{ "docId": "019dd923-622c-750b-8b98-17b017c6aac8", "docSlug": "384ff8288d23", "documentTitle": "Acutus Medical Inc. (AFIB)", "authorId": "53_Kerrisdale_Capital", "authorName": "Kerrisdale Capital", "documentKindSlug": "research-note", "documentKindLabel": "Research note", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2021-07-01 00:00:00", "orientation": "portrait", "aspectRatio": 0.77272725, "pageNumber": 21, "pageCount": 29, "prevPage": 20, "nextPage": 22, "slideType": "other", "function": "summarize", "density": "dense", "nDataPoints": 0, "notes": "This is a text-heavy research note slide summarizing qualitative feedback from Electrophysiologists (EPs).", "elementsJson": [ "paragraph" ], "metadataConfidence": 0.9, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b98-17b017c6aac8/21", "deckHref": "/decks/019dd923-622c-750b-8b98-17b017c6aac8", "deckJsonHref": "/decks/019dd923-622c-750b-8b98-17b017c6aac8.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b98-17b017c6aac8#slide-21", "components": [ { "bbox": null, "kind": "callout", "text": "In sum, the feedback we received from practitioners with first-hand knowledge of AcqMap did more than confirm the impressive ablation effectiveness AcqMap enabled in the clinical literature.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd952-fb8f-761b-afce-156d716239fa", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.22, "w": 0.8, "x": 0.11, "y": 0.31 }, "kind": "paragraph", "text": "Several EPs explained that the ease, rapidity, and quality of the mapping is a crucial advantage in the context of the increasing pervasiveness of cryoablation. 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. EPs trained on cryo are unlikely to have the handling skills necessary to maneuver a contact mapping catheter with the dexterity it requires, and so AcqMap can be crucial to the success of their redo procedures.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "0187d8c5-0a4d-4047-b4f9-5c723509c696", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.8, "x": 0.11, "y": 0.81 }, "kind": "paragraph", "text": "In sum, the feedback we received from practitioners with first-hand knowledge of AcqMap did more than confirm the impressive ablation effectiveness AcqMap enabled in the clinical literature. It also impressed upon us that AcqMap’s successful commercialization will be significantly enhanced by its ability to improve physician workflow and procedural efficiency, and respond to physician feedback in ways that legacy med-tech companies cannot.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "2c8ea54c-6d72-4a0f-a04d-5bd4df31260b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.8, "x": 0.11, "y": 0.54 }, "kind": "paragraph", "text": "In persistent AF, like in redo cases after an initial PVI, AcqMap is an effective guide for where in the chamber to focus. As one physician explained to us, an EP treating persistent AF knows they need to do more than a PVI. “There’s always a desire to burn off more [tissue], and Acutus can cater to that desire by really pointing to what should be further ablated.” Too much ablation will result in unnecessary lesions that can lead to atrial flutter, and AcqMap can help avoid those.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "2e5d3d1f-4a01-41ca-b7ec-7440af927892", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.05, "w": 0.8, "x": 0.11, "y": 0.09 }, "kind": "paragraph", "text": "sales reps at Biosense Webster. EPs who were high-volume AcqMap users agreed that the high-resolution activation recording allows for better results in complex arrhythmias because the conduction patterns are just much clearer and more identifiable.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "4c9355c2-c365-4c7e-827c-bc1993469c1f", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.8, "x": 0.11, "y": 0.15 }, "kind": "paragraph", "text": "Several EPs observed that PVI is the kind of relatively simple procedure in which AcqMap resolution is overkill, but that in redo ablations and persistent AF, AcqMap can be indispensable. In redo cases, for example, EPs explained that prior ablation can frequently create scar tissue that makes arrhythmic conduction even harder to identify, and AcqMap’s visualization avoids that problem. Redo cases that are performed after PVI can also leave an EP with the difficult puzzle of where to even begin looking for errant conduction if the PVs are properly isolated, and AcqMap rapidly points the physician to the appropriate site.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b8d13b65-93da-4f51-bde2-814d5324cdbe", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.13, "w": 0.8, "x": 0.11, "y": 0.67 }, "kind": "paragraph", "text": "Aside from procedural improvements, several EPs explained that as the older generation of practitioners retires, younger practitioners will be much more apt to want to only work off the highest possible resolution activation maps, and no one can provide that like Acutus. Acutus has also endeared itself to the so-far niche segment of the EP community that has adopted AcqMap by being nimble and responsive to their requests: the second generation AcqMap is a huge improvement over the first in both its capabilities as well as its physical build, mostly because the company has been willing to rapidly incorporate physician feedback into their engineering process.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "d74c9a69-4464-475b-a19d-ad72da9a2410", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "There’s always a desire to burn off more [tissue], and Acutus can cater to that desire by really pointing to what should be further ablated. — An EP treating persistent AF", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd952-fb8f-761b-afce-1a7cd367e00e", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [ { "name": "Authority citation", "slug": "authority-citation", "agent": null, "layer": "slide", "matchId": "3ea081d0-dbb1-469d-8998-8173d1d16c44", "evidence": "\"the specific mechanisms and determinants remain to be elucidated, along with their implications for therapy.\" — 2017 HRS consensus statement", "confidence": 0.8 } ], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }