Rationale

Using interactive simulations consisting of 2D grids of 'cells', the aim of this website is to help you visualise arrhythmias and complex electrophysiology concepts in real time without relying on plain text and static schematic diagrams. After all, the surface ECG is at its core an imaging technique (albeit one with very poor resolution). Just as an xray or CT scan helps you visualise what a body looks like inside, an ECG's ultimate purpose should be to help you visualise propagation of the cardiac impulse(s) within a patient's heart.

You wouldn't learn for the very first time how to interpret an xray or CT scan of a region of the body without first studying the anatomy of that region. At the very least, it helps to first be able to roughly visualise where and what size everything is relative to each other. But the ultimate test would be whether you can draw it from scratch. Any imaging technique is simply a less accurate representation of the real thing, and studying that real thing first is fundamental to understanding what the imaging technique can actually show. It also keeps the focus on the pathology itself (rather than the particularities of the imaging technique), and provides a springboard for speeding up pattern recognition.

And yet throughout the world, the cardiac conduction system and its pathologies (mainly arrhythmias) are almost always taught for the first time by encouraging students to refer straight to an imaging technique, i.e. the surface ECG, rather than first trying to more directly show what is happening in the heart. The time dimension makes learning the cardiac conduction system more complex than other aspects of anatomy and physiology. Diagrams like this help, but their static nature really doesn't lend well to helping you visualise a dynamic system. Blocks of text are even worse. With the time and effort it takes to translate such a set of pictures or text like this into an animation in our minds, and even longer to ingrain, it's no wonder that so many students and doctors choose to simply learn the ECG pattern recognition necessary for the most common pathologies, rather than truly understand what is happening in the heart, which is what will equip them with the skills needed to walk through and troubleshoot ECGs which show more complex rhythms.

This website aims to bridge this gap by providing interactive simulations so you can more directly see the working cardiac conduction system with your own eyes in real time. You can even try recreating arrhythmias from scratch yourself. Just like being able to draw an anatomical region, if you can create the arrhythmia/concept yourself, then you'll know you understand it well. Of course there is accompanying text too, but the 'heart' of the website is in the interactive simulations.

Who is this for?

The tutorials here should be useful for the following groups:

• Students of medicine and other healthcare professions just starting out with learning cardiac physiology and the ECG. The website includes a simulation of every tachy and bradyarrhythmia.
• Those interested in cardiology - the website includes some of the more complex concepts like re-entry circuits and other arrhythmia mechanisms, and EP study basics
• For those at a more advanced stage, e.g. those looking to understand pacing and EP studies, please watch this space as I intend to use this platform to make tutorials, especially as I learn and become more confident with such topics myself

Whether you're just starting to learn about the heart and ecgs, or you feel pretty confident already, there's probably something for you here.

Happy browsing, and feel free to get in touch!