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The Guidant SYNCRUS™ Internal Cardioversion System is indicated for use in post-operative cardiac surgery patients who require temporary atrial or ventricular pacing/sensing and/or atrial cardioversion.

The Syncrus System consists of three components:

• Three temporary heart wires sutured onto the heart during open-heart surgery. The wires include a unipolar defibrillation heart wire (left atrium), a bipolar pacing/sensing heart wire (right or left ventricle) and a tripolar defibrillation and pacing and sensing heart wire (right atrium).
• An attenuator box (External Defibrillator Interface Module EDIM). The EDIM attenuates the delivered energy from a standard, low energy defibrillator by 97% (50 - 360 Joules to 1.3 - 11.5 Joules).
• A cardioversion extension cable, which connects the defibrillation heart wires to the EDIM.
  The user must supply an external, low-energy defibrillator that is capable of synchronized cardioversion, an external pacemaker, and temporary patient cables to connect the pacemaker to the patient. The Syncrus System is designed to perform the following cardiac rhythm management functions:
• Atrial pacing and electrocardiogram sensing
• Ventricular pacing and electrocardiogram sensing
• Atrial defibrillation using low energy, synchronized cardioversion.

The provided text is a 510(k) summary for the Guidant Syncrus Internal Cardioversion System. It details an acceptance of a Special 510(k) application, which typically focuses on demonstrating substantial equivalence to a previously cleared predicate device, rather than explicit acceptance criteria and performance studies in the same way a de novo or PMA application might.

Based on the document, here's an analysis of the requested information:

1. Table of Acceptance Criteria and Reported Device Performance

The document does not explicitly state acceptance criteria in terms of specific performance metrics (e.g., sensitivity, specificity, accuracy) or numerical thresholds that the device had to meet to be deemed acceptable. Instead, the focus of this Special 510(k) is on demonstrating substantial equivalence to a predicate device (Syncrus System K020701).

The "device performance" reported is that the device "met specified requirements" in bench testing, confirming its compatibility with a biphasic defibrillator. However, these "specified requirements" are not detailed in the document.

2. Sample Size Used for the Test Set and Data Provenance

The document mentions "bench testing" was performed. This typically refers to laboratory testing, not human or animal studies with a "test set" in the context of clinical data. Therefore, information about a "sample size" for a test set (e.g., number of patients, cases) or its "data provenance" (country of origin, retrospective/prospective) is not applicable or not provided in this type of submission.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of those Experts

As the evaluation was based on bench testing and comparison to a predicate device, there was no "ground truth" to be established by human experts in a clinical context for a "test set" of cases. Therefore, this information is not applicable or not provided.

4. Adjudication Method for the Test Set

Again, given the nature of bench testing and substantial equivalence, a formal "adjudication method" in the clinical sense (e.g., 2+1, 3+1 for resolving discrepancies in expert opinions) for a clinical "test set" is not applicable or not provided.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size of How Much Human Readers Improve with AI vs. Without AI Assistance

This question is entirely not applicable. The device described is a medical hardware system (internal cardioversion system), not an AI algorithm designed to assist human readers (e.g., in medical image interpretation). Therefore, an MRMC study or an assessment of AI assistance is irrelevant to this device.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

This question is also entirely not applicable for the same reasons as point 5. The device is a hardware system, not a standalone algorithm.

7. The Type of Ground Truth Used

The "ground truth" for this submission was primarily established through:

• Bench Testing Results: Verifying the electrical and functional performance of the device components, such as the energy attenuation of the EDIM and compatibility with biphasic defibrillators. The "ground truth" here is the physical and electrical measurements obtained during testing against predefined engineering specifications.
• Substantial Equivalence to a Predicate Device: The primary "ground truth" for regulatory approval in a 510(k) is the demonstration that the new device is as safe and effective as a legally marketed predicate device. This involves comparing intended use, indications, device characteristics, method of use, labeling, materials, and safety features.

There was no "expert consensus, pathology, or outcomes data" used to establish ground truth in the context of a clinical study for this 510(k) submission.

8. The Sample Size for the Training Set

Since this involves bench testing and substantial equivalence to a predicate device, there is no "training set" in the context of machine learning. Therefore, the sample size is not applicable or not provided.

9. How the Ground Truth for the Training Set Was Established

As there is no training set, this information is not applicable or not provided.

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The Guidant Syncrus™ Internal Cardioversion System is indicated for use in post-operative cardiac surgery patients who require temporary atrial or ventricular pacing/sensing and/or atrial cardioversion.

The Syncrus Heart Wires and Connectors are used for atrial and ventricular pacing and electrocardiogram sensing to diagnosis and treat atrial (type I) flutter and some forms of tachycardia. The wires are also used to treat post-operative arrhythmias, particularly atrial fibrillation, when used in conjunction with the Syncrus Cardioversion Extension Cable and Syncrus External Defibrillator Interface Module (EDIM). The EDIM is a passive device. The EDIM when used with a compatible external monophasic defibrillator reduces the energy to approximately 3% and delivers the low-energy cardioversion shock directly to the atria. The cardioversion is achieved by delivering a synchronized electrical pulse of approximately 11.1 Joules or less to the atrial chambers of the heart. There are three types of Heart Wires:

• A tripolar atrial wire, capable of pacing and sensing, and cardioversion, when used in conjunction with the unipolar wire.
• A unipolar atrial wire, capable of cardioversion when used in conjunction with the cardioversion electrode on the tripolar wire.
• A bipolar ventricular wire, capable of pacing and sensing.
  The wires are comprised of curved needle(s), attached to lead(s) on the proximal end. The wires are insulated for long length. A straight needle is attached to the leads on the distal end of the wires. Cardioversion connectors are provided that attach to the appropriate heart wire leads. Pacing connector pins are pre-assembled onto the appropriate heart wire leads.
  The Syncrus Heart Wires are intended to be affixed to the surfaces of their respective heart chambers, during or immediately following open-heart surgery, before the median sternotomy is closed. Temporary pacing heart wires are routinely implanted in a similar manner. The unipolar atrial wire is placed on the left atrium, the tripolar atrial wire is placed on the right atrium, and the bipolar ventricular wire is placed on either ventricle. If all of the Heart Wires are implanted, the atrial and ventricular temporary sensing and pacing ability can be used, and only if the patient develops post-operative AF would the cardioversion feature be used. Both the unipolar atrial wire and the tripolar atrial wires are required in order to perform a cardioversion. When only the capability to treat post-operative AF is desired, the ventricular wire is not required.
  When the pacing feature is used, the pacing lead is inserted into the myocardial tissue of the atrium using the curved needles. Location and pattern of the lead is not critical, as the lead simply requires tissue contact. The "bullet" (define) on the ground wire is then pulled through the hole formed by the curved needle, and is thus buried in the myocardial wall.

The provided text describes a medical device called the Syncrus™ Internal Cardioversion System and its intended use, but it does not contain detailed information about specific acceptance criteria or the study data that "proves" the device meets these criteria in the format requested.

The document is a 510(k) summary, which focuses on demonstrating substantial equivalence to predicate devices rather than providing a detailed report of performance against specific, quantifiable acceptance criteria.

Here's what can be extracted and what is missing, based on your request:

1. Table of Acceptance Criteria and Reported Device Performance:

• Acceptance Criteria: Not explicitly stated as quantifiable metrics. The document broadly states that "All necessary testing was performed on the Guidant Syncrus System to ensure that the system is substantially equivalent to the predicate devices and to ensure that the device is safe and effective."

• Reported Device Performance:

  • Low-energy cardioversion shock: "approximately 11.1 Joules or less to the atrial chambers of the heart."
  • Energy Reduction: When used with the EDIM, a compatible external monophasic defibrillator "reduces the energy to approximately 3%."

  Therefore, a table cannot be fully generated as requested due to the lack of specific, quantifiable acceptance criteria and corresponding detailed performance metrics.

2. Sample size used for the test set and the data provenance:

• Sample Size: Not specified.
• Data Provenance: Not specified (e.g., country of origin, retrospective/prospective). The document only mentions "All necessary testing was performed."

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

• Number of Experts: Not specified.
• Qualifications of Experts: Not specified.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:

• Adjudication Method: Not specified.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

• MRMC Study: Not applicable. This device is a hardware system for pacing, sensing, and cardioversion, not an AI-assisted diagnostic or interpretative tool.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

• Standalone Performance: Not applicable. This device is a medical device requiring human intervention for implantation and operation, not an algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc):

• Type of Ground Truth: Not explicitly stated. The testing would likely involve technical performance verification (e.g., electrical output, material biocompatibility, mechanical integrity) and potentially some animal or limited human subject testing to confirm physiological response, but the document does not detail this. The "ground truth" would be related to meeting established engineering and medical device standards.

8. The sample size for the training set:

• Training Set Sample Size: Not applicable. This is a hardware device, not an AI/machine learning model that requires a training set.

9. How the ground truth for the training set was established:

• Ground Truth for Training Set: Not applicable, as it's a hardware device.

Summary of what is present:

• Device Name: Syncrus™ Internal Cardioversion System
• Intended Use: For use in post-operative cardiac surgery patients who require temporary atrial or ventricular pacing/sensing and/or atrial cardioversion.
• Substantial Equivalence: Demonstrated against Medtronic Pacing & Sensing Wires (Model 6500), Physio-Control Internal Paddles (accessory to LifePak 9 External Defibrillator), and the R2 Cable Adapter.
• Performance Claim: Delivers a synchronized electrical pulse of approximately 11.1 Joules or less for cardioversion. Reduces external defibrillator energy to approximately 3% when used with EDIM.
• Conclusion: "All necessary testing was performed... to ensure that the system is substantially equivalent... and to ensure that the device is safe and effective..."

Key Takeaway: The provided document is a regulatory submission summary focused on substantial equivalence rather than a detailed performance study with explicit acceptance criteria and corresponding granular data as would be found in a clinical trial report or a comprehensive engineering validation.

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