Epicardio Simulation. Introductory Guide

Size: px

Start display at page:

Download "Epicardio Simulation. Introductory Guide"

Tiffany Morgan
5 years ago
Views:

1 Epicardio Simulation Introductory Guide

2 Introduction Epicardio Simulation is a fully validated advanced cloud-based 3D interactive real-time simulation of the heart that shortens the Cardiology learning curve Provides interactive e-training tutorials and online customisable testing Enables the educator to deliver more content quicker, in a far more visually engaging way Helps students to fully master the complexity of the heart and take tests in their own time Epicardio Ltd All rights reserved.! 2/22

End-User Licence Agreement Read the EULA Scroll down to the end

4 Login Independent validation studies from academia and industry compared Epicardio Simulation with attending Cardiology lectures and found it to be far superior Tap on LOGIN at the top right corner of the app window Use your User Name and Password to login Epicardio Ltd All rights reserved.! 4/22

5 Cardiac anatomy views Control the camera angle by dragging your mouse with left button pressed or by dragging a single finger pressed on the pad Drag the camera left/right and up/down by dragging your mouse with right button pressed or dragging two fingers pressed on the pad Zoom in/out by rolling the mouse wheel or by dragging two fingers on the pad Tap on the heart icon on the top left side of the window to reveal the anatomy controls Use the preset anatomical views: Cranial, RAO, LAO, Caudal, AP Chose between various anatomical views using the buttons on the left side of the window Epicardio Ltd All rights reserved.! 5/22

6 Our Cardiac Electrophysiology simulator generates accurate real-time Action Potential maps and ECG/EKG signals. The Action Potential and the ECG you see here is not pre-recorded playback Tap on the heart icon on the top right corner of the window to reveal the EP controls Observe the AP wavefront and the ECG signal Tap anywhere on the ECG signal to pause and use the grey slider below to scroll back the simulation Observe the correlation between the yellow line Cardiac electrophysiology simulator! on the ECG and the Action Potential propagation wavefront on the 3D heart Epicardio Ltd All rights reserved. 6/22

7 Action potential wavefront You may customise and simplify the action potential wavefront colours Tap on the heart icon on the left side of the window to reveal the anatomy controls Tap on the colour spectrum icon near the bottom Tap on the colour bar to select a colour scheme Use the sliders to set the min and max displayed AP voltage Epicardio Ltd All rights reserved.! 7/22

Pacemaker The best way to witness that the cardiac electrical activity is simulated as we speak, is to use a pacemaker Tap on the pacemaker icon on the right side of the window Observe the ECG

8 Pacemaker The best way to witness that the cardiac electrical activity is simulated as we speak, is to use a pacemaker Tap on the pacemaker icon on the right side of the window Observe the ECG changing due to the pacing stimulus on the lateral side of the left ventricle Tap anywhere on the right ventricle to place the pacing wire and see the ECG changing again Tap anywhere on the left atrium to place the pacing wire and see ECG changing again Epicardio Ltd All rights reserved.! 8/22

ECG electrodes and leads Yo u m a y d i s p l a y t h e E C G / E K G electrodes and the respective leads Tap on the Torso & Electrodes button on the right side of the window Observe the

9 ECG electrodes and leads Yo u m a y d i s p l a y t h e E C G / E K G electrodes and the respective leads Tap on the Torso & Electrodes button on the right side of the window Observe the selected ECG lead (default lead II ) Tap on < to select lead I Pick-drag-drop the red, yellow and green electrodes and see the resulting changes on the ECG Epicardio Ltd All rights reserved.! 9/22

10 Myocardium contraction The myocardium contraction in the ventricles is also simulated in real-time Tap on the heart muscle contraction button on the right side of the window Tap on the graph button on the right side of the window The S-L is the time delay of activation between the S point on the Septum and the L point on the Left Ventricle The LVEF is the Left Ventricle Ejection Fraction Allow a couple of heart beats until the values settle to normal: S-L: ~20ms, LVEF: ~50% Turn off heart muscle and graph Epicardio Ltd All rights reserved.! 10/22

Tutorials There are over 30 simulated cardiac pathologies and variations organised in 40 interactive tutorials Each tutorial guides you step-by step through the key

11 Tutorials There are over 30 simulated cardiac pathologies and variations organised in 40 interactive tutorials Each tutorial guides you step-by step through the key features of each pathology Tap on Tutorials at the top menu Choose Basics -> Normal Rhythm Go through the tutorial slides Epicardio Ltd All rights reserved.! 11/22

Normal Rhythm tutorial Normal Rhythm Tutorial Tap on NEXT at the bottom of the text window to advance to the 5th tutorial slide Observe the PR interval (red horizontal line) Reduce the AVN Conduction

12 Normal Rhythm tutorial Normal Rhythm Tutorial Tap on NEXT at the bottom of the text window to advance to the 5th tutorial slide Observe the PR interval (red horizontal line) Reduce the AVN Conduction Velocity to 0.09 Observe that the PR interval has become longer Reduce the AV Node Conduction Velocity further to 0.05 Observe that the AV Node is now completely blocked - no QRS waves on the ECG, only P waves Epicardio Ltd All rights reserved.! 12/22

13 Normal Rhythm tutorial Normal Rhythm Tutorial Tap on 12-lead ECG on the right side of the window The right half side of the window now shows the 12-lead ECG as it is generated in real-time Tap on Pause Use the callipers to measure the heart rate Epicardio Ltd All rights reserved.! 13/22

14 LBBB tutorial Left Bundle Branch Block Tutorial Navigate to Tutorials -> Conduction Abnormalities -> Left Bundle Branch Block Tap on NEXT at the bottom of the text window to advance to the 3rd tutorial slide Observe the block on the left branch of the conduction pathway Observe the wide negative QRS (W effect) on lead V1 ECG below Epicardio Ltd All rights reserved.! 14/22

LBBB tutorial Left Bundle Branch Block Tutorial Tap on the Patient ECG icon on the right side of the window The pop-up window now shows a patient case ECG with LBBB

15 LBBB tutorial Left Bundle Branch Block Tutorial Tap on the Patient ECG icon on the right side of the window The pop-up window now shows a patient case ECG with LBBB Tap on the zoom +/- buttons to enlarge the ECG Tap on Annotated ECG icon to see an annotated version of the 12-lead ECG Epicardio Ltd All rights reserved.! 15/22

Bi-Ventricular Pacing tutorial Bi-Ventricular Pacing Tutorial Navigate to Tutorials -> Pacing -> BiVentricular Pacing Tap on NEXT at the bottom of the text window to advance to the 3rd tutorial slide

16 Bi-Ventricular Pacing tutorial Bi-Ventricular Pacing Tutorial Navigate to Tutorials -> Pacing -> BiVentricular Pacing Tap on NEXT at the bottom of the text window to advance to the 3rd tutorial slide Observe the wide QRS of the LBBB pathology Tap on PACE at the bottom left side of the window Observe how the ECG has changed before and after the pacing (the QRS becomes narrower with pacing)! Pause and scroll to the point where you can see the synced stimulus from both left and right pacing wires Epicardio Ltd All rights reserved. 16/22

Multi-Point Pacing tutorial Multi-Point Pacing Tutorial Navigate to Tutorials -> Multi-Point Pacing Pause and measure the QRS with callipers without pacing - observe very wide QRS Tap on PACE Tap on

17 Multi-Point Pacing tutorial Multi-Point Pacing Tutorial Navigate to Tutorials -> Multi-Point Pacing Pause and measure the QRS with callipers without pacing - observe very wide QRS Tap on PACE Tap on MPP Vectors Choose Distal - RV coil (default option) Pause and measure the QRS with callipers - observe marginal improvement in QRS width Choose Prox4 - RV coil + M3 - RV coil Pause and measure the QRS with callipers - observe narrower QRS Epicardio Ltd All rights reserved.! 17/22

Cardiac EP tutorial Cardiac EP Navigate to Tutorials -> Cardiac EP -> Introduction to Cardiac EP Tap on NEXT at the bottom of the text window and advance to the last tutorial slide Tap on the EGM

18 Cardiac EP tutorial Cardiac EP Navigate to Tutorials -> Cardiac EP -> Introduction to Cardiac EP Tap on NEXT at the bottom of the text window and advance to the last tutorial slide Tap on the EGM icon on the right side of the window Observe each intra-cardiac catheter and the respective Electrograms (EGM s) - notice the colour coding Use the Program Electrical Stimulus to pace Use Select Pathology to start a pathology, e.g. AFib Epicardio Ltd All rights reserved.! 18/22

19 ECG/EKG test A generic ECG/EKG Test is embedded within the app. Each student is presented with an individualised test consisting of 10 random 12-lead ECG s and is presented with 5 MCQ options on each ECG. The score is uploaded on the server or can be ed to the educator We can customise this test with your own ECG cases and MCQ s Tap on ECG Test at the top menu bar Tap on Cancel Test to exit Epicardio Ltd All rights reserved.! 19/22

20 Support You may access the online User Guide and product support Tap on Help at the top menu bar. This will display a pop-up web-browser window with links to the User Guide, etc. Epicardio Ltd All rights reserved.! 20/22

Final Epicardio Simulation provides leading edge blended and self-learning in Cardiac Anatomy, Electrophysiology and ECG/ EKG Enables the educator to deliver more content

21 Final Epicardio Simulation provides leading edge blended and self-learning in Cardiac Anatomy, Electrophysiology and ECG/ EKG Enables the educator to deliver more content quicker, in a far more visually engaging way Helps students to fully master the complexity of the heart and take tests in their own time Epicardio Ltd All rights reserved.! 21/22

EPicardio Simulation. User Reference Guide

EPicardio Simulation. User Reference Guide EPicardio Simulation User Reference Guide If you require technical assistance please contact support@epicardio.com For product details see here: www.epicardio.com Introduction Epicardio Simulation is a