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AtriCure NASDAQ: ATRC reported double-digit revenue growth and a return to GAAP profitability in the second quarter of 2026, with management pointing to strong demand across its pain management, appendage management and open ablation franchises while noting continued pressure in minimally invasive ablation.
The medical device company generated worldwide revenue of $153.6 million, up 12.8% on a reported basis and 12.4% in constant currency from the second quarter of 2025, according to Chief Financial Officer Angela Wirick. U.S. revenue rose 13.6% to $125.6 million, while international revenue increased 9.6% on a reported basis to $28 million.
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President and CEO Michael Carrel said the quarter reflected “solid” performance and highlighted improving profitability. AtriCure recorded adjusted EBITDA of $27.3 million, up 78% from $15.4 million a year earlier. Net income was $9 million, compared with a net loss of $6.2 million in the prior-year quarter. Earnings per share and adjusted earnings per share were both $0.18, compared with a loss per share of $0.13 and an adjusted loss per share of $0.02 a year earlier.
Growth Led by Pain Management, Appendage Management and Open Ablation AtriCure’s U.S. business was supported by continued adoption of several newer devices, including CryoSphere MAX and cryoXT in pain management, AtriClip FLEX-Mini and PRO-Mini in appendage management, and the Encompass clamp in open ablation.
Pain management was the company’s fastest-growing franchise, with worldwide revenue up 27% in the quarter. U.S. pain management sales reached $27.1 million, up 27.8% year over year. Carrel said CryoSphere MAX remained a key driver, with the company continuing to add accounts while also seeing early traction in sternotomy procedures. During the question-and-answer portion of the call, Wirick said CryoSphere MAX represented about 75% of U.S. pain management revenue and that the company ended the quarter with “a little over 700 active accounts” in pain management.
Carrel also pointed to early momentum for CryoXT, which is designed for use in amputation procedures. He said the product was included in a presentation at the Society for Vascular Surgery annual meeting and that early adopters are reporting improvements in patient experience and recovery. Management said CryoXT is expected to contribute more meaningfully to revenue in the second half of the year, though from a small base.
Open ablation revenue increased 11% worldwide, led by the Encompass clamp. U.S. open ablation product sales were $40.9 million, up 12.1% year over year. Carrel said the company expects further adoption from a new Society of Thoracic Surgeons quality metric on concomitant AFib treatment, which he described as a potential long-term catalyst for surgical AFib ablation and left atrial appendage management.
Appendage management revenue grew 14% in the quarter. U.S. sales of appendage management products increased 14.4% to $51.6 million, reflecting adoption of AtriClip FLEX-Mini and PRO-Mini devices. Carrel said the mini devices now account for 45% of appendage management revenue in their respective open and minimally invasive categories.
Minimally Invasive Ablation Remains Under Pressure The company’s minimally invasive ablation business continued to decline, contributing $6 million in U.S. revenue for the quarter. Carrel said the market remains focused on treating patients with pulsed field ablation, or PFA, catheters. He added that AtriCure still believes hybrid AFib therapy has a role in patients with longstanding persistent AFib, but said broader stabilization is needed before the franchise can return to growth.
“We have seen referral patterns for hybrid procedures stabilize over the last several quarters in a small subset of accounts,” Carrel said. “However, we need to see this stabilization across a broader customer base before we can expect return to growth for this franchise.”
Clinical Trials Advance Toward Potential Label Expansion Management emphasized progress in two major clinical trials that AtriCure says could expand the market for its cardiac surgery products.
The BoxX-NoAF clinical study, which evaluates ablation and left atrial appendage management in cardiac surgery patients without a history of AFib, has surpassed 50% enrollment with more than 500 patients enrolled. AtriCure expects to complete enrollment of 960 patients by the end of 2026, ahead of its original plan, and anticipates data readouts in the first half of 2027.
Carrel said the company sees a large unmet need in preventing post-operative AFib, noting that U.S. healthcare spending for the condition exceeds $2 billion annually. In response to an analyst question, he said the trial’s first endpoint is post-operative AFib measured 30 days after final enrollment, with a potential data presentation at a major medical meeting in 2027. He said the product is under a PMA pathway and that approval could take roughly a year after submission to the FDA.
AtriCure is also continuing follow-up of more than 6,500 patients enrolled in the LeAAPS trial, which is studying the stroke reduction benefit of left atrial appendage management in cardiac surgery patients without AFib. Carrel said LeAAPS and BoxX-NoAF provide “multiple complementary paths for label expansion” and could be catalysts in the cardiac surgery market.
Guidance Raised for Adjusted EBITDA AtriCure updated its 2026 outlook, now expecting revenue of $602 million to $610 million, representing growth of approximately 12.5% to 14% over 2025. The company expects growth to be led by pain management, appendage management and open ablation, while pressure persists in minimally invasive ablation and certain international markets.
Wirick said AtriCure expects normal seasonal patterns in the second half, with third-quarter revenue down 1% to 2% sequentially from the second quarter, followed by a rebound in the fourth quarter.
The company raised its adjusted EBITDA outlook to approximately $85 million to $89 million for 2026, implying an adjusted EBITDA margin of about 14% at the midpoint of guidance. AtriCure also reiterated its expectation for full-year net income and projected full-year earnings per share of approximately $0.05 to $0.13, with adjusted earnings per share of approximately $0.24 to $0.32.
AtriCure ended the quarter with $167.8 million in cash and investments and generated approximately $22 million in cash during the quarter. Wirick said the company expects positive cash generation through the remainder of the year.
Management Addresses Competition and International Trends During the call, analysts asked about new competitors in the appendage management market. Carrel said new entrants validate the market opportunity, but argued AtriCure has advantages in product innovation, clinical evidence and physician education. He said competitive trialing in the back half of the year is incorporated into the company’s guidance.
Internationally, Wirick said Asia-Pacific weakness discussed in the prior quarter appeared transitory, while Europe saw softness in key markets including the U.K. and Germany. She said the company’s outlook incorporates continued pressure in certain markets.
Carrel concluded that AtriCure’s double-digit revenue growth, margin improvement and profitability leave the company “well ahead” of its long-range plan, while ongoing trials could shape the company’s next decade.
About AtriCure (NASDAQ:ATRC)AtriCure, Inc is a medical device company focused on the development, manufacture and marketing of innovative therapies to treat atrial fibrillation (AF) and related conditions. Founded in 2000 and headquartered in Mason, Ohio, AtriCure has established itself as a leader in surgical ablation devices designed to interrupt the errant electrical pathways that cause AF. The company's solutions are used by cardiac surgeons and electrophysiologists to reduce the risk of stroke and improve patient outcomes in the treatment of both paroxysmal and persistent AF.
The company's product portfolio centers on its Synergy Surgical Ablation System, which delivers controlled radiofrequency energy in a minimally invasive format, and the cryoICE Cryoablation System, which offers an alternative ablation modality using precise freezing techniques.
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