InterSim II hardware

Power supply: wall power supply, 100 – 230 V AC, 50 – 60 Hz
PC Interface: USB 2.0
Pacemaker interface: 15 pin SubD
InterSim-Box

Available cables:
ISII-1
to connect InterSim II with Pacemaker/CRT devices [connectors: IS1 Atrium, IS1 Left Ventricle, IS1 Right Ventricle, CAN clamp]
cable InterSim II-1

ISII-3
to connect InterSim II with ICD devices [commectors: IS1 Atrium, IS1 Left Ventricle, IS1 Right Ventricle, DF1 HVB/RV coil, DF1 HVA/SVC coil]
cable InterSim II-3

ISII-4
to connect temporary Pacemaker [connectors: banana plugs 2mm Atrium, banana plugs 2mm Right Ventricle]
cable InterSim II-4

Channels:

Channel output peak voltage input resistance maximum stimulation amplitude/
maximum defibrillation pulse energy
normal short cut broken
 ECG A 9 mV 470 Ohm 50 Ohm 4600 Ohm 7.5 V / 1.5 ms
 ECG LV 27 mV 430 Ohm 50 Ohm  4600 Ohm  7.5 V / 1.5 ms
 ECG RV 27 mV 400 Ohm 50 Ohm 4600 Ohm 7.5 V / 1.5 ms
 ECG LL, LA, RA  2.5 mV 510 Ohm      
 HVB (RV coil)
 HVA (SVC coil)
 23.8 mV 66 Ohm     35 J (only 'Cold Can')

InterSim II Software

The requirements for the InterSim software to run are:

  • At least 1 GB RAM
  • Microsoft Microsoft Windows 7 (32/64 bit), Microsoft Windows 8, Microsoft Windows 10
  • USB 2.0 Interface
    Attention: There must be only one InterSim II at the PC at the same time!
  • Display 1024 x 768 or better, High Color or True Color
  • At least 100 MB free Disc Space

The following rhythns are provided for simulation:InterSim Menu Rhythm

  • Sinus Rhythm (sinus rate 68 bpm)
  • Sinus Brady (sinus rate 39 bpm)
  • Sinus Arrest (sinus rate 2 bpm)
  • Idioventricular Rhythm (left ventricle rate 41 bpm)
  • Sinus Tachy (sinus rate 119 bpm)
  • Atrial Flutter (atrial rate 240 bpm)
  • Atrial Fibrillation (atrial rate 280 ... 370 bpm)
  • AVNRT (AVN rate 130 bpm)
  • LV Tachy Slow (left ventricle rate 130 bpm)
  • LV Tachy Medium (left ventricle rate 165 bpm)
  • LV Tachy Fast (left ventricle rate 220 bpm)
  • RV Tachy Slow (right ventricle rate 130 bpm)
  • RV Tachy Medium (right ventricle rate 165 bpm)
  • RV Tachy Fast (right ventricle rate 220 bpm)
  • Polymorphous VT (left, right ventricle rate 155 ... 171 bpm)
  • Torsade de Pointes (left, right ventricle rate 167 bpm)
  • Ventricular Flutter (left, right ventricle rate 230 bpm)
  • Ventricular Fibrillation (left, right ventricle rate 239 ... 333 bpm)

Some rhythms have adjustable rates.

The following atrio-ventricular conduction options are available:InterSim Menu Blocks

  • 1:1 conduction (no block, block rate 171 bpm, PR delay 170 msec)
  • AV Block I (block rate 171 bpm, PR delay 250 msec)
  • AV Block II Mobitz II (block rate 52 bpm, PR delay 170 msec)
  • AV Block II Mobitz I (block rate 66bpm, PR delay 170 ... 370 msec)
  • AV Block III
  • Retrograde Conduction (RP delay 210 msec)
  • Accessory Pathway (demonstration of a reentry loop)
  • LBBB
  • RBBB
  • The values Block rate, PR delay and RP delay are adjustable.

Beside the predefined settings a bundle of parameters are adjustable:InterSim Menu Parameters

  • Atrium rate from 2 to 245 bpm
  • AVN rate from 2 to 200 bpm
  • Ventricle rate from 2 to 220 bpm
  • PR interval from 50 to 400 msec
  • RP interval from 130 to 600 msec
  • Block rate from 20 to 210 bpm
  • Coupling interval (of prematures) from 100 to 1000 msec
  • RV-LV interval from 70 to 150 msec
    (that is the delay between the right ventricular and the left ventricular R wave components in the ventricular IEGM)
  • Vulnerable phase from 40 to 80 msec
    (the width of the vulnerable phase at the end of the refractory period)
  • A-Pace-P latency from 10 to 150 msec
  • Workload from 0 to 100 %
  • Chances
    (determines the chances of changing a tachyarhythmia in case of three consecutive hits of pace pulses in the vulnerable phase)
  • Farfield R-wave amplitude off, small, large
  • Farfield R-wave intrinsic VA interval from 0 to 100 msec
  • Farfield R-wave paced VA interval from 50 to 200 msec
  • Dual tachycardia
    (provides the means to use a atrial and a ventricular tachycardia at the same time)
  • Biventricular
    (provides the means to use biventricular pacing)
  • A-pace crosstalk
    (a large crosstalk signal appears in the ventricular IEGM)
  • ERAF (Early Recurrence of AF)
  • ERVT (Early Recurrence of VT)

The characteristics of the InterSim hardware is adjustable with the means of different interface settings.

Electrode settings

     Atrium right Ventricle left Ventricle
bipolar unipolar bipolar unipolar biplar unipolar
Normal   Impedance 580 Ohm 480 Ohm 510 Ohm 410 Ohm 540 Ohm 440 Ohm
Threshold 0.5 V / 1 V / 3 V at 0.5 ms
accordingly to the adjusted value
Amplitude P Wave
Amplitude R Wave
0 .. 4 mV accordingly to the adjusted value
0..14 mV accordingly to the adjusted value
Leakage Impedance 150 Ohm 50 Ohm 150 Ohm 50 Ohm 150 Ohm 50 Ohm
Threshold 3.5 V / 0.5 ms
Amplitude P/R Wave 20% of the adjusted value
Scar Impedance 580 Ohm 480 Ohm 510 Ohm 410 Ohm 540 Ohm 440 Ohm
Threshold 3.5 V / 0.5 ms
Amplitude P/R Wave 40% of the adjusted value
Fracture Impedance 4700 Ohm 4600 Ohm 4700 Ohm 4600 Ohm 4700 Ohm 4600 Ohm

Threshold

always ineffective

Amplitude P/R Wave

0

Wave amplitudes:

  • Atrium: 0 .. 4 mVpeak
  • Right Ventricle: 0 .. 14 mV peak
  • Left Ventricle: 0 .. 14 mV peak

EMI (separately for atrium, right and left ventricle)

  • 50 Hz 5 mv
  • 50 Hz 0.5 mV
  • Artifacts

Defibrillation thresholds

  • Atrium: 0.5 .. 40 Joule (with/without randomly variation)
  • Venticle: 0.5 .. 40 Joule (with/without randomly variation)

ICD far field ECG wave amplitude:

  • 0 .. 10 mV peak

ICD EMI

  • 50 Hz 5 mv
  • 50 Hz 0.5 mV
  • Artifacts

Miscellaneous

  • Control window for basic settings
  • One or two visible ECG traces
  • Possibility to freeze and continue the ECG trace
  • Four different “paper” speeds
  • Three different zoom levels of ECG trace
  • Possibility to measure times on ECG trace
  • Possibility to record ECG and replay with the “InterSim Player” software
  • Possibility to save and reload different complete simulator states
  • Possibility to save InterSim screen or ECG window as JPEG
  • Possibility to print the ECG
  • Possibility to create and play macros