title: A Low-Cost Simulation Model for R-Wave Synchronized Atrial Pacing in Pediatric Patients with Postoperative Junctional Ectopic Tachycardia.
abstract: BACKGROUND
  Postoperative junctional ectopic tachycardia (JET) occurs frequently after pediatric cardiac surgery. R-wave synchronized atrial (AVT) pacing is used to re-establish atrioventricular synchrony. AVT pacing is complex, with technical pitfalls. We sought to establish and to test a low-cost simulation model suitable for training and analysis in AVT pacing.
  
  
  METHODS
  A simulation model was developed based on a JET simulator, a simulation doll, a cardiac monitor, and a pacemaker. A computer program simulated electrocardiograms. Ten experienced pediatric cardiologists tested the model. Their performance was analyzed using a testing protocol with 10 working steps.
  
  
  RESULTS
  Four testers found the simulation model realistic; 6 found it very realistic. Nine claimed that the trial had improved their skills. All testers considered the model useful in teaching AVT pacing. The simulation test identified 5 working steps in which major mistakes in performance test may impede safe and effective AVT pacing and thus permitted specific training. The components of the model (exclusive monitor and pacemaker) cost less than $50. Assembly and training-session expenses were trivial.
  
  
  CONCLUSIONS
  A realistic, low-cost simulation model of AVT pacing is described. The model is suitable for teaching and analyzing AVT pacing technique.
authors.affiliation: Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Entenmann
authors.affiliation: Department of Pediatric Cardiology, University of Leipzig, Leipzig, Germany.
authors.forename: Ronald
authors.initials: R
authors.lastname: Schmiedel
authors.affiliation: Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Miriam
authors.initials: M
authors.lastname: Michel
authors.affiliation: Department for Congenital Heart Disease and Pediatric Cardiology, Schleswig-Holstein University Hospital, Kiel, Germany.
authors.forename: Friedemann
authors.initials: F
authors.lastname: Egender
authors.affiliation: Department for Congenital Heart Disease and Pediatric Cardiology, Schleswig-Holstein University Hospital, Kiel, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Heßling
authors.affiliation: Department of Pediatric Cardiology, University of Leipzig, Leipzig, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Dähnert
authors.affiliation: Department of Pediatric Cardiology, University of Leipzig, Leipzig, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Gebauer
mesh_terms: D002304:Cardiac Pacing, Artificial; D002648:Child; D003198:Computer Simulation / Q000191:economics*; D003365:Costs and Cost Analysis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008955:Models, Cardiovascular; D011183:Postoperative Complications / Q000209:etiology*; D013613:Tachycardia, Ectopic Junctional / Q000209:etiology* / Q000503:physiopathology*