K Number
K233755
Device Name
HeartKey® Rhythm
Manufacturer
Date Cleared
2024-08-16

(268 days)

Product Code
Regulation Number
870.1425
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
HeartKey Rhythm is intended for use by qualified healthcare professionals for analysing ECG data from adults. HeartKey Rhythm analyses a single ECG lead recorded from compatible devices used for arrhythmia diagnostics such as Holters, Extended Holters, ECG Patches, Event Recorders, or other similar devices when assessment of the rhythm is necessary. The HeartKey Rhythm application program interface (API) is intended to be integrated into other device software to provide the following capabilities: - ECG signal conditioning, - ECG signal quality assessment, - QRS beat detection, - Ventricular ectopic beat detection, - ECG rhythm analysis HeartKey Rhythm is not intended for use in life supporting, or sustaining systems, or real-time ECG monitors, or cardiac alarm devices, or OTC-use only devices. HeartKey Rhythm analysis results are not intended to be the sole means of diagnosis. It is offered to physicians on an advisory basis only in conjunction with the physician's knowledge of ECG patterns, patient background, clinical history, symptoms, and other diagnostic information.
Device Description
HeartKey Rhythm is intended to automatically analyse ECG data and provide ECG signal processing and assessment of cardiac arrhythmias. The software processes the following types of ambulatory ECGs: - Standard Holter: Lead I, II, III electrode configuration using gel electrodes e.g., Ag/AgCl, - Patch: Modified Lead II, Lead III, sternum using gel electrodes e.g., Ag/AgCl . HeartKey Rhythm is capable of analysing both continuous ECGs as well as event recorders. The device provides the following analysis: Feature | Description ------- | ----------- ECG Signal Processing Engine (SPE) | Signal Conditioning (SC): Reduce the noise artefact present in the input ECG signal for physician review of NSR, AF and VE beats. Beat Detector (BD): Detect the QRS complexes of the input ECG signal. Signal Quality (SQ): Identify and classify the ECG segments' signal quality from the input ECG signal. ECG Arrhythmia Analysis (AA) | Rhythm Analysis: Normal Sinus Rhythm, Atrial Fibrillation, Cardiac Pause, Tachycardia, Bradycardia, Inconclusive, Unreadable. Beat Analysis: Normal (N), Ventricular (V) Ectopic. Beat Clustering: Beat Cluster Template, Beat Cluster Count, QRS Location, Beat Classification, Heart Rate The Software Library may be integrated into ECG management systems, ECG analysis platforms or remote patient monitoring platforms. The filtered and enhanced ECG is not intended to be used by other automated analysis algorithms.
More Information

Yes
The document explicitly states that the device "analyses the input ECG using a combination of rules-based calculations and AI / ML technology" and mentions an "automated proprietary machine-learning algorithm".

No
The device is described as an analysis tool for ECG data, providing advisory information to healthcare professionals, and is not intended for life-supporting systems or as the sole means of diagnosis. This indicates it supports therapy rather than being a therapeutic device itself.

Yes

Explanation: The "Intended Use / Indications for Use" section states that HeartKey Rhythm "analyses a single ECG lead recorded from compatible devices used for arrhythmia diagnostics" and provides "ECG rhythm analysis" and "Ventricular ectopic beat detection". The "Device Description" also details its capabilities for "ECG Arrhythmia Analysis" including detection of various rhythms and beats (e.g., Atrial Fibrillation, Tachycardia, Bradycardia, Ventricular Ectopic). This indicates its role in identifying medical conditions or states, which is the definition of a diagnostic device. While it states results are "not intended to be the sole means of diagnosis," it clearly contributes to the diagnostic process by providing analytical information.

Yes

The device is described as a "Software Library" and an "application program interface (API)" intended to be integrated into other device software. It performs analysis on ECG data provided by compatible hardware devices but does not include or require specific hardware components for its function.

Based on the provided information, this device is likely an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The device is intended for analyzing ECG data from adults for arrhythmia diagnostics. While ECG data is collected from the patient, the analysis itself is performed on the collected data, which is a biological sample (electrical signals from the heart).
  • Analysis of Biological Samples: The core function is the analysis of ECG data, which represents the electrical activity of the heart. This data is derived from the patient's body.
  • Diagnostic Purpose: The intended use explicitly states "arrhythmia diagnostics" and that the analysis is "necessary" for assessment of the rhythm. While the results are advisory and not the sole means of diagnosis, the purpose is to provide information for diagnostic purposes.
  • Comparison to Predicate Device: The predicate device (K210822 - DeepRhythmAI) is also likely an IVD, as it performs similar ECG analysis for diagnostic purposes.

While the device doesn't analyze traditional biological fluids like blood or urine, the analysis of electrical signals from the heart, when used for diagnostic purposes, falls under the scope of IVDs in many regulatory frameworks. The key is that it's analyzing data derived from a biological source for diagnostic information.

No
The provided text does not contain any explicit statement that the FDA has reviewed, approved, or cleared a Predetermined Change Control Plan (PCCP) for this specific device.

Intended Use / Indications for Use

HeartKey Rhythm is intended for use by qualified healthcare professionals for analysing ECG data from adults. HeartKey Rhythm analyses a single ECG lead recorded from compatible devices used for arrhythmia diagnostics such as Holters, Extended Holters, ECG Patches, Event Recorders, or other similar devices when assessment of the rhythm is necessary.

The HeartKey Rhythm application program interface (API) is intended to be integrated into other device software to provide the following capabilities:

  • · ECG signal conditioning,
  • · ECG signal quality assessment,
  • · QRS beat detection,
  • · Ventricular ectopic beat detection,
  • ECG rhythm analysis

HeartKey Rhythm is not intended for use in life supporting, or sustaining systems, or real-time ECG monitors, or cardiac alarm devices, or OTC-use only devices. HeartKey Rhythm analysis results are not intended to be the sole means of diagnosis. It is offered to physicians on an advisory basis only in conjunction with the physician's knowledge of ECG patterns, patient background, clinical history, symptoms, and other diagnostic information.

Product codes

DQK, DPS

Device Description

HeartKey Rhythm is intended to automatically analyse ECG data and provide ECG signal processing and assessment of cardiac arrhythmias. The software processes the following types of ambulatory ECGs:

  • Standard Holter: Lead I, II, III electrode configuration using gel electrodes e.g., Ag/AgCl,
  • Patch: Modified Lead II, Lead III, sternum using gel electrodes e.g., Ag/AgCl .

HeartKey Rhythm is capable of analysing both continuous ECGs as well as event recorders. The device provides the following analysis:
ECG Signal Processing Engine (SPE):
Signal Conditioning (SC): Reduce the noise artefact present in the input ECG signal for physician review of NSR, AF and VE beats.
Beat Detector (BD): Detect the QRS complexes of the input ECG signal.
Signal Quality (SQ): Identify and classify the ECG segments' signal quality from the input ECG signal.

ECG Arrhythmia Analysis (AA):
Rhythm Analysis:
Normal Sinus Rhythm
Atrial Fibrillation
Cardiac Pause
Tachycardia
Bradycardia
Inconclusive
Unreadable
Beat Analysis:
Normal (N)
Ventricular (V) Ectopic
Beat Clustering:
Beat Cluster Template
Beat Cluster Count
QRS Location
Beat Classification
Heart Rate

The Software Library may be integrated into ECG management systems, ECG analysis platforms or remote patient monitoring platforms. The filtered and enhanced ECG is not intended to be used by other automated analysis algorithms.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

HeartKey Rhythm analyses the input ECG using a combination of rules-based calculations and AI / ML technology.

Input Imaging Modality

ECG data from compatible devices used for arrhythmia diagnostics such as Holters, Extended Holters, ECG Patches, Event Recorders, or other similar devices.
Input is a single ECG lead from one of the following:
Wet Electrode Lead I, II, and III
Wet Electrode Modified Leads II and III
Wet Electrode Sternum Lead

Anatomical Site

Not Found

Indicated Patient Age Range

Adults.

Intended User / Care Setting

Intended for use by qualified healthcare professionals.
Environments of use: Home or hospital environment.

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

B-Secur evaluated HeartKey Rhythm against a large independent proprietary set of ECGs and standard databases, comparing its analysis output against a known reference. The proprietary dataset included more than 1200 ECGs with approximately 25% females, 25% males and 50% gender unknown, approximately 16% whites, 24% non-whites, and 60% race unknown, and approximately 66% of ECGs recorded in the US.

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

Nonclinical performance testing was conducted in compliance with the appropriate recognised consensus standards, to demonstrate that HeartKey Rhythm satisfies its design and software requirements as well as demonstrate that the ECG analysis performance is substantially equivalent to the predicate device (DeepRhythmAI, K210822). Testing described in this 510(k) consisted of verification of all design input requirements and product specifications.
Performance testing included the evaluation of metrics such as sensitivity, specificity, and positive values. These outputs were evaluated against a clinically relevant acceptance criteria to demonstrate HeartKey Rhythm's effectiveness. Unit, integration and system level testing conducted identified no residual anomalies during verification software tests. Cybersecurity testing was conducted in which no vulnerabilities were identified and all software requirements were satisfied. Overall, the software verification & validation testing was completed successfully and met all requirements. Testing demonstrated that the subject device performance was deemed to be acceptable.

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

Performance testing included the evaluation of metrics such as sensitivity, specificity, and positive values.

Predicate Device(s)

K210822 - Medicalgorithmics S.A. - DeepRhythmAI

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).

0

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, which consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, with the word "ADMINISTRATION" underneath. The logo is simple and professional, and it is easily recognizable.

B-Secur Limited Cameron Moore Quality Assurance Manager 11th Floor, City Quays 3 92 Donegall Quay Belfast, BT1 3FE United Kingdom

Re: K233755

Trade/Device Name: HeartKey® Rhythm Regulation Number: 21 CFR 870.1425 Regulation Name: Programmable Diagnostic Computer Regulatory Class: Class II Product Code: DQK, DPS Dated: July 19, 2024 Received: July 22, 2024

Dear Cameron Moore:

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 (the 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 available 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

1

(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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. Kimberly N. Crowley -S

For: Jennifer Shih Kozen Assistant Director Division of Cardiac Electrophysiology, Diagnostics, and Monitoring Devices Office of Cardiovascular Devices

2

Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

3

Indications for Use

510(k) Number (if known) K233755

Device Name HeartKey® Rhythm

Indications for Use (Describe)

HeartKey Rhythm is intended for use by qualified healthcare professionals for analysing ECG data from adults. HeartKey Rhythm analyses a single ECG lead recorded from compatible devices used for arrhythmia diagnostics such as Holters, Extended Holters, ECG Patches, Event Recorders, or other similar devices when assessment of the rhythm is necessary.

The HeartKey Rhythm application program interface (API) is intended to be integrated into other device software to provide the following capabilities:

  • · ECG signal conditioning,
  • · ECG signal quality assessment,
  • · QRS beat detection,
  • · Ventricular ectopic beat detection,
  • ECG rhythm analysis

HeartKey Rhythm is not intended for use in life supporting, or sustaining systems, or real-time ECG monitors, or cardiac alarm devices, or OTC-use only devices. HeartKey Rhythm analysis results are not intended to be the sole means of diagnosis. It is offered to physicians on an advisory basis only in conjunction with the physician's knowledge of ECG patterns, patient background, clinical history, symptoms, and other diagnostic information.

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)

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."

4

510(k) Summary

Date Prepared:19 July 2024
Submitter/Applicant:B-Secur Ltd
City Quays 3
92 Donegall Quay
Belfast
BT1 3FE
United Kingdom
Official Contact:Cameron Moore, Quality Assurance Manager
Primary Contact Person:Cameron Moore
Quality Assurance Manager, B-Secur Limited.
Email: cameron.moore@b-secur.com
Phone: +44 (0)28 9568 5489
Secondary Contact Person:Prabhu Raghavan
Regulatory Consultant for B-Secur Limited.
Email: prabhu@mdqr.solutions
Phone: 408-316-5707
Proprietary or Trade Name:HeartKey® Rhythm
Common/Usual Name:Electrocardiograph
Classification Name:21CFR 870.1425
DQK - Programmable diagnostic computer
Class II
Predicate Device:K210822 - Medicalgorithmics S.A. - DeepRhythmAI

Device Description:

HeartKey Rhythm is intended to automatically analyse ECG data and provide ECG signal processing and assessment of cardiac arrhythmias. The software processes the following types of ambulatory ECGs:

  • Standard Holter: Lead I, II, III electrode configuration using gel electrodes e.g., Ag/AgCl,
  • Patch: Modified Lead II, Lead III, sternum using gel electrodes e.g., Ag/AgCl .

HeartKey Rhythm is capable of analysing both continuous ECGs as well as event recorders. The device provides the following analysis:

5

FeatureDescription
ECG Signal
Processing Engine
(SPE)Signal Conditioning (SC): Reduce the noise artefact present in
the input ECG signal for physician review of NSR, AF and VE
beats.

Beat Detector (BD): Detect the QRS complexes of the input
ECG signal.

Signal Quality (SQ): Identify and classify the ECG segments'
signal quality from the input ECG signal. |
| ECG Arrhythmia
Analysis (AA) | Rhythm Analysis:
Normal Sinus Rhythm
Atrial Fibrillation
Cardiac Pause
Tachycardia
Bradycardia
Inconclusive
Unreadable
Beat Analysis:
Normal (N)
Ventricular (V) Ectopic
Beat Clustering:
Beat Cluster Template
Beat Cluster Count
QRS Location
Beat Classification
Heart Rate |

The Software Library may be integrated into ECG management systems, ECG analysis platforms or remote patient monitoring platforms. The filtered and enhanced ECG is not intended to be used by other automated analysis algorithms.

Principle of Operation:

It is intended that the library is integrated into other software such as ECG management systems, ECG analysis platforms or remote patient monitoring platforms. Such applications could be written to run on a PC or server. All features are accessed via a documented rest application programming interface (API).

HeartKey Rhythm analyses the input ECG using a combination of rules-based calculations and AI / ML technology. The software is compiled and remains static, with no further modification of the code carried out once deployed.

Indications for Use:

HeartKey Rhythm is intended for use by qualified healthcare professionals for analysing ECG data from adults. HeartKey Rhythm analyses a single ECG lead recorded from compatible

6

devices used for arrhythmia diagnostics such as Holters, Extended Holters, ECG Patches, Event Recorders, or other similar devices when assessment of the rhythm is necessary.

The HeartKey Rhythm application program interface (API) is intended to be integrated into other device software to provide the following capabilities:

  • ECG signal conditioning, ●
  • ECG signal quality assessment,
  • QRS beat detection, ●
  • . Ventricular ectopic beat detection,
  • ECG rhythm analysis

HeartKey Rhythm is not intended for use in life supporting, or sustaining systems, or real-time ECG monitors, or cardiac alarm devices, or OTC-use only devices. HeartKey Rhythm analysis results are not intended to be the sole means of diagnosis. It is offered to physicians and clinicians on an advisory basis only in conjunction with the physician's knowledge of ECG patterns, patient background, clinical history, symptoms, and other diagnostic information.

Patient Population:

Adults.

Environments of use: Home or hospital environment.

7

Table 3.1. outlines the proposed device vs. the predicate.

As part of the comparison, the following shall be presented & discussed:

  • Indications for Use
  • Technology and Principle of Operation •
  • . Performance and Specifications

Table 3.1 is a comparison - Subject Device vs. the Predicate, K210822 - Medicalgorithmics S.A. - DeepRhythmAl.

Note: The comparison to the predicate is based upon available technical specifications vs. comparative testing.

8

PredicateSubject device
DeepRhythmAlHeartKey® Rhythm
K#K210822K233755
Product CodeDQK and DPSDQK and DPS
CFR870.1425870.1425
ClassificationClass IIClass II
Regulation Number(s)21 CFR §870.142521 CFR §870.1425
21 CFR §870.234021 CFR §870.2340
Classification nameProgrammable
Diagnostic Computer,
ElectrocardiographProgrammable
Diagnostic Computer,
Electrocardiograph
Intended UseDeepRhythmAI is a cloud-based
software for the assessment of
cardiac arrhythmias using two
lead ECG data in adult patients.
It is intended for use by a
healthcare solution integrator to
build web, mobile or another
types of applications to let
qualified healthcare
professionals review and
confirm the analytic result.HeartKey Rhythm is intended
for use for signal processing and
analysis of ambulatory ECGs. It
is intended for non-active
patient monitoring or for non-
urgent clinical decision making.
Indications for UseDeepRhythmAI is a
cloud-based software for the
assessment of
cardiac arrhythmias
using two lead ECG data in
adult patients.
It is intended for use by a
healthcare solution integrator to
build web, mobile or another
types of applications to let
qualified healthcare
professionals review and
confirm the analytic result. The
product supports downloading
and analyzing data
recorded in the
compatible formats from
dedicated ambulatory ECG
devices such asHeartKey Rhythm is intended
for use by qualified healthcare
professionals for analysing ECG
data from adults. HeartKey
Rhythm analyses a single ECG
lead recorded from compatible
devices used for arrhythmia
diagnostics such as Holters,
Extended Holters, ECG Patches,
Event Recorders, or other
similar devices when assessment
of the rhythm is necessary.
The HeartKey Rhythm
application program interface
(API) is intended to be
integrated into other device
software to provide the
following capabilities: ECG
signal conditioning, ECG signal
similar devices when the
assessment of the rhythm is
necessary.
The product can be
electronically interfaced
and perform analysis
with data transferred
from other computer based ECG
systems, such as an ECG
management system.
DeepRhythmAI can be
integrated into medical devices.
In this case, the medical device
manufacturer will identify the
indication for use depending on
the application of their device.
DeepRhythmAI is not for use in
life-supporting or sustaining
systems or ECG Alarm devices.
Interpretation results are not
intended to be the sole means of
diagnosis. It is offered to
physicians and clinicians on an
advisory basis only in
conjunction with the physician's
knowledge of ECG patterns,
patient background, clinical
history, symptoms and other
diagnostic information.beat detection, ECG rhythm
analysis.
HeartKey Rhythm is not
intended for use in life
supporting, or sustaining
systems, or real-time ECG
monitors, or cardiac alarm
devices, or OTC-use only
devices. HeartKey Rhythm
analysis results are not intended
to be the sole means of
diagnosis. It is offered to
physicians and clinicians on an
advisory basis only in
conjunction with the physician's
knowledge of ECG patterns,
patient background, clinical
history, symptoms, and other
diagnostic information.
Level of
Concern/Documentation
LevelModerateEnhanced
ComponentsSoftware only: 1) A web API 2)
An automated proprietary
algorithm.Software only: 1) A web API 2)
An automated proprietary
algorithm.
InterfaceWeb application
programming interface
(API)Web application
programming interface
(API)
Part responsible
for ECG signal
analysisThe automated
proprietary deep-learning
algorithm, which
measures and analyzes ECG
data to provide
qualified healthcare
professional with
supportive informationThe automated
proprietary machine-learning
algorithm, which
measures and analyzes ECG
data to provide
qualified healthcare
professional with
supportive information
for review.for review.
Number of leads
for a received
ECG signalTwo lead ECG dataA single lead from one of the
following leads:
Wet Electrode Lead I, II, and III
Wet Electrode Modified Leads II
and III
Wet Electrode Sternum Lead
Display or
Graphical User
Interface (GUI)No primary display or
GUINo primary display or
GUI

Table 3.1 – Comparison – Subject vs. Predicate

9

10

Substantial Equivalence Discussion

HeartKey Rhythm has the same general intended use and similar indications, technological characteristics, and principles of operation as the predicate Medicalgorithmics DeepRhythmAI, K210822.

Intended Use/ Indications for Use

The indications for use for HeartKey Rhythm and the predicate Medicalgorithmics DeepRhythmAI, K210822 both are rest API based software libraries which are intended to be integrated into computer-based ECG systems. Both devices allow for the processing and extraction of beats from an ECG signal, providing an accurate heart rate measurement, in an ambulatory environment.

Both the proposed and the predicate allow for ECG rhythm analysis and beat classification. The indications for use are substantially equivalent.

Environment of Use and Target Population

HeartKey Rhythm is intended for prescriptive use and for adults over 18. The predicate DeepRhythmAl has the same environment of use and population.

Both HeartKey Rhythm and DeepRhythmAl are intended for use in a home or hospital environment.

Technological Characteristics and Principles of Operation

HeartKey Rhythm is a library collection of callable functions that have been compiled into native machine code of the computer on which they will execute. A rest application programming interface (API) calls some or all the available functions within the library to securely exchange information. This can be deployed to a variety of cloud platforms or to a virtual or physical machine.

HeartKey Rhythm is intended to be integrated into different ECG platforms such as ECG management systems, ECG analysis platforms or remote patient monitoring platforms. Medicalgorithmics DeepRhythmAl software has the same intended use and users as the predicate.

11

HeartKey Rhythm provides the applications/platforms it is intended to be deployed in, with ECG signal processing and beat extraction in order to provide a heart rate reading and arrhythmia analysis to the device user. The predicate DeepRhythmAI (K210822) software assesses ambulatory electrocardiogram (ECG) rhythms from adult subjects.

HeartKey Rhythm and DeepRhythmAI are based on the following technological characteristics:

  • Process ECG signals ●
  • . Detect peaks in ECG signals
  • . Output heart rate measurements to the user
  • . Rhythm analysis
  • . Beat classification

HeartKey Rhythm and the predicate are substantially equivalent in relation to their technological characteristics.

Non-clinical Testing

Nonclinical performance testing was conducted in compliance with the appropriate recognised consensus standards, to demonstrate that HeartKey Rhythm satisfies its design and software requirements as well as demonstrate that the ECG analysis performance is substantially equivalent to the predicate device (DeepRhythmAI, K210822). Testing described in this 510(k) consisted of verification of all design input requirements and product specifications. B-Secur evaluated HeartKey Rhythm against a large independent proprietary set of ECGs and standard databases, comparing its analysis output against a known reference. The proprietary dataset included more than 1200 ECGs with approximately 25% females, 25% males and 50% gender unknown, approximately 16% whites, 24% non-whites, and 60% race unknown, and approximately 66% of ECGs recorded in the US. Performance testing included the evaluation of metrics such as sensitivity, specificity, and positive values. These outputs were evaluated against a clinically relevant acceptance criteria to demonstrate HeartKey Rhythm's effectiveness. Unit, integration and system level testing conducted identified no residual anomalies during verification software tests. Cybersecurity testing was conducted in which no vulnerabilities were identified and all software requirements were satisfied. Overall, the software verification & validation testing was completed successfully and met all requirements. Testing demonstrated that the subject device performance was deemed to be acceptable.

Verification and validation testing was completed in compliance with the following standards and guidance documents:

  • ANSI/AAMI EC57:2012, Testing and Reporting Performance Results of Cardiac Rhythm . And ST-Segment Measurement Algorithms.
  • ANSI/AAMI/IEC 60601-2-47:2012. Medical electrical equipment Part 2-47: Particular . requirements for the basic safety and essential performance of ambulatory electrocardiographic systems.
  • IEC 62304:2006+A1:2015, Medical device software Software life cycle processes. ●

12

  • . IEC 81001-5-1:2022, Health software and health IT systems safety, effectiveness and security - Part 5-1: Security - Activities in the product life cycle.
  • . General Principles of Software Validation; Final Guidance for Industry and FDA Staff (January, 2002)
  • Cybersecurity in Medical Devices: Quality System Considerations and Content of Premarket Submissions; Final Guidance for Industry and FDA Staff (September, 2023)

Substantial Equivalence Conclusion

In conclusion, HeartKey Rhythm has the same intended use as the predicate device, and any differences in technological characteristics do not raise different questions of safety or effectiveness. Differences between the subject device and the predicate have been tested to ensure that the device meets its intended use. Therefore, HeartKey Rhythm is substantially equivalent to the predicate device.