AtriCure surges on earnings beat, first annual profit forecast
Medical device company posts $0.06 EPS vs expected loss, raises 2026 revenue outlook
AtriCure shares advanced on Tuesday after the medical device maker reported a surprise fourth-quarter profit and issued an optimistic 2026 outlook that projects the company's first full year of positive net income.
The Mason, Ohio-based company reported adjusted earnings per share of $0.06 for the fourth quarter, far surpassing analyst expectations for a loss of $0.02 per share. The turnaround from a $15.6 million net loss in the prior-year period to $1.8 million in profit marked a significant milestone in the company's profitability journey.
Revenue of $140.5 million for the quarter represented 13.1% growth year-over-year, slightly edging past analyst estimates. The company's adjusted EBITDA surged 57% to $19.9 million, compared with $12.7 million in the fourth quarter of 2024.
For the full year 2025, AtriCure delivered $534.5 million in revenue, up 14.9% from the prior year, while adjusted EBITDA nearly doubled to $61.8 million. The company ended the year with $167.4 million in cash and investments, providing what analysts described as a strong foundation for 2026 growth.
The results were driven by robust performance across several product franchises. Pain management revenue grew 24% in the fourth quarter and 33% for the full year, fueled by continued adoption of the cryoSPHERE MAX device, which is now used by approximately 500 U.S. accounts. The company said more than 100,000 patients have been treated with cryoSPHERE probes since 2019.
Open appendage management also delivered strong results, with global growth of 15% in the quarter and 19% for the full year, led by the AtriClip FLEX MINI and AtriClip PRO MINI devices. The FLEX MINI was purchased by over 300 active accounts and contributed 18% of worldwide left atrial appendage management revenue in 2025. Open atrial fibrillation ablation growth exceeded 17% in both the quarter and full year, primarily driven by the Encompass clamp, now present in over 830 accounts worldwide.
Looking ahead, AtriCure raised its 2026 revenue guidance to $600-610 million, representing 12% to 14% growth over 2025 levels. The company projected adjusted EBITDA of $80-82 million and forecast its first annual net income, with expected adjusted earnings per share of $0.09 to $0.15.
"Pain management is expected to lead growth, followed by open appendage management and open ablation," the company said in its earnings materials. However, management acknowledged that the minimally invasive AFib treatment franchise continues to face pressure from pulsed field ablation adoption in the U.S., with U.S. MIS revenue declining 31.2% in 2025. The company anticipates continued but moderated pressure in 2026.
The company highlighted significant clinical progress, including completion of enrollment in its 6,573-patient LEAPS trial ahead of schedule in July 2025, and initiation of the BOX X NoAF trial to evaluate ablation for reducing postoperative AFib in cardiac surgery patients. A dual-energy EnCompass clamp completed first-in-human treatments in December with what management described as "excellent results," aiming to shorten RF ablation times and add pulsed field ablation capabilities.
Analysts have set a target price of $51.44 on AtriCure shares, suggesting significant upside from current levels. With 97% of shares held by institutional investors, the company's shift to profitability and positive cash flow generation could attract increased attention from growth-focused healthcare investors.
Risks include ongoing funding and reimbursement uncertainty with the UK's National Health Service, which affected international sales in the fourth quarter, and potential competitive pressures in the appendage management market later in 2026. However, management said it views competitor entry as market validation and believes its installed base of over 750,000 implants provides a competitive moat.