BackgroundElectrocardiogram (ECG) is commonly used in diagnosis of heart diseases, including many life-threatening disorders. We aimed to assess skills in ECG interpretation among Polish medical students and to analyze the determinants of these skills.Material/MethodsUndergraduates from all Polish medical schools were asked to complete a web-based survey containing 18 ECG strips. Questions concerned primary ECG parameters (rate, rhythm, and axis), emergencies, and common ECG abnormalities. Analysis was restricted to students in their clinical years (4th–6th), and students in their preclinical years (1st–3rd) were used as controls.ResultsWe enrolled 536 medical students (females: n=299; 55.8%), aged 19 to 31 (23±1.6) years from all Polish medical schools. Most (72%) were in their clinical years. The overall rate of good response was better in students in years 4th–5th than those in years 1st–3rd (66% vs. 56%; p<0.0001). Competency in ECG interpretation was higher in students who reported ECG self-learning (69% vs. 62%; p<0.0001) but no difference was found between students who attended or did not attend regular ECG classes (66% vs. 66%; p=0.99). On multivariable analysis (p<0.0001), being in clinical years (OR: 2.45 [1.35–4.46] and self-learning (OR: 2.44 [1.46–4.08]) determined competency in ECG interpretation.ConclusionsPolish medical students in their clinical years have a good level of competency in interpreting the primary ECG parameters, but their ability to recognize ECG signs of emergencies and common heart abnormalities is low. ECG interpretation skills are determined by self-education but not by attendance at regular ECG classes. Our results indicate qualitative and quantitative deficiencies in teaching ECG interpretation at medical schools.

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Background: Significant achievements in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) have provided effective therapeutic options for most patients. However, the true impact of the changed landscape of CTEPH therapies on patients’ management and outcomes is poorly known. We aimed to characterize the incidence, clinical characteristics, and outcomes of CTEPH patients in the modern era of CTEPH therapies. Methods: We analyzed the data of CTEPH adults enrolled in the prospective multicenter registry. Results: We enrolled 516 patients aged 63.8 ± 15.4 years. The incidence rate of CTEPH was 3.96 per million adults per year. The group was burdened with several comorbidities. New oral anticoagulants ( n = 301; 58.3%) were preferred over vitamin K antagonists ( n = 159; 30.8%). Pulmonary endarterectomy (PEA) was performed in 120 (23.3%) patients and balloon pulmonary angioplasty (BPA) in 258 (50%) patients. PEA was pretreated with targeted pharmacotherapy in 19 (15.8%) patients, and BPA in 124 (48.1%) patients. Persistent CTEPH was present in 46% of PEA patients and in 65% of patients after completion of BPA. Persistent CTEPH after PEA was treated with targeted pharmacotherapy in 72% and with BPA in 27.7% of patients. At a mean time period of 14.3 ± 5.8 months, 26 patients had died. The use of PEA or BPA was associated with better survival than the use of solely medical treatment. Conclusions: The modern population of CTEPH patients comprises mostly elderly people significantly burdened with comorbid conditions. This calls for treatment decisions that are tailored individually for every patient. The combination of two or three methods is currently a frequent approach in the treatment of CTEPH. Clinical Trial Registration: clinicaltrials.gov/ct2/show/NCT03959748