CAJ | 학술논문

目的：探讨培训心内科医师通过心电图快速准确定位流出道室性早搏的有效方法。方法流出道起源室性早搏是临床最常见的功能性室性早搏，集中于左，右室流出道及心外膜，射频消融治疗具有较高的成功率。术前通过心电图准确预判室早的起源部位，对缩短手术时间，减少X线曝光量，提高手术成功率至关重要。在培训过程中采用简化的术前心电图定位法则及假设推断相结合的方法预判室早位置，再根据术中实际标测靶点位置，分析术前定位准确或失败的具体原因。2013年6月～2014年6月共16名医师接受了培训。结果16名医师包括博士，硕士研究生及进修生分别为6，8，2名，所有医师均在3个月内熟练掌握了流出道室早的定位流程，对流出道室早的定位准确率超过90%。结论简化的术前心电图定位法则结合假设推断及术后对照分析的方法，循序渐进，可有效增强医师对流出道室早定位的准确性。
목적：탐토배훈심내과의사통과심전도쾌속준학정위류출도실성조박적유효방법。방법류출도기원실성조박시림상최상견적공능성실성조박，집중우좌，우실류출도급심외막，사빈소융치료구유교고적성공솔。술전통과심전도준학예판실조적기원부위，대축단수술시간，감소X선폭광량，제고수술성공솔지관중요。재배훈과정중채용간화적술전심전도정위법칙급가설추단상결합적방법예판실조위치，재근거술중실제표측파점위치，분석술전정위준학혹실패적구체원인。2013년6월～2014년6월공16명의사접수료배훈。결과16명의사포괄박사，석사연구생급진수생분별위6，8，2명，소유의사균재3개월내숙련장악료류출도실조적정위류정，대류출도실조적정위준학솔초과90%。결론간화적술전심전도정위법칙결합가설추단급술후대조분석적방법，순서점진，가유효증강의사대류출도실조정위적준학성。
Objective To investigate the effective training method to achieve accurate and rapid localization of ventricular premature contractions (PVC) with outflow tract origin by means of electrocardiogram analysis in junior cardiologist.MethodsPVC of outlfow tract origin are common in clinical practice, most of which locate in left, right outflow tract and epicardium, catheter radiofrequency ablation has been proved to effectively eliminate this type of arrhythmia. Prophylactic electrocardiographic localization the origin of PVC within outlfow tract plays an important role in shortening procedure time, reducing X ray exposure and improving success rate of procedure. In the process of training, simpliifed localization algorithm in combination with method of hypothesis deduce were applied in the primary determination of PVC origin, and the reason of success or failed locialization were investigated based on the result of success target of ablation, a total of 16 junior cardiologists received training between 2013 June to 2014 June.Results16 trainees, including doctor, master candidate and visiting doctors 6, 8, 2 respectively, mastered electrocardiographic localization algorithm with accuracy rate greater than 90%, in 3 months. ConclusionSimpliifed localization algorithm in combination with method of hypothesis deduce and post procedure analysis could effectively improve accuracy of electrocardiographic localization of PVC with outlfow tract origin.