AtriCure : Investor Presentation Q1 2025 vF

Published: 2025-05-02 12:01:51 ET ATRC

Published on 05/02/2025 at 12:01

Creating a World Class Platform

Investor Presentation

April 2025

Our

Vision

We are passionately focused on healing the lives of those affected by Afib and pain after surgery

Strong Portfolio

Existing products and solutions and continuous innovation driving consistent growth

Large and Growing Markets

Addressing underserved and growing patient populations, representing a $10B opportunity

Global Leader with Local Roots

Leader in our markets, reaching 58 countries, dedicated to our roots in the United States

A Bright Future

Novel therapies supported by growing body of clinical evidence: creating standards of care for a world of unmet needs

Strategic Focus

Innovation

Continuous improvement, increasing pipeline

Clinical Science

Differentiated clinical trials with superior patient outcomes

Expansion

Developing addressable markets and expanding patient impact globally

Profitable Growth

Strong history of revenue growth and acceleration from multiple catalysts with operating leverage

Afib: A Serious Problem

Afib affects more than 59 million people worldwide.

It is estimated that 45% have suffered more than a year from Afib.

Higher Risk of

Stroke

>5x

Higher Risk of Heart Failure

46%

Greater Risk of Mortality

>3x

Higher Risk of Dementia

A Persistent Pain Problem

Pain after surgery slows recovery.

Pain after surgery increases healthcare costs.

Pain after surgery reduces quality of life.

of patients report persistent pain lasting months to years post-surgery

thoracotomy patients develop an opioid addiction

minimally invasive lung surgery patients develop an opioid addiction

AtriCure Patient Profile

Differentiated Focus: Creating Standards of Care

for Patients with Advanced Afib and Managing Post-Operative Pain

Structural Heart Issue

Surgery required (Valve, CABG)

Afib

No Structural Issue

Afib is primary concern

Pain Management

Thoracic Surgery

Intercostal nerve pain

Afib corrected at same time

Medicine is effective

Intervention is better choice

addressed during surgery

Catheter often first line of treatment

Concomitant Open

PAROXYSMAL

(occasional)

PERSISTENT

LONG-STANDING PERSISTENT

Concomitant Cryo Nerve Block

Procedures

(Ablation/LAAM)

Standalone Hybrid Procedures

Complementary to catheter ablation

(Ablation/LAAM)

Procedure

(Ablation)

Evolution of Our Global Market Opportunity

Cardiac Surgery

Open Ablation + LAAM

Concomitant Treatment Pre-Op Afib

Pain Management

Ablation

Thoracic Procedures

Hybrid Therapy

MIS Ablation + LAAM

Standalone Treatment for Long-Standing Persistent Afib

$5B+

Cardiac Surgery

Open Ablation + LAAM

Concomitant Treatment Pre-Op Afib

Current Global Opportunity

Opportunity Will Grow to More Than $10B by 2030!

$10B+

Global Opportunity

Long-Standing Persistent Afib +

Hybrid Therapy

MIS Ablation + LAAM

Standalone Treatment for

Cardiac Surgery

Open Ablation + LAAM

Concomitant Treatment Pre-Op Afib

Pain Management

Ablation

Thoracic Procedures

Leading with innovation, clinical science and awareness to establish and grow our markets

Pain Management

Ablation

Sternotomy Procedures

Pain Management

Ablation

Extremities

Hybrid Therapy - MIS Ablation

PMA study underway for IST

Cardiac Surgery

LAAM

Cardiac Surgery

Ablation

Concomitant Treatment PMA study underway for Non-Afib LAAM

Concomitant Treatment PMA study underway for Non-Afib Ablation

Innovation and Clinical Milestones

2010+

2015+

2020+

Synergy system FDA approved for treatment of Afib concomitant to open heart procedures

AtriClip® devices

CONVERGE Trial begins

EPi-Sense® system acquired

AtriClip PRO-V®

AtriClip Flex-V®

Concomitant Ablation now Class 1A Guideline

cryoSPHERE® probe for Pain Management

EPi-Sense approved by FDA for treatment of long-standing persistent Afib

EnCompass® clamp

LeAAPS Trial studying prophylactic LAA exclusion in non-Afib patients begins

EPi-Sense ST device

Surgical LAA Exclusion now Class 1A Guideline

Reimbursement improves

cryoSPHERE+ and MAX probes

AtriClip FLEX-Mini device

AtriClip PRO-Mini device

cryoXT probe for amputations

BoxX-NoAF Trial studying prophylactic ablation of non-Afib patients begins

Treatment of Afib and LAAM

Advancing Guidelines for Clinical Practice

Treatment of Afib and LAAM

Improving Access through Reimbursement

Hospital Reimbursement

MS-DRG 233, 234

CABG + Surgical Ablation

$8k-$14k for addition of ablation

Physician Reimbursement

CPT 33267, 33268, 33269

Epicardial LAA

First time physician payment / RVU for surgical LAA

Hospital Reimbursement

MS-DRG 212

AVR + MVR + Surgical Ablation

$24k for addition of ablation

Hospital Reimbursement

MS-DRG 317

Epicardial Ablation + Epicardial LAA

$15k - $20k for combination

2021 2022 2023 2024

Cardiac Surgery Ablation + LAAM

Established Market and Advancing Innovation in Patient Care

Approved. Isolator Synergy Ablation System first medical device with FDA approval for treatment of Afib concomitant to open heart procedures

Endorsed. Advanced Ablation Courses endorsed by the Society of Thoracic Surgeons

Recommended. Guidelines state Surgical Ablation is recommended and LAA management is recommended

Key Initiatives and Growth Drivers

Penetrate global market with EnCompass clamp

Drive adoption of AtriClip FLEX-Mini device, launched in the US in 2024

Complete enrollment of 6,500 patients in LeAAPS Trial, studying prophylactic LAA exclusion for prevention of ischemic stroke in cardiac surgery patients without pre-operative AF diagnosis

PFA clamp development

Initiate BoxX-NoAF Trial studying prophylactic ablation for reduction of post-op AF (POAF)

Hybrid Therapy Ablation + LAAM

Growing Market with Unique Solutions for Advanced Afib Patients

Hybrid AF Therapy proven effective in long-standing persistent Afib patients

CONVERGE - DEEP - CEASE-AF

<5% Treated

Key Initiatives and Growth Drivers

>4 Million

People estimated to have longstanding persistent Afib in the US

Drive adoption of Hybrid AF Therapy with EPi-Sense / ST and AtriClip PRO devices, expanding global customer base

Continue investments in clinical studies;

evidence supporting Hybrid AF Therapies

New product development for MIS LAAM devices, PFA platform

Expand awareness for economic value and patient outcomes with Hybrid AF Therapy

Pain Management

Leading Market Development through Ablation Expertise

Key Initiatives and Growth Drivers

>1 day lower length of hospital stay

~$14k savings over 6 months

26% lower opioid

2024 study found Cryo Nerve Block Safe and Cost-Effective addition for pain

management strategies in lobectomy procedures

use between 90-180 days post-surgery

Expand adoption of 2024 new product launches: cryoSPHERE+ probe and cryoSPHERE MAX probe

Reduced freeze times by 25% (cryoSPHERE+) and 50% (cryoSPHERE MAX) compared to first generation technology

Continue investments in registries and studies to support economic benefit of Cryo Nerve Block therapy

Product and market development in new therapy areas

First Quarter 2025 Financial Highlights

Worldwide Revenue* ($M)

$124.3 $123.6

+13.6%

YoY

Key Metrics*

GROSS MARGIN 74.9% 74.7%

Q1 2025 Q1 2024

$108.9

OPERATING EXPENSES $98.6M $92.2M

ADJUSTED EBITDA+ $8.8M $2.8M

ADJUSTED LOSS PER SHARE+ ($0.14) ($0.25)

CASH & INVESTMENTS $100M $106M

Q1 2024 Q4 2024 Q1 2025

Continued Global Adoption of Our Products and Therapies

U.S. revenue of $101.1 million, an increase of 12.1% International revenue of $22.5 million, an increase of 20.8%

* Quarterly financial results are unaudited

+ Reconciliation of Adjusted EBITDA and Adjusted Loss per share to relevant GAAP measures may be found in Q1 2025 earnings release.

Financial Results and 2025 Outlook

$500

$450

$400

Worldwide Revenue

$350

$300

$250

$200

$150

$100

$50

+20%

+21%

+17%

2025 Guidance

Worldwide Revenue

$517 million to $527 million

Adjusted EBITDA

$44 million to $46 million

($ Millions)

2021 2022 2023 2024 2025**

Significant Investment in Growth Catalysts

Modest Cash Flow Generation

Adjusted EBITDA

$60

$45

$30

$15

$(15)

while Expanding Operating Leverage

** 2025 Worldwide Revenue and 2025 Adjusted EBITDA based on midpoint of guidance range.

Distinct Opportunity for Value Creation

As We Execute Our Vision for 2030

Driving profitable growth.

Bright outlook for revenue growth coupled with operating leverage.

Vastly underpenetrated markets.

Ability to grow within existing markets as we cultivate new opportunities.

Robust, organic R&D pipeline.

Broad Innovation and Clinical Science initiatives across platforms.

#1 Leader in each market.

Unrivaled commitment to develop and support our partners and patients.

Thank You!

Key Products

ISOLATOR® SYNERGY ENCOMPASS ® CLAMP

ATRICLIP

FLEX•MiniTM DEVICE

ATRICLIP ® FLEX・V ® DEVICE

cryoSPHERE ®

MAX PROBE

cryoSPHERE ® CRYOABLATION PROBE

ISOLATOR® SYNERGY

CLAMP

EPI-SENSE ®

DEVICE

ATRICLIP

PRO・V® DEVICE

59 million people with Afib Worldwide

Linz, D., Gawalko, M., Betz, K., Hendriks, J. M., Lip, G. Y., Vinter, N., Guo, Y. & Johnsen, S. (2024). Atrial fibrillation: epidemiology, screening and digital health. The Lancet Regional Health-Europe, Volume 37, 100786, February 2024

References and Abbreviations

Page Metric Reference

Key Abbreviations

Afib or AF

Atrial Fibrillation

5 45% with Afib greater than 1 year Percentages reflect percentage of diagnosed AF patience in long-standing persistent disease stage of AF progression

5x higher risk of stroke;

Odutayo, A. et al. (2016). Atrial fibrillation and risks of cardiovascular disease, renal disease, and deaths systematic review and meta analysis. BMJ 2016; 354:i4482

46% greater risk of mortality

Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S (2014) Epidemiology of atrial fibrillation: European perspective. Clin Epidemiol 6 213-220

>5x higher risk of heart failure

Boriani G, Proietti M (2017) Atrial fibrillation prevention: an appraisal of current evidence. Heart (0):1-6

>3x higher risk of dementia

Bunch TJ et al. Arrhythmia & Electrophysiology Review 2019;8(1):8-12

Bayman, E.O., Parekh, K. R. Keech, J., Selte, A., & Brennan, T.J. (2017). A prospective study of chronic pain after thoracic surgery. Anesthesiology: The Journal of the American Society of Anesthesiologists, 126(5), 938-951.

Niraj, G., Kelkar A., Kaushik, V., Tang, Y., Fleet, D., Tait, F., … & Rathinam, S. (2017). Audit of postoperative pain

6 30-50% patients report persistent pain management after open thoracotomy and the incidence of chronic posthoracotomy pain in more than 500 patients at a lasting months after surgery tertiary center. Journal of clinical anesthesia, 36, 174-177.

Maguire, M. F., Latter, J. A. Mahajan, R., Beggs, F.D., & Duffy, J. P. (2006). A study exploring the role of intercostal nerve damage in chronic pain after thoracic surgery. European journal of cardio - thoracic surgery, 29 (6), 873-879.

Boriani G, Proietti M (2017) Atrial fibrillation prevention: an appraisal of current evidence. Heart (0):1-6

AVR Aortic Valve Repair / Replacement

CABG Coronary Artery Bybass Graft

CNB Cryo Nerve Block

CPT Current Procedural Terminology code

EP Electrophysiologist

FDA Food & Drug Administration

IDE Investigational Device Exemption

IST Inappropriate Sinus Tachycardia

LAA Left Atrial Appendage

LAAM LAA Management

MS-DRG Medicare Severity Diagnosis Related Groups

MVR Mitral Valve Repair/Replacement

1 in 7 thoracotomy patients develop opioid addiction

1 in 11 minimally invasive lung surgery patients develop an opioid addiction

The Society of Thoracic Surgeons, Current News Release (1/30/2018): 1 in 7 Lung Surgery Patients at Risk for Opioid Dependence

PFA Pulsed Field Ablation

PMA Pre-Market Approval

RVU Relative Value Unit

POAF Post-Op Afib

Ablation & LAA Treatment Guidelines

The Society of Thoracic Surgeons 2017 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology

>4M people in U.S. estimated to have LSP

Demonstrated economic benefits in lobectomy procedures

Noubiap, J. Tang, J. Teraoka, J. et al. Minimum National Prevalence of Diagnosed Atrial Fibrillation Inferred From California Acute Care Facilities. JACC. 2024 Oct, 84 (16) 1501-1508.

Persistent patient estimate: Berisso et al Epidemiology of atrial fibrillation: European perspective Clin Epidemiol. 2014; 6: 213-220

Miller DL, Hutchins J, Ferguson MA,et al. Intercostal Nerve Cryoablation During Lobectomy for Postsurgical Pain: A Safe and Cost-Effective Intervention. Pain Ther. 2025 Feb;14(1):317-328. doi: 10.1007/s40122-024-00694-3. Epub 2024 Dec

17. PMID: 39688801; PMCID: PMC11751353

Sources Tables

Treatment of Afib and LAAM

Advancing Guidelines for Clinical Practice

Treatment of Afib and LAAM

Improving Access through Reimbursement

Sources:

January, C. T., Wann, L. S., Calkins, H., Chen, L. Y., Cigarroa, J. E., Cleveland Jr, J. C., ... & Yancy, C. W. (2019). 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in collaboration with the Society of Thoracic Surgeons. Circulation, 140(2), e125-e151.

Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., ... & Van Wagoner, D. R. (2024). 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 149(1), e1-e156.

Wyler von Ballmoos, M. C. W., Hui, D. S., Mehaffey, J. H., Malaisrie, S. C., Vardas, P. N., Gillinov, A. M., ... & Badhwar, V. (2024). The Society of Thoracic Surgeons 2023 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation. The Annals of Thoracic Surgery.

Van Gelder, I. C., Rienstra, M., Bunting, K. V., Casado-Arroyo, R., Caso, V., Crijns, H. J., ... & Kotecha, D. (2024). 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) Developed by the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC), with the special contribution of the European Heart Rhythm Association (EHRA) of the

ESC. Endorsed by the European Stroke Organisation (ESO). European Heart Journal, ehae176.

Sources:

In 2021, CMS moved CABG plus ablation cases to MS-DRGs 223/234 from MS-DRGs 235/236.

In 2022, CMS physician payment rates included new surgical LAA codes (CPT 33267, 33268, 33269).

In 2023, CMS created MS-DRG 212 which moves cases with an AVR plus and MVR plus an ablation from MS-DRGs 216-221 to MS-DRG 212.

In 2024, CMS created MS-DRG 317 which moves cases with ablation plus LAAM from MS-DRG 228/229 to MS-DRG 317.

Healthcare providers are solely responsible for the accuracy of codes selected for the services rendered and reported. AtriCure does not assume responsibility for coding decisions, nor recommend codes for specific cases. AtriCure also does not promote off-label use of its devices.

Disclaimer

AtriCure Inc. published this content on May 02, 2025, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on May 02, 2025 at 15:58 UTC.