were whispers among the teachers, and everyone had some ideas, but they were still not sure.

   for a long time.

   Seeing that there was no response from everyone, Yang Feng began to actively look for "prey".

   "Fang Ruzhang, you answer."

   Fang Ruzhang sat in the last row with an embarrassed smile on his face.

   "Professor Yang, this, I, I don't quite understand..."

   Yang Feng frowned and spoke without mercy, "Fang Ruzhang, how did you get into the third week? You can't even know this question?"

  Fang Ruzhang looked embarrassed and felt a little resentful in his heart, but he did not dare to attack.

  Although he borrowed the time from Lu Chen's simulated surgery room, he passed the second week's weekly exam with his own strength!

   However, Fang Ruzhang's current results ranked last in the promotion list.

   By the third week of the weekly test, with five people still to be eliminated, it was almost impossible for him to pass.

   "Duan Jiufang, do you know?" Yang Feng started to call names again, looking directly at Duan Jiufang who was sitting in the front row, "I think you are usually more active in the class, do you know the answer to this question?"

   With a confident smile on his face, Duan Jiufang stood up and said loudly, "After sensing myoelectric potential by the atrial electrodes of the dual-gun pacemaker, it may trigger cardiac arrest."

   Yang Feng raised his brows, "What's the reason?"

   "Uh..." Duan Jiufang paused and said, "It may be because the pacemaker inhibits the pacing pulse, and the electrocardiogram shows its own heart rhythm, causing a brief cardiac arrest!"

After   , Duan Jiufang looked at Yang Feng expectantly.

  Yang Feng shook his head slightly, "Not very accurate."

   "Huh?" Duan Jiufang looked disappointed. She thought about this answer for a long time, and it was justified, but she was rejected.

   Yang Feng was a little disappointed, he looked at Yu Hewei in front of him.

   wanted to name Yu Hewei, but he felt it was unnecessary, because he must have known.

  Yang Feng continued to look for the next target, and finally settled on one person.

   "Lu Chen, come and answer."

  Lu Chen sat in the first row, directly meeting Yang Feng's gaze.

   In the training class at this time, everyone's attention was also focused on this.

  Lu Chen's name has been revealed in the training.

  Many people have known this little genius who is somewhat enchanting.

Lu Chen smiled. He already had the answer in his mind, so he stood up and said, "If you use asynchronous pacing, that is, when the muscle potential frequency is very high, the pacemaker will pulse at the interference frequency or the low frequency. Its incidence is related to the quality of the pacemaker, the sensitivity of the set sensor, and the degree of swaying of the patient's upper limbs!"

   After a pause, Lu Chen continued: "Just like what Teacher Duan just said, it may cause temporary cardiac arrest. Of course, it may also cause other malignant arrhythmias."

   Lu Chen's words came out, the classroom was so quiet that you could hear needles falling.

   Everyone secretly pondered Lu Chen's words in their hearts.

"Okay!" Yang Feng finally showed a smile, he walked up to Lu Chen, patted him on the shoulder, then turned to Duan Jiufang and said, "Xiao Duan, although your answer is correct, it is not comprehensive. Lu Chen's answer is the most accurate!"

   "Professor Yang has won the award, but you still teach well." Lu Chen smiled.

  Yang Feng smiled, this flattering words are useful, "Then tell me, how to identify the effect of myoelectric waves on the pacemaker?"

  Lu Chen thought for a while and then said: "Sometimes obvious myoelectric waves can be seen on the body surface electrocardiogram, but it does not affect the pacemaker function. Sometimes the pacemaker function is inhibited even though the myoelectric waves are not obvious."

"The EMG interference mostly occurs when young people and manual workers are engaged in physical activities. In order to identify the effect of EMG on the pacemaker, the patient can use the limb on the side of the implanted pacemaker to do vigorous counter-exercise under ECG monitoring. , observe the functional status of the pacemaker and test the perception threshold of myoelectric waves, and then adjust the pacemaker's perception sensitivity through process control to eliminate the influence of myoelectric waves."

   Yang Feng smiled, "Well said!"

Then he waved his hand and motioned Lu Chen to sit down, "The influence of myoelectric potential on the pacemaker is very common in clinic, but it is easy to be ignored. We are doing a history of electrophysiological interventional surgery, once we ignore the influence of this detail , with potentially serious consequences, such as the points we just said, malignant arrhythmias, or even cardiac arrest."

  …

   Yang Feng is indeed an expert professor in the field of intracardiac electrophysiology.

   A class, explained the profound things in simple language, so that everyone will have a lot of aftertastes.

  Although Professor Yang Feng is more administrative and has fewer opportunities for clinical operations, his experience here is unmatched by the group of young and middle-aged doctors in front of him.

   In this lesson, Lu Chen gained a lot.

   He now has an advanced skill card for electrophysiological intervention, and he has a high acceptance ability for those obscure knowledge.

   In the blink of an eye, the third weekly exam was over.

  The first place, Yu Hewei!

   At present, no one can shake his position.

   The second place is still Lu Chen!

   Lu Chen, like Yu Hewei, once again won the second place.

  …

   Returning to the training class from the hospital where he was assessed, Lu Chen met Yang Feng on the way.

  I thought it was just passing by by chance, but Yang Feng took the initiative to come forward and talk to Lu Chen.

   "Lu Chen, are you interested in following me in the next second stage?"

  Yang Feng has a good smile, which is different from his indifferent expression in class all the time.

  The first phase is about to end.

   Yang Feng basically tacitly agreed that Lu Chen could pass the first stage of the assessment.

The first stage of    is one-to-many training.

   And the second stage is one-on-one training. Everyone else has to choose a mentor.

  Lu Chen looked at Yang Feng in front of him with a slightly dazed expression.

   He thought about the interview he sat in front of Professor Yang Feng a year ago.

   Lu Chen wished that Yang Feng could hire him.

   However, things backfired.

   One year later, Professor Yang Feng finally said this.

   However, Lu Chen smiled and shook his head: "Professor Yang, I'm sorry, I already have a favorite tutor."

   You can take a day off at noon tomorrow, 5 more!

   (end of this chapter)