EP-TRACER System

K161245 · Cardio Tek, BV · DQK · Aug 5, 2016 · Cardiovascular

Device Facts

• Record ID: K161245
• Device Name: EP-TRACER System
• Applicant: Cardio Tek, BV
• Product Code: DQK · Cardiovascular
• Decision Date: Aug 5, 2016
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.1425
• Device Class: Class 2

Intended Use

The EP-TRACER System is an electrophysiology measurement system used to acquire, filter, digitize, amplify, display, and record signals obtained during electrophysiological studies and related procedures. The system allows the user to monitor, display and record the signals. The system incorporates a stimulator intended to be used for diagnostic cardiac stimulation during electrophysiological testing of the heart

Device Story

EP-TRACER System is a computerized electrophysiology measurement system; acquires, filters, digitizes, amplifies, displays, and records cardiac signals; incorporates integrated stimulator for diagnostic cardiac stimulation. Used in clinical electrophysiology labs; operated by trained medical professionals. System hardware includes amplifier/stimulator; software provides user interface for signal monitoring and protocol management. Healthcare providers use real-time signal displays and recorded data to guide diagnostic cardiac testing and electrophysiological procedures. Benefits include precise signal acquisition and controlled cardiac stimulation to facilitate diagnosis of cardiac arrhythmias.

Clinical Evidence

Bench testing only. No clinical data presented. Performance verified through software validation protocols and electrical safety/EMC testing (IEC 60601-1, IEC 60601-1-2, IEC 60601-1-6, IEC 62366, IEC 60601-2-34). All tests passed.

Technological Characteristics

Class II programmable diagnostic computer. Hardware: Amplifier/stimulator with 38, 70, or 102 channels. Sensing: 1 kHz sampling rate, >100 dB CMRR, 20 MΩ input impedance. Stimulator: 2 isolated channels, 0-25.5 mA output, 0.1-9.9 ms pulse duration. Connectivity: Standalone system. Software: Multi-threaded, Visual C#/.NET environment. Standards: IEC 60601-1, IEC 60601-1-2, IEC 60601-1-6, IEC 62366, IEC 60601-2-34.

Indications for Use

Indicated for patients undergoing electrophysiological studies and diagnostic cardiac stimulation procedures.

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

• EP-TRACER System (K134044)

Submission Summary (Full Text)

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

August 5, 2016

CardioTek, B.V. % Melissa Walker President & CTO Graematter, Inc. 1324 Clarkson Clayton Center #332 St Louis. Missouri 63011

Re: K161245

Trade/Device Name: EP-Tracer System Regulation Number: 21 CFR 870.1425 Regulation Name: Programmable Diagnostic Computer Regulatory Class: Class II Product Code: DQK Dated: June 13, 2016 Received: June 22, 2016

Dear Melissa Walker:

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.

Muda Jellman
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) K161245

Device Name EP TRACER System

#### Indications for Use (Describe)

The EP-TRACER System is an electrophysiology measurement system used to acquire, filter, digitize, amplify, display, and record signals obtained during electrophysiological studies and related procedures.

The system allows the user to monitor, display and record the signals. The system incorporates a stimulator intended to be used for diagnostic cardiac stimulation during electrophysiological testing of the heart

| Type of Use (Select one or both, as applicable) | | | |
|--------------------------------------------------|---------------------------------------------|--|--|
| X Prescription Use (Part 21 CFR 801 Subpart D) | Over-The-Counter Use (21 CFR 801 Subpart C) | | |

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## Section 5: 510(k) Summary per 21CFR §807.92

# EP TRACER System Summary

| Submitter's<br>information | Contact: Oliver Roth<br>Schwarzer Cardiotek GmbH<br>Im Zukunftspark 3<br>74076 Heilbronn / Germany | Contact: Melissa Walker<br>Graematter, Inc.<br>1324 Clarkson Clayton Ctr #332<br>Ballwin, MO 63011<br>Phone: [phone]<br>Date: 02/14/2016 |
|-----------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------|
| Device/<br>classification<br>name | Device Name:<br>The EP-TRACER System is a Class 2 device (product code DQK).<br>Classification/Common name:<br>• Programmable diagnostic computer, 21 CFR §870.1425,<br>The marketed device(s) to which substantial equivalence is claimed:<br>• EP-TRACER System, K134044 | |
| Device<br>description | The EP-TRACER System is a computerized electrophysiology measurement<br>system designed for both regular and experimental EP studies.<br><br>The EP-TRACER System is comprised of these major components,<br><br>1. EP-TRACER hardware – Amplifier/stimulator<br>2. EP-TRACER Software – Software pre-installed | |
| Indications for<br>use | "The EP-TRACER System is an electrophysiology measurement system used<br>to acquire, filter, digitize, amplify, display, and record signals obtained<br>during electrophysiological studies and related procedures.<br><br>"The system allows the user to monitor, display and record the signals. The<br>system incorporates a stimulator intended to be used for diagnostic cardiac<br>stimulation during electrophysiological testing of the heart".<br><br>Continued on next page | |

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## EP TRACER System Summary, Continued

Technological The table below lists the technological characteristics for both the new and characteristics predicate devices.

| Device Characteristic | Predicate Device EP-TRACER V1.05<br>K134044 | New Device EP-TRACER V2<br>K161245 |
|------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------|
| Amplifier Dimensions (with<br>integrated stimulator) WxDxH | 38 channels: 28x27x7 in cm<br>70/102 channels: 28x27x12 in cm | Same |
| Environmental Specifications | | |
| Temperature Operating | +10°C to +30°C | Same |
| Temperature Transport/Storage | -29°C to +66°C | Same |
| Humidity Operating | 20 - 80 % rH (non-condensing) | Same |
| Humidity Transport/Storage | < 95 % rH (non-condensing) | Same |
| Power Specifications | | |
| Power Requirements | 100 - 240 V AC,<br>50 - 60 Hz | Same |
| Power Input | 38 channels:<br>+5 V, 0.3 A & +12 V, 0.9 A<br>70 channels:<br>+5 V, 0.3 A & +12 V, 1.5 A<br>102 channels:<br>+5 V, 0.3 A & +12 V, 2 A | Same |
| Design | | |
| Sampling and Hold | Each channel sampled prior the<br>acquisition | Same |
| Sampling Rate | 1 kHz | Same |
| CMRR | > 100 dB | Same |
| Input Impedance | Typical 20 MΩ | Same |
| Leakage Current | | |
| Patient Source | < 10 μA | Same |
| Patient Sink | < 10 μA | Same |
| Patient Sink (measured at patient<br>leads under single fault conditions) | < 50 μA | Same |
| Chassis Leakage | < 100 μA | Same |
| ECG Input | | |
| Outputs | 12 lead ECG produced | Same |
| High Pass Filter | 0.05 Hz, 0.2 Hz | Same |
| Low Pass Filter | 150 Hz | Same |
| RF Filtering | All inputs | Same |
| Gain | Between 0 and 255 mm/mV -<br>continuous | Same |
| Saturation Recovery | < 1 sec (manual reset) | Same |
| Notch Filter | Power line (50/60 Hz) | Same |
| Dynamic Range | ±5 mV | Same |
| Baseline Correction | +300 mV | Same |
| Device Characteristic | Predicate Device EP-TRACER V1.05<br>K134044 | New Device EP-TRACER V2<br>K161245 |
| Input/ Output | | |
| Inputs 32/38 channels | 20 intracardiac channels, 6 auxiliary<br>channels, 12 ECG channels | Same |
| Inputs 64/70 channels | 52 intracardiac channels, 6 auxiliary<br>channels, 12 ECG channels | Same |
| Inputs 102 channels | 84 intracardiac channels, 6 auxiliary<br>(pressure) channels, 12 ECG channels | Same |
| Outputs | No outputs | Same |
| Switching | Each channel can be either bipolar or<br>unipolar with manual switching | Same |
| High Pass Filter | 0.05 Hz, 0.2 Hz, 40 Hz, 80 Hz | Same |
| Low Pass Filter | 350 Hz | Same |
| RF Filtering | All inputs | Same |
| Gain | Between 0 and 255 mm/mV –<br>continuous | Same |
| Saturation Recovery | < 1 s (manual reset) | Same |
| Notch Filter | Power line (50/60 Hz) | Same |
| Dynamic Range | ±5 mV | Same |
| Baseline Correction | ±300 mV | Same |
| Stimulator (integrated into device) | | |
| Isolated Stimulus Channels | 2 | Same |
| Pulse Amplitude | | |
| Range | 0 - 25.5 mA into 1000 Ω load | Same |
| Increment | 0.1 ms | Same |
| Accuracy | ±0.15 ms | Same |
| Pulse Duration | | |
| Range | 0.1 - 9.9 ms | Same |
| Increment | 0.1 ms | Same |
| Accuracy | ±0.15 ms | Same |
| Inter-Stimulus Interval (ISI) | | |
| Range | 10 - 9999 ms | Same |
| Range (Burst) | 10 - 9999 ms | Same |
| Increment | 10 ms | Same |
| Sequential Delay (AV) | | |
| Range | 11 - 250 ms | Same |
| Increment | 1 ms | Same |
| Programmed Protocols | Preprogrammed protocols:<br>BASIC 1 (induction)<br>BASIC 2 (termination)<br>BASIC 3 (backup)<br>ACUTE<br>Multi-Sx | Same |
| Programmed Protocols | Pace<br>Automatic mode<br>Wenkebach mode | Same |
| Device Characteristic | Predicate Device EP-TRACER V1.05<br>K134044 | New Device EP-TRACER V2<br>K161245 |
| Programmable Protocol Key | 10 | Same |
| Number of Extra-Stimuli | 5 (S2 - S6) | Same |
| Sensing (ECG Synchronization) | | |
| Automatic or Manual Trigger<br>Setting - Sensitivity | Internal from any surface or intra-cardiac channel | Same |
| Automatic or Manual Trigger<br>Setting - Trigger lockup<br>(refractory time) | 5 - 5000 ms | Same |
| Automatic or Manual Trigger<br>Setting - ECG Delay | 5 - 5000 ms | Same |
| Additional Outputs | No | Same |
| Power Source | Integrated with amplifier<br>38 channels:<br>+5 V, 0.3 A & +12 V, 0.9 A<br>70 channels:<br>+5 V, 0.3 A & +12 V, 1.5 A<br>102 channels:<br>+5 V, 0.3 A & +12 V, 2 A | Same |
| Pacing Channels | | |
| Isolated Channels | (i) atrial and<br>(ii) ventricular and<br>(iii) emergency fixed pace output to atrium and ventricle | Same |
| Circuit Isolation | Compliant with IEC 60601-1, Class CF,<br>5 kV, common & differential mode | Same |
| Computer Controlled Stimulus Pulses | | |
| Current | 0 - 25.5 mA into 1000 Ω load | Same |
| Current Steps | 0.1 mA | Same |
| Accuracy | ±0.1 mA | Same |
| Pulse duration | Pulse width 0.1 - 9.9 ms, steps of 0.1 ms | Same |
| Accuracy | ±0.1 mA | Same |
| Load Impedance | 1000 Ω | Same |
| Max. Output Voltage | 25 V | Same |
| Inter-Stimulus Intervals | | |
| S1 Range | 10 - 9999 ms | Same |
| Stability | Quartz computer clock, ±30 parts per<br>million at +25°C | Same |
| Extra-Stimuli | 5 (S2 - S6) | Same |
| Coupling Interval | 30 - 9990 ms | Same |
| Accuracy | ±10 ms | Same |
| Protocol Automation | | |
| Auto decrement/<br>increment | Yes | Same |
| Backup Manually Controlled<br>Stimulation | Use external backup stimulator | Same |
| Device Characteristic | Predicate Device EP-TRACER V1.05<br>K134044 | New Device EP-TRACER V2<br>K161245 |
| Compliance with Standards | | |
| Standards | EN 60601-1<br>EN 60601-1-2 | Same |
| Device Directive | European Union Medical Device<br>Directive (CE Marked) | Same |
| Environmental/ Electrical Specifications | | |
| Operating Temperature | +10°C to +30°C | Same |
| Storage Temperature | -29°C to +66°C | Same |
| Operating Humidity | 20 - 80 % rH (non-condensing) | Same |
| Storage Humidity | < 95 % rH (non-condensing) | Same |
| Max. Current Draw | 15 A/115 V, 7 A/230 V | Same |
| Chassis Leakage Current | < 100 μΑ | Same |
| Advanced Features | | |
| Display Ablation Parameters | Connection to RF ablation generator(s) | Same |
| Certification | | |
| MDD Device Class | Class IIb | Same |
| IEC 60601-1 | Certified | Same |
| EMC Compliance | Certified | Same |
| CE Marking | Certified CE 0197 | Same |
| US Regulations | K134044 | Current submission |
| System Dimensions | | |
| W x D x H | Customer Option<br>Mobile Cart: 100x80x170 cm<br>Mobile Desk: 125x80x150 cm<br>Control Desk: customer defined<br>Laptop: customer defined | Same |
| Software | | |
| Programming language | Borland Delphi 5 | Visual C# |
| Component library | VCL Framework (Visual Component<br>Library) | .NET |
| Software architecture | Single Threaded | Multi Threaded |
| Drawing method | 2D | 3D |
| License concept | Text file | Dongle |
| Context sensitive help texts | No | Mouse over context help |
| Operating concept | Menus and short-cuts | Menus, short-cuts and display<br>elements (i.e. buttons) |
| Language support | English (full), partial support for other<br>languages | Full multi language support |

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Continued on next page

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### EP TRACER System Summary, Continued

Performance The updated version of the EP-TRACER system and software (V2.0) testing maintains the capabilities in the previous version, adding user interface enhancements.

> Testing has been conducted through software and/or user verification/validation protocols to ensure the EP TRACER System meets its intended use and user needs.

> Electrical safety and electromagnetic compatibility testing shown in the table below was performed. All tests passed.

| Test | Results |
|-----------------------------------------------------------------------------------------------------------------------|---------|
| Radiated emission: Conducted emission: Radiated immunity:<br>Conducted immunity | Pass |
| Conducted emission (harmonics); Radiated immunity (PMF);<br>Conducted immunity | Pass |
| IEC 60601-1:2005 + CORR. 1:2006 + CORR. 2:2007 +<br>AM1:2012 | Pass |
| Amendment - IEC 60601-1:2005 (Third Edition) + CORR.<br>1:2006 + CORR. 2:2007 + A1:2012 | Pass |
| IEC 60601-1-6:2010 (Third Edition) + A1:2013 | Pass |
| IEC 62366:2007 (First Edition) + A1: 2014 for use in conjunction<br>with IEC 60601-1-6: 2010 | Pass |
| IEC 60601-1-27:2011 (Third Edition) for use in conjunction with<br>IEC 60601-1:2005 + CORR. 1 (2006) + CORR. 2 (2007) | Pass |
| IEC 60601-2-34 (Third Edition): 2011 | Pass |

#### Based on the technical characteristics and the results of the performance Conclusion testing, the EP TRACER V2.0 is substantially equivalent to V1.05.