AtriCure (NASDAQ:ATRC) reported third-quarter 2026 revenue of $154.5 million, up 15% from a year earlier, as growth in its U.S. open ablation, appendage management and pain management businesses helped lift profitability.
Net income was $4.1 million, compared with a net loss of $0.3 million in the prior-year quarter. Adjusted EBITDA increased 50.6% to $26.8 million, while adjusted earnings per share reached $0.18, compared with an adjusted loss per share of $0.01 a year earlier.
Chief Executive Officer Mike Carrel said U.S. revenue rose 17%, driven by wider adoption of products including the EnCompass Clamp, cryoSPHERE MAX and cryoXT probes, and AtriClip FLEX-Mini and PRO-Mini devices.
Open Ablation and Appendage Management Growth
U.S. open ablation revenue increased 20.8% year over year to $43 million, led by continued demand for the EnCompass Clamp. Carrel said EnCompass now represents more than 70% of the company’s U.S. open ablation revenue and is generating sales growth at both new and existing accounts.
The company pointed to clinical data from its TRAC-AF registry, presented at the European Association for Cardio-Thoracic Surgery meeting, involving more than 1,700 patients. According to Carrel, the data showed 91% freedom from atrial fibrillation at one year and 86% at two years following epicardial ablation with the EnCompass Clamp.
AtriCure expects a new Society of Thoracic Surgeons quality metric for concomitant atrial fibrillation treatment to support adoption over time. Carrel said the metric, which takes effect Jan. 1, is expected to be implemented gradually and could increase awareness and treatment rates, particularly among coronary artery bypass graft and aortic surgery patients.
Worldwide appendage management revenue rose more than 12% during the quarter. U.S. appendage management sales increased 13.5% to $51.6 million, aided by adoption of AtriClip FLEX-Mini and AtriClip PRO-Mini products. Nearly half of U.S. appendage management revenue came from the two Mini devices, management said.
The company received FDA 510(k) clearance for a 30-millimeter AtriClip FLEX-Mini device and plans to launch it in December. Carrel said the device is smaller than existing products in the market, which generally begin at 35 millimeters. AtriCure also expects a late-2027 launch for its AtriClip FLEX-Mini V device.
Carrel said the company believes its clinical evidence and product portfolio position it well amid increased competition in appendage management. He also said AtriCure has roughly 350 sales and clinical personnel in the field and intends to add territories in 2027, primarily to prepare for potential future growth tied to clinical evidence and anticipated regulatory milestones.
Pain Management Remains Fastest-Growing Franchise
U.S. pain management revenue climbed 34.6% to $28.1 million, supported by greater use of cryoSPHERE MAX and ongoing adoption of cryoXT probes. Worldwide pain management revenue increased 33%.
Chief Financial Officer Angie Wirick said most of the franchise’s growth continued to come from deeper use among existing customers rather than newly added accounts. Cryo Nerve Block accounts increased 6% year over year, while cryoXT generated more than $1 million in quarterly revenue for the first time, ending the quarter just below $1.5 million.
Carrel said AtriCure has sold more than 1,000 cryoXT devices to date. The company is pursuing a targeted rollout for the product in amputation procedures, concentrating on one or two sites per region as it refines clinical workflow and training. He said management expects adoption to accelerate in 2027 and more substantially in 2028.
In sternotomy procedures, Wirick said AtriCure estimates it has reached mid-single-digit market penetration. Management expects steady expansion in that market, though it does not anticipate near-term adoption to mirror the pace seen in thoracic surgery.
Clinical Trial Progress and International Headwinds
AtriCure said it has enrolled more than 880 patients in its BoxX-NoAF trial, leaving fewer than 100 patients needed for full enrollment. The study is evaluating ablation and left atrial appendage management in cardiac surgery patients without a history of atrial fibrillation.
The company expects to complete enrollment before year-end and report data for the first primary endpoint in spring 2027. Carrel said AtriCure would likely submit to the FDA following the data release, with a potential approval timeline in mid-2028. He added that guideline changes would likely take longer.
The company also continues to follow more than 6,500 patients enrolled in its LeAAPS trial, which is evaluating stroke reduction from appendage management in cardiac surgery patients without atrial fibrillation.
International revenue totaled $26.4 million, rising 5.8% on a reported basis and 6.1% in constant currency. European sales grew 5% to $15.9 million, while Asia-Pacific and other international markets increased 6.9% to $10.5 million.
Wirick cited funding challenges in some European countries, a newer commercial team in certain markets and a localized U.K. reimbursement headwind involving cryoSPHERE. She said the company sees encouraging traction for the EnCompass Clamp in Europe following its launch there.
Meanwhile, minimally invasive ablation revenue declined to $5.4 million as the standalone atrial fibrillation treatment market remains focused on pulsed field ablation catheter therapies. Management said it remains committed to hybrid AF therapy for patients with longstanding atrial fibrillation.
Guidance Raised for Revenue and Adjusted EBITDA
AtriCure raised its full-year 2026 revenue outlook to approximately $606 million to $610 million, representing expected growth of about 13.4% to 14.1% over 2025. The company cited continued U.S. market strength but said it remains cautious about international conditions and headwinds in U.S. hybrid ablation.
Gross margin improved 180 basis points year over year to 77.3% in the third quarter, aided by favorable product and geographic mix. The company now expects full-year gross margin in the upper 76% range, though it anticipates a fourth-quarter impact from a full quarter of costs associated with a new manufacturing facility.
AtriCure raised its 2026 adjusted EBITDA outlook to approximately $91 million to $94 million and reaffirmed expectations for full-year net income. It expects earnings per share of approximately $0.21 to $0.27 and adjusted earnings per share of approximately $0.40 to $0.46.
The company ended the quarter with $187 million in cash and investments and generated $19.2 million of cash during the period.
About AtriCure (NASDAQ:ATRC)
AtriCure, Inc is a medical device company that develops and sells products for the surgical treatment of atrial fibrillation (AFib) and related conditions. Its technologies are designed to support cardiac surgeons and electrophysiologists performing tissue ablation, left atrial appendage management and other procedures intended to restore or maintain normal heart rhythm.
The company’s product portfolio includes the AtriClip device, which is used to exclude the left atrial appendage, along with surgical ablation systems such as the Isolator Synergy clamps and cryoablation products.
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