AtriCure Inc. reported that revenue growth and profitability are running ahead of its long-range plan, with 2026 adjusted EBITDA margin guidance set at 14% — a target the company originally slated for 2028 — during a presentation at Wells Fargo’s 21st Annual Healthcare Conference on Wednesday.
CFO Angie Wirick said the company is ahead on both the top line and bottom line relative to the long-range plan established at its 2025 Investor Day, which set targets for 2028 and 2030. The 2030 goals include $1 billion in annual revenue, a 20% adjusted EBITDA margin, and 75% free cash flow conversion.
Wirick described progress on clinical trials as "much better than we expected." The LEAPS trial completed enrollment in mid-2025 after reaching 50% event accrual earlier in the year, targeting approximately 469 stroke events. The BoxX-NoAF trial surpassed the 500-patient mark, with enrollment on track to finish by year-end; data is expected to be presented at the AATS conference in May 2026.
The company also outlined timing for its pipeline: a smaller AtriClip FLEX-Mini 510(k) extension is expected to launch by late 2026, the Mini V-Clip development is targeted for late 2027, and a PFA and RF dual-energy investigational device exemption submission is expected in early 2027, with trial initiation by year-end 2027.
On the revenue side, AtriCure’s pain management franchise grew 33% last year and 29% in the first half of the current year, driven largely by 25% volume growth with minimal pricing contribution. CryoSPHERE MAX has reached roughly 75% penetration in thoracic procedures, while its cryo nerve block technology sits at about 20% penetration. The Mini V-Clip device for amputations holds less than 1% penetration.
In appendage management, the AtriClip FLEX-Mini accounts for 45% of revenue in that segment. The EnCompass open ablation device has been adopted at nearly all U.S. cardiac surgery centers above 700 beds over the past year, out of roughly 1,000 such facilities nationwide. Approximately 65% of atrial fibrillation patients in the U.S. still do not receive ablation treatment, according to the company.
Wirick noted that Medtronic’s prior entry into the AtriClip competitive space did not meaningfully disrupt AtriCure’s position, citing surgeon feedback that the competing device’s performance could not rival the AtriClip. She also highlighted that the EnCompass device alone reduced a procedure that previously took about 45 minutes to roughly 10 minutes, with the addition of PFA potentially recovering another minute or two.
Gross margin has held near 77% for several quarters, though Wirick cautioned it may temporarily dip below that level — remaining above 75% — when a new manufacturing facility comes online in the third quarter. Quarter-end cash exceeded $167 million.
International business accounts for approximately 18% of total revenue. Wirick acknowledged that the hybrid segment of the business is facing more pressure than anticipated.
The Society of Thoracic Surgeons ACSQ has set a quality measure targeting a 70% treatment rate for surgical atrial fibrillation intervention, up from roughly 35% currently among U.S. cardiac surgery patients with Afib. Pre-existing Afib diagnosis represents about 30% of patients entering cardiac surgery; the remaining 70% are the target population for the BoxX-NoAF trial.
