IRhythm : First Quarter 2026 Results

Published: 2026-04-30 20:09:01 ET IRTC

Published on 04/30/2026 at 08:09 pm EDT

iRhythm Holdings

First Quarter 2026 Results

April 30, 2026

Addressing major challenges and opportunities in healthcare

IRHYTHM'S IMPACT

ADDRESSING UNMET NEED

MARKET CATALYSTS

GROWING ACCESS GAP

20 years advancing cardiac diagnostics and innovating to detect, predict, & prevent disease.

*See appendix for sources

Heart rhythm problems are among the most prevalent conditions in the Medicare population aged 65 and over.*

Aging population, consumer arrhythmia awareness, proliferation of therapies like pulsed field ablation, recognition of post-ablation monitoring, trends toward proactive medicine, and a growing shift to value-based care driving TAM growth.

46.3% of all U.S. counties -

and 86.2% of rural counties

- lack cardiologists and non-urgent cardiology wait times average 26.6 days & rising.*

$199.4 million

First quarter 2026 revenue,

a 25.7% increase year-over-year

2.6 million

Patient reports posted annually

27+ million

Potential patients in the United States who could benefit from ambulatory cardiac monitoring*

3.2 million tests

Target market opportunity across prioritized EU and APAC countries*

~40%

Penetration in core

U.S. ambulatory cardiac monitoring market as of

March 31, 2026

12+ million

Patient reports posted since company inception through March 31, 2026

140+

Original scientific research manuscripts

3+ billion

Hours of curated ECG data since company

inception through March 31,

2026

Data on file. iRhythm Holdings, Inc., April 2026. *See appendix for sources

ACM market is evolving with runway for durable growth

MARKET LEADERSHIP IN LTCM: 72% market share in LTCM (of 3.5 million tests in US today growing high teens % YOY) with ~ 27 million undiagnosed US patients at elevated risk

SHORT DURATION MONITORS YET TO CONVERT: 1.9 million

legacy technology tests still performed in US today, a ~$500 million

revenue opportunity

MARKET SHARE OPPORTUNIT Y IN MCT: 15% market share in

MCT (of 1.1 million MCT tests in US today growing high single digit % YOY), with each 10 points of share = ~$80 - $100 million

INTERNATIONAL MARKET EXPANSION: 3.2 million ACM tests in

active OUS markets

TREMENDOUS MARKET EXPANSION POTENTIAL AHEAD

~10 million

tests

~30 million

tests

2025 Market potential

Increasing TAM fueled by aging population, adjacent therapies and clinical evidence driving value-based care adoption

ACM = ambulatory cardiac monitoring; LTCM = long-term continuous monitoring; MCT = mobile cardiac telemetry. Estimates based off combination of Internal Data, Medicare Public-Use Files, IQVIA data, Definitive Healthcare data, Komodo Health data, and other publicly-available information.

Primary care adoption key to accessing expansive TAM

IRHYTHM UNIQUELY POSITIONED

TO WIN IN PRIMARY CARE

TOTAL MARKET CLAIMS BY MODALITY & SPECIALTY

APPROACHING PRIMARY CARE VIA

TWO-PRONGED STRATEGY

Market leader in LTCM, the preferred modality

Rule-in/rule-out tool to streamline clinician workflows

Home enrollment capabilities

Scale and efficiency

EHR integration

Land-and-expand within integrated delivery networks

Integration at large national accounts

MCT

EVENT

LTCM (PCP)

LTCM

(CARDIOLOGY)

SHORT-TERM

HOLTERS

2019 2020 2021 2022 2023 2024 2025E

TAM = total addressable market; ACM = Ambulatory cardiac monitoring; LTCM = Long-term continuous monitoring; MCT = Mobile cardiac telemetry; EHR = Electronic health records. Estimates based off combination of Internal Data, Medicare Public-Use Files, IQVIA data, Definitive Healthcare data, Komodo Health data, and other publicly-available information.

Next-gen MCT designed to extend our category leadership

Zio AT®

Zio MCT**

(Not yet FDA cleared, 510(k) submitted 3Q25)

Device form factor

Legacy patch technology

Improved form factor

Same platform as Zio monitor

Better adhesion and battery

Wear duration

Up to 14 days

Up to 21 days

Data transmission

Auto-detects and transmits symptomatic and

asymptomatic events during wear period

Increased maximum transmission limit and

enhanced auto-detection algorithm

Algorithms and reporting

Interim reports available plus final end-of-wear report

Enhanced arrhythmia detection and better reporting

Advanced software for enhanced detection parameters

Improved final wear report with additional

insights

*Continuous, uninterrupted refers to the recording of ECG data. Zio AT Gateway transmissions may be impacted by a variety of factors. See Product Labeling for more information. †Zio AT is contraindicated for critical care patients. ‡Do not use Zio AT for patients with symptomatic episodes where variations in cardiac performance could result in immediate danger to the patient or when real-time or in-patient monitoring should be prescribed. Refer to the Zio AT labeling and Clinical Reference Manual for full contraindications. **Zio MCT not yet FDA cleared.

Significant runway in international expansion

UNITED KINGDOM

Early commercialization

700,000

Ambulatory cardiac monitoring

tests annually

PRIORITIZED EU COUNTRIES

Switzerland, Spain, Austria, and the Netherlands

Early commercialization

900,000

Ambulatory cardiac monitoring

tests annually in target countries

JAPAN

Early commercialization

1,600,000

Ambulatory cardiac monitoring

tests annually

GOALS

Secure ongoing secondary care contracts and health system-level contract

Expanding into primary care

GOALS

Embed Zio in clinical practice

Continue improving service delivery

GOALS

Generate local evidence via head-to-head study against Japanese device

Increase physician awareness

See appendix for sources

1Q26 milestones reflective of execution and momentum

ACCELERATING MOMENTUM IN COMMERCIAL BUSINESS

$199.4 million revenue for 1Q26, reflective of continued commercial adoption and market expansion

12+ million patient reports worldwide generated to date

Opening new channel partnerships to address 27M patient opportunity

Commercialized in six OUS markets

PROVIDING A

WINNING CUSTOMER

EXPERIENCE

53% registration volumes from EHR-integrated accounts

Over three quarters of our top 100 customers now EHR-integrated

BRINGING INNOVATIVE

PRODUCTS TO

MARKET

Strong progress supports 1H27 Zio® MCT launch timeline

Advancing next generation AI algorithm toward regulatory clearance

First health system deployment of predictive identification workflows

GENERATING

PEER- REVIEWED

CLINICAL

EVIDENCE

ACC and HRS data showing superiority of Zio® LTCM

Over 140 original scientific research manuscripts published to date, demonstrating leadership in ACM clinical evidence generation

EXPANDING MARKET

ACCESS

Major policy shifts to provide favorable position for Zio®

Zio® covered by incremental payer policies

EXECUTING WITH

DISCIPLINE &

EFFICIENCY

7.1% adj. EBITDA

margin, demonstrating ability to deliver sustained margin expansion

Implemented additional operational efficiencies for sustained profitable growth

First quarter 2026 financial performance

GLOBAL NET REVENUE

(USD, MILLIONS)

GROSS PROFIT MARGIN

$208.9

$186.7

$192.9

$199.4

$158.7

1Q2025

2Q2025

3Q2025

4Q2025

1Q2026

71.2%

71.1%

70.9%

68.8%

1Q2025

2Q2025

3Q2025

4Q2025

1Q2026

ADJUSTED OPERATING EXPENSES*

(USD, MILLIONS)

ADJUSTED EBITDA MARGIN*

R&D SG&A

$140.4 *

$145.2 *

$141.4 *

$140.0 *

$153.5 *

1Q2025

2Q2025

3Q2025

4Q2025

1Q2026

16.4%*

8.4%*

11.2%*

7.1%*

-1.7%*

1Q2025

2Q2025

3Q2025

4Q2025

1Q2026

*Adjusted operating expenses and adjusted EBITDA margin for 1Q25, 2Q25, 3Q25, 4Q25, and 1Q26 include $0.3 million, $1.7 million, $0.3 million, $0.7 million, and $0.3 million respectively, of acquired in-process research and development expense. Adjusted operating expenses exclude impacts from business transformation, certain intellectual property litigation expenses, and impairment and restructuring charges. Adjusted EBITDA excludes non-cash operating charges for stock-based compensation expense, changes in fair value of strategic investments, impairment and restructuring charges, business transformation costs, certain intellectual property litigation expenses, and loss on extinguishment of debt. Business transformation costs include costs associated with professional services, employee termination and relocation, third-party merger and acquisition, integration, and other costs to augment and restructure the organization, inclusive of both outsourced and offshore resources.

PRIOR GUIDANCE

2026 annual revenue and profitability guidance

Net revenue

$870 - $880 million

Adjusted EBITDA margin

11.5 - 12.5% of revenue*

Net revenue

$875 - $885 million

Adjusted EBITDA

margin

12 - 13% of revenue*

UPDATED GUIDANCE

*Adjusted EBITDA excludes non-cash operating charges for stock-based compensation expense, changes in fair value of strategic investments, impairment and restructuring charges, business transformation costs, certain intellectual property litigation expenses, and loss on extinguishment of

debt. Business transformation costs include costs associated with professional services, employee termination and relocation, third-party merger and acquisition, integration, and other costs to augment and restructure the organization, inclusive of both outsourced and offshore resources.

2026 outlook balances growth across near-term opportunities

GLOBAL NET REVENUE (USD, MILLIONS)

$875 -

$885

U.S. CORE COMMERCIAL BUSINESS

Further expansion into PCP channel

New technologies (e.g., PFA) expand monitoring

MCT market expansion with continued innovation

$410.9

$492.7 $591.8

$747.1

INTERNATIONAL EXPANSION

Continued penetration in the UK and national reimbursement

2022 2023 2024 2025 2026G

ADJUSTED EBITDA MARGIN*

Entry into Japan, the second largest global ACM market

Commercial ramp in select European countries

9.2%*

12.0% -

13.0%*

ADJACENT MARKET OPPORTUNITIES

-2.7%

-1.0%

-1.3%*

Movement into proactive monitoring programs

Initial commercial pilots into obstructive sleep apnea

2022 2023 2024 2025 2026G

*Adjusted EBITDA margin for the years ended December 31, 2024, 2025 and 2026 include acquired in-process research and development expense. Adjusted EBITDA excludes non-cash operating charges for stock-based compensation expense, changes in fair value of strategic investments, impairment and restructuring charges, business transformation costs, certain intellectual property litigation expenses and settlements, and loss on extinguishment of debt. Business transformation costs include costs associated with professional services, employee termination and relocation, third-party merger and acquisition, integration, and other costs to augment and restructure the organization, inclusive of both outsourced and offshore resources.

Addressing the future focus of healthcare

Driving meaningful improvements in financial profile

Growing revenue through global market expansion

Expanding core & unlocking adjacent markets

Reconciliation of net income (loss) to adjusted EBITDA

Adjusted EBITDA is a non-GAAP financial measure and is presented for supplemental informational purposes only and should not be considered as an alternative or substitute to financial information presented in accordance with GAAP. Adjusted EBITDA excludes non-cash operating charges for stock-based compensation expense, changes in fair value of strategic investments, impairment and restructuring charges, business transformation costs, certain intellectual property litigation expenses and settlements, and loss on extinguishment of debt. Business transformation costs include costs associated with professional services, employee termination and relocation, third-party merger and acquisition, integration, and other costs to augment and restructure the organization, inclusive of both outsourced and offshore resources.

(USD, THOUSANDS)

THREE MONTHS ENDED MARCH 31,

ADJUSTED EBITDA RECONCILIATION*

2026

2025

Net loss, as reported1

$ (13,933)

$ (30,700)

Interest expense

3,290

3,273

Interest income

(4,879)

(4,919)

Changes in fair value of strategic investments

(1,447)

(843)

Income tax provision

500

665

Depreciation and amortization

5,042

5,210

Stock-based compensation

21,491

23,344

Business transformation costs

346

503

Intellectual property litigation costs2

3,689

832

Adjusted EBITDA

$ 14,099

$ (2,635)

*Certain numbers expressed may not sum due to rounding. 1 Net loss for the three months ended March 31, 2026 and 2025, includes $0.3 million of acquired in-process research and development expense. 2 Excludes third-party attorneys' fees and expenses associated with patent litigation brought against the Company by Welch Allyn, Inc. and Bardy Diagnostics, Inc., subsidiaries of Baxter International, Inc.

Reconciliation of GAAP to non-GAAP financial information

Adjusted EBITDA, adjusted net income (loss), adjusted net income (loss) per share, adjusted operating expenses, and free cash flow are non-GAAP financial measures and are presented for supplemental informational purposes only and should not be considered as an alternative or substitute to financial information presented in accordance with GAAP. Adjusted EBITDA excludes non-cash operating charges for stock-based compensation expense, changes in fair value of strategic investments, impairment and restructuring charges, business transformation costs, certain intellectual property litigation expenses and settlements, and loss on extinguishment of debt. Business transformation costs include costs associated with professional services, employee termination and relocation, third-party merger and acquisition, integration, and other costs to augment and restructure the organization, inclusive of both outsourced and offshore resources.

THREE MONTHS ENDED

(USD, THOUSANDS)

MARCH 31,

DECEMBER 31,

SEPTEMBER 30,

JUNE 30,

MARCH 31,

ADJUSTED EBITDA RECONCILIATION*

2026

2025

Net income (loss)1

$ (13,933)

$ 5,579

$ (5,212)

$ (14,218)

$ (30,700)

Interest expense

3,290

3,322

3,281

3,278

3,273

Interest income

(4,879)

(5,337)

(5,944)

(5,321)

(4,919)

Changes in fair value of strategic investments

(1,447)

(1,822)

(894)

(2,152)

(843)

Income tax (benefit) provision

500

447

(183)

665

Depreciation and amortization

5,042

5,254

5,173

5,105

5,210

Stock-based compensation

21,491

21,106

21,006

22,827

23,344

Impairment charges

1,979

2,479

Business transformation costs

346

692

913

925

503

Intellectual property litigation costs2

3,689

3,070

3,212

2,956

832

Adjusted EBITDA

$ 14,099

$ 34,290

$ 21,559

$ 15,696

$ (2,635)

Revenue

$ 199,390

$ 208,890

$ 192,884

$ 186,687

$ 158,677

Adjusted EBITDA margin

7.1%

16.4%

11.2%

8.4%

-1.7%

*Certain numbers expressed may not sum due to rounding. 1 Net income (loss) for 1Q25, 2Q25, 3Q25, 4Q25 and 1Q26 include $0.3 million, $1.7 million, $0.3 million, $0.7 million and $0.3 million, respectively, of acquired in-process research and development expense. 2 Excludes third-party attorneys' fees and expenses associated with patent litigation brought against the Company by Welch Allyn, Inc. and Bardy Diagnostics, Inc., subsidiaries of Baxter International, Inc.

Reconciliation of GAAP to non-GAAP financial information

(USD, THOUSANDS)

ADJUSTED NET LOSS RECONCILIATION*

2026

THREE MONTHS ENDED MARCH 31,

2025

Net loss, as reported1

$ (13,933)

$ (30,700)

Business transformation costs

346

503

Intellectual property litigation costs2

3,689

832

Changes in fair value of strategic investments

(1,447)

(843)

Tax effect of adjustments3

(91)

Adjusted net loss

$ (11,345)

$ (30,299)

THREE MONTHS ENDED MARCH 31,

ADJUSTED NET LOSS PER SHARE RECONCILIATION*

2026

2025

Net loss per share, as reported1

$ (0.43)

$ (0.97)

Business transformation costs per share

0.01

0.02

Intellectual property litigation costs per share2

0.11

0.03

Changes in fair value of strategic investments per share

(0.04)

(0.03)

Tax effect of adjustments per share3

Adjusted net loss per share

$ (0.35)

$ (0.95)

Weighted-average shares, basic and diluted

32,507

31,590

Reconciliation of GAAP to non-GAAP financial information

(USD, THOUSANDS)

ADJUSTED OPERATING EXPENSES RECONCILIATION*

2026

THREE MONTHS ENDED MARCH 31,

2025

Operating expenses, as reported

$ 157,538

$ 141,772

Business transformation costs

(346)

(503)

Intellectual property litigation costs1

(3,689)

(832)

Adjusted operating expenses

$ 153,503

$ 140,437

FREE CASH FLOW RECONCILIATION*

2026

THREE MONTHS ENDED MARCH 31,

2025

Net cash used in operating activities

$ (26,173)

$ (7,891)

Purchases of property and equipment

(6,905)

(9,419)

Free cash flow

$ (33,078)

(17,310)

*Certain numbers expressed may not sum due to rounding.

1 Excludes third-party attorneys' fees and expenses associated with patent litigation brought against the Company by Welch Allyn, Inc. and Bardy Diagnostics, Inc., subsidiaries of Baxter International, Inc.

‌SLIDE(S)

SOURCES

'Addressing major challenges and opportunities in healthcare'

Ward et al. Prevalence and health care expenditures among Medicare beneficiaries aged 65 years and over with heart conditions. Medicare Current Beneficiary Survey, 2017. (Prevalence of self-reported heart conditions.) American College of Cardiology. (2024, July 8).

Almost Half of US Counties Have No Cardiologists Despite Higher Prevalence of CV Risk Factors, Mortality [Press Release]. https://www.acc.org/About-ACC/Press-Releases/2024/07/08/18/25/Almost-Half-of-US-Counties-Have-No-Cardiologists-Despite-Higher-Prevalence-of-CV-Risk-Factors-Mortality. Pallikadavath SP, et. al.

High number of unnecessary referrals to cardiology clinics for benign palpitations due to poor adherence to local referral guidelines. European Journal of

Arrhythmia & Electrophysiology. 2024;10(1):1-2

iRhythm overview and 'Significant runway in international expansion'

UK: iRhythm estimate.

UK Office for National Statistics; Hospital Episode Statistics, NHS Digital, 2019-2020

UK Healthcare Market Review 33ed, LaingBuisson, 2021. Accessed 5 January 2022.

The UK private health market, Kings Fund, 2014. Accessed 5 January 2022.

NHS England and the Health and Social Care Information Centre, NHS Hospital Data and Datasets: A Consultation. Published July 22, 2013.

The Health and Social Care Information Centre, Hospital Episode Statistics (HES): Improving the quality and value of hospital data. Published 2011.

Prioritized EU countries: iRhythm estimate.

Ohlrogge etc. Burden of Atrial Fibrillation and Flutter by National Income: Results From the Global Burden of Disease 2019 Database. J Am Heart Assoc. 2023;12:e030438; supplemental data tables https://www.ahajournals.org/doi/suppl/10.1161/JAHA.123.030438.

Global population and healthcare spend per capita, World Bank, 2019 and 2020. https://data.worldbank.org

The Burden of Cardiovascular Disease and Diabetes, OECD, 2011.

Federal Statistical Office of Germany and Gesundheitsberichterstattung; Dutch Healthcare Authority; Swedish ICD & Pacemaker Registry and Swedish Society for Clinical Physiology.

Japan:

Irie, Shoichi and Hiroshi Tada. The Relationship between Holter Electrocardiography and Atrial Fibrillation Diagnosis Using Real-World Data in Japan: A Claims-Based Retrospective Study. Int Heart J, 2023; 64: 178-187.

Japan Ministry of Health Labor and Welfare.

Disclaimer

iRhythm Technologies Inc. published this content on April 30, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on April 30, 2026 at 23:49 UTC.