Executive Summary

Q1 2024 continuing operations revenue rose 192% year over year to $3.63M, with GAAP gross margin improving to −1% from −70% YoY as the business pivoted to Medtronic left-heart access manufacturing .
Net loss from continuing operations narrowed to $2.06M (EPS: $(0.07)), reflecting lower operating expenses under the streamlined model; total net loss was $(1.62)M given positive discontinued operations of $0.44M .
The company withdrew financial guidance amid its strategic realignment; management emphasized a manufacturing/distribution focus tied to Medtronic and potential earnouts .
Nasdaq delisting proceedings commenced April 30; shares moved to OTC Pink on May 9, 2024 (ticker AFIB), a liquidity and coverage headwind for equity investors .
Wall Street consensus via S&P Global was unavailable for AFIB, so estimate comparisons cannot be made (consensus not available via S&P Global).

What Went Well and What Went Wrong

What Went Well

Revenue growth driven by the Medtronic distribution agreement: continuing operations revenue reached $3.63M (+192% YoY), and gross margin improved to −1% on higher production volumes and lower overhead .
Operating expenses fell 38% YoY to $3.34M as the company reduced discretionary spend under the new business model .
Management reinforced the focus on left-heart access with potential earnouts: “reallocate capital from our mapping and ablation business to the manufacturing of left-heart access products for Medtronic, which we believe will maximize the potential for future earnouts and cash flow” — Chairman Scott Huennekens .

What Went Wrong

Profitability remains challenged: gross margin is still negative (−1%), with cost of goods exceeding revenue; continuing net loss was $(2.06)M .
Listing downgrade: Nasdaq commenced delisting proceedings; stock shifted to OTC Pink on May 9, 2024, reducing liquidity and likely institutional interest .
Legal overhang from operational wind-down: Biotronik filed an arbitration demand in February 2024 alleging breach of agreements related to licensing/manufacturing/distribution following the wind down, adding regulatory/legal uncertainty .

Financial Results

Quarterly trend (oldest → newest)

Metric	Q3 2023	Q4 2023	Q1 2024
Revenue ($USD Millions)	$5.238	$2.400	$3.625
Gross Margin % (GAAP)	−64%	N/A (not disclosed)	−1%
Net Loss - Continuing Operations ($USD Millions)	N/A (total net loss reported)	N/A (not disclosed)	$(2.055)
Diluted EPS - Continuing Operations ($USD)	N/A (total EPS $(0.45))	N/A (not disclosed)	$(0.07)

Notes: Q3 2023 press release reported results on a total-company basis pre full restructuring; Q4 2023 press release disclosed quarterly revenue but not quarterly EPS or continuing-ops net loss .

YoY comparison – Q1

Metric	Q1 2023	Q1 2024
Revenue ($USD Millions)	$1.242	$3.625
Gross Margin % (GAAP)	−70%	−1%
Net Loss - Continuing Operations ($USD Millions)	$(4.280)	$(2.055)
Diluted EPS - Continuing Operations ($USD)	$(0.15)	$(0.07)

Operating detail – Q1 2024

Metric	Q1 2024
Operating Expenses - Continuing Ops ($USD Millions)	$3.337
Gain on Sale of Business ($USD Millions)	$2.792
Income (Loss) from Discontinued Ops ($USD Millions)	$0.435

Discrepancy note: The press text references a “loss on discontinued operations of $0.4M,” while the financial statements show income of $0.435M for discontinued operations in Q1 2024 .

Balance Sheet KPIs

Metric	Dec 31, 2023	Mar 31, 2024
Cash & Cash Equivalents ($USD Millions)	$19.170	$18.459
Marketable Securities, Short-term ($USD Millions)	$3.233	$1.495
Restricted Cash, Short-term ($USD Millions)	$7.030	$0.000
Accounts Receivable ($USD Millions)	$11.353	$7.750
Inventory ($USD Millions)	$4.278	$5.888
Total Liabilities ($USD Millions)	$54.839	$45.688
Stockholders’ Deficit ($USD Millions)	$(0.879)	$(4.020)

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Financial Guidance (all metrics)	FY 2024 and beyond	Previously provided historically	No longer providing guidance	Withdrawn

Earnings Call Themes & Trends

Topic	Q-2 (Q3 2023)	Q-1 (Q4 2023)	Current (Q1 2024)	Trend
Business model shift	Announced strategic realignment; wind-down of EP mapping/ablation; focus on Medtronic left-heart access manufacturing; ~65% workforce reduction	Reaffirmed continuing ops focus; full-year metrics reflect transition	Operating model driving revenue and margin improvement in continuing ops	Consolidation to contract manufacturing/distribution model
Guidance policy	Ceased guidance due to restructuring	No longer providing guidance	Guidance withdrawn	Continued non-guidance policy
Gross margin dynamics	Negative 64% GAAP; improvement from prior year on production volumes/overhead	Full-year GM −44% GAAP	Q1 GM −1% GAAP; improved with higher volumes and reduced overhead	Improving margins with scale/efficiencies
Liquidity/Listing	Cash/marketable/restricted $45.5M; plan to reduce burn	Year-end cash/marketable/restricted $29.4M	Nasdaq delisting; OTC Pink trading from May 9	Lower liquidity/coverage post-delist
Regulatory/Legal	Restructuring/WARN Act actions disclosed	—	Biotronik arbitration demand regarding wind-down agreements noted in 10-Q	Legal overhang persists

Management Commentary

“We are taking the hard but necessary steps to streamline our operations… reallocate capital from our mapping and ablation business to the manufacturing of left-heart access products for Medtronic, which we believe will maximize the potential for future earnouts and cash flow.” — Scott Huennekens, Chairman .
“The realignment of resources and corporate restructuring unfortunately impacts our team… I want to thank each one of them for their dedication to Acutus and our mission.” — David Roman (then CEO) .
Q1 2024 press release emphasized that gross margin improvement was “driven by higher production volumes related to left-heart access manufacturing and reduced manufacturing overhead expenses,” and that operating expense reductions came from “reduced discretionary spend under this new business model” .

Q&A Highlights

No Q1 2024 earnings call transcript was located in company documents or common transcript repositories; management did not provide a Q&A record for analysts this quarter .

Estimates Context

Wall Street consensus (S&P Global) for AFIB Q1 2024 EPS and revenue was unavailable in S&P Global’s mapping for this ticker; therefore, comparisons to consensus estimates cannot be made at this time (S&P Global data unavailable).

Key Takeaways for Investors

The pivot to a manufacturing/distribution model for Medtronic left-heart access products is translating into materially higher revenue and sharply improved GAAP gross margin (−1% vs −70% YoY), but profitability remains negative; scaling and overhead discipline are critical levers .
Guidance withdrawal and OTC Pink listing post-Nasdaq delist reduce visibility and likely diminish institutional participation; expect thinner liquidity and wider spreads .
The earnout structure tied to Medtronic net end-user sales (100% in year 1; 75% in year 2; 50% in years 3–4) underpins medium-term cash flow potential; execution on production and Medtronic demand cadence is the key variable .
Legal/arbitration risk with Biotronik adds uncertainty; investors should monitor developments given potential financial and operational impacts on the streamlined business .
Balance sheet shows declining liabilities and increased inventory as operations reconfigure; working capital management remains vital amidst transition and earnout timing .
Near-term trading: headlines around legal matters, OTC liquidity, and any Medtronic volume updates could drive volatility; absence of guidance and consensus estimates elevates uncertainty premium .
Medium-term thesis: if the company sustains volume increases and overhead control under the Medtronic agreement while resolving legal issues, margin trajectory could continue improving, supporting lower cash burn and potential positive cash flow per management’s strategic intent .

Acutus Medical, Inc. (AFIB)·Q1 2024 Earnings Summary