Development of simulation combining a physical heart model and three‐dimensional system for electrophysiology training

Rossi, Luca; Penela, Diego; Doni, Lorenzo A.; Marazzi, Raffaella; Napoli, Velia; Napoli, Leonardo; Vilotta, Manola; Villani, Giovanni; Ponti, Roberto De

doi:10.1111/pace.13508

Cited by 9 publications

(8 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Simulation-based training is emerging for teaching and learning and have proved useful in different medical fields [20][21][22][23]. New available technologies supporting complex procedures [24] are spreading worldwide and, consequently, the importance of simulation training has been increasing over the years [25,26].…”

Section: Discussionmentioning

confidence: 99%

Pre-graduation medical training including virtual reality during COVID-19 pandemic: a report on students’ perception

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background The Coronavirus Disease 19 (COVID-19) pandemic brought significant disruption to in-hospital medical training. Virtual reality simulating the clinical environment has the potential to overcome this issue and can be particularly useful to supplement the traditional in-hospital medical training during the COVID-19 pandemic, when hospital access is banned for medical students. The aim of this study was to assess medical students’ perception on fully online training including simulated clinical scenarios during COVID-19 pandemic. Methods From May to July 2020 when in-hospital training was not possible, 122 students attending the sixth year of the course of Medicine and Surgery underwent online training sessions including an online platform with simulated clinical scenarios (Body Interact™) of 21 patient-based cases. Each session focused on one case, lasted 2 h and was divided into three different parts: introduction, virtual patient-based training, and debriefing. In the same period, adjunctive online training with formal presentation and discussion of clinical cases was also given. At the completion of training, a survey was performed, and students filled in a 12-item anonymous questionnaire on a voluntary basis to rate the training quality. Results were reported as percentages or with numeric ratings from 1 to 4. Due to the study design, no sample size was calculated. Results One hundred and fifteen students (94%) completed the questionnaire: 104 (90%) gave positive evaluation to virtual reality training and 107 (93%) appreciated the format in which online training was structured. The majority of participants considered the platform of virtual reality training realistic for the initial clinical assessment (77%), diagnostic activity (94%), and treatment options (81%). Furthermore, 97 (84%) considered the future use of this virtual reality training useful in addition to the apprenticeship at patient’s bedside. Finally, 32 (28%) participants found the online access difficult due to technical issues. Conclusions During the COVID-19 pandemic, online medical training including simulated clinical scenarios avoided training interruption and the majority of participant students gave a positive response on the perceived quality of this training modality. During this time frame, a non-negligible proportion of students experienced difficulties in online access to this virtual reality platform.

show abstract

Section: Discussionmentioning

confidence: 99%

Pre-graduation medical training including virtual reality during COVID-19 pandemic: a report on students’ perception

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge a common limitation of all prior physical simulators is the inability to visualize the delivered therapy. The state-of-the-art simulators developed by Rossi et al [3], Heartroid, and Pangolin are limited by not being RFA-sensitive. Since the goal of electroanatomic mapping systems is to guide the delivery of radiofrequency ablation therapy we argue that visualization of this therapy is an essential requirement to support effective simulator-based training of electrophysiologists.…”

Section: Discussionmentioning

confidence: 99%

“…However, several simulators have been developed that meet a subset of the criteria. Rossi et al [3] developed a physical simulator using a 3D-printed whole heart model embedded into a custom torso. The heart was printed using thermoplastic polyurethane and the simulator was compatible with the CARTO3 EAMS (Biosense Webster, Irvine, CA, USA).…”

Section: Introductionmentioning

confidence: 99%

Cardiac Radiofrequency Ablation Simulation Using a 3D-Printed Bi-Atrial Thermochromic Model

et al. 2022

View full text Add to dashboard Cite

Radiofrequency ablation (RFA) is a treatment used in the management of various arrhythmias including atrial fibrillation. Enhanced training for electrophysiologists through the use of physical simulators has a significant role in improving patient outcomes. The requirements for a high-fidelity simulator for cardiac RFA are challenging and not fully met by any research or commercial simulator at present. In this study, we have produced and evaluated a 3D-printed, bi-atrial model contained in a custom-made enclosure for RFA simulation using a new soft tissue-mimicking polymer, Layfomm-40, combined with thermochromic pigment and barium sulphate in an acrylic paint carrier. We evaluated the conductive properties of Layfomm-40, its sensitivity to RFA, and its visibility in X-ray imaging, and carried a full simulation of RFA in the cardiac catheterization laboratory by an electrophysiologist. We demonstrated that a patient-specific 3D-printed Layfomm-40 bi-atrial model coated with a custom thermochromic/barium sulphate paint was compatible with the CARTO3 electroanatomic mapping system and could be effectively imaged using X-ray fluoroscopy. We demonstrated the effective delivery and visualization of radiofrequency ablation lesions in this model. The simulator meets nearly all the requirements for high-fidelity physical simulation of RFA. The use of such simulators is likely to have impact on the training of electrophysiologists and the evaluation of novel RFA devices.

show abstract

“…Anonymized MRI and CT data sets were obtained from the University Hospital Zurich (USZ). The data were segmented, fused, and converted to a 3D model of the target organs and anatomies to derive and print the mold forms (Figure a) . The finished silicone phantoms (Figure b) were mounted on custom plates and connected to the other phantoms and structures of the TSP simulator.…”

Section: Methodsmentioning

confidence: 99%

Novel augmented physical simulator for the training of transcatheter cardiovascular interventions

Zimmermann

Steffen

Vicentini

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

Background: Training in transcatheter cardiovascular skills today represents a significant challenge because of the complexity of the interventions and an extensive use of multiple live imaging technologies. Objectives: We describe the design, the face validation, and content validation of a newly developed physical transseptal puncture (TSP) simulator using additive manufacturing techniques and novel imaging simulation solutions. Methods: The TSP simulator contains a femoral vein catheterization pad, silicon phantoms of the venous system, a replaceable interatrial septum, and cameras to mimic live fluoroscopic and echocardiographic imaging. A validation study was conducted at the University Hospital of Zurich. A total of 14 interventional cardiologists and cardiac surgeons assessed the TSP simulator. Participants performed a TSP on the simulator using standard interventional tools. Face and content validity was demonstrated using a 5-point Likert scale. Results: The TSP simulator is a new training tool for transcatheter cardiovascular interventions. All interventional cardiologists and cardiac surgeons completed the training exercise and scoring. Overall impression was rated (out of 5) 4.04 ± 1.03, haptic feedback scored 4.13 ± 0.82, and the realism of fluoroscopy simulation 4.39 ± 0.79. Usability was rated 4.50 ± 0.63 by the participants, indicating that the simulator could be suitable for training. Conclusion: We demonstrated face and content validity of a new simulator for transcatheter cardiovascular interventions. The TSP simulator's usability, haptic feedback, imaging solutions, and the overall impression of its usage were reported as very realistic. The TSP simulator represents a promising tool for simulation-based training using real interventional toolkits in a mimicked radiological environment. K E Y W O R D S education, simulation training, transseptal puncture

show abstract

Development of simulation combining a physical heart model and three‐dimensional system for electrophysiology training

Abstract: The 3D HAS is reliable and allows use of the main features of an EAM system in the right atrium. The ability to discriminate different levels of experience suggests that this simulator is enough realistic and could be useful for electrophysiology training.

Cited by 9 publications

References 19 publications

Pre-graduation medical training including virtual reality during COVID-19 pandemic: a report on students’ perception

Pre-graduation medical training including virtual reality during COVID-19 pandemic: a report on students’ perception

Cardiac Radiofrequency Ablation Simulation Using a 3D-Printed Bi-Atrial Thermochromic Model

Novel augmented physical simulator for the training of transcatheter cardiovascular interventions

Contact Info

Product

Resources

About