Financial Data and Key Metrics Changes - The company reported over 30% growth in the most recent quarter, indicating strong performance and momentum in the business [66] - Preliminary revenue guidance for 2026 is projected in the high teens, reflecting a thoughtful approach to setting expectations [65][66] Business Line Data and Key Metrics Changes - The long-term continuous monitoring segment, which the company pioneered, is growing at high teens percent year-over-year, outpacing the overall market growth [9][10] - The company has gained one to two points of market share in the long-term continuous monitoring segment, now holding a low 70% share of that market [19][20] Market Data and Key Metrics Changes - The overall ambulatory cardiac monitoring market in the U.S. is estimated at 6.7 million tests, growing at mid-single digits, while the long-term continuous monitoring segment is experiencing faster growth [8][9] - The aging population is a significant tailwind for the market, increasing the risk of cardiac arrhythmias and the need for monitoring [10] Company Strategy and Development Direction - The company is focusing on expanding its presence in the primary care market, with a goal to increase the percentage of XT patches used by primary care physicians from 30% to potentially over 40% [12][14] - The company is investing in innovative channel partnerships that allow for proactive monitoring of patients, which is expected to enhance market penetration [22][30] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the company's positioning to capitalize on market opportunities, particularly with the increasing awareness of cardiac arrhythmias and advancements in therapies [10][11] - The company is committed to maintaining profitable growth while investing in innovation, aiming for a 400 basis points expansion in adjusted EBITDA year-over-year [64] Other Important Information - The company is actively working on international expansion, having launched into five new markets, including Japan, which presents a significant opportunity for growth [54][55] - The company is addressing FDA comments regarding cybersecurity as part of the review process for Zio MCT, with no expected contribution to 2026 revenue [41][42] Q&A Session Summary Question: What is driving the accelerated growth in the ambulatory cardiac monitoring market? - Management highlighted several factors, including the shift to primary care, increased consumer awareness, and the aging population as key drivers of growth [10][11] Question: How is the company leveraging its channel partners? - The company has seen success with 18 active channel partners, with all pilot programs transitioning to full commercial programs, indicating strong value propositions [34][35] Question: What is the status of the FDA submission for Zio MCT? - The company received comments from the FDA and is working through the review process, with no expected revenue contribution from Zio MCT in 2026 [41][42] Question: Can you provide an update on the international business? - The company is making progress in international markets, particularly in Japan, and expects to see meaningful contributions starting in 2027 [54][55] Question: What are the reimbursement updates for the monitoring services? - Medicare rates for long-term continuous monitoring are expected to increase by approximately 8% next year, while rates for MCT may see a slight decrease [76]

Financial Data and Key Metrics Changes - The company reported over 30% growth in the most recent quarter, indicating strong performance and momentum in the business [66][67] - Preliminary revenue guidance for 2026 is projected in the high teens percentage range, reflecting a thoughtful approach to setting expectations [65][66] Business Line Data and Key Metrics Changes - The long-term continuous monitoring segment, which the company pioneered, is growing at high teens percentage year over year, outpacing the overall market growth [8][19] - The company has gained one to two points of market share in the long-term continuous monitoring segment, now holding approximately 70% of that market [19][20] Market Data and Key Metrics Changes - The overall ambulatory cardiac monitoring market in the U.S. is estimated at 6.7 million tests annually, growing at mid-single digits, while the long-term continuous monitoring segment is experiencing faster growth [8][10] - The aging population is a significant tailwind for the market, with more individuals entering Medicare and increasing the risk of cardiac arrhythmias [10] Company Strategy and Development Direction - The company is focusing on expanding its presence in the primary care market, with a goal to increase the percentage of XT patches used by primary care physicians from 30% to potentially over 40% [12][14] - The company is investing in innovative channel partnerships that allow for proactive monitoring of patients, which is expected to enhance market penetration [22][32] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to capitalize on market opportunities, particularly in the context of improving therapies and increasing consumer awareness [10][11] - The company is optimistic about its international expansion efforts, having launched into five new markets, including Japan, and expects meaningful contributions from these markets in the future [55][56] Other Important Information - The company is currently working through the FDA review process for Zio MCT, with no expected contributions to revenue in 2026 [40][41] - Recent updates indicate that Medicare reimbursement rates for long-term continuous monitoring will increase by approximately 8% next year, which is a positive outcome for the company [76] Q&A Session Summary Question: What is the current state of the ambulatory cardiac monitoring market? - The market is healthy, with the long-term continuous monitoring segment growing at high teens percentage year over year, driven by factors such as improved therapies and increased consumer awareness [8][10] Question: How is the company addressing the primary care market? - The company has seen an increase in the percentage of XT patches used by primary care physicians and believes this trend will continue to expand [12][14] Question: What is the status of the FDA submission for Zio MCT? - The company submitted Zio MCT to the FDA in September and is currently addressing comments received, with no expected revenue contribution in 2026 [40][41] Question: How is the international business progressing? - The company has launched into five new markets and is optimistic about future contributions, particularly from Japan, which is a significant market for ambulatory cardiac monitoring [55][56] Question: What is the company's approach to setting revenue guidance? - The company aims to provide thoughtful guidance based on high confidence in certain areas while leaving out less predictable factors [66][67]

Financial Performance & Guidance - Second quarter 2025 revenue reached $186.7 million, a 26.1% increase compared to the second quarter of 2024[8] - The company updated its 2025 annual net revenue guidance to $720 - $730 million[45] - The adjusted EBITDA margin is expected to be 8.0% - 8.5% of revenue for 2025[45] Market Opportunity & Penetration - The potential market includes over 27 million patients in the United States who could benefit from ambulatory cardiac monitoring[11] - The company has achieved over 30% penetration in the core U S ambulatory cardiac monitoring market as of December 31, 2024[13] - The international market represents a $1+ billion total addressable market (TAM) with 5+ million tests in prioritized countries across EMEA and Asia Pacific[36] Expansion & Growth Strategies - The company is targeting over 5 million ambulatory cardiac monitoring (ACM) tests in prioritized countries across EMEA and Asia Pacific[17] - There are over 27 million potential patients presenting in primary care who may be symptomatic or at-risk for arrhythmias[17,24] - The company is addressing population health management through targeted monitoring for undiagnosed arrhythmias, leveraging AI[25,26] Technology & Innovation - The company has curated over 2.5 billion hours of ECG data since its inception through 2024[15] - The company's AI capabilities are used for prediction of atrial fibrillation and heart failure[39,40]

Summary of iRhythm (IRTC) Conference Call Company Overview - **Company**: iRhythm Technologies, Inc. (IRTC) - **Industry**: Medical Devices, specifically cardiac monitoring solutions Key Points and Arguments Q1 Performance and Guidance - Q1 revenue beat expectations by $5 million, leading to a $15 million increase in guidance for 2025 [3][4] - Achieved over 20% year-over-year growth for the second consecutive quarter, indicating strong business momentum [4][5] - The primary driver for the Q1 performance was the significant growth of the Zio AT product, which is expected to sustain through 2025 [5][6] Seasonality and Revenue Distribution - Revenue distribution for 2025 is expected to follow historical seasonality: approximately 22.5% in Q1, 25% in Q2, 25% in Q3, and 27.5% in Q4 [6][7] Competitive Landscape - iRhythm capitalized on competitive disruptions in late Q3 and Q4 of 2024, gaining new accounts [8][9] - Despite competitors returning to the market, iRhythm has maintained a significant portion of the business acquired during the disruption [9] Market Share and Product Performance - iRhythm holds a 70% market share in the Zio monitoring segment, with expectations of continued share growth [11][12] - The Zio Monitor, launched 18 months ago, has been well-received, contributing to the company's strong competitive positioning [12] Gross Margin and Tariff Impact - Gross margin guidance for the year is flat, with an anticipated negative impact of 50 to 75 basis points from tariffs, primarily affecting imports from China and Taiwan [13][14] - The company is exploring mitigation strategies to reduce tariff exposure, which may lead to gross margin expansion in 2025 [15][17] FDA Submissions and Future Products - iRhythm plans to submit the next-generation Zio MCT product for FDA approval in Q3 2025, which is expected to enhance market share [20][21] - The company aims for a faster launch of Zio MCT compared to previous product transitions [22] Primary Care Strategy - The partnership with Epic is expected to enhance clinician workflows and has already shown a 20% average volume uplift in pilot accounts [26][28] - Over one-third of Q1 volume came from primary care prescribers, up from approximately 20% in 2023, indicating a successful land-and-expand strategy [33][35] Innovative Channel Partnerships - Innovative channel partnerships are beginning to contribute to volume, with low single-digit percentages of overall volume but showing growth from near zero [37] Financial Outlook - iRhythm anticipates slightly negative free cash flow for 2025, with expectations to turn positive in 2026 [53][54] - Long-term goals include achieving 15% EBITDA margins at $1 billion in revenue, with potential for mid-20% margins beyond that [49] International Market and Reimbursement - The Japanese market remains strategically important despite disappointing reimbursement rates, with plans to generate in-country clinical evidence for future reimbursement cycles [55][57] Pricing Strategy - A low single-digit pricing headwind is expected for the year, consistent with past trends, while the company focuses on volume growth [59] Additional Important Insights - iRhythm is committed to operational excellence and efficiency improvements, leveraging automation and global infrastructure to enhance profitability [41][44] - The company is actively investing in R&D for adjacent market opportunities, including multi-sensing capabilities [50][52]