Medtronic VirtualCSP

Developed for healthcare professionals who want to be trained on conduction system pacing using the Medtronic SelectSecure 3830 lead.

The course consists of structured tutorials organised in chapters and knowledge check with score report. All content is based on interactive real-time 3D heart simulation.

Use of Apple Pencil or a soft rubber tip pen is recommended for better interaction. This app executes in landscape mode only.

TRAINING OBJECTIVES
Pacing lead 3830 placement with selective, non-selective, anodal, or myocardium pacing.
Perform unipolar tip, unipolar ring and bipolar pacing.
Obtain live 12-lead ECG and intra-cardiac signals from pacing lead.
Observe ECG changes with different outputs and during lead progression.
Observe current of injury changes during lead progression.
Take intrinsic and paced QRS measurements.
Take potential - V measurements.
Take paced V6RWPT and V6-V1 inter-peak interval measurements.
Perform threshold test.
Observe patient cases LBBB, RBBB.

GUI FEATURES
Main menu
Guide
Chapters
Conduction system anatomy
Conduction system pacing
Types of capture
Measurements
Transitions
LBBAP algorithm
Observations during implant
Getting to know the tools
Knowledge check
Disclosures
Additional features

Preset lead positions: HB proximal, HB distal, LBB, LAF, LPF, RBB, LVS close to LBB and LVS further from LBB.
Manual interactive pacing lead insertion.
Types of capture: selective, non-selective, anodal, myocardium.
Pacing controls: pace on/off, pulse rate (30-200ppm), output (0.1-15V).
Pacing lead polarity: unipolar tip, unipolar ring, bipolar.
Patient cases: left bundle branch block, right bundle branch block, normal rhythm
Views: 3D transparent, fluoroscopy, close-up view

ADDITIONAL FEATURES
App rate and review
Settings:
General app settings: sounds on/off, action point indices on/off, tool tips on/off, self-study / tutor mode switch.
Anatomical views: atria on/off, ventricles on/off, cross-section view, transparent - b/w - color view, valves on/off, preset camera views.
Simulation speed: slow motion, standard (Hi-Fi) speed (recommended).
Intrinsic heart rate parameters (available in tutor mode)
DCCV
12-lead ECG / single lead ECG view

3D heart view: You can change the heart view by dragging your mouse, pad or finger on the screen. You can also use the RAO-LAO slider at the bottom of the screen to alter the horizontal viewing angle.

Live ECG window:
Displays the 12-lead ECG and two CSP (EGM) signals, filtered CSP signal (cyan), unfiltered signal with current of injury (COI) (green).
You can resize the ECG window by dragging the yellow dot at the top left of the ECG window.
You can pause the simulation by tapping anywhere on the live ECG window, or on the pause/play button at the top-right corner. Tap again to resume the simulation.
When paused, you can use the caliper tool to take measurements in ms or bpm. You can add up to 5 caliper segments.
When paused, a slider at the bottom of the ECG window, allows you to scroll the ECG back and forth and see the ECG waves in parallel with the action potential wavefront on the 3D heart view (in 3D transparent view).
You can also scroll the simulation by dragging your mouse or pad left/right on the paused ECG window.
The snapshot tool allows you to create an ECG snapshot in a pop-up window. Useful when you want to compare transition morphologies on the ECG.