Hi, I'm Rick Weiss. Welcome to the AtriCure presentation. I'd like to welcome the AtriCure team, Mike Carrel, President and Chief Executive Officer, Angie Wirick, Chief Financial Officer. It's great and fabulous to, once again, welcome you both to this event, the 2025 Stifel Healthcare Conference. Thank you so very much for being here. John, take it away. Sure. I think it'd be helpful just to start out by defining the story. At the March 2025 analyst meeting you hosted, I think it really helped frame your goals and priorities at AtriCure. In many ways, you're actually already exceeding and outperforming those goals. As we look ahead to the next several years, can you just frame for folks how we should think about AtriCure's key products, philosophy, and approach to these growing end markets? Sure. First, we love sitting in these really kind of deep chairs. I know. I know but t hat make short people look even shorter, but they swallow us up. Relative to the actual question, though, when you look at our business and you break it down into the three different components, if you look at first our cardiac surgery business, which is the concomitant businesses there, we continue to roll out products like Encompass, just rolled out three years ago, but we're still incredibly underpenetrated in that particular area. We just started a trial to go after post-operative atrial fibrillation, which is an incredibly big problem in cardiac surgery because 35% of the patients go into post-op. That trial's called BoxX-NoAF. It will probably take us about two years to enroll in that trial. We've enrolled our first patients already. We've got many sites up and running through IRBs. We'll be in full gear by January of this coming year. We think that's a huge catalyst combined with the full enrollment of LEAPS, which is for that non-AFib patient, prophylactically treating them. We think you've got a chance when you're on the operating room table to really help patients out for the rest of their life, and not having to go into AFib and not having strokes. We think that's going to be an absolute game changer in the space. Most of that data is probably going to come out near the end of the decade. Kind of, if you look at kind of what we talked about at the analyst meeting, is that when you go to the end of the decade, that opens up the market almost trifold, I mean, really expands the market quite dramatically. In the meantime, we'll continue to innovate on the product pipeline as well. We talked about Encompass. We're going to be adding PFA to all of our product lines. We'll be within the AtriClip franchise. We had Flex Mini out last year, which we're in 30% of the sites around the country already. We anticipate, like our other products, being in 100% of the sites over the next three or so years. Combined with that, we have a series of new products coming out within the AtriClip franchise. Right now, that product already is 30% or 60% smaller than any product on the market. It is a great product, by far the best thing that is out there. That is a closed-loop product, but we're going to have an open-ended product as well that'll come out sometime in early 2027. We think we've got a series of clinical and product catalysts over the, to kind of take us through the end of the decade in that and to significantly expand our market. On the cryo nerve block side of our business, the big product launch that we just did, we've done two, actually. The first one was the cryoSPHERE MAX which is, it reduced the time by which you need to ablate. Why that's important is that it opens up the opportunity to people who otherwise didn't want to spend the time on it. In addition to that, it opens up the market for sternotomy because before, when we tried to get into sternotomy, they said sticking is too long. By reducing that time in half, they're now interested in doing that. That's 255,000 patients in the U.S. alone that undergo sternotomy, probably about 1.5 million globally. You're talking about a massive opportunity to actually add cryo to reduce the pain in cardiac surgery patients as well. Just this, most recently, earlier this year, like a couple of months ago, we rolled out our XT product for extremities. Brand new market for us. This is for patients that undergo amputations. We all know amputations, a lot of diabetics get it, et cetera. It's an incredibly painful procedure. We have seen, we've done over 250 patients at this point in time. Those patients are seeing significant recovery advantages. They're being able to put their prosthetics on faster. We're beginning to see that they're actually reducing the phantom limb pain as well, which is a chronic problem in 70% of people that have amputations. We're super excited about it. We won't get much revenue in the near term, but we do anticipate that beginning to kind of kick up in 2026 and really kick in in 2027. If you think about how we launched cryo to begin with back in 2019, and you kind of saw the slow beginning as we got sites trained and up and running and we learned. Once those learnings came into effect, you started to see a year, a year and a half out that that began to accelerate as word got out that this was an incredibly powerful device that made a big difference on patients. How big an incremental opportunity could it be, Mike, over time? Yeah, in the U.S., in the U.S., there's 185,000. So at $3,500 per, you can kind of, it's a reasonably good opportunity in the United States. Combine that, you've got over 500,000 amputations globally. We're already kind of starting to get it into, it's not in any other country yet, but in a year or so, we'll kind of, we'll launch it in the U.S. and then launch it in other countries around the globe, much like what we do with our regular cryo product as well. We think that it's over 500,000 patients globally just for that. We're also, the cryo franchise is really interesting. You can see we've got, we started in thoracotomy. We're just starting at the beginning of sternotomy with the new MAX product. You've now got the extremity market first going after below the knee amputations. We're going to look at any area where you've got large nerves during surgery, where there's a lot of pain afterwards. We're already studying two or three other areas where this could apply. Yes, this market is $500,000, but we anticipate there are millions of patients that we probably can help address that just undergo some sort of surgery where they're exposing or hitting the nerves in some way, shape, or form. Good. That's a very helpful overview to kick it off. I just wanted to go back to the numbers. Just looking at the implied guidance for the fourth quarter, typically, and we look back over the last several years, the fourth quarter is something like 26%-27% of sales for the year. It would imply revenues at around $142 million consensus, and the guidance sort of came at $139 million for the fourth quarter. As well, in the fourth quarter, stepped down to low double digits after mid-teens in terms of revenue growth. Should we just view this guidance as sort of a classic, prudent, conservative guidance from AtriCure, or are there any specific quarterly puts and takes here that we should be appreciating? It's a short answer, yes. Classic AtriCure conservative, prudent guidance. We want to make sure that the numbers that we're putting out there, we feel confident, not just meeting, but also a pathway to a beat. Got it. And looking ahead now, I'll just say our 2026 number, we're at $597 million consensus, $599 million. So coming right around $600 million, $600 million in revenues, Adjusted EBITDA sort of ranging high $60 million-$70 million. I know you're very disciplined when you talk about next year, and you can comment on these numbers or not, but are there any dynamics in 2026 that we should be contemplating in our models that are not reflected today? And at the analyst day, I think sort of a 13% growth CAGR long term was the number you gave. I believe this revenue growth rate is something like 12%. So just any of these dynamics that we should be appreciating for next year that we aren't currently. Yeah, I think, you know, Mike touched on a number of new product launches. A key dynamic, a key growth driver as we work into 2026 is the continuation of the contribution from the new product launches. I think, you know, historically at AtriCure, we've got a lot of examples to point to Encompass clamp being one, our AtriClip FLEX- Mini product being another. You know, new product launches tend to drive really strong growth. We look for a benefit on a pricing angle where we're adding new innovation into products. So we're asking for an increase in pricing, but these products are also driving really strong volume growth. That tends to have a nice strong tailwind, you know, for more than just a couple of quarters beyond launch. You're talking years beyond launch. I think those are your key growth drivers when you think about 2026. At this point, we would expect our hybrid business not to be part of that growth engine when we look into 2026, you know, was a headwind for 2025. I feel good about the overall, you know, kind of pathway in 2026. Keeps us on track, if not ahead. You know, we're ahead at this point in time to our LRP numbers would keep us on track, if not ahead in 2026 as well. Just big picture question, you know, and, I mean, and this whole, the whole, cryo story you're talking about, Mike, is something you've done repeatedly since you got there on new markets, adjacent markets, expanding technology. I think if I think about the question I often get, it, it's how much more gas is in the tank here in terms of growth, sustainability of growth, you know, it, it, it how much is left in AtriClip? How much, more, can the open heart business, go or is it mature? You, each year, you've just done an, I really mean it's an outstanding job of delivering excellent growth despite some of the penetration, some of the other headwinds, which we'll talk about. Talk to us about why, what people need to understand about your ability to sustain growth. I mean, I know it's a, you work at it. I think it's an, you're asking a great question. It's an unappreciated part of our story is that when you look at, there's 2 million patients undergo cardiac surgery every year, and less than 150,000 are actually getting treated today with AtriClip or with ablation. We're number one in that space, and we've helped create that market. We're running trials and coming out with products to make it easier to help those patients out. We believe that almost all 2 million should be getting an ablation and a clip. I think people underappreciate how big that market is. Everybody gets super excited, understandably so, for minimally invasive and the TAVR world or the Watchman world, which are all great worlds to be in, and they're massive, massive market opportunities. If you just take the 2 million patients and you multiply it by what we get when you add ablation tools, maybe cryo tools, plus your AtriClip, these are $10 billion+ market opportunities when you start to add it up and look at it on a global basis. We have not only products, but we also have clinical evidence that's going to be coming out over the next three-plus years or so that's really going to generate and accelerate our growth in the back half of the decade. To get there, we're still so underpenetrated. I think number one is, I think people do not appreciate how underpenetrated the cardiac surgery market is and how much opportunity actually exists there and how the moat, I think that I think one of the words you guys used that we have built around clinical evidence and product excellence and being an innovator in this space, I think really kind of protects us in many different ways. Not that competition is not going to come in. It is, as we all know. The other underappreciated one is in cryo, which is that we started in thoracotomy. We are still underpenetrated just in thoracotomies. We have not really even addressed the robotic surgeon that does that today. We do see benefits there, but that was not the first part of that market that we went at as an example. Every one of our markets is completely underpenetrated right now. We have not years of growth ahead of us in those markets. We have decades of growth ahead of us in these markets as we look at them. These are things that are, we believe, we have started to see, and you can look at it over time. Clinical evidence has led to guideline changes. Guideline changes have led to reimbursement changes, which is going to lead to obviously better adoption. If you look at cardiac surgery, we used to grow in the single digits. Evidence came out, guidelines changed, reimbursements changed. We are now in the mid to high double digits there. A lot of that is driven by that kind of trajectory. We are doing the same thing in all of our franchises relative to that so that we can accelerate some of that adoption. Cardiac surgery is not going away. Everybody talks about it. It's not going away. Now, the procedures are more complicated. It is a more complex patient they're dealing with. They're not dealing with single vessel disease. They're dealing with kind of, you know, quintuple vessel disease when they're in there. That does not mean that the numbers are any lower at this point in time. It's been growing at 2% every year for the last 10 years or so. Take COVID out for a moment. It's an underpenetrated market and still a growing market to some degree that we think we've got lots of opportunity to grow for over the next 5- 10 years. That's great. I didn't want to ask this question, but John made me. I drew the short straw to ask about Converge. Let's get it out of the way. I know you're happy to talk about it because you do talk about it. That's sort of the crux of my question. I know you well enough to know you're a serious guy. You're not just saying it. You believe there's a future for Converge, and you articulated that, but I'm not smart, you know. When is this three years away, Mike, or five years away that you think there'll be, you know, I mean, why are you talking? Why do you keep bringing it up that we'll add sort of sooner rather than much, much later that you could, that AtriCure could, benefit again from? There's no question we're under a lot of pressure with PFA right now within the Convergent area. It's not a part of our growth story for now or even into next year. It's just, it's not, but it works incredibly well. It's the only data that has ever been produced that shows definitive benefit, clinical benefit, long-term benefit for patients undergoing a hybrid procedure are significantly advantaged over those that just do a catheter for patients that have been in AFib for a very long period of time. We know, I mean, there have been three randomized controlled trials that we have run. All three have demonstrated the exact same results, which is a doubling of the effect when you add the Convergent to these complicated to treat patients. It's incredibly durable. That number goes up even more when you start to look at durability. One study we did over in Europe was the CCAF trial. And when you looked at the three-year data, at three years, the catheter had 0% success. Let me just repeat that. 0% success. And we were still sitting at 60% success in that patient population. That just shows you how durable this procedure is. What gives me comfort long-term is that it's an incredibly durable procedure. And 45% of all patients that are out there today have longstanding persistent atrial fibrillation. I do believe that what's going to wind up happening in, I can't predict time though. I can't tell you that it's going to happen in this month or this quarter. There are going to be failures even with PFA. You see it, all the data from PFA, which is great technology. It has improved speed and it has improved safety in catheter-based technologies because you're not affecting the esophagus with it. As a result of that, they're super excited about it. You've seen the catheter-based procedures have gone up tremendously. We represent today 0.25% of all catheter ablations. Just think about that for a number. We'll do 1,500 or so converged procedures this year, and there's 600,000 catheter ablations for AFib in the U.S. It's so underpenetrated. The moment that those start to fall down, we don't need a lot of growth to help our overall business in the long term. Do I feel like this is going to be a growth driver for us eventually? 100%. I just can't give you the exact timeframe. I know it's clinically relevant. I know these patients need help. I know the EPs are distracted right now though. Right. I think they're going to realize that they are going to need help with these patients. I actually think PFA is going to help long term. Why? PFA has improved their efficiency. If they failed two catheter ablations, they are not going to want to go in and spend three or four hours on a patient anymore. They'll never do that again. As a result, I think the really complicated patients, they're just going to punt. Again, I can't tell you what that timeframe is because they're so enamored right now. They're so busy. I mean, they're just getting a flood of patients that they're having, they're trying to treat right now. Again, I think it's going to be something long term. We can't predict it in the short term, but long term, I still believe in that, in that therapy. That's a great answer. Thank you, John. Yeah, I wanted to shift gears to gross margins. In the third quarter, I was struck at 75.5%. A great result. Heard you mention business mix as one dynamic that drove the performance. Just want to maybe hope, I just hope you could speak to the consistency of that business mix. What's exactly contributing in terms of whether it's price or product mix and what should we be expecting as we look ahead? Yeah, I think all year you've seen, it's been a bit masked by the mix in our international business, but all year you've been seeing the increasing contribution to our gross margin from the new product launches, specifically the Flex Mini and the cryoSPHERE MAX both in, you know, accretive to the gross margin in the U.S. Within our international business, while it continues to grow, the growth outpaces the United States. That has been a headwind. I think the mix specifically within our distributor countries in the third quarter was much more favorable than you've seen in other quarters. I think longer term, if you look beyond just one quarter, longer term, we do expect to see continued improvement to our gross margin. Maybe not to the magnitude that we saw in the third quarter specifically, but on an annual basis, would expect for us to be improving our gross margins. Got it. Shifting further down, P&L, helping drive the rapidly growing Adjusted EBITDA is positive operating leverage as well that we're seeing in the SG&A line. Just curious what opportunities you're seeing today here. Is your sales force at scale, would you say, or are you still adding there or is G&A at scale? Just where, in what parts of the business are you, are you really seeing this leverage? Yeah, the back office functions, we're definitely starting to see the leverage here. Big investment, you know, as we were thinking towards kind of the future there. That's a component of it relative to our commercial teams. You know, in the field, I'd say, cardiac team is the most matured at this point in time. We're adding for volume purposes, continue to split territories when we've got big opportunity and know that there's growth there, as Mike talked about, underpenetrated market that we're working in. We're adding, but that's based on volume. Within the cryo team, it is volume growth. It's opportunity growth with the launch of XT. I think that this is an area that we're watching pretty closely going into 2026. What needs do we have on the team? We're starting with our pain management team, the existing team, because they're experts in pain. They understand how the devices work. They can talk incredibly well to a surgeon why the technology works. We'll start there, but it's a big opportunity. It's a new call point for us. We're evaluating that. Our hybrid team, I'd say at this point, no need to add. We've got a team that could scale well into the future at this point in time. You know, no adds there. On the international front, I'd say country by country, looking selectively where we've got opportunity and would add there. I think you add all of that up and it says some incremental additions to the sales force depending on where each of the franchises is at at this point in time, but not to the same pace that you would have seen over the past couple of years, which is what's driving the leverage. That's helpful. Shifting to the pipeline, Mike, an exciting trial that was, I think you first mentioned at the analyst meeting was the BoxX-NoAF trial. The idea of reducing post-cardiac surgery AFib with a prophylactic ablation is interesting and is potentially practice changing. Can you just remind us the timelines here and as well any precedent trials or examples of this that might give you a sense that this could be successful and positive? Sure. Timeline is, it's 960 patients randomized one to one. Half the patients will get an Encompass clamp plus an AtriClip. The other half will get standard of care today, which is nothing. We anticipate all the data tells you probably 35%-40% of patients that undergo cardiac surgery go into post-op AFib. What's unique about this trial is that there's actually two clinical endpoints. So we can win in one of the two or in both. We think we'll win in both, but, the first one is the post-op AFib that you talked about. That's the 35%-40% of patients go into post-op AFib. We think we can reduce that dramatically. What data has suggested that to us? There have been about seven different trials that have been done over the last 10 years. Two most recent kind of contemporary trials, one by Dr. Wilick, who's one of the national PIs on the trial. He did a IDE trial where he randomized against those. He saw a decrease in one arm. He had 55% post-op AFib in the arm that had nothing done, and he was 7% in the arm that had an ablation done. Obviously that's one trial. It was powered, it was only 60 patients. This is 960 patients, but obviously that's incredibly statistically significant even at that small of a scale. There were several that have done, I'll call it single arm trials that have done runs of patients too that have been done recently where they have seen where they use the Encompass clamp plus the clip, the exact same protocol, and then they compared it to their data in their retrospective, their data that they saw in that exact same patient population, and they saw reductions from about 45% down to about 5%. There are several studies that have been done recently that we used as a baseline to kind of look at this, kind of going forward. That is what gives us confidence that we'll win on that part of it. The second part of it, which is very interesting, is also looking, we're going to put a loop recorder in every one of these patients, and we're going to track out the clinical AF because 50% of patients that undergo cardiac surgery go into atrial fibrillation. Meaning longer term. We believe that you're going to see actually a divergence in that particular category where you're going to see these patients have less atrial fibrillation when they actually undergo surgery over that three-year period. That's another one. There have been several studies that have been done to look at that, but nothing's been, I would say, robust enough. That's why we've got kind of two ways to win. We can win short term, which is that data will probably be out, because we think it'll take about two years to enroll. Assume we're starting now, but just say January 1st- January 1st, say two years, probably sometime in 2028, we'll get the initial data from the post-op AFib, but then we've got to wait three years for the secondary endpoint. And the. I don't know if that helps or gives you the. No, that's very helpful. Just for the broader goal of the trial, I mean, what sort of market expansion would this mean for either ablations or the clip? I mean, to what extent, I guess you're really not penetrated with this patient group at all. Just how many more patients would this add to the TAM for either Encompass or the clip? 70% of patients that undergo cardiac surgery do not have pre-op AFib. You're going it from 30% was our opportunity before out of the 2 million patients. Call that 600,000 patients globally. Now you're adding 1.4 million patient population. Let's say 100,000 of those won't qualify for one reason or another. Maybe they're way too sick or some other reason you may not do it, but it's a vast increase in the number of patients, at least a doubling effect, from 600,000 to call it 1.2 million more patients that could basically get this. Our goal and our vision on this is that we can benefit every patient that undergoes cardiac surgery. We can help them avoid AFib in their life by basically treating them right at the time they're on the operating room table, whether they had AFib at the time or they're just undergoing surgery. Therefore, they've got a likelihood of getting it sometime in their life. It's a really. That's it. Amazing radical. Simple math. I mean, and I liked your word. I keep using the word standard of care, but actually it's practice changing is another way to think about that. I think it will change the practice. I think everybody, it's just going to be simple. Everybody's just going to know this is really easy to do. The other good news is we have the technology. The Encompass clamp with the AtriClip takes less than 10 minutes to do for most surgeons. What used to be, when you do a full Cox Maze 4, it takes 30-40 minutes, which is still a great procedure and super robust for a very complicated to treat patient. For this patient population, if you do that, you can do it in less than 10 minutes, maybe even down to eight minutes for that total, for the total, including all procedural time and everything else. The ablation time is less than one minute. I mean, it's an incredible procedure. It's easy to do, easy to approach. That's a great overview. I want to pick on Angie a second. I just, like, she's been neglected here. That's really nice. My pleasure. Anytime. I was reflecting, John was asking these excellent questions about gross margins and operating leverage, and I'm sort of thinking, wait a second. Angie said at the March 25 analyst meetings, not that long ago, that your 2028 Adjusted EBITDA goal was 14% or thereabouts. Correct. You agree? Yes. This is Perry Mason. We're putting you on. In the third quarter, you've already scaled Adjusted EBITDA margins to 13.3%. You're doing a good job over there. Do you want to update us and update that range today? Feel free. We're all interested. That 20%, 30%, 30% girl. I mean, it's like, shouldn't we pull it forward? Let's start today. 39%? Do I hear 29%, 28%? We are super pleased with the trajectory on the bottom line. I mean, super pleased with the diligence within the business. You know, we've always looked at each investment very carefully. I'd say our team is really rallying behind the improvements to bottom line, and seeing profitable growth. We want to be best in both worlds, profitable growth here. I think it tells you, given the numbers that you threw out and the performance that we've seen as of date, we are well ahead on the bottom line targets in our LRP. That's exciting to see. Yes. Yeah. Not going to change it today, but we're well ahead. Do you see it differently, Angie? I'm not here to have late breaking news, Rick. I'm sorry. We'll look for that soon. John. Yeah. I also wanted to ask about LEAPS, another major trial you guys are running. My impression is that enrollment completed this year. There's a five-year follow-up. Sounds like 2030-ish readout would be complete. Correct me on timing if we're off there. I just wanted to ask it similar to BoxX-NoAF. I mean, in terms of precedent trials that give you confidence in a success or the number of patients you have in the trial, it's powering it. Because we've also seen some data, and this might not be like for like recently in terms of OSHAN or ALONE-AF, where we've had lower rates of stroke than are expected, I think, across all metrics. Just want to maybe dive into LEAPS and get a sense of what gives you confidence in a success and key timelines. The patient population in LEAPS, again, are patients that did not have atrial fibrillation, but have a very good likelihood of getting atrial fibrillation, looking at both CHA2DS2-VASc scores and BNP rates for heart failure and kind of indications that the atrium is going to be sick and therefore be ready to kind of produce strokes in the left atrial appendage. We did an Atlas trial. We did a trial before, a pre-trial of 562 patients, and we demonstrated significant improvement in the stroke rates, even at just one year, let alone five years. The LAAOS III database, all these patients that we're talking about here become LAAOS III patients because many of them are going to go into AFib or they're going to go into heart failure. They saw a 33% reduction in at about 3.8 years. We feel very comfortable that the patient population is of that kind of ilk, and is going to lead to very good results relative to that. Now, on top of that, you mentioned some other trials that really do not apply to this patient population at all, but maybe I can give you some indication. We have talked about this a little bit, which is that it is an event-driven trial. It is 469 events is the total events that you basically have. Yes, it is a five-year follow-up. However, the events are what drive the look into the data. We are well ahead. The stroke rates have actually been much higher than we had expected in the totality. I cannot tell you in which arm they were in, but we think that actually feeds very well and positive to our readouts on the trial overall. Why is that? Because we believe, like in LAAOS III, which was the AFib trial, where you had AFib and you had your appendage managed, almost 80% of those patients were also on anticoagulation. They had like double protection. Those that had a clip, they had a clip and they had the DOAC, and in the other arm, they had a DOAC. You basically had a lot of these patients because they are on AFib and the standard of care or practice was to put somebody on medication. They did that. The standard of care for somebody that does not have AFib is to not put them on that. Maybe your first way you are seeing these events is that we are seeing a lot fewer patients on anticoagulation overall because they do not have AFib. There is no rational reason to effectively kind of go down that pathway. If we're accumulating at a faster rate than they did in the LAAOS III trial in terms of the number of patients that are actually having stroke, we think that we might have data before 2030 as a result of that because we're accumulating a lot faster. We think that is a signal to us that we could possibly actually win as well. We're almost out of time. We're basically out of time. I just want to ask one last question, squeeze it in here, Mike. Just, there's so many positive things happening at AtriCure, obviously. But just reflecting on M&A, adding another leg to the stool, as I reflect on it, AtriClip, Convergent, both acquisitions, pain management developed internally. Are there opportunities? AtriClip was developed internally. It was as well? Okay. I misremembered. Are there opportunities for tuck-in bolt-on that maybe might even accelerate near to medium-term growth or create new opportunities that you're thinking about? Is that a priority or? It's not a priority. I mean, our priority right now is we feel like, going back to the question you asked at the beginning, what don't people understand? We think our markets are so underpenetrated and we have the technology and the clinical evidence to win in those markets for the next decade, if not more. As a result, our focus is on pure execution and winning in those markets right now. That doesn't mean if something came up, we wouldn't necessarily, we're always looking, but that is not our priority. It is a lower priority for us. Anything we would do would be something that we would have to really evaluate very closely and it would have to be an accelerator to our overall business. Right now we're just not seeing that and it's not a focus for us. That's a great place to stop, but thank you for a very thoughtful, thorough presentation. Really appreciate it. Thank you both for being here. Thank you. Thanks for having us.