CommandEP Data Manager PC (DPC02), CommandEP HMD (HMD02)
Applicant
Sentiar, Inc.
Product Code
LLZ · Radiology
Decision Date
Jul 14, 2023
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 892.2050
Device Class
Class 2
Indications for Use
CommandEP is intended for use as a medical imaging system that allows the review, analysis, communication, and media interchange of multi-dimensional digital images. It is also intended for intraprocedural use. CommandEP is designed as an additional visualization modality to assist the clinician. CommandEP indicated for use in electrophysiology (EP) procedures to assist the clinician in visualization of the heart electroanatomic data.
Device Story
CommandEP is a medical imaging system for intraprocedural visualization of electroanatomic mapping system (EAMS) data. Input: multi-dimensional digital images from EAMS via wired network. Processing: Data Manager PC (DPC02) receives EAMS data and transmits it via encrypted Wi-Fi to Head Mounted Displays (HMD02). Output: stereoscopic 3D visualization of cardiac electroanatomic data. Used in cardiac EP labs by electrophysiologists. Clinicians view data via optical see-through (OST) HMDs, allowing simultaneous view of conventional EAMS displays and CommandEP visualization. Hands-free gaze-dwell controls enable manipulation without breaking sterility. Shared view function allows observers to view data on HMDs or a spectator PC display. Device does not deliver therapy, intervene with therapy, or assist in therapeutic decisions; serves as an adjunct visualization modality to improve clinician situational awareness.
Clinical Evidence
No clinical testing was required. Substantial equivalence was established through non-clinical performance testing, including biocompatibility, electromagnetic compatibility, wireless capability, electrical/mechanical/thermal safety, and design validation. Compliance with ISO 10993-1, ANSI AAMI ES60601-1, IEC 60601-1-2, IEC 62304, and IEC 63145 series standards was verified.
Technological Characteristics
System comprises Data Manager PC (DPC02) and HMDs (HMD02). Connectivity: wired EAMS input, encrypted Wi-Fi HMD transmission. Display: stereoscopic 3D optical see-through (OST). Controls: hands-free gaze-dwell. Non-patient contacting, non-sterile. Standards: ISO 10993-1 (biocompatibility), ANSI AAMI ES60601-1 (electrical safety), IEC 60601-1-2 (EMC), IEC 62304 (software lifecycle), IEC 63145-20-10/20 (eyewear display optical/image quality).
Indications for Use
Indicated for use in electrophysiology (EP) procedures to assist the clinician in visualization of heart electroanatomic data.
Regulatory Classification
Identification
A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.
Special Controls
*Classification.* Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).
CARTO 3 EP Navigation System Version 7.2 (K213264)
Submission Summary (Full Text)
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July 14, 2023
SentiAR, Inc. Alexander Schreiner Vice President, Quality and Regulatory Affairs 212 N Kingshighway Blvd., Suite 115 Mailbox 28 St. Louis, Missouri 63108
Re: K223290
Trade/Device Name: CommandEP Data Manager PC (DPC02), CommandEP HMD (HMD02) Regulation Number: 21 CFR 892.2050 Regulation Name: Medical Image Management And Processing System Regulatory Class: Class II Product Code: LLZ Dated: June 13, 2023 Received: June 13, 2023
Dear Alexander Schreiner:
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
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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 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 medical devices and radiation-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 (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
# Aneesh S. Deoras -S
Aneesh Deoras Assistant Director Division of Cardiac Electrophysiology, Diagnostics and Monitoring Devices 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) K223290
Device Name CommandEP Data Manager PC (DPC02); CommandEP HMD (HMD02)
### Indications for Use (Describe)
CommandEP is intended for use as a medical imaging system that allows the review, analysis, communication, and media interchange of multi-dimensional digital images. It is also intended for intraprocedural use. CommandEP is designed as an additional visualization modality to assist the clinician. CommandEP indicated for use in electrophysiology (EP) procedures to assist the clinician in visualization of the heart electroanatomic data.
| 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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Image /page/3/Picture/0 description: The image shows the logo for "sentiar". The logo consists of a stylized "S" shape on the left, colored with a gradient from blue to green. To the right of the "S" is the word "sentiar" in a dark blue sans-serif font, with a small dark blue circle above the "i".
# 510(K) SUMMARY
#### CONTACT DETAILS 1
| Date Prepared | July 9, 2023 |
|-----------------------------|---------------------------------------------------------------------------------------|
| Applicant Name | SentiAR, Inc. |
| Applicant Address | 212 N Kingshighway Blvd., Suite 115 Mailbox 28<br>St. Louis MO 63108<br>United States |
| Applicant Contact Telephone | (314) 499-0552 |
| Applicant Contact | Alex Schreiner, Vice President of Quality and Regulatory Affairs |
#### 2 DEVICE NAME
| Device Trade Name | CommandEP<br>• Data Manager PC (DPC02)<br>• HMD (HMD02) |
|---------------------|---------------------------------------------------------|
| Common Name | Medical image management and processing system |
| Classification Name | System, Image Processing, Radiological |
| Regulation Number | 892.2050 |
| Product Code | LLZ |
#### 3 LEGALLY MARKETED PREDICATE DEVICE
| Predicate # | Predicate Trade Name | Product Code |
|-------------|----------------------|--------------|
| K192890 | SentEP | LLZ |
#### 4 DEVICE DESCRIPTION SUMMARY
The SentiAR CommandEP device is a medical imaging system which allows for the review, analysis, communication, and media interchange of multi-dimensional digital images. CommandEP HMD provides a real-time, three-dimensional (3D) visualization of electroanatomic mapping system (EAMS) data (the Mixed Reality (MXR) EAMS Visualization). CommandEP is intended to be used as an adjunct device to assist the clinician in visualization of the cardiac electroanatomic data during cardiac electrophysiology procedures.
Real-time multi-dimensional images are received from an Electroanatomic Mapping System (EAMS) by the touchscreen, all-in-one computer (the Model DPC02 Data Manager PC) and wirelessly transmitted to up to five (5) Head Mounted Displays (the Model HMD02 CommandEP HMD). Additional HMDs may be allocated to facilitate charging and device management. The EAMS is directly connected to the CommandEP by a wired network cable. The CommandEP Data Manager PC communicates with the CommandEP HMDs through a dedicated, encrypted Wi-Fi network provided by the Data Manager PC.
Clinician users view the MXR EAMS Visualization in stereoscopic 3D using optical see-through (OST) HMDs and manipulate the MXR EAMS Visualization using hands-free gaze-dwell controls. The OST display enables clinicians to view both the conventional EAMS display and the CommandEP MXR EAMS Visualization during the procedure. The hands-free controls enable clinicians to control the device without breaking sterility and may also reduce the need to verbalize commands to a non-sterile EAMS technician.
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Image /page/4/Picture/1 description: The image shows the logo for Sentiar. The logo consists of a stylized "S" shape in shades of blue and green, followed by the word "sentiar" in a dark blue sans-serif font, with the "a" in a lighter blue gradient. The logo has a clean and modern design.
CommandEP allows a clinician user to modify the personal view of data, but does not deliver therapy, intervene with therapy, assist the clinician with therapeutic decisions, or otherwise affect the performance of any other medical device.
CommandEP also provides a shared view function which allows observers or supporting staff to view the cardiac electroanatomic data, with the notated perspective of a selected HMD user, on an either 1) an HMD or 2) a conventional PC display provided by the Data Manager PC (the Spectator Display) to facilitate team communication.
The intended physician user of the CommandEP device is an electrophysiologist. The electrophysiologist performs procedures in a cardiac electrophysiology laboratory, which is a sterile professional healthcare environment. All components of the CommandEP device are non-patient contacting device and are provided non-sterile.
#### 5 INTENDED USE/INDICATIONS FOR USE
CommandEP is intended for use as a medical imaging system that allows the review, analysis, communication, and media interchange of multi-dimensional digital images. It is also intended for intraprocedural use. CommandEP is designed as an additional visualization modality to assist the clinician. CommandEP indicated for use in electrophysiology (EP) procedures to assist the clinician in visualization of the heart electroanatomic data.
#### 6 INDICATIONS FOR USE COMPARISON
The CommandEP indications for use are identical to those of the predicate device.
#### TECHNOLOGICAL COMPARISON 7
CommandEP has identical intended use and indications for use, principles of operation as the legally marketed predicate device.
- Both devices are intended as medical imaging systems that allow the review, analysis, . communication, and media interchange of multi-dimensional digital images.
- . Both devices facilitate viewing 3D digital images on a head mounted display.
- Both devices are intended for intraprocedural use by healthcare professionals.
- . Both devices are provided non-sterile and are not intended to be sterilized.
- . Both devices are biocompatible for their intended use.
Differences between CommandEP and the predicate device have been evaluated for impact to safety and performance. Primary differences between CommandEP and the predicate device are identified below.
- . CommandEP incorporates compatibility with a different EAMS application programming interface (API), the CARTO® 3 EP Navigation System Version 7.2 (K213264), which uses a different multidimensional image data format. The CommandEP system intended use is identical to the predicate device; there are no different questions of safety and effectiveness.
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Image /page/5/Picture/1 description: The image shows the logo for Sentiar. The logo consists of a stylized letter "S" in blue and green gradient, followed by the word "sentiar" in dark blue. The "i" in "sentiar" is dotted with a circle.
- CommandEP incorporates a different commercially available computing platform for the HMD. The CommandEP system safety and performance requirements are equivalent to the predicate device; there are no different questions of safety and effectiveness.
- . CommandEP integrates an access point in place of a separate physical access point component. The CommandEP system safety and performance requirements are equivalent to the predicate device: there are no different questions of safety and effectiveness.
Other changes which are implemented via documentation include:
- . Modification of HMD shared view interface
- . Modification of HMD orientation indicator
- . Modification of error dialogs
Although CommandEP and the predicate device technological characteristics differ in image data format and HMD computing platform, performance testing has demonstrated that CommandEP is as safe and effective as the predicate and that the differences do not raise any different questions concerning safety and effectiveness. The implemented design controls, risk management activities, labeling, and performed verification and validation tests demonstrate the safety and performance of CommandEP. Based on the comparison information provided above, it is concluded that CommandEP is substantially equivalent to the predicate device.
#### NON-CLINICAL AND/OR CLINICAL TESTS SUMMARY & CONCLUSIONS 8
Verification and validation testing data summarized below were provided in support of the substantial equivalence determination. The test methods and acceptance criteria were equivalent to the predicate device in support of the intended use.
Non-clinical performance testing included an evaluation of performance; biocompatibility; electromagnetic compatibility; wireless capability; electrical, mechanical, and thermal safety; and design validation testing.
The safety and performance of CommandEP have been evaluated and verified according to the specified standards below. Verification and validation testing have demonstrated compliance to the software specifications and performance and safety standards:
- . ISO 10993-1 Fifth edition 2018-08 Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process [Recognition #2-258]
- . ANSI AAMI ES60601-1:2005/(R)2012 & A1:2012 C1:2009/(R)2012 & A2:2010/(R)2012 (Cons. Text) [Incl. AMD2:2021] Medical electrical equipment - Part 1: General requirements for basic safety and essential performance (IEC 60601-1:2005 MOD) [Including Amendment 2 (2021)] [Recognition #19-46]
- IEC 60601-1-2 Edition 4.1 2020-09 CONSOLIDATED VERSION Medical electrical equipment -. Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests [Recognition #19-39]
- IEC 62304 Edition 1.1 2015-06 CONSOLIDATED VERSION Medical device software Software ● life cycle processes [Recognition #13-79]
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Image /page/6/Picture/1 description: The image shows the logo for "sentiar". The logo consists of a stylized "S" shape on the left, followed by the word "sentiar" in a sans-serif font. The "S" shape is colored with a gradient from blue to green, while the word "sentiar" is colored with a gradient from dark blue to light blue. The logo has a modern and clean design.
- IEC 63145-20-10 Edition 1.0 2019-08 Eyewear display -- Part 20-10: Fundamental measurement methods -- Optical properties [Recognition #8-580]
- . IEC 63145-20-20 Edition 1.0 2019-09 Eyewear display -- Part 20-20: Fundamental measurement methods -- Image quality [Recognition #8-581]
No clinical testing was required to develop evidence of substantial equivalence to the predicate device.
Non-clinical performance testing demonstrated that CommandEP is as safe and effective as the legally marketed predicate and reference devices. Based on evidence submitted in this premarket notification, including similarities in the indications for use, technological characteristics, and performance between CommandEP and the predicate and reference devices, CommandEP raises no new questions of safety or effectiveness and is substantially equivalent to the predicate device.
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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.
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You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
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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.
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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.
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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.
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Reading rule for every project: how many summaries do you read in full?
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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.
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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.
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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.