K Number
K230008
Device Name
Ablamap® System
Manufacturer
Date Cleared
2023-06-08

(156 days)

Product Code
Regulation Number
870.1425
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Ablamap® System is used to analyze electrogram (EGM) signals and display results in a visual format for evaluation by a physician in order to assist in the diagnosis of complex cardiac arrhythmias.
Device Description
The Ablacon Ablamap System is an electrophysiology mapping system used during electrophysiology procedures for assisting in the diagnosis of complex cardiac arrhythmias. The system consists of several hardware elements including an amplifier, cart, monitor, and a workstation with proprietary patented mapping software. Electrogram (EGM) signals are detected by 64-electrode mapping "basket" catheters which are input into, sampled, and amplified by the system's amplifier. The data is transmitted via fiber-optic cable from the amplifier to the workstation and processed by the system's mapping software with the results displayed on the monitor. The system also accepts EGM data files recorded by EP amplifier recording systems from 64-electrode unipolar "basket" mapping catheters. The EGM data files are electrophysiology (EP) recordings that contain electrogram signals recorded by EP recording systems using 64-electrode "basket" mapping catheters. Compatible EP recording systems are the Boston Scientific LabSystem Pro™, the GE Healthcare CardioLab™ XT, and the St. Jude Medical WorkMate™ Claris System. The recorded EGM data files are saved onto the workstation and processed by the mapping software. Compatible catheters are 64-electrode mapping "basket" catheters with the following dimensions: 50mm and 60mm sizes; an 8 spline x 8 electrode configuration with nominal electrode spacing of 0.354'' and 0.440" for 50mm and 60mm basket sizes respectively. Through the software user interface, the user selects to record streamed EGM data from the Ablamap System signal amplifier that is saved to the workstation or the user selects an EGM data file recorded by an EP Recording System that has been saved to the workstation. The data file is processed by the Ablamap System software where the EGM signals are converted into electrographic flow® (EGF®) maps indicating flow consistency and direction of the action potential wave propagation during pre-defined time intervals. The resulting EGF® film maps display the flow with respect to the catheter electrodes and show the activity of sources of excitation where action potentials originate. A Summary Map is displayed that is the graphical representation of the summation of the activity of EGF® sources from all segments of the EGM data file recording indicating the rate of occurrence i.e. prevalence of sources of EGF® with respect to the catheter electrodes. These graphical maps are evaluated by the physician to assist in the diagnosis of complex cardiac arrhythmias during electrophysiology procedures.
More Information

Not Found

No
The summary describes proprietary mapping software that processes EGM signals to create visual maps (electrographic flow® (EGF®) maps and Summary Maps) based on predefined time intervals and signal characteristics. There is no mention of learning, training data, or adaptive algorithms, which are characteristic of AI/ML. The processing appears to be based on deterministic algorithms for signal conversion and visualization.

No.
The device is described as a diagnostic tool used to assist physicians in the diagnosis of complex cardiac arrhythmias by analyzing electrogram signals and displaying results. It does not perform any therapeutic intervention or treatment.

Yes

The "Intended Use / Indications for Use" section explicitly states that the system is used "to assist in the diagnosis of complex cardiac arrhythmias."

No

The device description explicitly states that the system consists of several hardware elements including an amplifier, cart, monitor, and a workstation, in addition to the software.

Based on the provided information, the Ablamap® System is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the examination of specimens derived from the human body in order to provide information for diagnostic, monitoring, or compatibility purposes. This typically involves analyzing biological samples like blood, urine, tissue, etc.
  • Ablamap® System Function: The Ablamap® System analyzes electrogram (EGM) signals which are electrical signals generated by the heart. These signals are acquired directly from the patient's heart using a catheter, not from a specimen derived from the body.
  • Intended Use: The intended use is to analyze EGM signals and display results for physician evaluation to assist in the diagnosis of complex cardiac arrhythmias. This is a direct physiological measurement and analysis, not an analysis of a biological specimen.

Therefore, the Ablamap® System falls under the category of a medical device used for physiological monitoring and analysis, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Ablamap® System is used to analyze electrogram (EGM) signals and display results in a visual format for evaluation by a physician in order to assist in the diagnosis of complex cardiac arrhythmias.

Product codes

DOK

Device Description

The Ablacon Ablamap System is an electrophysiology mapping system used during electrophysiology procedures for assisting in the diagnosis of complex cardiac arrhythmias. The system consists of several hardware elements including an amplifier, cart, monitor, and a workstation with proprietary patented mapping software. Electrogram (EGM) signals are detected by 64-electrode mapping "basket" catheters which are input into, sampled, and amplified by the system's amplifier. The data is transmitted via fiber-optic cable from the amplifier to the workstation and processed by the system's mapping software with the results displayed on the monitor.

The system also accepts EGM data files recorded by EP amplifier recording systems from 64-electrode unipolar "basket" mapping catheters. The EGM data files are electrophysiology (EP) recordings that contain electrogram signals recorded by EP recording systems using 64-electrode "basket" mapping catheters. Compatible EP recording systems are the Boston Scientific LabSystem Pro™, the GE Healthcare CardioLab™ XT, and the St. Jude Medical WorkMate™ Claris System. The recorded EGM data files are saved onto the workstation and processed by the mapping software.

Compatible catheters are 64-electrode mapping "basket" catheters with the following dimensions: 50mm and 60mm sizes; an 8 spline x 8 electrode configuration with nominal electrode spacing of 0.354'' and 0.440" for 50mm and 60mm basket sizes respectively.

Through the software user interface, the user selects to record streamed EGM data from the Ablamap System signal amplifier that is saved to the workstation or the user selects an EGM data file recorded by an EP Recording System that has been saved to the workstation. The data file is processed by the Ablamap System software where the EGM signals are converted into electrographic flow® (EGF®) maps indicating flow consistency and direction of the action potential wave propagation during pre-defined time intervals. The resulting EGF® film maps display the flow with respect to the catheter electrodes and show the activity of sources of excitation where action potentials originate.

A Summary Map is displayed that is the graphical representation of the summation of the activity of EGF® sources from all segments of the EGM data file recording indicating the rate of occurrence i.e. prevalence of sources of EGF® with respect to the catheter electrodes.

These graphical maps are evaluated by the physician to assist in the diagnosis of complex cardiac arrhythmias during electrophysiology procedures.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found. Input is electrogram (EGM) signals.

Anatomical Site

Cardiac

Indicated Patient Age Range

Not Found

Intended User / Care Setting

qualified medical professionals who are trained in electrophysiology / during electrophysiology procedures

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)

Performance testing was completed on the Ablamap® System which verified that the system meets the specification requirements and performs as designed. The Ablamap® System is suitable for its intended use.

Bench Testing for the subject device included and applied the following standards:

  • IEC 60601-1 Ed. 3.1 and applicable Collateral Standards .
  • IEC 62304 Edition 1.1 2015-06 Medical device software Software life cycle processes
  • ANSVAAMI/IEC 62366-1:2015 Medical devices Part 1: Application of usability ● engineering to medical devices
  • . ISO 15223-1:2021 Medical devices - Symbols to be used with information to be supplied by the manufacturer; Part 1: General Requirements

Verification testing was performed demonstrating the Ablamap® System met design specifications.

Validation testing was performed demonstrating the Ablamap® System met the user needs and was found to be clinically acceptable by all evaluators.

Usability testing demonstrated that the Usability Objectives for the Ablamap® System were met with no User Errors observed.

Testing demonstrated that the Ablamap® System met design requirements and functioned as intended.

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

Not Found

Predicate Device(s)

K203084, K141185

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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).

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, with the letters "FDA" in a blue square. Next to that is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

June 8, 2023

Ablacon, Inc. Frank Rodrigues VP Ouality Assurance & Regulatory Affairs 4800 Wadsworth Blvd. Suite 310 Denver, Colorado 80033

Re: K230008

Trade/Device Name: Ablamap® System Regulation Number: 21 CFR 870.1425 Regulation Name: Programmable diagnostic computer Regulatory Class: Class II Product Code: DOK Dated: December 31, 2022 Received: January 3, 2023

Dear Frank Rodrigues:

We have reviewed vour 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

1

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 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,

Aneesh S. Deoras -S

Aneesh Deoras Assistant Director 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

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Indications for Use

510(k) Number (if known) K230008

Device Name Ablamap® System

Indications for Use (Describe)

The Ablamap® System is used to analyze electrogram (EGM) signals and display results in a visual format for evaluation by a physician in order to assist in the diagnosis of complex cardiac arrhythmias.

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)

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Image /page/3/Picture/0 description: The image shows the Ablacon logo. The logo consists of an orange heart-shaped icon on the left and the word "ablacon" in black letters on the right. The heart-shaped icon is made up of two triangles that are joined together at their vertices. The word "ablacon" is written in a sans-serif font.

510(k) Summary

Date summary prepared:December 30, 2022
510(k) Submitter/Holder:Ablacon, Inc.
4800 Wadsworth Blvd. Ste 310
Wheat Ridge, CO 80033
Contact:Frank Rodrigues
VP Quality Assurance & Regulatory Affairs
Telephone: 303-955-5763
Fax: 720-390-7541
Email: fr@ablacon.com
Trade Name:Ablamap® System
Common Name:Diagnostic System
Classification Name:Programmable Diagnostic Computer
Classification:Class II
Product Code:DQK
Review Panel:Cardiovascular
Regulation:21 CFR 870.1425
510(k) Number:K230008
Predicate Device(s):

| Trade/Proprietary
Name: | Ablamap® Software
(Primary) | LabSystem Pro™ EP Recording
System (Secondary) |
|-----------------------------|------------------------------------------------------------------------|------------------------------------------------------------------|
| Common/Usual Name: | Diagnostic Computer | Diagnostic Computer |
| Classification Name: | Programmable Diagnostic
Computer | Programmable Diagnostic Computer |
| Class: | Class II | Class II |
| Product Code: | DQK | DQK |
| Regulation: | 21 CFR 870.1425 | 21 CFR 870.1425 |
| Review Panel: | Cardiovascular | Cardiovascular |
| 510(k)
Submitter/Holder: | Ablacon, Inc.
4800 Wadsworth Blvd. Ste 310
Wheat Ridge, CO 80033 | Boston Scientific Corp.
55 Technology Dr.
Lowell, MA 01851 |
| 510(k) #s: | K203084 | K141185 |

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Image /page/4/Picture/0 description: The image shows the Ablacon logo. The logo consists of a stylized orange heart shape on the left and the word "ablacon" in black, sans-serif font on the right. The heart shape is made up of several triangles, creating a faceted appearance. The word "ablacon" is written in lowercase letters.

Device Description

The Ablacon Ablamap System is an electrophysiology mapping system used during electrophysiology procedures for assisting in the diagnosis of complex cardiac arrhythmias. The system consists of several hardware elements including an amplifier, cart, monitor, and a workstation with proprietary patented mapping software. Electrogram (EGM) signals are detected by 64-electrode mapping "basket" catheters which are input into, sampled, and amplified by the system's amplifier. The data is transmitted via fiber-optic cable from the amplifier to the workstation and processed by the system's mapping software with the results displayed on the monitor.

The system also accepts EGM data files recorded by EP amplifier recording systems from 64electrode unipolar "basket" mapping catheters. The EGM data files are electrophysiology (EP) recordings that contain electrogram signals recorded by EP recording systems using 64-electrode "basket" mapping catheters. Compatible EP recording systems are the Boston Scientific LabSystem Pro™, the GE Healthcare CardioLab™ XT, and the St. Jude Medical WorkMate™ Claris System. The recorded EGM data files are saved onto the workstation and processed by the mapping software.

Compatible catheters are 64-electrode mapping "basket" catheters with the following dimensions: 50mm and 60mm sizes; an 8 spline x 8 electrode configuration with nominal electrode spacing of 0.354'' and 0.440" for 50mm and 60mm basket sizes respectively.

Through the software user interface, the user selects to record streamed EGM data from the Ablamap System signal amplifier that is saved to the workstation or the user selects an EGM data file recorded by an EP Recording System that has been saved to the workstation. The data file is processed by the Ablamap System software where the EGM signals are converted into electrographic flow® (EGF®) maps indicating flow consistency and direction of the action potential wave propagation during pre-defined time intervals. The resulting EGF® film maps display the flow with respect to the catheter electrodes and show the activity of sources of excitation where action potentials originate.

A Summary Map is displayed that is the graphical representation of the summation of the activity of EGF® sources from all segments of the EGM data file recording indicating the rate of occurrence i.e. prevalence of sources of EGF® with respect to the catheter electrodes.

These graphical maps are evaluated by the physician to assist in the diagnosis of complex cardiac arrhythmias during electrophysiology procedures.

Intended Use

The Ablamap® System is intended to be used during electrophysiology procedures on patients for whom an electrophysiology procedure has been prescribed and only by qualified medical professionals who are trained in electrophysiology.

Indications for Use

The Ablamap® System is used to analyze electrogram (EGM) signals and display results in a visual format for evaluation by a physician in order to assist in the diagnosis of complex cardiac arrhythmias.

Comparative Technological Characteristics

The Ablacon Ablamap System is an electrophysiological mapping system that uses a proprietary algorithm to process EGM signals and display electrical wave propagation information in a visual

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Image /page/5/Picture/0 description: The image shows the Ablacon logo. The logo consists of an orange, geometric shape resembling a stylized heart or diamond on the left, followed by the word "ablacon" in a bold, sans-serif font. The text is in a dark gray or black color, providing a strong contrast against the white background.

format during pre-defined time intervals. The intended use, indications for use, and fundamental performance are the same as the primary predicate device.

A comparison summary of the technological characteristics of the subject device and the predicate devices are as follows:

| Device Characteristic | Subject Device
Ablamap® System
(K230008) | Predicate Device
(Primary)
Ablamap®
Software
(K203084) | Predicate Device
(Secondary)
Boston Scientific
LabSystem Pro™ EP
Recording System
(K141185)
(Clearsign Amplifier
component only) |
|-----------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Device Classification,
Classification Name,
and Product Code
Indications For Use | Same | Same | Same |
| Indications For Use | Used to analyze electrogram
(EGM) signals and display
results in a visual format for
evaluation by a physician in
order to assist in the
diagnosis of complex cardiac
arrhythmias. | Same | A computer and
software driven data
acquisition and
analysis tool designed
to facilitate the
gathering, display,
analysis by a
physician, pace
mapping and storage
of cardiac
electrophysiologic
data. |
| Intended Use | Intended to be used during
electrophysiology procedures
on patients for whom an
electrophysiology procedure
has been prescribed and only
by qualified medical
professionals who are trained
in electrophysiology. | Same | Same |
| System | Components include an
amplifier, cart, monitor, and
a computer workstation with
Ablamap® mapping software. | Same (excluding
amplifier)
Stand-alone software
may be installed on
any commercially
available computer
meeting minimum
performance
specifications e.g. a
workstation and | Amplifier component
only |
| Device Characteristic | Subject Device
Ablamap® System
(K230008) | Predicate Device
(Primary)
Ablamap®
Software
(K203084) | Predicate Device
(Secondary)
Boston Scientific
LabSystem Pro™ EP
Recording System
(K141185)
(Clearsign Amplifier
component only) |
| Compatible Diagnostic
Catheters | 64-electrode unipolar
"basket" mapping catheters;
50mm and 60mm sizes; 8
spline x 8 electrode with
nominal electrode spacing of
0.354" and 0.440" for 50mm
and 60mm basket sizes
respectively. | Same | Same |
| Compatible EP
Recording Systems | Boston Scientific
LabSystem Pro™ | Same | N/A |
| | GE Healthcare
CardioLab™ | Same | N/A |
| | St. Jude Medical
WorkMate™ Claris System | Same | N/A |
| Signal amplification
up to 140 channels | Yes | No | Yes; 40 to 160
channels |
| Amplifies EGM and
ECG signals and
transmits to a
Workstation | Yes | No | Yes |
| Signal filter settings
-Notch (Power Line)
-High-Pass | - Yes

  • Yes | - No
  • Same | - Yes
  • Yes |
    | Signal processing
    (EGM) | Yes | Same | N/A |
    | Post-processing
    display | Yes | Same | N/A |
    | Grid display of
    electrode signals | Yes | Same | N/A |
    | Graphic display view
    of signal potentials
    (wave propagation) | Yes | Same | N/A |
    | Method to select and
    display all time
    segments of the entire
    electrogram recording | Yes | Same | N/A |
    | Play/replay animated
    (film) graphic
    representation of | Yes | Same | N/A |
    | Device Characteristic | Subject Device
    Ablamap® System
    (K230008) | Predicate Device
    (Primary)
    Ablamap®
    Software
    (K203084) | Predicate Device
    (Secondary)
    Boston Scientific
    LabSystem Pro™ EP
    Recording System
    (K141185)
    (Clearsign Amplifier
    component only) |
    | signals
    Various display
    options to assist the
    user with identification
    of arrhythmia patterns | Electrical activity
    Rotational activity
    Recording timeline
    Stability/Variability
    Flow consistency | Same | N/A |
    | Evaluate the quality of
    the electrogram
    recording | Yes | Same | N/A |
    | Display the
    electrogram and
    electrocardiogram
    signals (EGM chart
    including ECG
    signals) | Yes | Same | N/A |
    | Select and review a
    time sequence of the
    signals from various
    electrodes | Yes | Same | N/A |
    | Programming
    language | Object-oriented (Python) | Same | N/A |
    | Processing
    computation method
    for electrical wave
    propagation | Optical Flow | Same | N/A |
    | Generate a procedure
    history file | Yes | Same | N/A |
    | Allow user to add text
    notes/comments | Yes | Same | N/A |
    | Anatomical location
    capability | No | No | No |

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Image /page/6/Picture/0 description: The image shows the Ablacon logo. The logo consists of an orange heart-shaped icon on the left and the word "ablacon" in black letters on the right. The font of the word "ablacon" is sans-serif and appears to be bolded.

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Image /page/7/Picture/0 description: The image shows the Ablacon logo. The logo consists of an orange, geometric shape resembling a stylized heart or diamond on the left. To the right of the shape is the word "ablacon" in a bold, sans-serif font. The text is in a dark gray or black color, providing a strong contrast against the white background.

Performance Data

Performance testing was completed on the Ablamap® System which verified that the system meets the specification requirements and performs as designed. The Ablamap® System is suitable for its intended use.

Bench Testing for the subject device included and applied the following standards:

  • IEC 60601-1 Ed. 3.1 and applicable Collateral Standards .

8

Image /page/8/Picture/0 description: The image shows the Ablacon logo. The logo consists of an orange heart-shaped icon on the left and the word "ablacon" in black letters on the right. The heart-shaped icon is made up of four triangles that form a heart shape. The word "ablacon" is written in a sans-serif font.

  • IEC 62304 Edition 1.1 2015-06 Medical device software Software life cycle processes
  • ANSVAAMI/IEC 62366-1:2015 Medical devices Part 1: Application of usability ● engineering to medical devices
  • . ISO 15223-1:2021 Medical devices - Symbols to be used with information to be supplied by the manufacturer; Part 1: General Requirements

Verification Testing

Verification testing was performed demonstrating the Ablamap® System met design specifications.

Validation Testing

Validation testing was performed demonstrating the Ablamap® System met the user needs and was found to be clinically acceptable by all evaluators.

Usability Testing

Usability testing demonstrated that the Usability Objectives for the Ablamap® System were met with no User Errors observed.

Testing demonstrated that the Ablamap® System met design requirements and functioned as intended.

Conclusion

The data presented in this submission demonstrates that the proposed Ablamap® System operated as intended and is substantially equivalent to the cleared primary predicate device. the Ablamap Software, and the signal amplifier component of the cleared secondary predicate device, the Boston Scientific LabSystem Pro™ EP Recording System.