K Number
K161245
Device Name
EP-TRACER System
Manufacturer
Date Cleared
2016-08-05

(94 days)

Product Code
Regulation Number
870.1425
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The EP-TRACER System is an electrophysiology measurement system used to acquire, filter, digitize, amplify, display, and record signals obtained during electrophysiological studies and related procedures.

The system allows the user to monitor, display and record the signals. The system incorporates a stimulator intended to be used for diagnostic cardiac stimulation during electrophysiological testing of the heart.

Device Description

The EP-TRACER System is a computerized electrophysiology measurement system designed for both regular and experimental EP studies.

The EP-TRACER System is comprised of these major components,

  1. EP-TRACER hardware – Amplifier/stimulator
  2. EP-TRACER Software – Software pre-installed
AI/ML Overview

The EP-TRACER System is an electrophysiology measurement system. The acceptance criteria and supporting study are described below.

Acceptance Criteria and Reported Device Performance

TestAcceptance CriteriaReported Performance
Radiated emission, Conducted emission, Radiated immunity, Conducted immunityPassPass
Conducted emission (harmonics), Radiated immunity (PMF), Conducted immunityPassPass
IEC 60601-1:2005 + CORR. 1:2006 + CORR. 2:2007 + AM1:2012PassPass
Amendment - IEC 60601-1:2005 (Third Edition) + CORR. 1:2006 + CORR. 2:2007 + A1:2012PassPass
IEC 60601-1-6:2010 (Third Edition) + A1:2013PassPass
IEC 62366:2007 (First Edition) + A1: 2014 for use in conjunction with IEC 60601-1-6: 2010PassPass
IEC 60601-1-27:2011 (Third Edition) for use in conjunction with IEC 60601-1:2005 + CORR. 1 (2006) + CORR. 2 (2007)PassPass
IEC 60601-2-34 (Third Edition): 2011PassPass

Study Information

  1. Sample size used for the test set and data provenance: Not explicitly stated. The document indicates that "Testing has been conducted through software and/or user verification/validation protocols" and electrical safety and electromagnetic compatibility testing was performed. The data provenance (e.g., country of origin, retrospective/prospective) is not provided.

  2. Number of experts used to establish the ground truth for the test set and their qualifications: Not applicable. The testing primarily focuses on the device's adherence to electrical safety and electromagnetic compatibility standards, and software functionality, rather than diagnostic performance against a medical ground truth established by experts.

  3. Adjudication method for the test set: Not applicable. The testing involves standardized engineering and software validation protocols with pass/fail criteria.

  4. Multi-reader multi-case (MRMC) comparative effectiveness study: No, a MRMC comparative effectiveness study was not done. The device is an electrophysiology measurement system, not an AI-assisted diagnostic tool.

  5. Standalone (algorithm only without human-in-the-loop performance) study: Yes, the performance testing described appears to be a standalone evaluation of the device's compliance with safety and performance standards. The "results" provided in the table indicate whether the device "Passed" tests against specific IEC standards for electrical safety and electromagnetic compatibility.

  6. Type of ground truth used: The ground truth for the performance testing is based on the requirements and standards set forth by the listed IEC and other electrical safety and EMC standards (e.g., IEC 60601-1, IEC 60601-1-2, etc.).

  7. Sample size for the training set: Not applicable. This device is an electrophysiology measurement system with software (V2.0) that "maintains the capabilities in the previous version, adding user interface enhancements." It's not described as a machine learning or AI-driven system that would typically require a training set in the sense of predictive modeling.

  8. How the ground truth for the training set was established: Not applicable, as there is no mention of a training set for machine learning.

{0}------------------------------------------------

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized symbol featuring three human profiles facing to the right, with flowing lines above them, possibly representing hair or movement.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

August 5, 2016

CardioTek, B.V. % Melissa Walker President & CTO Graematter, Inc. 1324 Clarkson Clayton Center #332 St Louis. Missouri 63011

Re: K161245

Trade/Device Name: EP-Tracer System Regulation Number: 21 CFR 870.1425 Regulation Name: Programmable Diagnostic Computer Regulatory Class: Class II Product Code: DQK Dated: June 13, 2016 Received: June 22, 2016

Dear Melissa Walker:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration. listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

{1}------------------------------------------------

the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Muda Jellman
for

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{2}------------------------------------------------

Indications for Use

510(k) Number (if known) K161245

Device Name EP TRACER System

Indications for Use (Describe)

The EP-TRACER System is an electrophysiology measurement system used to acquire, filter, digitize, amplify, display, and record signals obtained during electrophysiological studies and related procedures.

The system allows the user to monitor, display and record the signals. The system incorporates a stimulator intended to be used for diagnostic cardiac stimulation during electrophysiological testing of the heart

Type of Use (Select one or both, as applicable)
X Prescription Use (Part 21 CFR 801 Subpart D)Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

{3}------------------------------------------------

Section 5: 510(k) Summary per 21CFR §807.92

EP TRACER System Summary

Submitter'sinformationContact: Oliver RothSchwarzer Cardiotek GmbHIm Zukunftspark 374076 Heilbronn / GermanyContact: Melissa WalkerGraematter, Inc.1324 Clarkson Clayton Ctr #332Ballwin, MO 63011Phone: 636-405-7498Date: 02/14/2016
Device/classificationnameDevice Name:The EP-TRACER System is a Class 2 device (product code DQK).Classification/Common name:• Programmable diagnostic computer, 21 CFR §870.1425,The marketed device(s) to which substantial equivalence is claimed:• EP-TRACER System, K134044
DevicedescriptionThe EP-TRACER System is a computerized electrophysiology measurementsystem designed for both regular and experimental EP studies.The EP-TRACER System is comprised of these major components,1. EP-TRACER hardware – Amplifier/stimulator2. EP-TRACER Software – Software pre-installed
Indications foruse"The EP-TRACER System is an electrophysiology measurement system usedto acquire, filter, digitize, amplify, display, and record signals obtainedduring electrophysiological studies and related procedures."The system allows the user to monitor, display and record the signals. Thesystem incorporates a stimulator intended to be used for diagnostic cardiacstimulation during electrophysiological testing of the heart".Continued on next page

{4}------------------------------------------------

EP TRACER System Summary, Continued

Technological The table below lists the technological characteristics for both the new and characteristics predicate devices.

Device CharacteristicPredicate Device EP-TRACER V1.05K134044New Device EP-TRACER V2K161245
Amplifier Dimensions (withintegrated stimulator) WxDxH38 channels: 28x27x7 in cm70/102 channels: 28x27x12 in cmSame
Environmental Specifications
Temperature Operating+10°C to +30°CSame
Temperature Transport/Storage-29°C to +66°CSame
Humidity Operating20 - 80 % rH (non-condensing)Same
Humidity Transport/Storage< 95 % rH (non-condensing)Same
Power Specifications
Power Requirements100 - 240 V AC,50 - 60 HzSame
Power Input38 channels:+5 V, 0.3 A & +12 V, 0.9 A70 channels:+5 V, 0.3 A & +12 V, 1.5 A102 channels:+5 V, 0.3 A & +12 V, 2 ASame
Design
Sampling and HoldEach channel sampled prior theacquisitionSame
Sampling Rate1 kHzSame
CMRR> 100 dBSame
Input ImpedanceTypical 20 MΩSame
Leakage Current
Patient Source< 10 μASame
Patient Sink< 10 μASame
Patient Sink (measured at patientleads under single fault conditions)< 50 μASame
Chassis Leakage< 100 μASame
ECG Input
Outputs12 lead ECG producedSame
High Pass Filter0.05 Hz, 0.2 HzSame
Low Pass Filter150 HzSame
RF FilteringAll inputsSame
GainBetween 0 and 255 mm/mV -continuousSame
Saturation Recovery< 1 sec (manual reset)Same
Notch FilterPower line (50/60 Hz)Same
Dynamic Range±5 mVSame
Baseline Correction+300 mVSame
Device CharacteristicPredicate Device EP-TRACER V1.05K134044New Device EP-TRACER V2K161245
Input/ Output
Inputs 32/38 channels20 intracardiac channels, 6 auxiliarychannels, 12 ECG channelsSame
Inputs 64/70 channels52 intracardiac channels, 6 auxiliarychannels, 12 ECG channelsSame
Inputs 102 channels84 intracardiac channels, 6 auxiliary(pressure) channels, 12 ECG channelsSame
OutputsNo outputsSame
SwitchingEach channel can be either bipolar orunipolar with manual switchingSame
High Pass Filter0.05 Hz, 0.2 Hz, 40 Hz, 80 HzSame
Low Pass Filter350 HzSame
RF FilteringAll inputsSame
GainBetween 0 and 255 mm/mV –continuousSame
Saturation Recovery< 1 s (manual reset)Same
Notch FilterPower line (50/60 Hz)Same
Dynamic Range±5 mVSame
Baseline Correction±300 mVSame
Stimulator (integrated into device)
Isolated Stimulus Channels2Same
Pulse Amplitude
Range0 - 25.5 mA into 1000 Ω loadSame
Increment0.1 msSame
Accuracy±0.15 msSame
Pulse Duration
Range0.1 - 9.9 msSame
Increment0.1 msSame
Accuracy±0.15 msSame
Inter-Stimulus Interval (ISI)
Range10 - 9999 msSame
Range (Burst)10 - 9999 msSame
Increment10 msSame
Sequential Delay (AV)
Range11 - 250 msSame
Increment1 msSame
Programmed ProtocolsPreprogrammed protocols:BASIC 1 (induction)BASIC 2 (termination)BASIC 3 (backup)ACUTEMulti-SxSame
Programmed ProtocolsPaceAutomatic modeWenkebach modeSame
Device CharacteristicPredicate Device EP-TRACER V1.05K134044New Device EP-TRACER V2K161245
Programmable Protocol Key10Same
Number of Extra-Stimuli5 (S2 - S6)Same
Sensing (ECG Synchronization)
Automatic or Manual TriggerSetting - SensitivityInternal from any surface or intra-cardiac channelSame
Automatic or Manual TriggerSetting - Trigger lockup(refractory time)5 - 5000 msSame
Automatic or Manual TriggerSetting - ECG Delay5 - 5000 msSame
Additional OutputsNoSame
Power SourceIntegrated with amplifier38 channels:+5 V, 0.3 A & +12 V, 0.9 A70 channels:+5 V, 0.3 A & +12 V, 1.5 A102 channels:+5 V, 0.3 A & +12 V, 2 ASame
Pacing Channels
Isolated Channels(i) atrial and(ii) ventricular and(iii) emergency fixed pace output to atrium and ventricleSame
Circuit IsolationCompliant with IEC 60601-1, Class CF,5 kV, common & differential modeSame
Computer Controlled Stimulus Pulses
Current0 - 25.5 mA into 1000 Ω loadSame
Current Steps0.1 mASame
Accuracy±0.1 mASame
Pulse durationPulse width 0.1 - 9.9 ms, steps of 0.1 msSame
Accuracy±0.1 mASame
Load Impedance1000 ΩSame
Max. Output Voltage25 VSame
Inter-Stimulus Intervals
S1 Range10 - 9999 msSame
StabilityQuartz computer clock, ±30 parts permillion at +25°CSame
Extra-Stimuli5 (S2 - S6)Same
Coupling Interval30 - 9990 msSame
Accuracy±10 msSame
Protocol Automation
Auto decrement/incrementYesSame
Backup Manually ControlledStimulationUse external backup stimulatorSame
Device CharacteristicPredicate Device EP-TRACER V1.05K134044New Device EP-TRACER V2K161245
Compliance with Standards
StandardsEN 60601-1EN 60601-1-2Same
Device DirectiveEuropean Union Medical DeviceDirective (CE Marked)Same
Environmental/ Electrical Specifications
Operating Temperature+10°C to +30°CSame
Storage Temperature-29°C to +66°CSame
Operating Humidity20 - 80 % rH (non-condensing)Same
Storage Humidity< 95 % rH (non-condensing)Same
Max. Current Draw15 A/115 V, 7 A/230 VSame
Chassis Leakage Current< 100 μΑSame
Advanced Features
Display Ablation ParametersConnection to RF ablation generator(s)Same
Certification
MDD Device ClassClass IIbSame
IEC 60601-1CertifiedSame
EMC ComplianceCertifiedSame
CE MarkingCertified CE 0197Same
US RegulationsK134044Current submission
System Dimensions
W x D x HCustomer OptionMobile Cart: 100x80x170 cmMobile Desk: 125x80x150 cmControl Desk: customer definedLaptop: customer definedSame
Software
Programming languageBorland Delphi 5Visual C#
Component libraryVCL Framework (Visual ComponentLibrary).NET
Software architectureSingle ThreadedMulti Threaded
Drawing method2D3D
License conceptText fileDongle
Context sensitive help textsNoMouse over context help
Operating conceptMenus and short-cutsMenus, short-cuts and displayelements (i.e. buttons)
Language supportEnglish (full), partial support for otherlanguagesFull multi language support

{5}------------------------------------------------

{6}------------------------------------------------

{7}------------------------------------------------

Continued on next page

{8}------------------------------------------------

EP TRACER System Summary, Continued

Performance The updated version of the EP-TRACER system and software (V2.0) testing maintains the capabilities in the previous version, adding user interface enhancements.

Testing has been conducted through software and/or user verification/validation protocols to ensure the EP TRACER System meets its intended use and user needs.

Electrical safety and electromagnetic compatibility testing shown in the table below was performed. All tests passed.

TestResults
Radiated emission: Conducted emission: Radiated immunity:Conducted immunityPass
Conducted emission (harmonics); Radiated immunity (PMF);Conducted immunityPass
IEC 60601-1:2005 + CORR. 1:2006 + CORR. 2:2007 +AM1:2012Pass
Amendment - IEC 60601-1:2005 (Third Edition) + CORR.1:2006 + CORR. 2:2007 + A1:2012Pass
IEC 60601-1-6:2010 (Third Edition) + A1:2013Pass
IEC 62366:2007 (First Edition) + A1: 2014 for use in conjunctionwith IEC 60601-1-6: 2010Pass
IEC 60601-1-27:2011 (Third Edition) for use in conjunction withIEC 60601-1:2005 + CORR. 1 (2006) + CORR. 2 (2007)Pass
IEC 60601-2-34 (Third Edition): 2011Pass

Based on the technical characteristics and the results of the performance Conclusion testing, the EP TRACER V2.0 is substantially equivalent to V1.05.

§ 870.1425 Programmable diagnostic computer.

(a)
Identification. A programmable diagnostic computer is a device that can be programmed to compute various physiologic or blood flow parameters based on the output from one or more electrodes, transducers, or measuring devices; this device includes any associated commercially supplied programs.(b)
Classification. Class II (performance standards).