BIOMONITOR IIIm, BIOMONITOR III

K221856 · Biotronik, Inc. · MXD · Jul 27, 2022 · Cardiovascular

Device Facts

• Record ID: K221856
• Device Name: BIOMONITOR IIIm, BIOMONITOR III
• Applicant: Biotronik, Inc.
• Product Code: MXD · Cardiovascular
• Decision Date: Jul 27, 2022
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 870.1025
• Device Class: Class 2

Intended Use

The BIOMONITOR III/BIOMONITOR IIIm is indicated to detect the following cardiac arrhythmias: - atrial fibrillation - bradycardia - sudden rate drop - high ventricular rate (HVR) - asystole The BIOMONITOR III/BIOMONITOR IIIm is indicated for use in: - Patients with clinical syndromes or situations at increased risk of cardiac arrhythmias - Patients who experience transient symptoms that may suggest a cardiac arrhythmia The device has not been tested for and it is not intended for pediatric use.

Device Story

Implantable cardiac monitor; records subcutaneous ECG (sECG) and physiological parameters. Automatically detects atrial fibrillation, bradycardia, asystole, sudden rate drop, and high ventricular rate. Patient-activated recording via Remote Assistant III during symptomatic episodes. Data transmitted wirelessly to BIOTRONIK Home Monitoring Service Center for physician review. Used in clinical settings; aids in arrhythmia diagnosis and management. Hardware changes implemented to optimize manufacturing and automation; no changes to fundamental technology or intended use.

Clinical Evidence

No clinical data submitted or relied upon. Bench testing and verification/validation testing performed to support hardware changes.

Technological Characteristics

Subcutaneous insertable cardiac monitor; 47.5 x 8.3 x 4.3 mm (can); 1.9 cc volume; 4.0 g weight. Senses sECG via two integrated electrodes. Wireless connectivity to Home Monitoring Service Center. MR Conditional. Hardware adapted from predicate with minor component changes.

Indications for Use

Indicated for patients at increased risk of cardiac arrhythmias or experiencing transient symptoms suggesting arrhythmia. Not for pediatric use.

Regulatory Classification

Identification

The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce a visible or audible signal or alarm when atrial or ventricular arrhythmia, such as premature contraction or ventricular fibrillation, occurs.

Special Controls

*Classification.* Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Arrhythmia Detector and Alarm” will serve as the special control. See § 870.1 for the availability of this guidance document.

Predicate Devices

• BIOMONITOR III and BIOMONITOR IIIm (K201865)

Submission Summary (Full Text)

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

July 27, 2022

BIOTRONIK, Inc. Jon Brumbaugh Vice President, Regulatory Affairs and New Product Development 6024 Jean Road Lake Oswego, Oregon 97035

## Re: K221856

Trade/Device Name: BIOMONITOR III, BIOMONITOR IIIm Regulation Number: 21 CFR 870.1025 Regulation Name: Arrhythmia Detector And Alarm (Including ST-Segment Measurement And Alarm) Regulatory Class: Class II Product Code: MXD Dated: June 24, 2022 Received: June 27, 2022

# Dear Jon Brumbaugh:

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. 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 located 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.

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

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801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 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 4. Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-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-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

for Hetal Odobasic Assistant Director DHT2A: Division of Cardiac Electrophysiology, Diagnostics and Monitoring Devices OHT2: Office of Cardiovascular Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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## Indications for Use

510(k) Number (if known) K221856

Device Name BIOMONITOR III BIOMONITOR IIIm

Indications for Use (Describe)

The BIOMONITOR III/BIOMONITOR IIIm is indicated to detect the following cardiac arrhythmias:

- atrial fibrillation
- · bradycardia
- · sudden rate drop
- · high ventricular rate (HVR)
- · asystole

The BIOMONITOR III/BIOMONITOR IIIm is indicated for use in:

- · Patients with clinical syndromes or situations at increased risk of cardiac arrhythmias
- · Patients who experience transient symptoms that may suggest a cardiac arrhythmia

The device has not been tested for and it is not intended for pediatric use.

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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Image /page/3/Picture/0 description: The image shows the logo for BIOTRONIK. The logo consists of the letters "BIO" inside of a circle that is divided into quadrants. To the right of the circle is the word "BIOTRONIK" in large, bold, dark blue letters. Below the word "BIOTRONIK" is the phrase "excellence for life" in a smaller, lighter font.

# 510(k) Summary

# BIOMONITOR III and BIOMONITOR IIIm, Implantable Cardiac Monitors

Special 510(k) Premarket Notification

- Submission Information 1.
July 26, 2022 Date prepared

- Contact Jon Brumbaugh VP, Requlatory Affairs and New Product Development BIOTRONIK, Inc. 6024 Jean Road Lake Oswego, OR 97035 Phone [phone] [e-mail]
- BIOTRONIK SE & Co. KG Manufacturer Woermannkehre 1, 12359 Berlin, Germany Registration number 9610139

#### 2. Subject Devices

| Trade Name | BIOMONITOR III and BIOMONITOR IIIm |
|-------------|------------------------------------|
| Common Name | Implantable Cardiac Monitor |

- Classification Name Recorder, Event, Implantable Cardiac (With Arrhythmia Detection)
- Classification Class II (21 CFR 870.1025)
- Product Code MXD

#### 3. Predicate Device

BIOTRONIK BIOMONITOR III and BIOMONITOR IIIm, K201865, cleared December 08, 2020

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Image /page/4/Picture/0 description: The image shows the logo for BIOTRONIK. The logo consists of the letters "BIO" inside of a circle that is divided into four quadrants. To the right of the circle is the word "BIOTRONIK" in large, bold, dark blue letters. Below the word "BIOTRONIK" is the phrase "excellence for life" in smaller, light gray letters.

#### Device Descriptions 4.

BIOMONITOR III and BIOMONITOR IIIm are programmable, subcutaneous insertable cardiac monitors able to record subcutaneous ECGs (sECGs) and other physiological parameters.

The BIOMONITOR III and BIOMONITOR IIIm are designed to automatically record the occurrence of arrhythmias in a patient. Arrhythmia may be classified as atrial fibrillation (AF), bradvarrhythmia, asystole, sudden rate drop, or high ventricular rate. In addition, the BIOMONITOR III and BIOMONITOR IIIm can be activated by the patient using the Remote Assistant III to record cardiac rhythm during symptomatic episodes. BIOMONITOR III and BIOMONITOR IIIm may be used with the current legally marketed BIOTRONIK Home Monitoring® technology, which is an automatic, wireless, remote monitoring system for management of patients with implantable cardiac monitors.

#### 5. Indications for Use

The indications for use for the BIOMONITOR III and BIOMONITOR IIIm are identical to the predicate device.

The BIOMONITOR III/BIOMONITOR IIIm are indicated to detect the following cardiac arrhythmias:

- . atrial fibrillation
- . bradycardia
- . sudden rate drop
- . high ventricular rate (HVR)
- . asystole

The BIOMONITOR III/BIOMONITOR IIIm is indicated for:

- Patients with clinical syndromes or situations at increased risk of cardiac arrhythmias
- Patients who experience transient symptoms that may suggest a cardiac arrhythmia ●

The device has not been tested for and it is not intended for pediatric use.

#### 6. Technological Characteristics

The substantial equivalence claim between the subject and the predicate device is supported by the information included in the premarket notification. This includes the following information :

- Description of the subject and predicate devices .
- . Intended use of the subject and predicate devices
- Performance of the subject and predicate devices
- . Technological characteristics of the subject and predicate devices
- . Validation testing

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Image /page/5/Picture/0 description: The image shows the logo for BIOTRONIK. The logo consists of a circular symbol with the letters "BIO" inside, followed by the word "BIOTRONIK" in bold, dark blue letters. Below the word "BIOTRONIK" is the phrase "excellence for life" in a smaller, lighter font.

| Technical Data | Predicate BIOMONITOR<br>III, BIOMONITOR IIIm | Updated<br>BIOMONITOR III and<br>BIOMONITOR IIIm |
|--------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------|
| FDA Clearance | K201865, Predicate | Subjects of this 510(k) |
| Indications | Patients with clinical syndromes or situations at increased<br>risk of cardiac arrhythmias<br>Patients who experience transient symptoms that may<br>suggest a cardiac arrhythmia<br>The device has not been tested for and it is not intended<br>for pediatric use | |
| Principle of Operation | The BIOMONITOR III/BIOMONITOR IIIm senses<br>subcutaneous electrocardiograms (SECG) using two<br>integrated electrodes and has the capability of detecting a<br>number of arrhythmias. Like the predicate device,<br>BIOMONITOR III/BIOMONITOR IIIm sends recorded SECG<br>and statistics to the Home Monitoring Service Center. | |
| Dimensions (mm)<br>Length x Width x Height | 47.5 x 8.3 x 4.3 (can)<br>77.5 x 8.6 x 4.6 w/ lead | |
| Volume | 1.9 cc | |
| Weight | 4.0 g | |
| AT/AF | 40 s/episode<br>30 s prior auto activation<br>10 s post auto activation | |
| MR Conditional | Yes | |

## Table 1. Comparison of Updated BIOMONITOR III, BIOMONITOR IIIm and Predicate, BIOMONITOR III

Several device hardware changes were implemented with this Special 510(k). These changes are being made to optimize manufacturing and prepare for further automation of the manufacturing process. The effect on determination of substantial equivalence was minimal as there was no associated change to intended use, indications for use, or fundamental technology and no additional questions regarding safety or effectiveness.

#### 7. Non-Clinical Performance Data

The following performance data are provided in support of the substantial equivalence determination :

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Image /page/6/Picture/0 description: The image shows the logo for BIOTRONIK. The logo consists of the letters "BIO" inside of a circle with a plus sign in the middle. To the right of the circle is the word "BIOTRONIK" in large, bold, dark blue letters. Underneath the word "BIOTRONIK" is the phrase "excellence for life" in a smaller, lighter font.

#### 7.1 Validation and Verification Testing:

The BIOMONITOR III and BIOMONITOR IIIm have undergone thorough validation and verification testing to ensure final device functionality. The following categories of tests were performed and passed:

• Verification Testing for BIOMONITOR III and BIOMONITOR IIIm hardware changes

#### 8. Clinical Performance Data

No clinical performance data was submitted or relied upon in support of the substantial equivalence determination.

#### 9. Conclusion

BIOTRONIK concludes that the BIOMONITOR III and BIOMONITOR IIIm with hardware changes are substantially equivalent to BIOTRONIK's predicate BIOMONITOR III and BIOMONITOR IIIm. The subject devices and predicate devices have the same principle of operation and physical device characteristics as well as software features and functionality and there are no new issues of safety or effectiveness. The hardware design is adapted from the predicate with minor component changes. These aspects of equivalence are confirmed by testing provided within the application.