The RhythmStar system is intended for use by patients who either have or are at risk of having cardiac disease and those that demonstrate intermittent symptoms indicative of cardiac disease and require cardiac monitoring on a continuing basis. The device continuously records ECG data and upon detection by an ECG analysis algorithm or manually initiated by the patient, automatically delivers the recorded cardiac activity to the server where it is presented and can be reviewed by a medical professional. The data received from the RhythmStar device can be used by another device for arrhythmia analysis, reporting and signal measurements. The RhythmStar system is not intended to sound any alarms. The device does not deliver any therapy, administer any drugs, provide interpretive or diagnostic statements or provide for any life support. RhythmStar is for prescription use only.
Device Story
Portable, battery-powered, wireless cardiac monitor; records ECG and activity data via 3-lead (optional 5-lead) cable for up to 30 days. Device uses embedded arrhythmia detection algorithm to identify Bradycardia, Tachycardia, and Atrial Fibrillation; captures patient-activated events via Record button. Data transmitted to server via mobile network or USB connection for review by medical professional. Server allows configuration of auto-triggering parameters. Device does not provide diagnostic statements, therapy, or alarms. Used in home/clinical settings; operated by patient and reviewed by physician. Benefits include continuous monitoring for intermittent cardiac symptoms and improved patient compliance through integrated wireless design.
Monitor includes analog ECG front end, accelerometer, MCU, flash storage, RF modem, LCD, and Record button. Powered by rechargeable Li-Ion battery (externally charged). Connectivity via mobile network or USB. Biocompatibility per ISO 10993. Complies with IEC 60601-1, 60601-1-2, 60601-1-11, 60601-2-47, 60601-2-25, and ANSI/AAMI-EC 57.
Indications for Use
Indicated for patients with or at risk of cardiac disease, or those with intermittent symptoms requiring continuous cardiac monitoring.
Regulatory Classification
Identification
A telephone electrocardiograph transmitter and receiver is a device used to condition an electrocardiograph signal so that it can be transmitted via a telephone line to another location. This device also includes a receiver that reconditions the received signal into its original format so that it can be displayed. The device includes devices used to transmit and receive pacemaker signals.
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Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
August 5, 2014
Rhythmedix, LLC c/o Mr. Mark Job Responsible Third Party Official Regulatory Technology Services LLC 1394 25th Street NW Buffalo, MN 55313
Re: K141813
Trade/Device Name: RhythmStar System Regulation Number: 21 CFR 870.2920 Regulation Name: Telephone electrocardiograph transmitter and receiver Regulatory Class: Class II Product Code: DXH Dated: July 3, 2014 Received: July 7, 2014
Dear Mr. Job:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug. and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must
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Page 2 - Mr. Mark Job
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 (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to
http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely yours,
Image /page/1/Picture/8 description: The image shows a logo with the letters "K" and "I" in a stylized, handwritten font. The "K" is larger and bolder, while the "I" is thinner and taller. Below the logo, there is text that reads "Ken Skodacek for". The background of the image is a light gray color.
en Skodacek for Bram D. Zuckerman, MD. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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## Indications for Use
510(k) Number (if known) K141813
Device Name
RhythmStar System
Indications for Use (Describe)
The RhythmStar system is intended for use by patients who cither have or are at risk of having cardiac disease and those that demonstrate intermittent symptoms indicative of cardiac disease and require cardiac monitoring on a continuing basis. The device continuously records ECG data and upon detection by an ECG analysis algorithm or manually initiated by the patient, automatically delivers the recorded cardiac activity to the server where it is presented and can be reviewed by a medical professional.
The data received from the RhythmStar device can be used by another device for arrhythmia analysis, reporting and signal measurements. The RhythmStar system is not intended to sound any alarms.
The device does not deliver any therapy, administer any drugs, provide interpretive or diagnostic statements or provide for any life support. RhythmStar is for prescription use only.
Type of Use (Select one or both, as applicable)
الا Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)
PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.
FOR FDA USE ONLY
| Concurrence of Center for Devices and Radiological Health (CDRH) (Signature) | <img alt="Signature" src="signature.png"/> |
|------------------------------------------------------------------------------|--------------------------------------------|
| | Ken Skodacek for |
| | Bram Zuckerman |
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Image /page/3/Picture/0 description: The image shows the logo for "RhythMedix". The logo is in gray and features a stylized font. To the right of the word "Medix" is a small trademark symbol and a graphic of three curved lines emanating from a corner, resembling radio waves.
| Submitted by | Rhythmedix, LLC<br>Horizon Corporate Center<br>5000 Atrium Way, Suite 1<br>Mt. Laurel, NJ 08054 |
|--------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact | Stan Biletsky<br>sbiletsky@rhythmedix.com |
| Establishment Registration<br>Number | N/A |
| Date Prepared | June 20, 2014 |
| Trade Name | RhythmStar System |
| Common Name | Mobile Cardiac Monitor |
| Device Classification (regulation) | 870.2920 Telephone electrocardiograph transmitter and<br>receiver. |
| Class | II |
| Product Code | DXH |
| Classification Panel | Cardiovascular |
| Equivalent Marketed Device(s)<br>(Predicate device(s)) | K131699, eMotion ECG Mobile, Mega Electronics Ltd<br>K083535, Heartrak Smart ECAT, Universal Medical, Inc. |
| Device Description (abbreviated) | The RhythmStar system consists of the RhythmStar<br>device and the server. The RhythmStar device is a<br>portable, battery-powered, wireless cardiac monitor which<br>may be worn by a patient to record ECG and activity level<br>data for up to 30 consecutive days. The device can<br>capture patient activated and auto-triggered events such<br>as Bradycardia, Tachycardia, and Atrial Fibrillation as<br>identified by an embedded arrhythmia detection algorithm.<br>The device is capable to automatically deliver the data to<br>the server. The data can be delivered to the server<br>wirelessly via mobile network or via USB connection. A<br>medical professional, using the server, can adjust and<br>program the device configuration and auto-triggering<br>parameters. |
| Intended Use | The RhythmStar system is intended for use by patients<br>who either have or are at risk of having cardiac disease<br>and those that demonstrate intermittent symptoms<br>indicative of cardiac disease and require cardiac<br>monitoring on a continuing basis. The device continuously |
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records ECG data and upon detection by an ECG analysis algorithm or manually initiated by the patient, automatically delivers the recorded cardiac activity to the server where it is presented and can be reviewed by a medical professional.
The data received from the RhythmStar device can be used by another device for arrhythmia analysis, reporting and signal measurements. The RhythmStar system is not intended to sound any alarms.
The device does not deliver any therapy, administer any drugs, provide interpretive or diagnostic statements or provide for any life support. RhythmStar is for prescription use only.
## Technological Characteristics
The RhythmStar device patient kit includes:
- RhythmStar monitor -
- Patient ECG lead cable (3-lead cable included, 5-lead cable optional)
- -2 externally re-chargeable batteries
- -Wall battery charger (the charger cannot be connected to the device)
The monitor consists of an analog ECG front end, accelerometer, MCU, flash data storage, RF modem for data transmission, LCD screen, and Record button. The server components facilitate data communication with the RhythmStar device, provide data storage, and present the data for evaluation by a medical professional.
There are known similarities between the new device and the predicate devices:
- . All devices are small, lightweight ambulatory cardiac monitors.
- . All devices use the same wireless technology to deliver data to a server.
- . All devices are battery powered and have a rechargeable Li-lon battery.
- . The RhythmStar and Heartrak Smart ECAT (K083535), using a server, can adjust device programming parameters such as pre-post recording times and autotriggering configuration.
- The RhythmStar and eMotion ECG Mobile (K131699) ● devices incorporate an accelerometer to capture activity level data related to patient motion and device orientation.
- . All devices have Record button for manual event recordings and a user interface capabilities to indicate device status and mode of operation.
- The RhythmStar and Heartrak Smart ECAT (K083535) ● incorporate embedded ECG analysis algorithm to auto-
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capture Bradycardia. Tachycardia and Atrial Fibrillation. The eMotion ECG Mobile (K131699) detects arrhythmia events on the server. All devices detect arrhythmia events between the signal acquisition point and the reviewer of the data.
- . All devices have at least 2 ECG channels and 3-lead electrodes.
- All devices have identical or very similar Functional, Environmental and Electrical characteristics
There are known differences between the new device and the predicate devices that do not impact safety or effectiveness:
- Predicate devices use external RF component (cell . phone) between ECG sensor and the server for long range data transmission and transmit ECG data to the cell phone communicator using a close range RF link such as Bluetooth connection. Essentially, the predicate devices utilize two different RF technologies (BT and Mobile Network) and two separate components – ECG sensor to collect ECG data and a wireless communicator (cell phone) to deliver the data to the server. The new device integrates a wireless modem module into a single unit design to improve reliability of the overall system, reduce risks related to delayed data delivery, improve patient compliance by reducing complexity of the device, and lower production costs. The RhythmStar uses the same wireless technology (Mobile Network) as the predicate devices to deliver data to the server and is therefore substantially equivalent to the predicates.
- Predicate devices can recharge the internal battery onboard. The new device utilizes batteries that are charged externally in a wall charger made by a thirdparty. This design eliminates any risks of electrical shock during charging because the charger cannot be connected to the device and the patient is never connected to the charger directly or indirectly. All devices use the same energy source - rechargeable Li-lon battery and require the patient to recharge it and are therefore substantially equivalent.
- The new device supports USB connectivity in addition ● to being able to transmit data to the server via the mobile network. The predicate devices deliver data to the server via the mobile network only. The RhythmStar's ability to deliver and/or receive data to/from the server in more than one way addresses risks related to potential failures to deliver data wirelessly due to: wireless service unavailability,
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wireless component malfunction, and issues that arise from misuse of the device. According to the RhythmStar System Requirements Specification, the physical design of the cable connector on the device makes it physically impossible to connect the RhythmStar to a USB or any other device while patient ECG lead cable is plugged-in. Adding USB capability in RhythmStar device does not introduce any new risks, change the intended use, or pose any questions concerning safety or effectiveness.
- . There are several minor differences related to electrical and environmental characteristics between the new and predicate devices. All devices meet minimum requirements for the corresponding parameters as sited in AAMI-EC38/IEC 60601-2:47 standards for ambulatory arrhythmia monitoring and are therefore substantially equivalent.
## Performance Testing (Bench, Animal, Clinical)
The following performance and safety tests have been passed successfully:
- 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 60601-1:2005 3rd Edition, Medical electrical equipment - Part 1: General requirements for basic safety and essential performance.
- -IEC 60601-1-2:2007 300 Edition, Medical Electrical Equipment – Part 1-2: General requirements for basic safety and essential performance- Collateral standard: Electromagnetic compatibility - Requirements and tests.
- IEC 60601-1-11:2010 Edition 1.0. Medical electrical equipment - Part 1-11: General requirements for basic safety and essential performance - Collateral Standard: Requirements for medical electrical equipment and medical electrical systems used in the home healthcare environment.
- ANSI/AAMI-EC 57:2012, Testing and Reporting -Performance Results of Cardiac Rhythm and ST Segment Measurement Algorithms.
- -IEC 60601-2-25:2011 standard (Particular requirements for the basic safety and essential performance of electrocardiographs).
- -IEC 60601-1-6:2010 Edition 3.0, Medical electrical equipment - Part 1-6: General requirements for basic safety and essential performance - Collateral standard: Usability.
- -Biocompatibility testing of patient contacting materials according to ISO 10993.
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| | Bench test results verify that RhythmStar system can continuously record ECG signal, store ECG data in the device memory, and transmit manual or auto activated event recordings to the server via mobile network or USB connection for evaluation by a medical professional. |
|-----------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | Test results verify that all requirements were met and that the RhythmStar performs as designed. |
| Substantial Equivalence Rationale | The intended use, performance and technological characteristics of the RhythmStar system compared to the named predicate devices demonstrates that the RhythmStar is substantially equivalent to the predicates. |
| Conclusions | The analysis of the differences between RhythmStar and the predicate deices does not raise new questions of safety and effectiveness. Based on device performance test results, Rhythmedix determines that the RhythmStar system is safe, effective, performs within its design specifications, and is substantially equivalent to the predicate devices. |
| | The information in this 510(k) submission demonstrates that the RhythmStar system is substantially equivalent to the predicate devices, with respect to safety, effectiveness, and performance. |
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.