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Cryo has made it possible for less skilled EPs to perform PVIs, but it doesn’t solve for the difficulty of contact mapping. For the initial PVI, high-resolution contact mapping is not a necessity. But the PVI itself frequently results in scarring that causes other SVTs, which require detailed activation maps to ablate. When patients come back to ablate these, AcqMap allows the EP to rapidly and accurately find and ablate the arrhythmia without requiring a high degree of skill. 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As the pandemic has ebbed, the logistical restrictions on training have fallen and, at the same time, Acutus's new Chief Commercial Officer - Duane Wilder - has both expanded the training regimen and bulked up the training and mapping staff to assist physicians in making the workflow and procedural changes that are entailed in the adoption of AcQMap. 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The thinking was that AcQMap was so good, system installations would be inexorably followed by increasing utilization of AcQMap in ablation procedures. But that's not what happened. Instead, at many labs, utilization dropped to almost nothing after the first few procedures. Partly, this was due to inadequate initial physician training on the part of Acutus, which was itself very much driven by the logistical difficulty of setting up training centers, inviting EPs to Acutus's central training facilities, or providing on-premises close-contact training in the middle of a raging pandemic. Another issue was that Acutus reps didn't discriminate in their push to rack up system installs, and many centers that were philosophically oriented towards empirical ablation methods ended up with an AcQMap system that's a lot less useful for EPs who know exactly which tissue they're going to ablate even before they insert their catheters.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:45:21.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5e6fc4b5-8cac-499d-bb7d-23776c66d9b3", "parentComponentId": null }, { "bbox": { "h": 0.155, "w": 0.764, "x": 0.118, "y": 0.478 }, "kind": "paragraph", "text": "Marketing in the first year of AcQMap's commercialization was also a factor in subpar utilization. Acutus's strategy was to focus on the \"holy grail\" aspects of AcQMap, namely the ability of the EP to use the technology to find the triggers of AF in complex cases and subsequently ablate them. While it's true that AcQMap has proven its ability to increase the effectiveness of an ablation procedure, there were two problems with the marketing approach. 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Based on extensive conversations with EPs and hospital procurement managers, we believe Acutus's stumbles stem from a temporary but unlucky combination of pandemic-driven purchasing and training hurdles, excessively broad early sales targeting, and a strategically misguided initial marketing message from which Acutus has since successfully pivoted.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:45:21.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "81921737-d723-47b7-b999-1d208da1de62", "parentComponentId": null }, { "bbox": { "h": 0.215, "w": 0.764, "x": 0.118, "y": 0.641 }, "kind": "paragraph", "text": "More importantly, though, is that EPs have been subjected to numerous new technologies over the last decade with the promise of finally finding the physical sources of AF. 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In addition, the Authors may benefit from any change in the valuation of any other companies, securities, or commodities discussed in this document. Analysts who prepared this report are compensated based upon (among other factors) the overall profitability of the Authors' operations and their affiliates. The compensation structure for the Authors' analysts is generally a derivative of their effectiveness in generating and communicating new investment ideas and the performance of recommended strategies for the Authors. This could represent a potential conflict of interest in the statements and opinions in the Authors' documents.\n\nThe information contained in this document may include, or incorporate by reference, forward-looking statements, which would include any statements that are not statements of historical fact. Any or all of the Authors' forward-looking assumptions, expectations, projections, intentions or beliefs about future events may turn out to be wrong. These forward-looking statements can be affected by inaccurate assumptions or by known or unknown risks, uncertainties and other factors, most of which are beyond the Authors' control. Investors should conduct independent due diligence, with assistance from professional financial, legal and tax experts, on all securities, companies, and commodities discussed in this document and develop a stand-alone judgment of the relevant markets prior to making any investment decision.", "attrs": null, "canon": { "kind": { "name": "Disclaimer", "slug": "disclaimer", "status": "active", "canonId": "91173477-d91f-4024-bbaf-d4f93e3f82dc", "version": 1, "description": "Legal/cautionary text that occupies most of the body of its slide." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:45:23.321+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "037e8327-8178-4a7b-8656-9d95a20f3e48", "parentComponentId": null }, { "bbox": { "h": 0.015, "w": 0.764, "x": 0.118, "y": 0.945 }, "kind": "other", "text": "Kerrisdale Capital Management, LLC | 1212 Avenue of the Americas, 3rd Floor | New York, NY 10036 | Tel: 212.792.7999 | Fax: 212.531.6153", "attrs": null, "canon": { "kind": { "name": "Other", "slug": "other", "status": "active", "canonId": "019de52c-fa90-743c-8bf6-20d1fbe82b6d", "version": 1, "description": "Fallback when no canonical kind applies." }, "tool": null, "subkind": { "name": "Unclassified", "slug": "unclassified", "status": "active", "canonId": "019de52d-05ca-77db-81fb-db7d4234bbc0", "version": 1, "description": null }, "framework": null }, "subkind": "unclassified", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:45:23.321+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "999da6c2-bd41-40c0-9997-425e2612a064", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true } ], "arcBeats": [], "loops": [] }