AtriCure, Inc. develops, manufactures, and sells devices for the surgical ablation of cardiac tissue and systems, and intercostal nerves to medical centers in the United States, Europe, Asia, and internationally. The company offers Isolator Synergy Clamps, a single-use disposable radio frequency products; multifunctional pens and linear ablation devices, such as the MAX Pen device that enables surgeons to evaluate cardiac arrhythmias, perform temporary cardiac pacing, sensing, and stimulation and ablate cardiac tissue with the same device; and the Coolrail device, which enable users to make longer linear lines of ablation. It also provides cryoICE Cryoablation System that enables the user to make linear ablations of varied lengths; EPi-Sense Guided Coagulation System, a single-use disposable device used for the treatment of symptomatic, drug-refractory, and long-standing persistent atrial fibrillation; AtriClip System, an implantable device coupled to a single-use disposable applier; and LARIAT System, a suture-based solution for soft-tissue closure compatible with a range of anatomical shapes. In addition, the company sells Lumitip Dissectors to separate tissues to provide access to key anatomical structures that are targeted for ablation; Glidepath guides for placement of clamps; Subtle Cannula's to support access for EPi-Sense catheters; and various reusable cardiac surgery instruments, which are used during surgical procedures for repair or replacement of certain heart valves. It markets and sells its products through independent distributors and direct sales personnel. The company was incorporated in 2000 and is headquartered in Mason, Ohio.
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- Medtronic for surgical atrial fibrillation devices.
- Boston Scientific for surgical AFib tools.
- Johnson & Johnson for surgical atrial fibrillation and cardiac arrhythmia solutions.
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- AtriClip™ Left Atrial Appendage (LAA) Exclusion System: A portfolio of devices designed to exclude the left atrial appendage, a common source of blood clots in patients with atrial fibrillation.
- Isolator® Synergy™ Ablation System: An FDA-approved surgical device for ablating cardiac tissue to treat persistent atrial fibrillation.
- Epi-Sense® System: A platform for the treatment of cardiac arrhythmias via catheter-based ablation on the epicardial surface of the heart.
- CryoForm® and CryoICE® Cryoablation Probes: Surgical tools that use extreme cold to create lesions in cardiac tissue for arrhythmia treatment.
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AtriCure (ATRC) Major Customers
AtriCure primarily sells its medical devices and technologies to **healthcare institutions** rather than directly to individual patients. Their customer base consists of a broad range of facilities where cardiac procedures are performed.
AtriCure does not typically disclose the names of specific major customer companies (such as individual hospital systems or chains) in its public filings. This is common for medical device companies as their sales are often distributed across a large number of hospitals and surgical centers globally, rather than concentrated with a few large purchasers.
Therefore, while AtriCure sells primarily to other organizations (companies in a broad sense), they do not name specific major corporate customers. Instead, their customers fall into the following categories of healthcare facilities:
* Hospitals: This includes a wide range of hospitals, such as academic medical centers, university hospitals, community hospitals, and private hospitals, where cardiac surgeons and electrophysiologists perform procedures for atrial fibrillation and other heart conditions.
* Surgical Centers: Some freestanding surgical centers that perform cardiac or thoracic procedures may also be customers.
* Integrated Delivery Networks/Healthcare Systems: These are large organizations that own and operate multiple hospitals, clinics, and other healthcare facilities. AtriCure's products would be purchased by and distributed within these larger systems for use across their network.
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Michael H. Carrel, President and Chief Executive Officer
Mr. Carrel has served as President and Chief Executive Officer of AtriCure since November 2012. Prior to joining AtriCure, he was President and Chief Executive Officer of Vital Images, a publicly-traded medical imaging software company, which he led through a sale to Toshiba Medical Systems Corporation. Before Vital Images, Mr. Carrel was President and CEO of Zamba Corp., a publicly-traded technology company, and Chief Financial Officer of NextNet Wireless, Inc., both of which also had successful acquisition exits. He also serves as the Chairman of the Board for Axonics, Inc., a publicly traded medical device company that recently announced an agreement to be acquired by Boston Scientific.
Angela L. Wirick, Chief Financial Officer
Ms. Wirick was appointed Chief Financial Officer of AtriCure in August 2020. She joined the company in July 2014 and previously held the position of Vice President of Finance, where she was responsible for the global accounting and finance functions. Before her tenure at AtriCure, Ms. Wirick spent 12 years in managerial roles at Deloitte & Touche LLP and began her career at Arthur Andersen LLP, working with clients across various industries. She is a Certified Public Accountant.
Douglas J. Seith, Chief Operating Officer
Justin Noznesky, Chief Marketing and Strategy Officer
Karl Dahlquist, Chief Legal Officer
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The primary emerging threats for AtriCure stem from the continuous advancements and increasing adoption of less invasive, transcatheter-based therapies for atrial fibrillation (AFib) and left atrial appendage (LAA) management.
- Advancements in Transcatheter Left Atrial Appendage (LAA) Closure Devices: While AtriCure's AtriClip is a leading device for surgical LAA exclusion, the market for LAA management is increasingly shifting towards less invasive transcatheter solutions such as Boston Scientific's Watchman FLX and Abbott's Amplatzer Amulet. The ongoing development, expanding indications, and growing physician adoption of these transcatheter devices could reduce the demand for surgical LAA exclusion procedures, potentially eroding AtriCure's market share in this segment.
- Emergence of Pulsed Field Ablation (PFA) and Other Advanced Catheter Ablation Technologies: AtriCure offers solutions for surgical and hybrid AFib ablation. However, newer, highly effective, and potentially safer transcatheter ablation technologies like Pulsed Field Ablation (PFA) are rapidly gaining regulatory approvals and market adoption. Major players such as Boston Scientific (Farapulse) and Medtronic (PulseSelect) have recently launched PFA systems. If PFA proves to be significantly superior in terms of safety, efficacy, and procedure time compared to existing RF and cryoablation methods, it could establish a new standard of care for AFib ablation, potentially reducing the need for surgical or hybrid approaches that AtriCure specializes in. This represents a potential paradigm shift in AFib treatment away from more invasive options.
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AtriCure (ATRC) operates in several addressable markets for its main products and services:
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Surgical Atrial Fibrillation (AFib) Procedures: The global addressable market for surgical AFib procedures is estimated to be $1.5 billion, with the U.S. market specifically at $700 million.
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Convergent Hybrid AF Therapy: AtriCure estimates a global addressable market of over $4 billion for its Convergent Hybrid AF Therapy, which targets persistent and long-standing persistent AF patients.
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Left Atrial Appendage (LAA) Management: The global addressable market for Left Atrial Appendage (LAA) management is estimated to be $3 billion.
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Pain Management (Cryo Nerve Ablation Platform): The global addressable market for AtriCure's cryo nerve ablation platform for pain management is $2.5 billion.
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Total Atrial Fibrillation (AFib) Opportunity (including PFA): AtriCure anticipates a total global addressable market opportunity for AF, encompassing advancements like its EPi-Sense PFA System, to be over $20 billion.
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AtriCure (ATRC) is positioned for future revenue growth over the next two to three years, driven by several key factors:
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Continued Success of Recently Launched Products and Product Innovation: AtriCure expects to see sustained revenue growth from the strong adoption and performance of recently launched products, including cryoSPHERE MAX, AtriClip FLEX Mini, and the EnCompass clamp. These devices are contributing significantly to growth in pain management, appendage management, and open ablation segments. Future contributions are also anticipated from new innovations like the cryoXT device for pain management.
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Market Expansion Through Clinical Trials and Broader Indications: The company is actively pursuing market expansion through ongoing clinical trials such as LEAPS and BOX-NOAF. These trials are anticipated to substantially increase the addressable market for AtriCure's technologies, particularly for stroke prevention in non-AFib patients and within cardiac surgery applications. Additionally, new indications for pain management in procedures like sternotomy and extremity amputations are expected to significantly broaden the market for its pain management portfolio.
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Increased Global Market Penetration and Adoption in Underpenetrated Markets: AtriCure plans to capitalize on low existing penetration rates in its target markets. The company notes that less than 20% of the U.S. market and less than 10% of international markets for certain cardiac surgery applications have been penetrated, indicating substantial room for increased adoption of its products. Continued expansion in both new and existing accounts, alongside strong international revenue growth, particularly in Europe and Asia Pacific, is expected to fuel overall revenue.
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Operational Efficiencies and Margin Expansion: While not a direct driver of top-line revenue, AtriCure's focus on improving operational efficiencies and expanding profit margins is crucial for future growth. Analysts anticipate a shift to positive profit margins within the next three years, supported by a disciplined approach to managing SG&A and R&D expenses relative to revenue growth. This improved profitability and financial health will enable the company to further invest in research and development, new product initiatives, and market expansion efforts, indirectly contributing to sustained revenue growth.
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Share Repurchases
No significant share repurchases or authorized future share repurchases were identified during the last 3-5 years.
Share Issuance
- Net proceeds from the issuance of common stock in connection with stock option exercises and the employee stock purchase plan were $10.9 million in 2023.
- Net proceeds from the issuance of common stock were $11.4 million in 2022.
- Net proceeds from the issuance of common stock totaled $14.3 million in 2021.
Outbound Investments
- In 2021, AtriCure completed the acquisition of SentreHEART, Inc. for approximately $297.9 million, net of cash acquired, primarily to expand its left atrial appendage management offerings.
- AtriCure acquired specific assets related to the cryoSPHERE® Surgical Ablation System for $16.0 million in 2020.
Capital Expenditures
- Capital expenditures were approximately $17.3 million in 2023.
- Capital expenditures totaled approximately $12.3 million in 2022.
- Capital expenditures were approximately $10.1 million in 2021.
- The primary focus of capital expenditures includes investments in manufacturing capabilities, research and development facilities, and information technology infrastructure.
