# Temporary Pacing Simulator: A Training Tool for Clinicians
## 3 Experimental Results
### Capture and Sensitivity Thresholds
Figure 29 illustrates an example of an undersensing scenario resulting from an inadequate atrial sensing threshold value entered by the user, where the introduced value is higher than the generated maximal sensitivity threshold for that patient. The TCPS simulates this byautomatically switching the failure mode dropdown menu to undersensing when the user's input exceeds the randomly generated maximum sensitivity threshold. Simultaneously, the TCPS updates the signals to reflect the undersensing failure mode and generates a warning message on the screen, informing the user that the entered value caused atrial undersensing. An inadequate ventricular sensing threshold value, where the introduced value is higher than the generated maximal ventricular sensitivity threshold for that patient, triggers a similar response from the TCPS. An example of this scenario is shown in Figure 21. Additionally, if the user inputs values for both the atria and the ventricles that exceed the maximum generated sensitivity thresholds, this will trigger undersensing in both the atria and the ventricles, as demonstrated in Figure 22.  
Similarly, when the user inputs values below the minimum sensitivity thresholds, the TCPS triggers corresponding failure modes (atrial or ventricular oversensing, or both), effectively simulating clinical scenarios where the TP fails to properly sense intrinsic cardiac activity. Figure 30 illustrates an example of an oversensing scenario resulting from an inadequate ventricular sensing threshold value entered by the user, where the introduced value is higher than the generated minimal sensitivity threshold for that patient. The TCPS simulates this by automatically switching the failure mode dropdown menu to oversensing when the user's input is lower than the randomly generated minimum sensitivity threshold. Simultaneously, the TCPS updates the signals to reflect the oversensing failure mode and generates a warning message on the screen, informing the user that the entered value caused ventricular oversensing. An inadequate atrial sensing threshold value, where the introduced value is lower than the generated minimal atrial sensitivity threshold for that patient, triggers a similar response from the TCPS and can be seen in Figure 24. Additionally, if the user selects DDI pacing mode and inputs values for both the atria and the ventricles that are below the minimum generated sensitivity thresholds, this will trigger oversensing in both the atria and the ventricles, as demonstrated in Figure 25.  
Figure 26: Ventricular Capture Threshold Test: This figure illustrates the signal generated when the user selects SR with LBBB as the baseline rhythm, and sets the pacemaker to VVI mode at a rate of 80 bpm. After inputting a value for the ventricular capture threshold and clicking the “Insert V Capture Threshold” button, the TCPS system compares the input against a predefined minimal ventricular capture threshold. In this scenario, the entered threshold successfully captures the ventricles, and the system confirms this by displaying an informational message on the screen. Figure 27: Ventricular Capture Threshold Test: This figure shows the signal output when the user selects SR with LBBB as the baseline rhythm, and chooses the VVI pacing mode with a rate of 80 bpm. After entering a value for the ventricular capture threshold and clicking the “Insert V Capture Threshold” button, the TCPS system evaluates the input against the randomly generated minimal ventricular capture threshold. In this case, the entered threshold fails to capture the ventricles, prompting the TCPS to automatically switch the failure mode to VLOC. A warning message is then displayed, informing the user that the selected threshold has caused VLOC. Figure 28: Atrial Sensitivity Threshold Test: This figure depicts the signal output when the user selects LBBB as baseline rhythm and sets the pacing mode to AAI at a rate of 80 bpm. The user inputs a value for the atrial sensitivity threshold and clicks the “Insert A Sensitivity Threshold” button.