K Number
K240826
Device Name
Reprocessed DECANAV™ Electrophysiology Catheter; Reprocessed WEBSTER® Duo-Decapolar Electrophysiology Catheter
Manufacturer
Date Cleared
2024-10-11

(199 days)

Product Code
Regulation Number
870.1220
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Reprocessed DECANAV™ Electrophysiology Catheter is indicated for electrophysiological mapping of cardiac structures i.e., recording and stimulation, in the Coronary Sinus. In addition, the Reprocessed DECANAV™ Catheter is used with compatible Carto® 3 EP Navigation Systems to provide catheter tip location information. The Reprocessed WEBSTER® Duo-Decapolar Electrophysiology Catheter is indicated for electrophysiological mapping of cardiac structures, i.e., stimulation and recording only. In addition, the Reprocessed WEBSTER® Duo-Decapolar Catheter is designed to facilitate electrogram mapping in the atrial region of the heart and coronary sinus.
Device Description
The Reprocessed DECANAV™ Catheter is a sterile, single patient use device designed to be used with the CARTO® 3 EP Navigation System (a magnetic field location technology) to facilitate electrophysiological mapping of the heart. The catheter has a high torque shaft with a deflectable tip section containing an array of platinum/iridium electrodes that can be used for stimulation and recording of cardiac electrical signals. The Reprocessed DECANAV™ Catheter has a single proximal electrode that can be used for unipolar recording signals. The Reprocessed DECANAV™ Catheter tip deflection is controlled by a proximal hand piece that features a thumb operated sliding piston and is offered in curve types D and F. Pushing the thumb knob forward causes the catheter tip to bend (curve); when the knob is pulled back, the tip straightens. The plane of the curved tip can be rotated during use. The Reprocessed DECANAV™ Catheter interfaces with standard recording equipment and CARTO® 3 EP Navigation System equipment via interface cables with the appropriate connectors. The Reprocessed WEBSTER® Duo-Decapolar Catheter (DDP) is a sterile, single patient use device designed to facilitate electrophysiological mapping of the heart. The catheter has a high-torque shaft with a deflectable tip section containing an array of platinum electrodes that can be used for stimulation and recording. Tip deflection is controlled at the proximal end by a tubular handpiece in which a piston slides. When the piston is pushed forward with the thumb knob, the tip is deflected (curved). When the piston is pulled back, the tip straightens. The high torque shaft allows the plane of the curved tip to be rotated to facilitate accurate positioning of the catheter tip at the desired site. The catheter interfaces with standard recording equipment via interface cables with the appropriate connectors.
More Information

Not Found

No
The summary describes a reprocessed electrophysiology catheter used for mapping cardiac structures. The technology described is focused on the physical characteristics of the catheter, its electrodes for stimulation and recording, and its compatibility with a magnetic field navigation system. There is no mention of AI or ML in the intended use, device description, or performance studies.

No.
The device is indicated for electrophysiological mapping of cardiac structures for recording and stimulation, which makes it a diagnostic device rather than a therapeutic one.

Yes.
The device is indicated for "electrophysiological mapping of cardiac structures," which involves recording and providing information about the electrical activity of the heart. This mapping is used to diagnose cardiac conditions.

No

The device description clearly details physical components like a catheter shaft, electrodes, a deflectable tip, and a hand piece, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use clearly states the device is for "electrophysiological mapping of cardiac structures i.e., recording and stimulation" and providing "catheter tip location information." This involves interacting directly with the patient's body to measure electrical signals and provide positional data.
  • Device Description: The description details a catheter designed to be inserted into the body to perform these functions.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue, etc.) in vitro (outside the body) to provide information for diagnostic purposes.

IVD devices are used to perform tests on samples taken from the body to diagnose diseases or conditions. This device is used in vivo (within the body) for mapping and stimulation.

N/A

Intended Use / Indications for Use

The Reprocessed DECANAV™ Electrophysiology Catheter is indicated for electrophysiological mapping of cardiac structures i.e., recording and stimulation, in the Coronary Sinus. In addition, the Reprocessed DECANAV™ Catheter is used with compatible Carto® 3 EP Navigation Systems to provide catheter tip location information.

The Reprocessed WEBSTER® Duo-Decapolar Electrophysiology Catheter is indicated for electrophysiological mapping of cardiac structures, i.e., stimulation and recording only. In addition, the Reprocessed WEBSTER® Duo-Decapolar Catheter is designed to facilitate electrogram mapping in the atrial region of the heart and coronary sinus.

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

NLH

Device Description

The Reprocessed DECANAV™ Catheter is a sterile, single patient use device designed to be used with the CARTO® 3 EP Navigation System (a magnetic field location technology) to facilitate electrophysiological mapping of the heart. The catheter has a high torque shaft with a deflectable tip section containing an array of platinum/iridium electrodes that can be used for stimulation and recording of cardiac electrical signals. The Reprocessed DECANAV™ Catheter has a single proximal electrode that can be used for unipolar recording signals. The Reprocessed DECANAV™ Catheter tip deflection is controlled by a proximal hand piece that features a thumb operated sliding piston and is offered in curve types D and F. Pushing the thumb knob forward causes the catheter tip to bend (curve); when the knob is pulled back, the tip straightens. The plane of the curved tip can be rotated during use. The Reprocessed DECANAV™ Catheter interfaces with standard recording equipment and CARTO® 3 EP Navigation System equipment via interface cables with the appropriate connectors.

The Reprocessed WEBSTER® Duo-Decapolar Catheter (DDP) is a sterile, single patient use device designed to facilitate electrophysiological mapping of the heart. The catheter has a high-torque shaft with a deflectable tip section containing an array of platinum electrodes that can be used for stimulation and recording. Tip deflection is controlled at the proximal end by a tubular handpiece in which a piston slides. When the piston is pushed forward with the thumb knob, the tip is deflected (curved). When the piston is pulled back, the tip straightens. The high torque shaft allows the plane of the curved tip to be rotated to facilitate accurate positioning of the catheter tip at the desired site. The catheter interfaces with standard recording equipment via interface cables with the appropriate connectors.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Cardiac structures, Coronary Sinus, atrial region of the heart

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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)

Representative samples of reprocessed devices were tested to demonstrate appropriate functional characteristics. Process validation testing was performed to validate cleaning and sterilization as well as device packaging. In addition, the manufacturing process includes visual and validated functional testing of all products produced.
The Reprocessed DECANAV™ and Reprocessed WEBSTER® Duo-Decapolar Electrophysiology Catheters are reprocessed no more than one (1) time. The catheters are marked and tracked through the reprocessing cycle. After the devices have reached the maximum number of reprocessing cycles, the devices are rejected from further reprocessing. It is Sterilmed's policy to restrict its reprocessing to exclude devices previously reprocessed by other reprocessors.

Specific non-clinical tests performed included: cleaning validation, sterilization verification, ethylene oxide residual testing (ISO 10993-7), packaging validation (ASTM D4169, ASTM F88, ASTM F2096), and shelf-life validation (ASTM 1980-07). In addition, validation of functional performance (bench testing) was performed through simulated use, visual inspection, and fatigue testing. Testing performed:
• Joint Bond Strength
• Torsional Resiliency
• Tip Buckle
• Fluid Integrity
• Deflection Cycling
• Flexation Cycling
• Shaft Stiffness
• Electrical Continuity
• Electrical Leakage
• Electrical Connector Cycling
• Cable to Handle Retention Strength
• CARTO® 3 System Compatibility of Duo-Decapolar
• CARTO® 3 System Recognition of DECANAV Electrical Resistance and Isolation Coronary Sinus Handling

Performance testing shows the Reprocessed DECANAV™ and Reprocessed WEBSTER® Duo-Decapolar Electrophysiology Catheters perform as originally intended.
In addition, the devices were tested for biocompatibility per ISO 10993-1 for external communicating device, short duration contact with circulating blood (

§ 870.1220 Electrode recording catheter or electrode recording probe.

(a)
Identification. An electrode recording catheter or an electrode recording probe is a device used to detect an intracardiac electrocardiogram, or to detect cardiac output or left-to-right heart shunts. The device may be unipolar or multipolar for electrocardiogram detection, or may be a platinum-tipped catheter which senses the presence of a special indicator for cardiac output or left-to-right heart shunt determinations.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image contains the logos of the Department of Health & Human Services and the U.S. Food & Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the text "FDA U.S. FOOD & DRUG ADMINISTRATION" in blue.

October 11, 2024

Sterilmed, Inc. Rachel Poltilove Regulatory Affairs 5010 Cheshire Pkwy N, Suite 2 Plymouth, Minnesota 55446

Re: K240826

Trade/Device Name: Reprocessed DECANAV™ Electrophysiology Catheter; Reprocessed WEBSTER® Duo-Decapolar Electrophysiology Catheter Regulation Number: 21 CFR 870.1220 Regulation Name: Electrode Recording Catheter Or Electrode Recording Probe Regulatory Class: Class II Product Code: NLH Dated: September 10, 2024 Received: September 11, 2024

Dear Rachel Poltilove:

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.

1

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" (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 QS 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.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

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-regulatory

2

assistance/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

3

K240826 - Rachel Poltilove

The following devices are included in the scope of this 510(k) premarket notification:

| Device Name | Biosense Webster
Model Numbers | Sterilmed
Model Numbers | Description |
|----------------------------------------------------------------------------|-----------------------------------|----------------------------|--------------------------------------------------------------------------------------------------------------|
| Reprocessed
DECANAV™
Electrophysiology
Catheter | R7D282CT | RR7D282CT | D Curve, 7F, 115cm, Electrodes: 11, SP: 2-8-2mm,
Tip Length: 2.4mm, Pin Connector: 34 |
| Reprocessed
WEBSTER® Duo-
Decapolar
Electrophysiology
Catheter | R7F282CT | RR7F282CT | F Curve, 7F, 115cm, Electrodes: 11, SP: 2-8-2mm,
Tip Length: 2.4mm, Pin Connector: 34 |
| Reprocessed
WEBSTER® Duo-
Decapolar
Electrophysiology
Catheter | D728260RT | RD728260RT | Large Curve 270, 7F, 110 cm, Electrodes: 20, SP: 2-9-3...61...3-9-3mm, Tip Length: 2mm, Pin
Connector: 10 |

4

Indications for Use

510(k) Number (if known) K240826

Device Name

Reprocessed DECANAVTM Electrophysiology Catheter Reprocessed WEBSTER® Duo-Decapolar Electrophysiology Catheter

Indications for Use (Describe)

The Reprocessed DECANAV™ Electrophysiology Catheter is indicated for electrophysiological mapping of cardiac structures i.e., recording and stimulation, in the Coronary Sinus. In addition, the Reprocessed DECANAV™ Catheter is used with compatible Carto® 3 EP Navigation Systems to provide catheter tip location information.

The Reprocessed WEBSTER® Duo-Decapolar Electrophysiology Catheter is indicated for electrophysiological mapping of cardiac structures, i.e., stimulation and recording only. In addition, the Reprocessed WEBSTER® Duo-Decapolar Catheter is designed to facilitate electrogram mapping in the atrial region of the heart and coronary sinus.

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) Summary

This 510(k) summary is being submitted in accordance with the requirements of 21 CFR 807.92.

Date Prepared:October 11, 2024
Submitter and
Manufacturer:Sterilmed, Inc.
5010 Cheshire Parkway N, Suite 2
Plymouth, MN 55446
www.sterilmed.com
Manufacturing
Facility Address:11400 73rd Avenue
North Maple Grove, MN 55369
Official
Correspondent:Dr. Rachel Poltilove
Regulatory Consultant
Sterilmed, Inc.
Tel: 301-213-7224
Email: rpoltilo@its.jnj.com
Trade Name:Reprocessed DECANAV™ Electrophysiology Catheter
Reprocessed WEBSTER® Duo-Decapolar Electrophysiology
Catheter
Classification
Name:Catheter, Recording, Electrode, Reprocessed
Common Name:Diagnostic Electrophysiology Catheter
Device
Classification:Class II, 21 CFR 870.1220
Product CodeNLH
Primary Predicate
Device:Biosense Webster CS RefStar™ (DECANAV) Catheter (K080425)
Secondary
Predicate Devices:Biosense Webster CS RefStar™ (DECANAV) Catheter (K231312)
Biosense Webster Duo-Decapolar Catheter (K101991)
Device Description:The Reprocessed DECANAV™ Catheter is a sterile, single patient
use device designed to be used with the CARTO® 3 EP Navigation
System (a magnetic field location technology) to facilitate
electrophysiological mapping of the heart. The catheter has a high
torque shaft with a deflectable tip section containing an array of
platinum/iridium electrodes that can be used for stimulation and
recording of cardiac electrical signals. The Reprocessed
DECANAV™ Catheter has a single proximal electrode that can be
used for unipolar recording signals. The Reprocessed DECANAV™
Catheter tip deflection is controlled by a proximal hand piece that
features a thumb operated sliding piston and is offered in curve
types D and F. Pushing the thumb knob forward causes the
catheter tip to bend (curve); when the knob is pulled back, the tip
straightens. The plane of the curved tip can be rotated during use.
The Reprocessed DECANAV™ Catheter interfaces with standard
recording equipment and CARTO® 3 EP Navigation System
equipment via interface cables with the appropriate connectors.
The Reprocessed WEBSTER® Duo-Decapolar Catheter (DDP) is a
sterile, single patient use device designed to facilitate
electrophysiological mapping of the heart. The catheter has a
high-torque shaft with a deflectable tip section containing an
array of platinum electrodes that can be used for stimulation and
recording. Tip deflection is controlled at the proximal end by a
tubular handpiece in which a piston slides. When the piston is
pushed forward with the thumb knob, the tip is deflected
(curved). When the piston is pulled back, the tip straightens. The
high torque shaft allows the plane of the curved tip to be rotated
to facilitate accurate positioning of the catheter tip at the desired
site. The catheter interfaces with standard recording equipment
via interface cables with the appropriate connectors.
RR7D282CTReprocessed DECANAV™ Electrophysiology Catheter,
D Curve, 7F, 115cm, Electrodes: 11, SP: 2-8-2mm, Tip
Length: 2.4mm, Pin Connector: 34
Model NumbersRR7F282CTReprocessed DECANAV™ Electrophysiology Catheter,
F Curve, 7F, 115cm, Electrodes: 11, SP: 2-8-2mm, Tip
Length: 2.4mm, Pin Connector: 34
RD728260RTReprocessed WEBSTER® Duo-Decapolar
Electrophysiology Catheter, Large Curve 270, 7F, 110
cm, Electrodes: 20, SP: 2-9-3613-9-3mm, Tip
Length: 2mm, Pin Connector: 10
tip location information.
Indications For
Use:The Reprocessed DECANAV™ Electrophysiology Catheter is
indicated for electrophysiological mapping of cardiac structures,
i.e., recording and stimulation, including in the Coronary Sinus. In
addition, the Reprocessed DECANAV™ Catheter is used with
compatible Carto® 3 EP Navigation Systems to provide catheter
and coronary sinus.The Reprocessed WEBSTER® Duo-Decapolar Electrophysiology
Catheter is indicated for electrophysiological mapping of cardiac
structures, i.e., stimulation and recording only. In addition, the
Reprocessed WEBSTER® Duo-Decapolar Catheter is designed to
facilitate electrogram mapping in the atrial region of the heart
Technological
Characteristics:The design, materials, function, and intended use of the
Reprocessed DECANAV™ and Reprocessed WEBSTER® Duo-
Decapolar Electrophysiology Catheters are the same as that of the
predicate devices. There are no changes to the claims, clinical
applications, patient population, performance specifications, or
method of operation.
Functional and
Safety Testing:Representative samples of reprocessed devices were tested to
demonstrate appropriate functional characteristics. Process
validation testing was performed to validate cleaning and
sterilization as well as device packaging. In addition, the
manufacturing process includes visual and validated functional
testing of all products produced.
The Reprocessed DECANAV™ and Reprocessed WEBSTER® Duo-
Decapolar Electrophysiology Catheters are reprocessed no more
than one (1) time. The catheters are marked and tracked through
the reprocessing cycle. After the devices have reached the
maximum number of reprocessing cycles, the devices are rejected
from further reprocessing. It is Sterilmed's policy to restrict its
reprocessing to exclude devices previously reprocessed by other
reprocessors.
Summary of
Non-Clinical Tests
Conducted:Specific non-clinical tests performed included: cleaning
validation, sterilization verification, ethylene oxide residual
testing (ISO 10993-7), packaging validation (ASTM D4169, ASTM
F88, ASTM F2096), and shelf-life validation (ASTM 1980-07). In
addition, validation of functional performance (bench testing)
was performed through simulated use, visual inspection, and
fatigue testing. Testing performed:
• Joint Bond Strength
• Torsional Resiliency
• Tip Buckle
• Fluid Integrity
• Deflection Cycling
• Flexation Cycling
• Shaft Stiffness
• Electrical Continuity
• Electrical Leakage
• Electrical Connector Cycling
• Cable to Handle Retention Strength
• CARTO® 3 System Compatibility of Duo-Decapolar
CARTO® 3 System Recognition of DECANAV Electrical Resistance and Isolation Coronary Sinus Handling Performance testing shows the Reprocessed DECANAV™ and
Reprocessed WEBSTER® Duo-Decapolar Electrophysiology
Catheters perform as originally intended.
In addition, the devices were tested for biocompatibility per
ISO 10993-1 for external communicating device, short
duration contact with circulating blood (