K Number
K190593
Device Name
Zio XT ECG Monitoring System, Zio AT ECG Monitoring System
Date Cleared
2019-08-23

(169 days)

Product Code
Regulation Number
870.1425
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Zio ECG Utilization Service (ZEUS) System is intended to analyze and report symptomatic and asymptomatic cardiac events and continuous electrocardiogram information for long-term monitoring by Zio XT or Zio AT Patch, a final report is generated based on the beat information from the entire ECG recording. It is indicated for use on patients 18 years or older who may be asymptomatic or who may suffer from transient symptoms such as palpitations, shortness of breath, dizziness, light-headedness, pre-syncope, fatigue, or anxiety and patients who are asymptomatic. The reports are provided for review by the intended user to render a diagnosis based on clinical judgment and experience. It is not intended for use on critical care patients.
Device Description
The ZEUS System is an electrocardiogram (ECG) processing and analysis system, designed to handle continuously recorded, single-lead ECG data. It downloads, stores, analyzes and aggregates the ECG data for a Certified Cardiographic Technician (CCT) to review and generate a report of the findings contained within the data; thereby enabling the provision of a complete ECG processing and analysis service.
More Information

No reference devices were used in this submission.

No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and does not describe any AI/ML-specific components or training/testing data sets.

No
The device is described as an ECG processing and analysis system that generates reports for review by a user to render a diagnosis. It is not intended to treat, mitigate, or cure a disease or condition, which are characteristics of a therapeutic device.

Yes

The "Intended Use / Indications for Use" states that the system is intended to "analyze and report symptomatic and asymptomatic cardiac events and continuous electrocardiogram information" and that "a final report is generated based on the beat information from the entire ECG recording." It further specifies that "The reports are provided for review by the intended user to render a diagnosis based on clinical judgment and experience." This clearly indicates its role in providing information for diagnostic purposes.

No

The device description explicitly states that the ZEUS System processes data from the "Zio XT or Zio AT Patch," which are hardware ECG monitoring devices. The software is part of a larger system that includes hardware for data acquisition.

Based on the provided information, the Zio ECG Utilization Service (ZEUS) System is not an In Vitro Diagnostic (IVD).

Here's why:

  • IVDs analyze samples taken from the human body (like blood, urine, tissue). The ZEUS system analyzes electrocardiogram (ECG) data, which is a recording of electrical activity of the heart, not a sample taken from the body.
  • The intended use is to analyze and report cardiac events and ECG information. This is a diagnostic tool that processes physiological signals, not a test performed on a biological specimen.
  • The input modality is Electrocardiogram (ECG). This confirms it's dealing with electrical signals from the body, not biological samples.

Therefore, the ZEUS System falls under the category of a medical device that processes physiological data for diagnostic purposes, but it does not meet the definition of an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Zio ECG Utilization Service (ZEUS) System is intended to analyze and report symptomatic and asymptomatic cardiac events and continuous electrocardiogram information for long-term monitoring by Zio XT or Zio AT Patch, a final report is generated based on the beat information from the entire ECG recording. It is indicated for use on patients 18 years or older who may be asymptomatic or who may suffer from transient symptoms such as palpitations, shortness of breath, dizziness, light-headedness, pre-syncope, fatigue, or anxiety and patients who are asymptomatic. The reports are provided for review by the intended user to render a diagnosis based on clinical judgment and experience. It is not intended for use on critical care patients.

Product codes (comma separated list FDA assigned to the subject device)

DQK

Device Description

The ZEUS System is an electrocardiogram (ECG) processing and analysis system, designed to handle continuously recorded, single-lead ECG data. It downloads, stores, analyzes and aggregates the ECG data for a Certified Cardiographic Technician (CCT) to review and generate a report of the findings contained within the data; thereby enabling the provision of a complete ECG processing and analysis service.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

18 years or older

Intended User / Care Setting

Certified Cardiographic Technician (CCT) to review and generate a report of the findings contained within the data; thereby enabling the provision of a complete ECG processing and analysis service. It is not intended for use on critical care patients.

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Overall system performance testing was conducted as part of the verification activities on incremental changes to the ZEUS System to ensure performance as intended per specifications and to support a determination of substantial equivalence to the predicate device.
Nonclinical testing included:

  • . System performance testing
  • . Software verification testing

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Automated ECG analysis performance was quantified for any claimed analysis metrics. The resulting statistics demonstrate sensitivity and positive predictivity levels which satisfy requirements and minimize safety or efficacy concerns.

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K181502

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

No reference devices were used in this submission.

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 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).

0

Image /page/0/Picture/0 description: The image contains two logos. On the left is the Department of Health & Human Services logo. On the right is the FDA logo, which includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

iRhythm Technologies, Inc. Gabrielle Logan Senior Regulatory Affairs Specialist 650 Townsend Street, Ste 500 San Francisco, California 94103

Re: K190593

Trade/Device Name: Zio® ECG Utilization Service (ZEUS) System Regulation Number: 21 CFR 870.1425 Regulation Name: Programmable diagnostic computer Regulatory Class: Class II Product Code: DQK Dated: July 19, 2019 Received: July 23, 2019

Dear Gabrielle Logan:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

1

801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4. Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Nicole Goodsell Assistant Director (Acting) External Heart Rhythm and Rate Devices Team Division of Cardiac Electrophysiology, Diagnostics and Monitoring Devices Office of Cardiovascular Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K190593

Device Name Zio® ECG Utilization Service (ZEUS) System

Indications for Use (Describe)

The Zio ECG Utilization Service (ZEUS) System is intended to analyze and report symptomatic and asymptomatic cardiac events and continuous electrocardiogram information for long-term monitoring by Zio XT or Zio AT Patch, a final report is generated based on the beat information from the entire ECG recording. It is indicated for use on patients 18 years or older who may be asymptomatic or who may suffer from transient symptoms such as palpitations, shortness of breath, dizziness, light-headedness, pre-syncope, fatigue, or anxiety and patients who are asymptomatic. The reports are provided for review by the intended user to render a diagnosis based on clinical judgment and experience. It is not intended for use on critical care patients.

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

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510(k) Notification K190593

l. General Information

Applicant:

iRhythm Technologies, Inc. 650 Townsend Street, Suite 500 San Francisco, CA 94103, USA Phone: 415-632-5700 Fax: 415-632-5701

Contact Person:

Gabrielle Logan Sr. Regulatory Affairs Specialist Phone: 415-214-7092 Email: glogan@irhythmtech.com

Date Prepared: August 22, 2019

ll. Device Information

Trade Name: Zio® ECG Utilization Service (ZEUS) System

Generic/Common Name:

Programmable diagnostic computer

Classification Names:

Programmable diagnostic computer [21CFR§870.1425]

Regulatory Class: Class II

Product Codes: DQK

III. Predicate Devices

The following predicate device has been selected:

  • iRhythm Technologies, Inc. Zio® AT ECG Monitoring System [K181502] |
    No reference devices were used in this submission.

4

Section 1b 510(k) Summary

IV. Indications for Use

The Zio ECG Utilization Service (ZEUS) System is intended to analyze and report symptomatic and asymptomatic cardiac events and continuous electrocardiogram information for long-term monitoring. After patient monitoring by Zio XT or Zio AT Patch, a final report is generated based on the beat information from the entire ECG recording. It is indicated for use on patients 18 years or older who may be asymptomatic or who may suffer from transient symptoms such as palpitations, shortness of breath, dizziness, light-headedness, pre-syncope, fatigue, or anxiety and patients who are asymptomatic. The reports are provided for review by the intended user to render a diagnosis based on clinical judgment and experience. It is not intended for use on critical care patients.

V. Device Description

The ZEUS System is an electrocardiogram (ECG) processing and analysis system, designed to handle continuously recorded, single-lead ECG data. It downloads, stores, analyzes and aggregates the ECG data for a Certified Cardiographic Technician (CCT) to review and generate a report of the findings contained within the data; thereby enabling the provision of a complete ECG processing and analysis service.

Automated ECG analysis performance was quantified for any claimed analysis metrics. The resulting statistics demonstrate sensitivity and positive predictivity levels which satisfy requirements and minimize safety or efficacy concerns.

5

Section 1b 510(k) Summary

VI. Substantial Equivalence

The proposed indications for use statement for the Zio Utilization Service (ZEUS) System is substantially equivalent to the intended use in the cleared Indications for Use statement for the predicate device. The performance testing results demonstrate that the differences in the technological characteristics between the devices do not raise any new issues of safety or efficacy. Therefore, the ZEUS System is determined to be substantially equivalent to the predicate device.

VII. Nonclinical Testing in Support of Substantial Equivalence Determination

There are no required FDA performance standards for the ZEUS System. Overall system performance testing was conducted as part of the verification activities on incremental changes to the ZEUS System to ensure performance as intended per specifications and to support a determination of substantial equivalence to the predicate device.

Nonclinical testing included:

  • . System performance testing
  • . Software verification testing

The results confirm by examination and provision of objective evidence that the design output met the design input requirements in conformance with the following list of recognized consensus standards:

FDA#BodyNumber / VersionTitle
5-70AAMI
ANSI ISO14971:2007(R)2010
(Corrected 4 October 2017)Medical Devices – Applications Of Risk
Management To Medical Devices
3-127AAMI
ANSI IEC60601-2-47:2012Medical Electrical Equipment -- Part 2-
47: Particular Requirements For The
Basic Safety And Essential Performance
Of Ambulatory Electrocardiographic
Systems
3-118AAMI
ANSIEC57:2012Testing And Reporting Performance
Results Of Cardiac Rhythm And ST-
Segment Measurement Algorithms
N/AU.S. FDAOctober 2, 2014Guidance for Industry and FDA Staff –
Content of Premarket Submissions for
Management of Cybersecurity in
Medical Devices

No clinical testing was performed in support of this premarket notification.

6

Section 1b 510(k) Summary

VIII. Conclusion

The ZEUS System is substantially equivalent to the predicate device.