Virtual EP Lab / Case 001

Follow the signals.
Build the reasoning.

A guided mock SVT study: from baseline conduction to induction and interpretation.

Synthetic educational simulator. Every tracing, interval and response is invented for this case. This is not a clinical stimulator, procedural protocol, or substitute for institutional/manufacturer training. It does not connect to equipment. Fixed case settings are illustrative, not instructions for patient care.
  1. 1 · Baseline
  2. 2 · Drive train
  3. 3 · Extrastimuli
  4. 4 · SVT
  5. 5 · Interpretation
Case controls

Baseline sinus rhythm

Each click loads a frozen synthetic recording. Nothing is delivered to a patient. No live controls or pacing outputs.

Synthetic • Sinus rhythm

Think before you advance

Synthetic observation log

Compare the response

RecordingS1–S2AHHVObservation

All intervals in ms. AH refers to local His-channel A onset to H onset. HV refers to H onset to earliest ventricular activation (surface QRS onset in this model).

Read the recording

A / H / V: local atrial, His and ventricular deflections. AH mainly reflects AV nodal conduction; HV reflects conduction from the His bundle toward the ventricles. They are not interchangeable with PR or QRS duration.

S1 / S2: S1 is the repeated drive stimulus. S2 is a single earlier stimulus after that train. Here atrial capture and a constant 10 ms stimulus-to-local-A delay are assumed, so S1–S2 and A1–A2 are equal.

Channel map: HRA = high right atrium; His = His-region bipolar signal; CS 9–10 = proximal, CS 1–2 = distal coronary sinus in this model; RV = right ventricular signal. Channel names alone do not confirm catheter position.

The surface channel is a continuous synthetic lead-II-style rhythm strip with rounded P and T waves and an 80 ms QRS complex. During this mock SVT, retrograde atrial activity overlaps the QRS and may not be separately visible. This is a single rhythm strip, not a diagnostic 12-lead ECG. HRA, His, CS and RV display continuous, smooth multiphasic bipolar electrograms with distinct shapes. HRA and CS emphasize atrial components with small modeled far-field ventricular components; His shows separate A, H and V components; RV emphasizes ventricular activation. These are intracardiac electrograms, not surface P–QRS–T waves. Choose Beat close-up to inspect their contours. Waveforms are schematic, with arbitrary amplitude and no clinical filtering. Small components and far-field signals are simplified. Time is linear within each view; full-recording mode compresses detail.

Concepts & sources

Case values are author-created examples, not patient data or settings copied from a protocol. The linked literature supports the concepts, not validation of this simulator.

In this case, VA is measured from surface QRS onset to the His-channel atrial onset. A short interval and the activation sequence are interpreted together, with diagnostic limitations.

Review intervals → · Review pacing concepts →