Q2 2025 Stereotaxis Inc Earnings Call

Speaker #3: Good afternoon. Thank you joining us for Stereotaxis' second quarter 2025 earnings conference call. Strengthened statements during the conference call and question-and-answer period to follow may may relate to future events, expectations, and as such, constitute forward-looking statements within the meaning of the private securities litigation reform act of 1995.

Speaker #3: Such statements involve known and unknown risks and certainties and other factors which may cause the actual results, performance, or achievements of the company in the future to be materially different from the statements that the company's executives may make today.

Speaker #3: These risks are described in detail in our public filings with the securities and exchange commission, including our latest periodic report from 10K, or 10Q.

Speaker #3: We assume no duty to update these statements. At this time, all participants have been placed on a listen-only mode. The floor will be open for questions and comments following the presentation.

Speaker #3: As a reminder, today's call is being recorded. It is now my pleasure to turn the floor over to your host, Mr. David Fischel, Chairman and CEO of Stereotaxis.

Speaker #4: Thank you, operator. And good noon, everyone. We've described this year as a pivotal, milestone-rich year in which we advance a broad portfolio of strategic innovations to market and demonstrate their initial commercial impact.

Speaker #4: We're diligently executing on multiple fronts and I'm pleased with our results. From both the regulatory and commercial perspective, our results are in line with the guidance provided at the start of this year.

Speaker #4: I'll keep our prepared remarks brief, providing updates on our key innovation and commercial efforts. As a reminder, our innovation strategy rests on four primary pillars: first, making our robot widely available by innovating it so that it doesn't require construction and can be rapidly installed in the majority of labs; second, building an ecosystem of catheters and integrations in our core EP ablation market, so physicians have greater choice in technologies while we reduce our dependencies and build an attractive razor-blade business; third, developing the right interventional devices so that our robots become a platform for endovascular surgery more broadly, providing value in several new clinical indications; and fourth, establishing a digital backbone that introduces connectivity and AI to our robot and the broader cath lab environment.

Speaker #4: Genesis X is the key technological innovation enabling robotics to be more broadly accessible. We received CE mark in Europe and have been working through the regulatory process for FDA clearance in the US.

Speaker #4: On our call, we described having addressed the vast majority FDA's questions and that we received additional questions on a few final topics. We addressed these topics in a submission to the FDA late in second quarter and view regulatory approval of Genesis X as likely still this summer.

Speaker #4: Concurrent with the regulatory effort, we are working to enhance compatibility of the robot with various X-rays, and preparing our supply chain manufacturing installation and commercial processes for a full launch.

Speaker #4: We successfully completed transfer to manufacturing of Genesis X in the second quarter, manufacturing the first commercial Genesis X system. That system is expected to be installed at our first customer in Europe as on as they complete installation of an X-ray in their lab, as they are placing Genesis X in a newly built cath lab.

Speaker #4: We expect to demonstrate Genesis X working in daily clinical use in one or two hospitals still this year, upon which we should be ready for full launch in Europe and the US.

Speaker #4: We continue to see steady demand for Genesis, but expect Genesis X orders to outpace the tempo of Genesis orders following the full launch. Our effort to build an ecosystem of proprietary EP catheters in our core EP ablation market has seen two significant regulatory milestones so far this year.

Speaker #4: CE mark of the magic ablation catheter during the first quarter and FDA clearance of the magic sweep high-density mapping catheter just a couple of weeks ago.

Speaker #4: We've talked about the importance and impact of magic on previous guidance, magic contributed approximately a couple of undred thousand dollars in revenue from initial European customers during the second quarter.

Speaker #4: We've talked about the importance and impact of magic on previous guidance, magic contributed approximately a couple of undred thousand dollars in revenue from initial European customers during the second calls.

Speaker #4: Initial procedures have now taken place at approximately 30% of our EU accounts, and administrative efforts at others are ongoing. We continue to work on FDA approval for magic and maintain a continuous dialogue with FDA.

Speaker #4: the second quarter, and we are working with FDA through a body of questions on sterility biocompatibility and manufacturing practices. We continue to expect US regulatory approval of magic later this In line with our year.

Speaker #4: US regulatory clearance of magic sweep was a major milestone for Stereotaxis. We discussed on a previous call the impact of high-density mapping on the EP field, and why a robotic HD mapping catheter is a significant opportunity to positively impact physicians' clinical results and workflow, the relevance of robotics in EP and our commercial results.

Speaker #4: Prominent KOLs were quoted in the press release announcing sweeps clearance, describing the importance of the catheter and how the lack of a mapping catheter has held back overall adoption of robotics.

Speaker #4: Magic sweep promises rapid and detailed electroanatomical mapping with the precision and inherent safety of our technology, the ability to map otherwise difficult-to-reach areas of the heart, and more anatomically accurate maps by oiding distention caused by rigid catheters.

Speaker #4: There are many EPs who think similar to those KOLs, and are excited to use the catheter. We're all already working through hospital administrative processes at several hospitals that will be the first users of the catheter, and expect usage at multiple accounts this quarter.

Speaker #4: We expect the combination of Magic and Magic Sweep to increase our disposable revenue per procedure significantly and to expand our user base and robotic utilization.

Speaker #4: Stepping back, FDA clearance of magic sweep is reflective of a major strategic transformation underway. It's the first FDA clearance Stereotaxis has received for a catheter in nearly 20 years.

Speaker #4: It demonstrates the foresight of our strategy to bring catheter development and manufacturing expertise in-house with the acquisition of APT last year. It's a tangible reflection of our progress building a robust ecosystem of robotically navigated interventional devices, a strategy that provides a much more attractive technological and commercial foundation for growth.

Speaker #4: It is even more exciting that this is just one of several proprietary catheters we are advancing to market across key geographies this year. In addition to magic and magic sweep, we've ed a portfolio of catheters and wires that enable our robot to provide value in several new clinical indications.

Speaker #4: We submitted the Imagine catheter for regulatory approval earlier this year, and continue to expect clearance this quarter. Following clearance, we look forward beginning the process of demonstrating that our robot can serve as a broad platform for endovascular surgery.

Speaker #4: We have initial physician interest in working with us to pioneer use across several neurointerventional cardiology and interventional radiology procedures. We expect that following regulatory clearance, we'll have several quarters of clinical updates demonstrating initial use and clinical value in these procedures.

Speaker #4: This transition of Stereotaxis from a single-application robot to a platform endovascular robot is a significant driver of strategic value and ultimately increases our total addressable market multiple-fold.

Speaker #4: The final significant innovation effort nearing regulatory milestones is our digital surgery platform that enables operating room connectivity and smart AI capabilities in the cath lab.

Speaker #4: Synchrony and Syncs digitize the various disparate systems in the cath lab, allowing for seamless control of all those systems from a consolidated cockpit. They offer modern cloud-based connectivity between the lab and the external world, and provide attractive opportunities for smart AI features to be integrated into the operating room.

Speaker #4: The technology has been designed for use with our robot, but also as a very attractive independent offering across non-robotic cath labs. We've completed all regulatory testing for Synchrony and expect to submit it for FDA clearance and declare CE mark in Europe very shortly.

Speaker #4: During the recently completed second quarter, we began limited commercialization of just the first comprehensive innovation strategy. Our results in the quarter benefited from revenue recognition on the first Genesis X system, and initial magic sales in Europe.

Speaker #4: technologies in this Kim will now provide additional commentary on our financial results, and then I'll make a few financial comments as well before opening the call to Q&A.

Speaker #4: These launches will accelerate and, as we achieve additional regulatory milestones, we will benefit from the layering of additional growth tailwinds. While these innovations are modestly contributing to system and recurring revenue in 2025, they set us up for breakout growth as we look towards 2026.

Speaker #4: Kim?

Speaker #5: Thank you, David, and good afternoon, everyone. Revenue for the second quarter of 2025 totaled $8.8 million, growth of 95% from $4.5 million in the prior year's second quarter, and growth of 18% sequentially compared to $7.5 million in the first quarter of 2025.

Speaker #5: System revenue for the second quarter was $3 million, and recurring revenue was $5.8 million, compared to $0.2 million and $4.3 million in the prior year's second quarter.

Speaker #5: System revenue in the quarter reflects revenue recognition on a Genesis system and our first Genesis X system. Recurring revenue growth reflects the contribution of mapping catheters from last year's acquisition of APT, as well as initial sales our robotically navigated magic ablation catheter.

Speaker #5: Gross margin for the second quarter 2025 was $52% of revenue. Recurring revenue gross margin was 68%, and system gross margin was 22%. Gross margins remain impacted by acquisition-related accounting that temporarily reduces disposable margin and by fixed overhead allocated over low system production levels.

Speaker #5: Operating expenses in the quarter of $8.6 million included $2.6 million in non-cash charges for stock compensation expense, a favorable mark-to-market adjustment for acquisition-related contingent earnout consideration, and amortization of acquired intangible assets.

Speaker #5: Excluding these non-cash charges, adjusted operating expenses were $6 million, compared to the prior year adjusted operating expenses of $6.8 million. Approximately half of the decline in adjusted operating expenses is from the receipt of an employee retention tax credit for the 2020 tax year, where the remaining decline due to natural reductions in R&D spending was a completion of certain larger projects.

Speaker #5: Operating loss and net loss in the second quarter of 2025 were $4 million and $3.8 million, compared with $6 million and $5.8 million in the previous year.

Speaker #5: Adjusted operating loss and adjusted net loss for the quarter, excluding non-cash charges, were $1.4 million and $1.3 million, compared with $3.5 million and $3.3 million in the previous year.

Speaker #5: Negative free cash flow for second quarter was $3.7 million, compared to $3.1 million in the previous year. At June 30th, Stereotaxis had cash and cash equivalents of $7 million and no debt.

Speaker #5: Subsequent to the end of the quarter, in July, Stereotaxis announced a registered direct financing for the sale of $12.5 million of its shares of common stock to a strategic industry partner and select institutional investors.

Speaker #5: A first closing of $8.5 million was completed in July, where the remaining $4 million to be completed in a second closing within four months.

Speaker #5: Incorporating the net proceeds from this offering, Stereotaxis would have $18.8 million in cash and no debt. I will now hand the call back to David.

Speaker #1: Thank you, Kim. As mentioned

Speaker #6: in our press release, we are reiterating our revenue guidance of double-digit revenue growth for the full year 2025, with system revenue in any given quarter fluctuating between approximately $2 to $3 million, and recurring revenue scaling to approximately $7 million in fourth quarter.

Speaker #6: Our revenue expectations assume only modest contributions from Genesis X, and no system revenue from China. We have demonstrated the ability to launch new technologies while maintaining stable operating expenses.

Speaker #6: Our recently completed equity financing offers us a stronger balance sheet with which to accelerate adoption of our comprehensive innovation strategy as the puzzle pieces come together and we are preparing for a full launch.

Speaker #6: We expect to launch our new technologies with a balanced focus on accelerating growth while also ensuring improved margins, earnings accretion, and achievement of profitability.

Speaker #6: We will now take your estions. Operator, can you please open the line to Q&A?

Speaker #1: Thank ou. We will now begin to question and answer session. At this time, I would like to remind everyone in order to ask a estion, press star, then the number one on your telephone keypad.

Speaker #1: We do request for today's session that you please limit to one question and one follow-up. And your first question comes from the line of Adam Mater with Piper Sandler.

Speaker #1: Your line is open.

Speaker #7: Hi, good afternoon. Thank you taking the questions and congrats on all of the progress. Great to see David, maybe we can start on kind your closing remarks there and a little bit of discussion around the financing and kind how you're thinking about use of proceeds.

Speaker #7: You know, the portfolio has obviously transformed a lot here over the past, you know, 12, 18 months, and you ow, kind of a complete refresh.

Speaker #7: And so will you, I think you've run pretty lean from a commercial standpoint historically, you know, will you to build out the sales force to, you know, push more aggressively?

Speaker #7: Maybe just talked , you know, the commercial strategy there with the new products in hand. And if you could provide some kind of headcount figures too, that would be appreciated.

Speaker #7: Thanks.

Speaker #8: Sure. Thanks a lot, Adam, for the estions. Good afternoon. And so, so it's great question. We, we obviously, this is the year in which we are getting regulatory approvals and starting the initial launches of many technologies as described in the prepared remarks.

Speaker #8: Both capital systems and then several catheters in the EP space and outside of the EP. And so that is kind of exciting for our sales team and for us as a company.

Speaker #8: We have a good existing commercial team direct in both the US, Europe, and even have direct sales members in Asia. In total, the commercial team numbers about 40 people, of which about 20 are in the US, 15 are in Europe, and 5 are in Asia.

Speaker #8: That spans clinical support and capital sales, as well as sales management and training. So, that's kind of the broader commercial team, with the predominant focus on the clinical side.

Speaker #8: We have demonstrated, I believe, you've en pretty nicely that both with the mapped catheters since the acquisition of APT a year ago, and more recently with the magic catheters, and we're seeing already the start of activity with magic sweep, very quickly after the regulatory approval.

Speaker #8: That our team has the ability to do much more than what historically they were doing. And in some ways, it's not just adding additional work to them.

Speaker #8: It makes the work much more successful, and it contributes to the success of their work. So I think there's a lot of synergy to the product portfolio and the way it's coming together in allowing each of the team members to actually be much more successful than what they've been historically.

Speaker #8: It's very synergistic, all of these product approvals and the addition of them to their back. With that said, I know that we have a relatively lean team, and we could increase our team significantly.

Speaker #8: And so there's going to be a balanced approach between on the one hand, during the al launch stage, our ing team is fantastic and able to do everything with the products that are gaining approval and starting to launch.

Speaker #8: As we start to see traction at individual accounts, we definitely plan to shift gradually to the model of having one clinical rep per hospital, rather than our current model where we have about one clinical rep for every three or four hospitals.

Speaker #8: That will allow us to go much deeper in terms of utilization and provide much better support and the revenue model with our own proprietary catheters allows that model to be very attractive and sustainable.

Speaker #8: And that's definitely a model that we're going to be implementing both in Europe and the US as we gain the regulatory approvals. I think we can do that in an accretive way.

Speaker #8: So we can build up the sales force while the adoption of these new catheters is growing and that all can happen incredibly, but we will be reinvesting a lot of the incremental gross profit and operating profit from these catheters back into the sales team for that growth.

Speaker #8: On the capital side, we have a very lean team. They've able to continue a relatively steady tempo of Genesis orders and sales but as we have Genesis X transitioning to a full launch later this year, we probably invest a couple of million dollars in a more robust dedicated capital team both in Europe and the US, and that should allow us to see capital sales next year growing very significantly.

Speaker #8: And so that's kind of our that's our overall high-level plan. I ope that gave enough color to help you. That was fantastic. Thank you for the detailed response, David.

Speaker #8: And for the follow-up, I'll ask about Europe. And you know the catheter business and two-part question, I guess. know first, you talked a little bit about the progress that Magic RF is making.

Speaker #8: In Europe, in terms of account penetration, you know could you just maybe double-click on how your customers are using the Magic RF catheter? Is it still largely SVP, VT, or are they doing you know kind of broader, more simple cases as well?

Speaker #8: And then just quickly, Genesis sweep, the mapping catheter, just OUS timelines there, and I'll drop back into Q. Thank ou. Sure. Thanks. So yeah, Magic in Europe we talked about approximately 30% of our European accounts have now started to use Magic in procedures.

Speaker #8: That's up from about 20% when we talked last quarter. And we see kind of steady it's amazing the administrative burdens in various countries. In Europe, and how just getting through tenders and getting on contract in certain countries and certain hospitals just takes it's kind of an administrative grind.

Speaker #8: But we're working on many of those in tandem. So I kind of see that percentage very naturally increasing, you know, month by month.

Speaker #8: We see usage of Magic so far across the full breadth of procedures. So you're correct that predominantly our robot has been used and is being used to treat more complex arrhythmias, VTs, PVCs, congenital patients, but we've en Magic being used already in AF, in AVNRTs, AVRTs, flutters.

Speaker #8: So really kind of across the spectrum from the simpler cases to the most complex. And so that's kind of obviously been nice to see that usage and to see the value that the catheter can provide across a broader spectrum procedures.

Speaker #8: In Europe, we have a very broad label for ablation in all four chambers of the heart. And so that obviously supports kind of a broad utilization across the spectrum.

Speaker #8: We're still in the earlier stages this launch, right? The second quarter was our first real quarter sales and revenue. And so I kind of I don't have any statistics yet on how Magic will grow utilization at individual accounts, but obviously as we kind of as we as we penetrate further in these accounts and and go kind more broadly across all of the accounts in Europe, I do expect Magic to have a positive halo effect on overall utilization.

Speaker #8: And if we step back to your second question, was related to I remember Magic Sweep. And European regulatory timeline, and there was something else that I'm missing, but on the European Magic Sweep, we talked about still getting clearance in Europe.

Speaker #8: This quarter, that's our expectation. But you know it obviously depends on the notified body, and so as we know more, we will share more.

Speaker #8: That's perfect. Thanks again. Thank you.

Speaker #1: And your next question comes from the line of Frank Tekinen with Lake Street Capital Markets. Your line is open.

Speaker #8: Great. Thanks for taking the questions and congrats on all the progress in the next quarter. I was hoping to start with some additional color on Magic FDA interactions, previous appreciate the update you provided today, but maybe help us understand kind of the how long some of these interactions could take with the FDA, when those could be submitted, and then the timeline from when those are submitted to answered, and then hearing back.

Speaker #8: Just bridging us from kind of where we are today to that second half approval. Okay. Sure. And we FDA does professional diligent work in its reviews.

Speaker #8: We see that across all of our submissions. And they're very much active and kind fulfill their professional mandate in reviewing submissions. We have been working with FDA very collaboratively in a lot of back and forth on the many topics that are part of a PMA submission and PMA approval process.

Speaker #8: I mentioned on in the prepared remarks that we are predominantly working through a body of questions on sterility biocompatibility and GMP good manufacturing practices.

Speaker #8: And so that's where most of the effort is. We submitted clinical data from the ongoing trial in Europe. In the second quarter, and so overall, ind of there is a regular tempo of interaction between FDA and us.

Speaker #8: We feel given that tempo and given the type of commentary from the ongoing discussions that approval in the second half of this year still makes a lot of sense.

Speaker #8: I think FDA is also aware of that and of the importance of this catheter to US patients and US physicians who benefit from robotics.

Speaker #8: And so we're just grinding through the process. And I've appreciated the collaborative nature of FDA in this process. Got it. That's helpful. then maybe just sizing up a sweep in the US a little bit more, happy to hear that's up to a strong start, but maybe talk about kind what that can contribute per procedure.

Speaker #8: What how many of your current cases today may use the catheter and then just kind of extrapolating that into how much revenue that could contribute.

Speaker #8: Sure. And so high-density mapping catheters are typically priced north of $2,000. Per procedure. And so you should expect kind of similar numbers for us.

Speaker #8: I'd say that high-density mapping is probably used in the majority and the majority probably means somewhere in the 70% or so perhaps a little bit more than that percentage of the procedures that we see.

Speaker #8: On our robot, so it's not every procedure, but it's a significant number of them. I ink that kind of one of the big benefits of Magic Sweep, though, is not just having it used in our existing procedures, but this is really if you think about our existing utilization and our core business, it has been it's predicated on still a catheter that is by now 20 years old with no catheter innovation.

Speaker #8: For these physician users for many, many years, essentially since they started using us. And so this is a significant opportunity, I think, to have them rethink how they do workflow and to kind of to have other benefits from the robot beyond what they've historically experienced.

Speaker #8: And so I think this is a real opportunity also to grow utilization to engage with physicians at existing sites that perhaps historically weren't using our robot as much.

Speaker #8: And so I think that there's going to be a broader benefit beyond just the step up in revenue per procedure. Perfect. Really helpful. Thank you.

Speaker #8: Thank you.

Speaker #1: Thank you. I'm not showing any further questions in the queue. I would now like to turn it back to David for closing remarks.

Speaker #9: Okay. Thank you very much for your questions and for your continued support. We look forward to working hard on your behalf and speaking again soon.

Speaker #9: Thank you very much.

Speaker #1: And ladies and gentlemen, this concludes today's call. Thank you all for joining. You may now disconnect.

Speaker #10: Hey, we just picked up blue pole in the station.