However, there are objective difficulties in achieving lege artis MSP (according to MPP-IDE study standards) given that two prerequisites must be met: 1. Interpolar distance for the first left ventricular pulse >30mm (i.e. non-sequential poles used), 2. Nearly simultaneous (Δt=5msec) left ventricular pulses and 3. Threshold of ≤3.5V@0.5msec.