Identification. An external pacemaker pulse generator (EPPG) is a prescription device that has a power supply and electronic circuits that produce a periodic electrical pulse to stimulate the heart. This device, which is used outside the body, is used as a temporary substitute for the heart's intrinsic pacing system until a permanent pacemaker can be implanted, or to control irregular heartbeats in patients following cardiac surgery or a myocardial infarction. The device may have adjustments for impulse strength, duration, R-wave sensitivity, and other pacing variables.

Classification. Class II (special controls). The special controls for this device are:

Appropriate analysis/testing must validate electromagnetic compatibility (EMC) within a hospital environment.

Electrical bench testing must demonstrate device safety during intended use. This must include testing with the specific power source (i.e., battery power, AC mains connections, or both).

Non-clinical performance testing data must demonstrate the performance characteristics of the device. Testing must include the following:

Testing must demonstrate the accuracy of monitoring functions, alarms, measurement features, therapeutic features, and all adjustable or programmable parameters as identified in labeling;

Mechanical bench testing of material strength must demonstrate that the device and connection cables will withstand forces or conditions encountered during use;

Simulated use analysis/testing must demonstrate adequate user interface for adjustable parameters, performance of alarms, display screens, interface with external devices (e.g. data storage, printing), and indicator(s) functionality under intended use conditions; and

Methods and instructions for cleaning the pulse generator and connection cables must be validated.

Appropriate software verification, validation, and hazard analysis must be performed.

Labeling must include the following:

The labeling must clearly state that these devices are intended for use in a hospital environment and under the supervision of a clinician trained in their use;

Connector terminals should be clearly, unambiguously marked on the outside of the EPPG device. The markings should identify positive (+) and negative (−) polarities. Dual chamber devices should clearly identify atrial and ventricular terminals;

The labeling must list all pacing modes available in the device;

Labeling must include a detailed description of any special capabilities (e.g., overdrive pacing or automatic mode switching); and

Appropriate electromagnetic compatibility information must be included.