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
Available cables:
ISII-1
to connect InterSim II with Pacemaker/CRT devices [connectors: IS1 Atrium, IS1 Left Ventricle, IS1 Right Ventricle, CAN clamp]
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]
ISII-4
to connect temporary Pacemaker [connectors: banana plugs 2mm Atrium, banana plugs 2mm Right Ventricle]
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:
- 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:
- 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:
- 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