AutoMark Module

K160218 · St Jude Medical · DQK · Dec 13, 2016 · Cardiovascular

Device Facts

• Record ID: K160218
• Device Name: AutoMark Module
• Applicant: St Jude Medical
• Product Code: DQK · Cardiovascular
• Decision Date: Dec 13, 2016
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.1425
• Device Class: Class 2

Intended Use

The EnSite™ Velocity™ Cardiac Mapping System is a suggested Diagnostic tool in patients for whom electrophysiology studies are indicated. When used with EnSite™ Array Catheter, the EnSite™ Velocity™ Cardiac Mapping System is intended to be used in the right atrium of patients with complex arrhythmias that may be difficult to identify using conventional mapping system alone. OR When used with the EnSite™ Velocity™ Surface Electrode Kit, the EnSite™ Velocity™ Cardiac Mapping System is intended to display the position of conventional electrophysiology (EP) catheters in the heart. When used with compatible hardware, the AutoMark Module is intended to automatically catalog and display various parameters associated with RF information on the 3D model in real-time.

Device Story

EnSite Velocity Cardiac Mapping System is a diagnostic tool for electrophysiology (EP) studies. It uses electrode catheters introduced into the heart to record electrical activity. The system consists of a display workstation (DWS) and an amplifier subsystem. The amplifier collects electrical signals from catheters and surface electrodes, converts them to digital format, and transmits them to the DWS via fiber optic/Ethernet. The DWS displays cardiac electrical activity as waveform traces and dynamic 3D isopotential maps of the cardiac chamber. The AutoMark Module is an optional software add-on that automatically catalogs and displays RF ablation parameters on the 3D model in real-time based on user-defined criteria. Used in EP laboratories by physicians to identify arrhythmias and guide ablation procedures. The system aids clinical decision-making by providing real-time visualization of catheter position and cardiac electrical activity, potentially improving the accuracy and efficiency of complex arrhythmia identification and treatment.

Clinical Evidence

No clinical data. Bench testing only. Software verification and validation activities were performed to ensure the AutoMark Module meets performance specifications and does not affect device safety or effectiveness. Risk management and cybersecurity assessments were conducted.

Technological Characteristics

System comprises a display workstation and amplifier subsystem. Connectivity via fiber optic/Ethernet. Software-based mapping and signal processing. AutoMark Module is an optional software feature for real-time RF parameter cataloging and display. Conforms to IEC 62304 for software life cycle processes.

Indications for Use

Indicated for patients undergoing electrophysiology studies. Specifically, the EnSite Array Catheter is indicated for patients with complex arrhythmias in the right atrium. The EnSite Velocity Surface Electrode Kit is indicated for displaying the position of conventional EP catheters in the heart.

Regulatory Classification

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.

Predicate Devices

• EnSite™ Velocity™ Cardiac Mapping System (K141050)
• WorkMate Claris™ System (K151911)

Reference Devices

• EnSite™ Velocity™ Cardiac Mapping System v5.0.1 with AutoMap Module v1.0.1 (K160187)
• EnSite Precision™ Cardiac Mapping System v2.0.1 (K160210)

Submission Summary (Full Text)

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized depiction of a bird or eagle in flight, composed of three overlapping profiles facing to the right. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular fashion around the bird symbol.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

December 13, 2016

St. Jude Medical Melissa Frank Senior Regulatory Affairs Specialist One St. Jude Medical Drive St. Paul, Minnesota 55117

Re: K160218

Trade/Device Name: EnSite Velocity Cardiac Mapping System v5.0.1 with AutoMark Module v1.0.1 Regulation Number: 21 CFR 870.1425 Regulation Name: Programmable Diagnostic Computer Regulatory Class: Class II Product Code: DQK Dated: September 20, 2016 Received: September 21, 2016

Dear Melissa Frank:

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 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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

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the quality systems (OS) 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 [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

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 [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Mule Jellm
for

Bram D. Zuckerman, M.D. 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) K160218

Device Name

EnSite™ Velocity™ Cardiac Mapping System v5.0.1 with AutoMark Module v1.0.1

Indications for Use (Describe)

Device Name: EnSite™ Velocity™ Cardiac Mapping System v5.0.1

Indications for Use:

The EnSite™ Velocity™ Cardiac Mapping System is a suggested Diagnostic tool in patients for whom electrophysiology studies are indicated.

When used with EnSite™ Array Catheter, the EnSite™ Velocity™ Cardiac Mapping System is intended to be used in the right atrium of patients with complex arrhythmias that may be difficult to identify using conventional mapping system alone.

OR

When used with the EnSite™ Velocity™ Surface Electrode Kit, the EnSite™ Velocity™ Cardiac Mapping System is intended to display the position of conventional electrophysiology (EP) catheters in the heart

Device Name: AutoMark Module v1.0.1

Indications for Use:

When used with compatible hardware, the AutoMark Module is intended to automatically catalog and display various parameters associated with RF information on the 3D model in real-time.

Type of Use (Select one or both, as applicable)

| <span style="font-size: 10px;"> <svg height="10" width="10"> <rect height="10" style="fill:lightgrey;stroke-width:1;stroke:rgb(0,0,0)" width="10"></rect> <line style="stroke:rgb(0,0,0);stroke-width:2" x1="0" x2="10" y1="0" y2="10"></line> <line style="stroke:rgb(0,0,0);stroke-width:2" x1="0" x2="10" y1="10" y2="0"></line> </svg> </span> Prescription Use (Part 21 CFR 801 Subpart D) |
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| <span style="font-size: 10px;"> <svg height="10" width="10"> <rect height="10" style="fill:white;stroke-width:1;stroke:rgb(0,0,0)" width="10"></rect> </svg> </span> Over-The-Counter Use (21 CFR 801 Subpart C) |

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# 510KSUMMARY

| 510(k) Number | K160218 |
|------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Date Prepared | October 18, 2016 |
| Submitter Information | |
| Manufacturer<br>Name/Address | St. Jude Medical<br>One St. Jude Medical Drive<br>St. Paul, MN 55117 |
| Contact Person | Melissa Frank<br>Sr. Regulatory Affairs Specialist<br>Phone [phone]<br>[e-mail] |
| Device Information | |
| Trade Name | EnSite™ Velocity™ Cardiac Mapping System v5.0.1 with AutoMark Module v1.0.1 |
| Common Name | Programmable Diagnostic Computer |
| Class | II |
| Classification Name | 870.1425, computer, diagnostic, programmable |
| Product Code | DQK |
| Predicate Device | EnSite™ Velocity™ Cardiac Mapping System (K141050) |
| Secondary Predicates | WorkMate Claris™ System (K151911) |
| Reference Devices | EnSite™ Velocity™ Cardiac Mapping System v5.0.1 with AutoMap Module v1.0.1<br>(K160187)<br>EnSite Precision™ Cardiac Mapping System v2.0.1 (K160210) |
| Base System Device<br>Description: | The EnSite™ Velocity™ Cardiac Mapping System with software version 5.0.1 is a<br>catheter navigation and mapping system capable of displaying the three-dimensional<br>(3D) position of conventional electrophysiology catheters, as well as displaying<br>cardiac electrical activity as waveform traces and as dynamic 3-D isopotential maps<br>of the cardiac chamber. The contoured surfaces of these three-dimensional maps are<br>based on the anatomy of the patient's own cardiac chamber.<br><br>The EnSite Velocity™ Cardiac Mapping System, Model EE3000 consists of a<br>display workstation subsystem (DWS) and an Amplifier subsystem. The EnSite<br>Amplifier collects the data from the patient connections and sends them to the DWS<br>Workstation. The Amplifier connects to the DWS through a fiber optic cable and a<br>media converter to convert the optical signals to digital signals. The EnSite™<br>Velocity™ DWS software displays the cardiac signal data received from the |

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Amplifier on the workstation monitors and stores it for later retrieval.

### Display Work Station (DWS) Subsystem

- DWS The DWS houses the system software and connects all the components . together.
- . Monitors - Two monitors display patient information. One monitor is positioned near the workstation and keyboard for system operation, and the physician places the second monitor near the patient table for use.
- . Isolation transformer - All system components on the DWS connect to line power through a medical-grade isolation transformer.
- . Printer - Allows for printing study data

### Amplifier Subsystem

- Amplifier contains electronic circuitry and firmware responsible for collecting . and transmitting the electrical signal data of the patient to the DWS software application via fiber Ethernet. The Amplifier converts these signals to a digital format and sends them to the workstation for processing.
- NavLink Connects surface electrodes and the system reference surface . electrode to the Amplifier.
- ArrayLink Connects the EnSite Array Multi-electrode Diagnostic Catheter to . the Amplifier. It also has a connection for an auxiliary unipolar reference electrode.
- . CathLink - Connects the diagnostic catheters to the Amplifier
- . GenConnect - Connects the ablation catheter and dispersive surface electrodes to the Amplifier.
- . RecordConnect - The RecordConnect allows simultaneous connection for catheters and surface ECG to a recording system and to the Amplifier.
- . ECG cable - The ECG cable connects standard ECG electrodes to the Amplifier.

The EnSite™ Velocity™ Cardiac Mapping System is used as a diagnostic tool in electrophysiology (EP) Studies. An EP study involves the introduction of one or more electrode catheters into the heart to record its electrical activity. These catheters

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| | connect to the EnSite™ Velocity™ Cardiac Mapping System through specialized |
|--------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | catheter input modules (CIMs). The EnSite™ Velocity™ Cardiac Mapping System |
| | v5.0.1 is designed for use in the EP laboratory in conjunction with other equipment |
| | as described in the labeling. |
| Expansion Module<br>Device Description: | The AutoMark Module is an optional add-on module to the EnSite™ Velocity™<br>System v5.0.1. The software module allows the user to set criteria for ablation-<br>related parameters and the software automatically displays the lesion marks on the<br>EnSite Velocity model during RF ablation when the user set criteria are met. The<br>color, size, and ranges of the AutoMark are defined by the user. |
| Secondary Predicate<br>Device Descriptions | The following secondary predicate devices are provided to ensure that all features of<br>the proposed AutoMark Module are demonstrated to be substantially equivalent to<br>features of currently cleared medical devices |
| | |
| | WorkMate Claris System |
| | The WorkMate Claris™ System is a fully computerized system for capturing and |
| | measuring physiological data in the clinical electrophysiology (EP) laboratory. It |
| | provides digital signal acquisition and display of those electrical signals on high |
| | resolution monitors. |
| | |
| | The WorkMate Claris System is connected to electrophysiology catheters that are |
| | guided into various locations within the heart, and to surface electrocardiogram |
| | (ECG) cables. Intracardiac and ECG signals are then acquired from electrodes on the |
| | indwelling catheters and ECG leads connected to the amplifier, which amplifies and |
| | conditions the signals before they are received by the WorkMate Claris System |
| | computer for display, measurement and storage. |
| | |
| | During the procedure, cardiac signals are acquired and an automated software |
| | waveform detector (trigger) performs online recognition of cardiac activation on |
| | preselected leads. Temporal interval measurements are computed on a beat-by-beat |
| | basis on multiple channels and dynamically posted on the Real Time display. |
| | Intervals are calculated between waveforms from the same source on a specific |
| | channel (intra-channel measurements) and from multi-source signals across two or |
| | more channels (inter-channel measurements). |
| | |
| | Signals are also presented on a review monitor for measurement and analysis. |
| | Continuous capture of the digitized signals can be invoked, and the user can also |
| | retrieve and display earlier passages of the current study without interruption of the |
| | real-time display. The system can also acquire, display and record data from other |
| | interfaced devices in use during the procedure, such as imaging devices and ablation |
| | generators. |
| Base System | Device Name: EnSite™ Velocity™ Cardiac Mapping System v5.0.1 |
| Indications for Use | The EnSite Velocity Cardiac Mapping System is a suggested Diagnostic tool in |
| | patients for whom electrophysiology studies are indicated. |
| | |
| | When used with EnSite Array Catheter, the EnSite System is intended to be used in |
| | the right atrium of patients with complex arrhythmias that may be difficult to identify |
| | using conventional mapping system alone. |
| | OR |
| | When used with the EnSite Velocity Surface Electrode Kit, the EnSite System is |
| | intended to display the position of conventional electrophysiology (EP) catheters in |
| | the heart |
| Expansion Module | Device Name: AutoMark Module v1.0.1 |
| Indications for Use | When used with compatible hardware, the AutoMark Module is intended to |
| | automatically catalog and display various parameters associated with RF information |
| | on the 3D model in real-time. |
| Submission History | No prior submissions have been made to FDA for the device subject of this |
| | submission. |
| Predicate Comparison | |
| Comparison | The AutoMark module was developed to provide additional functionality to the |
| | predicate devices in allowing the user to set parameters and the software |
| | automatically displays the lesion marks on the EnSite Velocity model during RF |
| | ablation. The proposed AutoMark Module has the same intended use and |
| | fundamental scientific technology as the predicate devices, EnSite™ Velocity™ |
| | Cardiac Mapping System v4.0.2 and WorkMate Claris™ System |
| Non-Clinical Testing<br>Summary | Design verification activities for functional testing were performed with their<br>respective acceptance criteria to ensure that the software modifications do not affect |
| | the safety or effectiveness of the device. All testing performed met the established<br>performance specifications. |
| | <b>Testing</b> |
| | The AutoMark software module was developed and tested in accordance with the<br>following industry guidance documents and standards: |
| | FDA Reviewers and Compliance on Off-the-Shelf Software used in Medical<br>Devices and IEC 62304 OTS classification Guidance for the Content of Premarket Submissions for Software Contained<br>in Medical Devices IEC 62304:2006 Medical Device Software - Software Life Cycle Processes Content of Premarket Submissions for Management of Cybersecurity in<br>Medical Devices: Guidance for Industry and Food and Drug Administration<br>Staff |
| | Software Documentation for a Major Level of Concern software per FDA's Guidance<br>Document "Guidance for the Content of Premarket Submissions for Software<br>Contained in Medical Devices" is included as part of this submission. |
| | The changes to the optional AutoMark software module were evaluated through<br>software verification and validation to show that the software is acceptable for use<br>and meets the requirements. |
| | <b>Risk Management</b> |
| | The changes to the AutoMark software were evaluated through review of risk<br>management to ensure no new hazards have been introduced by this change. The risk<br>analysis was completed and risk controls were implemented to mitigate identified<br>hazards. |
| | The AutoMark software module conforms to the Cybersecurity requirements through<br>the cybersecurity risk management process comprised of a risk assessment, risk<br>control, and maintenance of cybersecurity activities. |
| Statement of | The technological characteristics for the device are the same as the predicate devices. |

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| Equivalence: | Based on this and the data provided in this pre-market notification, the subject device and predicate devices have been shown to be substantially equivalent. |
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