Table of Contents
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
____________________________
FORM
10-Q

(Mark one)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 20202023
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from
to 
Commission File
Number 001-39430

gbk0ijuxhbuw000001.jpg
ACUTUS MEDICAL, INC.
(Exact name of registrant as specified in its charter)

Delaware
45-1306615
(State or other jurisdiction of

incorporation or organization)
(I.R.S. Employer

Identification No.)
2210 Faraday Ave.,
Suite 100, Carlsbad, CA
92008
(Address of principal executive offices)(Zip Code)
2210 Faraday Ave., Suite 100, Carlsbad, CA 92008
(Address of principal executive offices and zip code)
(442) 232-6080
(Registrant’s telephone number, including area code) (442) 232-6080

Securities registered pursuant to Section 12(b) of the Act:
Title of each class
Trading symbol

Symbol
Name of each exchange
on which registered
Common Stock, par value $0.0001$0.001 per share
AFIB
The Nasdaq Stock Market LLC
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days
.    
YES
days.    Yes  ☒    No  
    NO  
Indicate by check mark whether the registrant has submitted electronically if any, every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation
S-T
232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    
YESYes  ☒    NONo  ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a
non-accelerated
filer, a smaller reporting company or an emerging growth company. See definition of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule
12b-2
of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filer
Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  ☐
Indicate by check mark whether registrant is a shell company (as defined in Rule
12b-2
of the Exchange Act).    
YESYes  ☐    NONo  ☒
Indicate the number of shares outstanding of each of the registrant’s classes of common stock, as of the latest practicable date.
Class of Common Stock
Outstanding Shares as of September 1
7
, 2020
Common Stock, $0.001 par value
27,826,408

ACUTUS MEDICAL, INC. AND SUBSIDIARIES
Form 10-Q
For the Quarter Ended June 30, 2020
Table of Contents
Class of Common Stock
Page
Outstanding Shares as of August 2, 2023
PART I. FINANCIAL INFORMATION
Common Stock, $0.001 par value
29,259,086


Acutus Medical, Inc.
Form 10-Q
For the Quarter Ended June 30, 2023
Table of Contents
Page
6
31
47
47
48
48
48
49
51

Item 1. Financial Statements.
Acutus Medical, Inc. and Subsidiaries
Condensed Consolidated Balance Sheets
June 30,
2023
December 31,
2022
(in thousands, except share and per share amounts)(unaudited)
ASSETS
Current assets:
Cash and cash equivalents$23,055 $25,584 
Marketable securities, short-term31,461 44,863 
Restricted cash, short-term7,002 5,764 
Accounts receivable7,670 21,085 
Inventory15,671 13,327 
Employer retention credit receivable— 4,703 
Prepaid expenses and other current assets2,444 2,541 
Total current assets87,303 117,867 
Property and equipment, net7,245 9,221 
Right-of-use assets, net3,533 3,872 
Intangible assets, net1,483 1,583 
Other assets731 897 
Total assets$100,295 $133,440 
LIABILITIES AND STOCKHOLDERS' EQUITY
Current liabilities:
Accounts payable$5,492 $4,721 
Accrued liabilities9,759 9,686 
Contingent consideration, short-term— 1,800 
Operating lease liabilities, short-term466 319 
Warrant liability2,504 3,346 
Total current liabilities18,221 19,872 
Operating lease liabilities, long-term3,679 4,103 
Long-term debt34,634 34,434 
Other long-term liabilities20 12 
Total liabilities56,554 58,421 
Commitments and contingencies (Note 12)
Stockholders' equity
Preferred stock, $0.001 par value; 5,000,000 shares authorized as of June 30, 2023 and December 31, 2022; 6,666 shares of the preferred stock, designated as Series A Common Equivalent Preferred Stock, are issued and outstanding as of June 30, 2023 and December 31, 2022— — 
Common stock, $0.001 par value; 260,000,000 shares authorized as of June 30, 2023 and December 31, 2022; 29,206,570 and 28,554,656 shares issued and outstanding as of June 30, 2023 and December 31, 2022, respectively29 29 
Additional paid-in capital597,578 594,173 
Accumulated deficit(552,975)(518,314)
Accumulated other comprehensive loss(891)(869)
Total stockholders' equity43,741 75,019 
Total liabilities and stockholders' equity$100,295 $133,440 
(in thousands, except share and per share amounts)
   
June 30,

2020
  
December 31,
2019
 
   
(unaudited)
    
ASSETS:
   
Current assets:
   
Cash and cash equivalents
  $24,295  $9,452 
Marketable securities
   5,037   62,351 
Restricted cash
   150   150 
Accounts receivable
   860   263 
Inventory
   12,266   8,424 
Deferred offering costs
  
2,506
 
 
 
—  
 
Prepaid expenses and other current assets
   1,323   1,816 
  
 
 
  
 
 
 
Total current assets
   46,437   82,456 
  
 
 
  
 
 
 
Property and equipment, net
   7,584   4,427 
Right-of-use asset, net
   2,005   2,341 
Intangible assets, net
   3,890   4,110 
Goodwill
   12,026   12,026 
Other assets
   87   95 
  
 
 
  
 
 
 
Total assets
  
$
72,029
 
 
$
105,455
 
  
 
 
  
 
 
 
LIABILITIES, CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS’ DEFICIT
   
Current liabilities:
   
Accounts payable
  $9,084  $3,882 
Accrued liabilities
   7,036   10,076 
Contingent consideration, short-term
   3,500   8,200 
Operating lease liabilities, short-term
   882   833 
Common and preferred stock warrant liability
   10,791   8,919 
  
 
 
  
 
 
 
Total current liabilities
   31,293   31,910 
  
 
 
  
 
 
 
Operating lease liabilities, long-term
   1,594   2,054 
Long-term debt
   38,558   38,244 
Contingent consideration, long-term
   4,000   5,700 
  
 
 
  
 
 
 
Total liabilities
   75,445   77,908 
  
 
 
  
 
 
 
Commitments and contingencies (Note 11)
    
 
 
 
C
onvertible preferred stock
  
Series A convertible preferred stock, $0.001 par value; 3,848,696 shares authorized as of each of June 30, 2020 and
December 31, 2019; 391,210 shares issued and outstanding as of each of June 30, 2020 and December 31, 2019;
liquidation preference of $3,245 as of each of June 30, 2020 and December 31, 2019
   3,059   3,059 
Series B convertible preferred stock, $0.001 par value; 30,032,100 shares authorized as of each of June 30, 2020
 
and
December 31, 2019; 3,088,444 shares issued and outstanding as of each of June 30, 2020 and December 31, 2019;
liquidation preference of $41,294 as of each of June 30, 2020 and December 31, 2019
   40,685   40,685 
Series C convertible preferred stock, $0.001 par value; 48,184,000 shares authorized as of each of June 30, 2020 and December 31, 2019; 4,499,921 shares issued and outstanding as of each of June 30, 2020 and December 31, 2019; liquidation preference of $75,000 as of each of June 30, 2020 and December 31, 2019
   74,575   74,575 
Series D convertible preferred stock, $0.001 par value; 90,000,000 shares authorized as of each of June 30, 2020 and December 31, 2019; 8,593,360 and 8,200,297 issued and outstanding as of June 30, 2020 and December 31, 2019, respectively; liquidation preference of $157,348 and $136,675 as of June 30, 2020 and December 31, 2019,
respectively
   142,236   135,039 
 
 
 
 
 
 
 
 
 
Stockholders’ deficit
   
Common stock, $0.001 par value; 260,000,000 shares authorized as of each of June 30, 2020 and December 31, 2019; 775,403 and 695,902 shares issued and outstanding as of June 30, 2020 and December 31, 2019, respectively
   1   1 
Additional
paid-in
capital
   36,355   33,252 
Accumulated deficit
   (300,325  (259,034
Accumulated other comprehensive loss
   (2  (30
  
 
 
  
 
 
 
Total stockholders’ deficit
   (263,971  (225,811
  
 
 
  
 
 
 
Total liabilities, convertible preferred stock and stockholders’ deficit
  
$
72,029
 
 
$
105,455
 
  
 
 
  
 
 
 
The accompanying notes are an integral part of these condensed consolidated financial statements.
1

Acutus Medical, Inc. and Subsidiaries
Condensed Consolidated Statements of Operations and Comprehensive Loss
Income (Loss)
(in thousands, except share and per share amounts)
Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
(in thousands, except share and per share amounts)(unaudited)
Revenue$5,289 $4,076 $9,458 $7,757 
Cost of products sold8,063 9,697 $14,852 $16,638 
Gross profit(2,774)(5,621)$(5,394)$(8,881)
Operating expenses (income):
Research and development6,799 7,935 12,916 15,938 
Selling, general and administrative9,284 14,143 18,849 28,528 
Goodwill impairment— — — 12,026 
Restructuring463 — 475 949 
Change in fair value of contingent consideration(77)948 123 955 
Gain on sale of business(2,072)(43,575)(3,279)(43,575)
Total operating expenses (income)14,397 (20,549)29,084 14,821 
Income (loss) from operations(17,171)14,928 (34,478)(23,702)
Other income (expense):
Loss on debt extinguishment— (7,947)— (7,947)
Change in fair value of warrant liability(604)— 842 — 
Interest income824 27 1,676 51 
Interest expense(1,395)(1,290)(2,701)(2,701)
Total other expense, net(1,175)(9,210)(183)(10,597)
(Loss) income before income taxes(18,346)5,718 (34,661)(34,299)
Income tax benefit— — — — 
Net (loss) income$(18,346)$5,718 $(34,661)$(34,299)
Other comprehensive income (loss)
Unrealized gain (loss) on marketable securities(8)18 (39)
Foreign currency translation adjustment(85)(387)(26)(553)
Comprehensive income (loss)$(18,439)$5,349 $(34,683)$(34,891)
Basic net income (loss) per common share$(0.63)$0.16 $(1.20)$(1.22)
Diluted net income (loss) per common share$(0.63)$0.16 $(1.20)$(1.22)
Basic weighted average shares outstanding29,039,732 28,339,362 28,902,808 28,229,338 
Diluted weighted average shares outstanding29,039,732 28,349,429 28,902,808 28,229,338 
(Unaudited)
   
Three Months Ended June 30,
  
Six Months Ended June 30,
 
   
2020
  
2019
  
2020
  
2019
 
Revenue
  $1,134  $734  $2,717  $1,521 
    
Costs and operating expenses:
         
Cost of products sold
   2,663   2,435   5,857   4,611 
Research and development
   8,176   5,247   16,149   9,624 
Selling, general and administrative
   9,125   6,927   19,360   11,020 
Change in fair value of contingent consideration
   635   —     (1,584  —   
  
 
 
  
 
 
  
 
 
  
 
 
 
Total costs and operating expenses
   20,599   14,609   39,782   25,255 
  
 
 
  
 
 
  
 
 
  
 
 
 
Loss from operations
   (19,465  (13,875  (37,065  (23,734
    
Other income (expense):
         
Change in fair value of warrant liability and embedded derivative
   (2,453  (1,446  (1,872  (605
Loss on debt extinguishment
   —     (1,398  —     (1,398
Interest income
   95   143   370   208 
Interest expense
   (1,370  (13,769  (2,724  (19,511
  
 
 
  
 
 
  
 
 
  
 
 
 
Total other expense, net
   (3,728  (16,470  (4,226  (21,306
  
 
 
  
 
 
  
 
 
  
 
 
 
Net loss
  $(23,193 $(30,345 $(41,291 $(45,040
  
 
 
  
 
 
  
 
 
  
 
 
 
    
Other comprehensive income (loss)
         
Unrealized (loss) gain on marketable securities
   (14  6   (41  7 
Foreign currency translation adjustment
   96   2   69   (12
  
 
 
  
 
 
  
 
 
  
 
 
 
Comprehensive loss
  
$
(23,111
 
$
(30,337
 
$
(41,263
 
$
(45,045
  
 
 
  
 
 
  
 
 
  
 
 
 
    
Net loss per common share, basic and diluted
  $(32.24 $(45.70 $(58.16 $(68.21
  
 
 
  
 
 
  
 
 
  
 
 
 
Weighted-average shares outstanding, basic and diluted
   719,421   663,972   709,961   660,333 
  
 
 
  
 
 
  
 
 
  
 
 
 
The accompanying notes are an integral part of these condensed consolidated financial statements.
2

Acutus Medical, Inc. and Subsidiaries
Condensed Consolidated Statements of Convertible Preferred Stock and Stockholders’ DeficitEquity
(in thousands, except share amounts)
(Unaudited)
For the Three Months Ended June 30, 2020
2023
(in thousands, except share amounts)Preferred StockCommon StockAdditional
Paid-in
Capital
Accumulated
Deficit
Accumulated
Other
Comprehensive
Loss
Total
Stockholders'
Equity
SharesAmountSharesAmount
Balance as of March 31, 20236,666 $ 28,894,080 $29 $595,864 $(534,629)$(798)$60,466 
Unrealized loss on marketable securities— — — — — — (8)(8)
Foreign currency translation adjustment— — — — — — (85)(85)
Stock-based compensation— — 267,328 — 1,689 — — 1,689 
Employee stock purchase plan shares issued— — 45,162 — 25 — — 25 
Net loss— — — — — (18,346)— (18,346)
Balance as of June 30, 2023 (unaudited)6,666 $ 29,206,570 $29 $597,578 $(552,975)$(891)$43,741 
 
  
Series A
Convertible
Preferred Stock
 
  
Series B
Convertible
Preferred Stock
 
  
Series C
Convertible
Preferred Stock
 
  
Series D
Convertible
Preferred Stock
 
  
Common Stock
 
  
Additional
Paid-in

Capital
 
  
Accumulated

Deficit
 
 
Accumulated

Other
Comprehensive

Income (Loss)
 
 
Total
Stockholders’

Deficit
 
 
  
Shares
 
  
Amount
 
  
Shares
 
  
Amount
 
  
Shares
 
  
Amount
 
  
Shares
 
  
Amount
 
  
Shares
 
  
Amount
 
Balance as of March 31, 2020 (unaudited)
  
 
391,210
 
  
$
3,059
 
  
 
3,088,444
 
  
$
40,685
 
  
 
4,499,921
 
  
$
74,575
 
  
 
8,593,360
 
  
$
 142,236
 
  
 
710,841
 
  
$
1
 
  
$
34,993
 
  
$
(277,132
 
$
(84
 
$
(242,222
Unrealized
loss on marketable securities
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
 
 
(14
 
 
(14
Foreign currency translation adjustment
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
 
 
96
 
 
 
96
 
Stock option exercises
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
64,562
 
  
 
—  
 
  
 
205
 
  
 
—  
 
 
 
—  
 
 
 
205
 
Stock-based compensation
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
1,157
 
  
 
—  
 
 
 
—  
 
 
 
1,157
 
Net loss
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
 
  
 
(23,193
 
 
—  
 
 
 
(23,193
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
Balance as of June 30, 2020 (unaudited)
  
 
391,210
 
  
$
3,059
 
  
 
3,088,444
 
  
$
40,685
 
  
 
4,499,921
 
  
$
74,575
 
  
 
8,593,360
 
  
$
142,236
 
  
 
775,403
 
  
$
1
 
  
$
36,355
 
  
$
(300,325
 
$
 (2)
 
 
$
(263,971
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
For the Three Months Ended June 30, 2019
2022
(in thousands, except share amounts)Preferred StockCommon StockAdditional
Paid-in
Capital
Accumulated
Deficit
Accumulated
Other
Comprehensive
Income (Loss)
Total
Stockholders'
Equity
SharesAmountSharesAmount
Balance as of March 31, 20226,666 $ 28,279,065 $28 $587,889 $(518,715)$(440)$68,762 
Unrealized gain on marketable securities— — — — — — 18 18 
Foreign currency translation adjustment— — — — — — (387)(387)
Stock-based compensation— — 70,135 — 2,540 — — 2,540 
Net income— — — — — 5,718 — 5,718 
Balance as of June 30, 2022 (unaudited)6,666 $ 28,349,200 $28 $590,429 $(512,997)$(809)$76,651 
 
  
Series A
Convertible
Preferred Stock
 
  
Series B
Convertible
Preferred Stock
 
  
Series C
Convertible
Preferred Stock
 
  
Series D
Convertible
Preferred Stock
 
  
Common Stock
 
  
Additional
Paid-in

Capital
 
  
Accumulated

Deficit
 
 
Accumulated

Other
Comprehensive

Income (Loss)
 
  
Total
Stockholders’

Deficit
 
 
  
Shares
 
  
Amount
 
  
Shares
 
  
Amount
 
  
Shares
 
  
Amount
 
  
Shares
 
  
Amount
 
  
Shares
 
  
Amount
 
Balance as of March 31, 2019 (unaudited)
  
 
391,210
 
  
$
3,059
 
  
 
3,088,444
 
  
$
40,685
 
  
 
4,499,921
 
  
$
74,575
 
  
 
—  
 
  
$
—  
 
  
 
656,654
 
  
$
1
 
  
$
30,709
 
  
$
(176,690
 
$
7
 
  
$
(145,973
Unrealized
gain on marketable securities
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
 
 
6
 
  
 
6
 
Foreign currency translation adjustment
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
 
 
2
 
  
 
2
 
Issuance of Series D convertible preferred stock for cash, net of issuance costs of $274
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
2,309,959
 
  
 
38,226
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
 
 
—  
 
  
 
—  
 
Issuance of Series D convertible preferred stock for 2018 Convertible Notes and 2019 Convertible Notes
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
 
  
 
—  
 
  
 
4,108,478
 
  
 
68,476
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
 
 
—  
 
  
 
—  
 
Stock-based compensation
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
6,837
 
  
 
—  
 
  
 
803
 
  
 
—  
 
 
 
—  
 
  
 
803
 
Stock option exercises
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
8,469
 
  
 
—  
 
  
 
57
 
  
 
—  
 
 
 
—  
 
  
 
57
 
Net loss
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
—  
 
  
 
(30,345
 
 
—  
 
  
 
(30,345
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
 
 
 
 
  
 
 
 
Balance as of June 30, 2019 (unaudited)
  
 
391,210
 
  
$
3,059
 
  
 
3,088,444
 
  
$
40,685
 
  
 
4,499,921
 
  
$
74,575
 
  
 
6,418,437
 
  
$
 106,702
 
  
 
671,960
 
  
$
1
 
  
$
31,569
 
  
$
(207,035
 
$
15
 
  
$
(175,450
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
 
 
 
 
  
 
 
 
The accompanying notes are an integral part of these condensed consolidated financial statements.

3

Acutus Medical, Inc. and Subsidiaries
Condensed Consolidated Statements of Convertible Preferred Stock and Stockholders’ DeficitEquity
(in thousands, except share amounts)
(Unaudited)
For the Six Months Ended June 30, 2020
2023
(in thousands, except share amounts)Preferred StockCommon StockAdditional
Paid-in
Capital
Accumulated
Deficit
Accumulated
Other
Comprehensive Income (Loss)
Total
Stockholders'
Equity
SharesAmountSharesAmount
Balance as of December 31, 20226,666 $ 28,554,656 $29 $594,173 $(518,314)$(869)$75,019 
Unrealized gain on marketable securities— — — — — — 
Foreign currency translation adjustment— — — — — — (26)(26)
Stock option exercises— — 3,218 — — — 
Stock-based compensation— — 603,534 — 3,376 — — 3,376 
Employee stock purchase plan shares issued— — 45,162 — 25 — — 25 
Net loss— — — — — (34,661)— (34,661)
Balance as of June 30, 2023 (unaudited)6,666 $ 29,206,570 $29 $597,578 $(552,975)$(891)$43,741 
  
Series A
  
Series B
  
Series C
  
Series D
  
Common Stock
  
Additional
Paid-in

Capital
  
Accumulated

Deficit
  
Accumulated

Other
Comprehensive

Income (Loss)
  
Total
Stockholders’

Deficit
 
  
Convertible
Preferred Stock
  
Convertible
Preferred Stock
  
Convertible
Preferred Stock
  
Convertible
Preferred Stock
 
  
Shares
  
Amount
  
Shares
  
Amount
  
Shares
  
Amount
  
Shares
  
Amount
  
Shares
  
Amount
 
Balance as of December 31, 2019
  
 
391,210
 
  
$
 3,059
 
  
 
3,088,444
 
  
$
 40,685
 
  
 
4,499,921
 
  
$
 74,575
 
  
 
8,200,297
 
  
$
 135,039
 
  
 
695,902
 
  
$
1
 
  
$
 33,252
 
  
$
 (259,034)
 
 
$
 (30)
 
 
$
 (225,811)
 
Unrealized loss on marketable securities
   —      —      —      —      —      —      —      —      —      —      —      —     (41  (41
Foreign currency translation adjustment
   —      —      —      —      —      —      —      —      —      —      —      —     69   69 
Issuance of Series D convertible preferred stock for the Biotronik Asset Purchase
   —      —      —      —      —      —      273,070    5,000    —      —      —      —     —     —   
Issuance of Series D convertible preferred stock for the contingent consideration related to the Rhythm Xience Acquisition
   —      —      —      —      —      —      119,993    2,197    —      —      —      —     —     —   
Stock option exercises
   —      —      —      —      —      —      —      —      64,562    —      205    —     —     205 
Stock-based compensation
   —      —      —      —      —      —      —      —      14,939    —      2,898    —     —     2,898 
Net loss
   —      —      —      —      —      —      —      —      —      —      —      (41,291  —     (41,291
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
Balance as of June 30, 2020  (unaudited)
  
 
391,210
 
  
$
3,059
 
  
 
3,088,444
 
  
$
40,685
 
  
 
4,499,921
 
  
$
74,575
 
  
 
8,593,360
 
  
$
142,236
 
  
 
775,403
 
  
$
1
 
  
$
36,355
 
  
$
(300,325)
 
 
$
(2)
 
 
$
(263,971
)
 
 
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
 
For the Six Months Ended June 30, 2019
2022
(in thousands, except share amounts)Preferred StockCommon StockAdditional
Paid-in
Capital
Accumulated
Deficit
Accumulated
Other
Comprehensive Loss
Total
Stockholders'
Equity
SharesAmountSharesAmount
Balance as of December 31, 20216,666 $ 27,957,223 $28 $584,613 $(478,698)$(217)$105,726 
Unrealized loss on marketable securities— — — — — — (39)(39)
Foreign currency translation adjustment— — — — — — (553)(553)
Stock option exercises— — 35,478 — 66 — — 66 
Stock-based compensation— — 262,273 — 5,568 — — 5,568 
Employee stock purchase plan shares issued— — 94,226 — 182 — — 182 
Net loss— — — — — (34,299)— (34,299)
Balance as of June 30, 2022 (unaudited)6,666 $ 28,349,200 $28 $590,429 $(512,997)$(809)$76,651 
  
Series A

Convertible
Preferred Stock
  
Series B

Convertible
Preferred Stock
  
Series C

Convertible
Preferred Stock
  
Series D

Convertible
Preferred Stock
  
Common Stock
  
Additional
Paid-in

Capital
  
Accumulated

Deficit
  
Accumulated
Other
Comprehensive

Income (Loss)
  
Total
Stockholders’

Deficit
 
  
Shares
  
Amount
  
Shares
  
Amount
  
Shares
  
Amount
  
Shares
  
Amount
  
Shares
  
Amount
 
Balance as of December 31, 2018
  
 
388,558
 
  
$
 3,059
 
  
 
3,088,444
 
  
$
 40,685
 
  
 
4,499,921
 
  
$
 74,575
 
  
 
—  
 
  
$
—  
 
  
 
656,654
 
  
$
1
 
  
$
 30,150
 
  
$
 (161,995)
 
 
$
20
 
 
$
 (131,824)
 
Unrealized gain on marketable securities
   —      —      —      —      —      —      —      —      —      —      —      —     7   7 
Foreign currency translation adjustment
   —      —      —      —      —      —      —      —      —      —      —      —     (12  (12
Issuance of Series A preferred stock for cashless warrant exercise
   2,652    —      —      —      —      —      —      —      —      —      —      —     —     —   
Issuance of Series D convertible preferred stock for cash, net of issuance costs of $274
   —      —      —      —      —      —      2,309,959    38,226    —      —      —      —     —     —   
Issuance of Series D convertible preferred stock for 2018 Convertible Notes and 2019 Convertible Notes
   —      —      —      —      —      —      4,108,478    68,476    —      —      —      —     —     —   
Stock-based
compensation
   —      —      —      —      —      —      —      —      6,837    —      1,362    —     —     1,362 
Stock option exercises
   —      —      —      —      —      —      —      —      8,469    —      57    —     —     57 
Net loss
   —      —      —      —      —      —      —      —      —      —      —      (45,040  —     (45,040
 
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
 
Balance as of June 30, 2019 (unaudited)
  
 
391,210
 
  
$
3,059
 
  
 
3,088,444
 
  
$
40,685
 
  
 
4,499,921
 
  
$
74,575
 
  
 
6,418,437
 
  
$
 106,702
 
  
 
671,960
 
  
$
1
 
  
$
31,569
 
  
$
(207,035)
 
 
$
15
 
 
$
(175,450)
 
 
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
 
The accompanying notes are an integral part of these condensed consolidated financial statements.

4

Acutus Medical, Inc. and Subsidiaries
Condensed Consolidated Statements of Cash Flows
Six Months Ended June 30,
20232022
(in thousands)(unaudited)
Cash flows from operating activities
Net loss$(34,661)$(34,299)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense2,473 3,145 
AcQMap Systems converted to sales238 110 
Sales-type lease gain(310)(57)
Amortization of intangible assets100 320 
Non-cash stock-based compensation expense3,639 5,613 
(Accretion of discounts) amortization of premiums on marketable securities, net(1,037)264 
Amortization of debt issuance costs212 641 
Amortization of operating lease right-of-use assets339 321 
Loss on debt extinguishment— 7,947 
Goodwill impairment— 12,026 
Gain on sale of business, net(3,279)(43,575)
Direct costs paid related to sale of business— (2,488)
Change in fair value of warrant liability(842)— 
Loss on disposal of property and equipment277 — 
Change in fair value of contingent consideration123 955 
Changes in operating assets and liabilities:
Accounts receivable(204)1,037 
Inventory(2,344)1,101 
Employer retention credit receivable4,703 — 
Prepaid expenses and other current assets432 (3,592)
Other assets452 223 
Accounts payable824 236 
Accrued liabilities(1,963)(386)
Operating lease liabilities(277)(203)
Other long-term liabilities(45)
Net cash used in operating activities(31,097)(50,706)
Cash flows from investing activities
Proceeds from sale of business17,000 50,000 
Purchases of available-for-sale marketable securities(33,880)— 
Sales of available-for-sale marketable securities— 13,099 
Maturities of available-for-sale marketable securities48,250 27,787 
Purchases of property and equipment(984)(1,718)
Net cash provided by investing activities30,386 89,168 
Cash flows from financing activities
Repayment of debt— (44,550)
Penalty fees paid for early prepayment of debt— (1,074)
Borrowing under new debt— 35,000 
Payment of debt issuance costs— (624)
Proceeds from the exercise of stock options66 
Repurchase of common shares to pay employee withholding taxes(263)(45)
Proceeds from employee stock purchase plan25 182 
Payment of contingent consideration— (598)
Net cash used in financing activities(234)(11,643)
Effect of exchange rate changes on cash, cash equivalents and restricted cash(346)(323)
Net change in cash, cash equivalents and restricted cash(1,291)26,496 
Cash, cash equivalents and restricted cash, at the beginning of the period31,348 24,221 
Cash, cash equivalents and restricted cash, at the end of the period$30,057 $50,717 
Supplemental disclosure of cash flow information:
Cash paid for interest$2,458 $2,073 
(in thousands)5

(Unaudited)
Table of Contents
Supplemental disclosure of noncash investing and financing activities:
Accounts receivable from sale of business$3,381 $— 
Change in unrealized (gain) loss on marketable securities$(4)$39 
Change in unpaid purchases of property and equipment$(54)$42 
Contingent consideration escrow release$— $157 
Net book value on AcQMap system sales-type leases$238 $110 
Amount of debt proceeds allocated to warrant liability$— $3,379 
Unpaid transaction costs from sale of business$— $429 
Unpaid debt issuance costs$— $177 
   
Six Months Ended June 30,
 
   
2020
  
2019
 
Cash flows from operating activities
   
Net loss
  $ (41,291 $ (45,040
Adjustments to reconcile net loss to net cash used in operating activities:
     
Depreciation expense
   978   1,142 
Amortization of intangible assets
   220   —   
Stock-based compensation expense
   2,898   1,362 
Accretion of discounts/(amortization of premiums) on marketable securities, net
   5   (19
Amortization of debt issuance costs
   314   17,309 
Amortization of
right-of-use
assets
   336   312 
Loss on debt extinguishment
   —     1,398 
Change in fair value of warrant liability and embedded derivative
   1,872   605 
Change in fair value of contingent consideration
   (1,584  —   
Changes in operating assets and liabilities, net of effect from business combination:
     
Accounts receivable
   (597  (280
Inventory
   (3,616  (1,961
Prepaid expenses and other current assets
   666   (43
Other assets
   8   (12
Accounts payable
   5,286   1,682 
Accrued liabilities
   155   1,810 
Operating lease liabilities
   (411  (349
  
 
 
  
 
 
 
Net cash used in operating activities
   (34,761  (22,084
  
 
 
 
 
 
 
 
Cash flows from investing activities
     
Purchases of
available-for-sale
marketable securities
   —     (22,208
Sales of
available-for-sale
marketable securities
   17,095   —   
Maturities of
available-for-sale
marketable securities
   40,000   8,100 
Purchases of property and equipment
   (4,445  (316
Cash paid, net of cash acquired for the Rhythm Xience Acquisition
   —     (3,000
  
 
 
  
 
 
 
Net cash provided by (used in) investing activities
   52,650   (17,424
  
 
 
  
 
 
 
Cash flows from financing activities
     
Proceeds from issuance of debt and warrants
   —     77,000 
Repayment of debt
   —     (15,000
Payment of issuance and extinguishment costs related to debt
   —     (2,332
Payment of contingent consideration
   (2,619  —   
Proceeds from issuance of convertible preferred stock, net of issuance costs
   —     38,226 
Payment of deferred offering costs
  
(701
 
 
—  
 
Proceeds from stock options exercises
   205   57 
  
 
 
  
 
 
 
Net cash (used in) provided by financing activities
   (3,115  97,951 
  
 
 
  
 
 
 
Effect of exchange rate changes on cash, cash equivalents and restricted cash
   69   (12
  
 
 
  
 
 
 
Net change in cash, cash equivalents and restricted cash
   14,843   58,431 
Cash, cash equivalents and restricted cash, at the beginning of the period
   9,602   9,775 
  
 
 
  
 
 
 
Cash, cash equivalents and restricted cash, at the end of the period
  
$
24,445
 
 
$
68,206
 
  
 
 
  
 
 
 
Supplemental disclosure of cash flow information:
     
Cash paid for income taxes
  $—    $—   
Cash paid for interest
  $2,376  $1,168 
Supplemental disclosure of noncash investing and financing activities:
     
Issuance of Series D convertible preferred stock for 2018 Convertible Notes and 2019 Convertible Notes
  $—    $68,476 
Issuance of Series D convertible preferred stock for Biotronik asset purchase
  $5,000  $—   
Issuance of Series D convertible preferred stock for Rhythm Xience Acquisition
  $2,197  $—   
Change in unrealized (gain) loss on marketable securities
  $41  $(7
Warrants issued in conjunction with OrbiMed debt
  $—    $872 
Right-of-use
assets exchanged for operating lease liabilities
  $—    $2,978 
Unpaid purchases of property and equipment
  $55  $77 
Unpaid deferred offering costs
  
$
1,805
 
 
$
—  
 
The accompanying notes are an integral part of these condensed consolidated financial statements.
5
6

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note 1—Organization and Description of Business
Acutus Medical, Inc. (the “Company”) is an arrhythmia management company focused on improving the way cardiac arrhythmias are diagnosed and treated. The Company designs, manufactures and markets a range of tools for catheter-based ablation procedures to treat various arrhythmias. The Company’s product portfolio includes novel access sheaths, transseptal crossing tools, diagnostic and mapping catheters, ablation catheters, mapping and imaging consoles and accessories, as well as supporting algorithms and software programs. The Company was incorporated in the state of Delaware on March 25, 2011, and is located in Carlsbad, California.
Liquidity, Capital Resources and Going Concern
Reverse Stock Split
The Company has limited revenue, has incurred significant operating losses and negative cash flows from operations since its inception, and anticipates that it will incur significant losses for at least the next several years. As of June 30, 2023 and December 31, 2022, the Company had cash, cash equivalents, restricted cash and marketable securities of $61.5 million and $76.2 million, respectively. For the six months ended June 30, 2023 and 2022, net losses were $34.7 million and $34.3 million, respectively, and net cash used in operating activities was $31.1 million and $50.7 million, respectively. As of June 30, 2023 and December 31, 2022, the Company had an accumulated deficit of $553.0 million and $518.3 million, respectively, and working capital of $69.1 million and $98.0 million, respectively.

The Company’s board of directors approved a reverse split of shares of the Company’s common stock and convertible preferred stock on a 9.724-for-one basis (the “Reverse Stock Split”Since raising $166.3 million from its initial public offering ("IPO"), which was effected on July 28, 2020. The par value and the number of authorized shares of the convertible preferred stock and common stock were not adjusted in connection with the Reverse Stock Split. All references to common stock, convertible preferred stock, warrants to purchase common stock, warrants to purchase convertible preferred stock, options to purchase common stock, restricted stock units, restricted stock awards, share data, per share data and related information contained in the condensed consolidated financial statements have been retrospectively adjusted to reflect the effect of the Reverse Stock Split for all periods presented. No fractional shares of the Company’s common stock were issued in connection with the Reverse Stock Split. Any fractional share resulting from the Reverse Stock Split was rounded down to the nearest whole share, and any stockholder entitled to a fractional share as a result of the Reverse Stock Split will receive a cash payment in lieu of receiving fractional shares. See Note 19 – Subsequent Events for further information.
Initial Public Offering
On August 10, 2020, the Company has issued 10,147,058additional shares of common stock. From time to time, the Company's Board of Directors issues common stock
for its stock-based compensation plans and for its ESPP. Additionally, in an
 initialJuly 2021, the Company issued 6,325,000 shares of common stock in a public offering, (“IPO
”), which included 1,323,529825,000 shares of common stock issued upon the underwriters’underwriter’s exercise in full of
an option to purchase atadditional shares of common stock. The price to the public offering price less underwriting discounts and commissions, up to an additional 1,323,529 shares. The price
to the pu
blic
for each share was $18.00.
On August 10, 2020, in connection with the closing of the IPO, 391,210 shares of Series A, 3,088,444 shares of Series B, 4,499,921 shares of Series C and 8,593,360 shares of Series D convertible preferred stock, respectively, automatically converted into an equal number of shares of common stock and the warrants to purchase 446,990 shares of Series D convertible preferred stock were automatically converted to an equal number of warrants to purchase common stock at an exercise price of $16.67 per share.
As a result of the IPO, the underwriters’ exercise of their option, and the conversions of the Series A, B, C and D convertible preferred stock, the Company’s total number of outstanding shares increased by 26,719,993 immediately following the closing of the IPO. See Note 19 – Subsequent Events for further information.
Going Concern, Liquidity and Capital Resources
$14.00. The Company has limited revenue, has incurred operating losses since inceptionreceived gross proceeds of $88.6 million from the offering. Net of underwriting discounts and expects to continue to incur significant operating losses for at leastcommission and other offering expenses, the next several years and may never become profitable. AsCompany received proceeds of $82.7 million.

On June 30, 2020 and December 31, 2019,2022, Medtronic, Inc. (“Medtronic”) paid the Company had an accumulated deficit$50.0 million at the first closing (the "First Closing") of $300.3 million and $259.0 million, respectively, and working capital of $15.1 million and
$50.5 million, respectively. The Company has historically funded its operations primarily through the sale of debt and equity securities, as well as other indebtedness.
With the closingCompany's left-heart access portfolio to Medtronic, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure the Company's indemnification obligations under the asset purchase agreement ("Asset Purchase Agreement") entered into with Medtronic on April 26, 2022. The OEM Earnout (as defined in Note 3 - Sale of Business, below)under the Asset Purchase Agreement with Medtronic was achieved on October 31, 2022, with $20.0 million paid by Medtronic to the Company in November 2022. Additionally, the Transfer Earnout (as defined in Note 3 - Sale of Business, below) under the Asset Purchase Agreement with Medtronic was achieved on December 21, 2022, with $17.0 million paid by Medtronic to the Company in January 2023. Beginning in February 2023, following Medtronic's first commercial sale of the Company’s IPO,left-heart access products after the Company's achievement of the OEM Earnout (as defined in Note 3 - Sale of Business, below), the Company became eligible to earn amounts equal to 100%, 75%, 50% and 50%, respectively, of quarterly Net Sales (as defined in the Asset Purchase Agreement) from sales of the left-heart access products achieved by Medtronic each year over four years. During the six months ended June 30, 2023, the Company earned $3.4 million in contingent consideration based on Medtronic's left-heart access products sales.

Management believes the Company’s current cash, and cash equivalents and marketable securities are sufficient to fund operations for at least the next 12 months. However,months from the date of this filing. To ensure that the Company has sufficient resources to fund operations, management continues to review cost improvement opportunities and pathways to reduce expenses and cash burn, while preserving the resources to invest in future growth.

In the future, the Company may need to raise additional funds through one or more of the following: the issuance of additional debt and/or equity securities or both.otherwise. Until such time, if ever, that the Company can generate revenue sufficient to achieve profitability, the Company expects to finance its operations through equity or debt financings, which may not be available to the Company on the timing needed or on terms that the Company deems to be favorable. To the extent that the Company raises additional capital through the sale of equity or convertible debt securities, the ownership interest of its stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect the rights of common stockholders. Debt financing and preferred equity financing, if available, may involve agreements that
6

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
include covenants limiting or restricting the Company’s ability to take specific actions, such as incurring additional debt, making acquisitions or capital expenditures or declaring dividends. If the Company is unable to maintain sufficient financial resources, its business, financial condition, and results of operations will be materially and adversely affected. The Company may be required to delay, limit, reduce or terminate its product discovery and development activities or future commercialization efforts. There can be no assurance that the Company will be able to obtain the needed financing on acceptable terms or at all.
Beginning in early March 2020, the
COVID-19
pandemic and the measures imposed to contain this pandemic disrupted the Company’s business. The effects of the pandemic began to decrease in late April 2020 as electrophysiology labs began reopening and procedure volumes began increasing as compared to
COVID-19
related low points in March 2020. The Company could experience similar, or even more sustained, access restrictions or decreases in procedural activities as hospitals continue to deal with the
COVID-19
pandemic. If cases of
COVID-19
increase and hospitals again prioritize those patients, additional restrictions may be implemented which would adversely impact our business and financial results.
7

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note 2—Summary of Significant Accounting Policies
Basis of Presentation
The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form
10-Q
and Article 10 of Regulation
S-X.
Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.
Principles of Consolidation
The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiary Acutus Medical NV (“Acutus NV”), which was incorporated under the laws of Belgium in August 2013.subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates and Assumptions
The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue, expenses and disclosures of contingent assets and liabilities. The most significant estimates and assumptions in the Company’s condensed consolidated financial statements include, but are not limited to, revenue recognition, useful lives of intangible assets, assessment of impairment of goodwill, provisions for income taxes, measurement of operating lease liabilities, and the fair value of common stock, stock options, warrants, intangible assets, contingent consideration and goodwill. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of revenue and expenses that are not readily apparent from other sources. Actual results could differ from those estimates.
Segments
Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business inas one operating segment and reportable segment.
Cash and Cash Equivalents and Restricted Cash
The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of June 30, 20202023 and December 31, 2019,2022, exceeded federally insured limits.

8

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Restricted cash serves asconsists of (i) deposited cash collateral for the Company’s corporate credit card program. program and (ii) cash received for the sale of business to Medtronic held in an indemnity escrow account until certain terms of sale are met.
The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statementstotal balances as of cash flowsJune 30, 2023 and December 31, 2022 (in thousands):
June 30,
2023
December 31,
2022
(unaudited)
Cash and cash equivalents$23,055 $25,584 
Restricted cash7,002 5,764 
Total cash, cash equivalents and restricted cash$30,057 $31,348 
   
June 30,

2020
   
December 31,
2019
 
   
(unaudited)
     
Cash and cash equivalents
  $ 24,295   $ 9,452 
Restricted cash
   150    150 
  
 
 
   
 
 
 
Total cash, cash equivalents and restricted cash
  $24,445   $9,602 
  
 
 
   
 
 
 
Marketable Securities
The Company’s marketable securities portfolio consists of investments in money market funds, commercial paper, U.S. treasury securities and Yankee debt securities.
The Company considers its debt securities to be
available-for-sale
securities.
Available-for-sale
securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability
8

to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term
available-for-sale
securities and are reported as a component of current assets.
Securities that are classified as
available-for-sale
are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss,income (loss), and as a component of stockholders’ deficitequity until their disposition or maturity. See “Fair Value Measurements” below. The Company reviews all
available-for-sale
securities at each period end to determine if they remain
available-for-sale
based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method.
Marketable securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’investor’s financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive loss.income (loss). The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive lossincome (loss) for the
six-month
periods three and six months ended June 30, 20202023 and 2019.2022.
Deferred Offering Costs
Deferred offering costs consist of legal and accounting fees incurred through the balance sheet date that are directly related to the Company’s IPO and will be reflected as issuance costs upon the completion of the offering.
Concentrations of Credit Risk and
Off-Balance
Sheet Risk
Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions which, at times, may exceed the Federalfederal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts, and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant. The Company’s marketable securities portfolio consists primarily of investments in money market funds, commercial paper and short-term high credit quality corporate debt securities.
9

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Revenue from Contracts with Customers
The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”("ASC") 606,
Revenue from Contracts with Customers
(“
(“ASC 606”), and ASC 842, Leases ("ASC 842"). The core principle of the revenue standardASC 606 is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle:
Step 1: Identify the contract with the customer.
Step 2: Identify the performance obligations in the contract.
Step 3: Determine the transaction price.
Step 4: Allocate the transaction price to the performance obligations in the contract.
Step 5: Recognize revenue when, or as, the company satisfies a performance obligation.

ASC 842 provides guidance on determining whether an agreement contains a lease. ASC 842 defines a lease as a contract, or part of a contract, that conveys the right to control the use of identified property, plant or equipment for a period of time in exchange for consideration.

TheFor new customers, the Company
usually
places its medical diagnostic equipment, the AcQMap System, at customer sites under loanevaluation agreements and generates revenue from the sale of disposable products used with the AcQMap System. Disposable products primarily include AcQMap Catheterscatheters and AcQGuide Steerable Sheaths.steerable sheaths. Outside of the United States, the Company also has the Qubic Force Device which generates revenue from the sale of the AcQBlate Force Ablation Catheters. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company also sells the AcQMap System to customers along with software updates on a
when-and-if-available
basis and equipment service. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation.

Additionally, the Company sells the AcQMap System to customers along with software updates on a when-and-if-available basis, as well as the Qubic Force Device and a transseptal crossing line of products which can be used in a variety of heart
9

procedures and does not need to be accompanied with an AcQMap System or Qubic Force Device. Included in the transseptal crossing line of products are primarily the AcQRef Introducer Sheath, the AcQGuide Sheaths and the AcQCross Transseptal Dilator/Needle.

The following table sets forthCompany also enters into deferred equipment agreements that are generally structured such that the Company’s revenue for disposables and systems/serviceCompany agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the threecustomer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two to four years. The Company has determined that such deferred equipment agreements include an embedded sales-type lease. The Company allocates contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and six months ended June 30, 2020non-lease components at contract inception. The Company expenses the cost of the device at the inception of the agreement and 2019 (in thousands):records a financial lease asset equal to the gross consideration allocated to the lease. The lease asset is reduced by payments for minimum disposable purchases that are allocated to the lease.
   
Three Months Ended June 30,
   
Six Months Ended June 30,
 
   
2020
   
2019
   
2020
   
2019
 
   
(unaudited)
   
(unaudited)
 
Disposables
  $ 1,122   $ 730   $ 2,179   $ 1,512 
Systems
  
 
—  
 
  
 
—  
 
  
$
520
 
  
 
—  
Service/Other
   12    4    18    9 
  
 
 
   
 
 
   
 
 
   
 
 
 
Total
  $1,134   $734   $2,717   $1,521 
  
 
 
   
 
 
   
 
 
   
 
 
 

Lastly, the Company enters into short-term operating leases for the rental of the AcQMap System after an evaluation. These lease agreements impose no requirement on the customer to purchase the equipment, and the equipment is not transferred to the customer at the end of the lease term. The short-term nature of the lease agreements does not result in lease payments accumulating to an amount that equals the value of the equipment nor is the lease term reflective of the economic life of the equipment.
The Company’s contracts onlyprimarily include fixed consideration. ThereGenerally, there are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days.
10

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
The delivery of disposable products are performance obligations satisfied at a point in time. The disposable products are shipped Free on Board (“FOB”) shipping point or FOB destination. For disposable products that are shipped FOB shipping point, the customer has the significant risks and rewards of ownership and legal title to the assets when the disposable products leave the Company’s shipping facilities, thusat which point the customer obtains control and thus revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination.

TheFor direct customers, the installation and delivery of the AcQMap systemSystem is satisfied at a point in time when the installation is complete, which is when the customer can benefit and has control of the system. For AcQMap System sales sold to Biotronik SE & Co. KG (“Biotronik”), the installation is not a performance obligation as it is performed by Biotronik, and therefore the AcQMap System is satisfied at a point in time when they have control of the system. The Company’s software updates and equipment service performance obligations are satisfied evenly over time as the customer simultaneously receives and consumes the benefits of the Company’s performance for these services throughout the service period.

The Company allocates the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company determines SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which includes,include, but isare not limited to, sales transactions where the specific performance obligations are sold separately, Company list prices and specific offers to customers.
TheExcept for the deferred equipment agreements noted above, the Company’s contracts with customers generally have an expected duration of one year or less, and therefore the Company has elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts are recorded as selling, general and administrative ("SG&A") expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of June 30, 20202023 and December 31, 2019.
2022.

In May 2020, the Company entered into
bi-lateral
distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the
“Bi-Lateral
“Bi-Lateral Distribution Agreements”). with Biotronik. Pursuant to the
Bi-Lateral
Distribution Agreements, the Company obtained a
non-
exclusive non-exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption or IDE,(“IDE”) clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a coexclusiveco-exclusive right to distribute these products in Hong Kong. Each party will pay to the other party a specified transfer pricesprice on the sale of the other party’s products and, accordingly, will earn a distribution margin on the sale of the other party’s products.

10

In 2022, the Company sold the left-heart access transseptal crossing business to Medtronic. In connection with the sale, the Company entered into a distribution agreement (the "Distribution Agreement") with Medtronic, pursuant to which the Company acts as the original equipment manufacturer ("OEM") supplier of these products. The Company will produce and sell the products to Medtronic for a period of up to four years. Revenue is recognized when the title to the products are transferred to Medtronic, which occurs when the products are shipped from our facility (or FOB shipping point).
The following table sets forth the Company’s revenue for disposables, systems and service/other for the three and six months ended June 30, 2023 and 2022 (in thousands):
Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
(unaudited)(unaudited)
Disposables$3,914 $3,334 $7,340 $6,545 
Systems691 346 691 346 
Service/Other684 396 1,427 866 
Total revenue$5,289 $4,076 $9,458 $7,757 
The following table provides revenue by geographic location for the three and six months ended June 30, 20202023 and 20192022 (in thousands):
Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
(unaudited)(unaudited)
United States$3,125 $2,037 $5,373 $4,060 
Outside the United States2,164 2,039 4,085 3,697 
Total revenue$5,289 $4,076 $9,458 $7,757 
   
Three Months Ended June 30,
   
Six Months Ended June 30,
 
   
2020
   
2019
   
2020
   
2019
 
   
(unaudited)
   
(unaudited)
 
United States
  $559   $221   $1,328   $456 
Europe
   575    513    1,389    1,065 
  
 
 
   
 
 
   
 
 
   
 
 
 
Total Revenue
  $1,134   $734   $2,717   $1,521 
  
 
 
   
 
 
   
 
 
   
 
 
 
Inventory
Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost
(first-in,
(first-in, first-out
basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory of $0.3 million and $1.4 million for the three months ended June 30, 2023 and 2022, respectively, and $0.6 million and $2.4 million for the six months ended June 30, 2023 and 2022, respectively, based on management’s review of inventories on hand, comparedcomparisons to estimated future usage and sales, observed shelf-life and assumptions about the likelihood of obsolescence of $0.1 million and $0.1 million, for the three months ended June 30, 2020 and 2019, respectively, and $0.1 million and $0.2 million, for the six months ended June 30, 2020 and 2019, respectively.obsolescence.

11

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Accounts Receivable
Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of June 30, 20202023 or December 31, 2022.

Pursuant to the Asset Purchase Agreement with Medtronic, the Company was eligible to receive the Transfer Earnout, a contingent cash consideration of $17.0 million upon the Company’s initial submission for CE Mark certification. The Company met this condition as of December 31, 2022 and recorded a receivable on the consolidated balance sheets for the year then ended. Medtronic provided full payment in January 2023. See Note 3 - Sale of Business.

In addition, beginning in February 2023, following Medtronic's first commercial sale of the left-heart access products after the Company's achievement of the OEM Earnout (as defined in Note 3 - Sale of Business, below), the Company became eligible to earn amounts equal to 100%, 75%, 50% and 50%, respectively, of quarterly Net Sales (as defined in the Asset Purchase Agreement) from sales of the left-heart access products achieved by Medtronic each year over four years. During the six months ended June 30, 2023, the Company earned $3.4 million in contingent consideration based on Medtronic's left-heart access products sales and recorded a receivable on the condensed consolidated balance sheets for the period then ended.

Accounts receivable recorded on the condensed consolidated balance sheets as of June 30, 2023 and December 31, 2019.
2022 consists of the following (in thousands):
11


June 30,
2023
December 31,
2022
(unaudited)
Trade accounts receivable$4,289 $4,085 
Earnouts receivable from Medtronic3,381 17,000 
Total accounts receivable$7,670 $21,085 

Employee Retention Credit Receivable
The Employee Retention Credit is a refundable U.S. tax credit separate from tax based on income for businesses that continued to pay employees while shut down due to the COVID-19 pandemic or had significant declines in gross receipts from March 13, 2020 to December 31, 2021. The Company applied for the tax credit in 2022 and as of June 30, 2023, the entire $6.8 million claimed tax credit has been refunded to the Company, of which $4.7 million was received during the six months ended June 30, 2023.
Property and Equipment, Net
Property and equipment are recorded at cost. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the related assets, generally three to five years, or, in the case of leasehold improvements, over the lesser of the useful life of the related asset or the lease term.
Intangible Assets
IntangibleThe Company’s intangible assets consist of acquired developed technology, acquired
in-process
technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019.license agreement with Biotronik. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired
in-process
technology was classified as an indefinite-lived intangible asset, until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the
in-process
technology wasis classified as a finite-lived intangible and amortization for
in-process
technology began.amortized accordingly. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite
-
livedIndefinite-lived intangible assets are impaired if their estimated fair values are less than their carrying value.
Goodwill
Goodwill represents the excess of the purchase price of an entity over the estimated fair value of the assets acquired and liabilities assumed, and it is presented as goodwill in the accompanying condensed consolidated balance sheets. Under ASC 350,
Intangibles
 – Goodwill and Other
(“
(“ASC 350”), goodwill is not amortized but is subject to periodic impairment testing. ASC 350 requires that an entity assign its goodwill to reporting units and test each reporting unit’s goodwill for impairment at least on an annual basis and between annual tests if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. In the evaluation of goodwill for impairment, which is performed annually during the fourth quarter, the Company first assesses qualitative factors to determine whether the existence of events or circumstances led to a determination that it was more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events or circumstances, it is determined that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, the Company is required to perform the quantitative goodwill impairment test. The Company has one reporting unit. ForDuring the six months ended June 30, 2020,2022, the qualitative testing did not indicate any impairment for the carrying amountCompany fully impaired its goodwill balance of goodwill.$12.0 million.
Impairment of Long-Lived Assets
The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three and six months ended June 30, 20202023 and 2019,2022, the Company determined that there was no impairment of property and equipment or intangible assets.
Foreign Currency Translation and Transactions
12

The assets, liabilities and results of operations of Acutus NVMedical N.V. and Acutus Medical UK Limited are measured using their functional currency, the Euro and British Pound Sterling, respectively, which is the currency of the primary foreign economic environment in which this subsidiary operates.the subsidiaries operate. Upon consolidating this entitythese entities with the Company, itstheir assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and itstheir revenues and expenses are translated at the weighted-averageweighted average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating this entity’sthe entities’ financial statements are reported in accumulated other comprehensive loss in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive loss.
income (loss).
Lease Property
1
2

Acutus Medical, Inc.The Company leases office space in Carlsbad, California as its corporate headquarters and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Leases
Effective January 1, 2019, thefor manufacturing operations. Additionally, it leases office space in Zaventem, Belgium for international operations. The Company accounts for its leaseslease property under ASC 842,
Leases
(“ASC 842”).842. Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases, and are recorded on the condensed consolidated balance sheetsheets as both a
right-of-use
asset and a lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate.rate, which is the rate for collateralized borrowings based on the current economic environment, credit history, credit rating, value of leases, currency in which the lease obligation is satisfied, rate sensitivity, lease term and materiality. Lease liabilities are increased by interest and reduced by payments each period, and the
right-of-use
asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the
right-of-use
asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred.

In calculating the
right-of-use
asset and lease liability, the Company electselected to combine lease and
non-lease
components. The Company excludesadopted the policy election to exclude short-term leases having initial terms of 12twelve months or less from the new guidance as an accounting policy election.initial recognition provisions of ASC 842. See
Note 11 - Operating Leases for additional details.
Cost of Products Sold
Cost of products sold includes raw materials, direct labor, manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products.
Research and Development
The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. Research and development expenses also include payments for the asset acquisition from Biotronik and VascoMed GmbH (collectively, the “Biotronik Parties”) for certain licenses of patents, technology,
know-how
rights and equipment (the “Biotronik Asset Acquisition”).
Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials.
Selling, General and Administrative
Selling, general and administrative (“SG&A”)&A expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs. The Company expenses all SG&A costs as incurred.
Fair Value Measurements
Financial Instruments
Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy has beenis used in determining the inputs used infor measuring fair value:
13

Level 1—Quoted prices in active markets for identical assets or liabilities.
Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace.
Level 3—Unobservable inputs which are supported by little or no market activity and that areconsist of financial instruments whose values are determinedvalued using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation.
Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts
1
3

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for the three and six months ended June 30, 20202023 and 2019.2022.
As of June 30, 20202023 and December 31, 2019,2022, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of the instruments.
each instrument. The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt.
The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of June 30, 20202023 and December 31, 20192022 (in thousands):

Fair Value Measurements as of June 30, 2023
  
Fair Value Measured at June 30, 2020 (unaudited)
     (unaudited)
  
Quoted Prices in
Active Markets for
Identical Assets
(Level 1)
   
Significant Other
Observable Inputs
(Level 2)
   
Significant
Unobservable
Inputs (Level 3)
   
Fair Value at
June 30, 2020
 Quoted
Prices
in Active
Markets for
Identical
Assets
(Level 1)
Significant
Other
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Total
Assets included in:
        Assets included in:
Cash and cash equivalents
            Cash and cash equivalents
Money market securities
  $21,544   $—     $—     $21,544 Money market securities$20,196 $— $— $20,196 
Marketable securities at fair value
            Marketable securities at fair value
U.S. treasury securities
   —      5,037    —      5,037 U.S. treasury securities— 10,942 — 10,942 
  
 
   
 
   
 
   
 
 
Commercial paperCommercial paper— 19,265 — 19,265 
Yankee debt securitiesYankee debt securities— 1,254 — 1,254 
Total fair value
  $21,544   $5,037   $—     $26,581 Total fair value$20,196 $31,461 $— $51,657 
  
 
   
 
   
 
   
 
 
Liabilities included in:
            Liabilities included in:
Contingent consideration
  $—     $—     $7,500   $7,500 
Common and preferred stock warrant liability
   —      —      10,791    10,791 
Warrant liabilityWarrant liability$— $— $2,504 $2,504 
  
 
   
 
   
 
   
 
 
Total fair value
  $—     $—     $18,291   $18,291 Total fair value$— $— $2,504 $2,504 
  
 
   
 
   
 
   
 
 
 
 
   
  
Fair Value Measured at December 31, 2019
     
  
Quoted Prices in
Active Markets for
Identical Assets
(Level 1)
   
Significant Other
Observable Inputs
(Level 2)
   
Significant
Unobservable
Inputs (Level 3)
   
Fair Value at
December 31, 2019
 
Assets included in:
        
Cash and cash equivalents
        
Money market securities
  $8,901   $—     $—     $8,901 
Marketable securities at fair value
         
Corporate debt securities
   —      28,224    —      28,224 
Asset-backed securities
   —      17,121    —      17,121 
U.S. treasury securities
   —      5,032    —      5,032 
Commercial paper
   —      11,974    —      11,974 
  
 
   
 
   
 
   
 
 
Total fair value
 $8,901   $62,351    $—     $71,252 
  
 
   
 
   
 
   
 
 
Liabilities included in:
         
Contingent consideration
  $—     $—     $13,900   $13,900 
Common and preferred stock warrant liability
   —      —      8,919    8,919 
  
 
   
 
   
 
   
 
 
Total fair value
  $—     $—     $22,819   $22,819 
  
 
   
 
   
 
   
 
 

14

Fair Value Measurements as of December 31, 2022
Quoted
Prices
in Active
Markets for
Identical
Assets
(Level 1)
Significant
Other
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Total
Assets included in:
Cash and cash equivalents
Money market securities$22,700 $— $— $22,700 
Marketable securities at fair value
U.S. treasury securities— 26,897 — 26,897 
Commercial paper— 14,764 — 14,764 
Yankee debt securities— 3,202 — 3,202 
Total fair value$22,700 $44,863 $— $67,563 
Liabilities included in:
Warrant liability$— $— $3,346 $3,346 
Contingent consideration— — 1,800 1,800 
Total fair value$— $— $5,146 $5,146 

The fair value of the Company’s money market fundssecurities is determined using quoted market prices in active markets for identical assets.
14

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
The Company’s portfolio of marketable securities is comprised of commercial paper, asset-backed securities, U.S. treasury securities, and short-term highly liquid, high credit quality corporate debt securities. The fair value for the
available-for-sale
marketable securities is determined based on trade prices in active markets for identical assets (Level 1 inputs) or valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets, or liabilities, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments, or debt, broker and dealer quotes, as well as other relevant economic measures.
Financial Obligations
The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 20202023 (in thousands):
Contingent
Consideration
Warrant Liability
Balance, December 31, 2022$1,800 $3,346 
Change in fair value123 (842)
Accrued final contingent consideration payment(1)
$(1,923)$— 
Balance, June 30, 2023 (unaudited)$— $2,504 
   
Common and
Preferred Stock
Warrant Liability
    
Contingent
Consideration
   
Total
 
Balance, December 31, 2019
  $8,919    $13,900   $22,819 
Payment of contingent consideration
   —       (2,619   (2,619
Issuance of preferred stock for contingent consideration
   —       (2,197   (2,197
Change in fair value
   1,872     (1,584   288 
  
 
 
    
 
 
   
 
 
 
Balance, June 30, 2020 (unaudited)
  $10,791    $7,500   $18,291 
  
 
 
    
 
 
   
 
 
 
(1)     The earn-out period under the Rhythm Xience, Inc. ("Rhythm Xience") acquisition agreement concluded on June 19, 2023. The Company recorded the final contingent consideration payment owed to Rhythm Xience as an accrued liability on the condensed consolidated balance sheet as of June 30, 2023 (see Note 9 - Accrued Liabilities).

Unrealized gains and losses associated with liabilities withinAs of June 30, 2023, the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long-dated volatilities) inputs.
The fair value of the common and preferred stock
warrant liability
has been warrants was estimated using a Monte Carlo simulation in the first quarter of 2019 and as an output of the Hybrid Method for the
second quarter
of 2019 and
the first and second
quarter of 2020. The underlying equity included in the Monte Carlo simulation and the Hybrid Method was determined based on the equity value implied from the preferred stock transactions and from examination of income and market approaches for measurement dates in which a preferred transaction was not applicable. Additionally, the expected IPO value was considered in the determination of the equity value.Black-Scholes option pricing model. The fair value of the warrants was impacted by the model selected as well as assumptions surrounding unobservable inputs including the underlying equity value, risk-free interest rate, expected dividend yield, contractual term and expected volatility. The weighted-average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the common and preferred stockestimated to be $0.6625 per warrant liabilities as of June 30, 20202023 and December 31, 2019the significant inputs used in the estimation of the fair value were as follows:
15

June 30,

2020
December 31,

2019
2023
(unaudited)
Risk-free interest rate
0.153.97%% - 0.18%
1.59% - 1.60%
Expected dividend yield
—  —  
Contractual term in years
0.2 - 0.50.7 - 1.07.0
Expected volatility
67.085.0%% - 123.0%
60.0% - 110.5%

The fair value of the contingent consideration from the acquisition of Rhythm Xience represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective
earn-out
period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales or earnings; (iii) risk-free 
15

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
interest rate; and (iv) expected volatility of earnings. Estimated payments, as determined through the respective model, were further discounted by a credit spread assumption to account for credit risk. The fair value of the milestones-based contingent consideration was determined by probability weighting and discounting to the respective valuation date at the Company’s cost of debt. The Company’s cost of debt was determined by performing a synthetic credit rating for the Company and selecting yields based on companies with a similar credit rating. The contingent consideration is revalued to fair value each period, and any increase or decrease is recorded in operating loss. The fair value of the contingent consideration may be impacted by certain unobservable inputs, most significantly with regard to discount rates, expected volatility and historical and projected performance. Significant changes to these inputs in isolation could result in a significantly different fair value measurement. The weighted-average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of June 30, 2020 and December 31, 2019 were as follows:
   
June 30, 2020
  
December 31, 2019
   
(unaudited)
   
Risk-free interest rate
  0.20%  1.60%
Expected term in years
  1.0 - 2.0  1.0 - 2.0
Expected volatility
  18.3%  11.8%
Stock-Based Compensation
The Company accounts for all stock-based payments to employees and
non-employees,
including grants of stock options, restricted stock awards (“RSAs”units ("RSUs"), and restricted stock units with
non-market
performance and service conditions (“PSUs”awards ("RSAs"), to be recognized in the condensed consolidated financial statements based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAsRSUs and PSUsRSAs, are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSUs and RSAs over the requisite service period. As the PSUs have a performance condition, compensation expense is recognized for each vesting tranche over the respective requisite service period of each tranche if and when the Company’s management deems it probable that the performance conditions will be satisfied. The Company may recognize a cumulative
true-up
adjustment related to PSUs once a condition becomes probable of being satisfied if the related service period had commenced in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive lossincome (loss) based upon the respective employee’s or
non-employee’s
roles within the Company. Forfeitures are recorded as they occur. See “Note
Note 15—Stock-Based Compensation” below.Compensation for additional details.
Income Taxes
Income taxes are recorded in accordance with ASC 740,
Income Taxes
(“
(“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the condensed consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse, and net operating loss (“NOL”) carryforwards and research and development (“R&D”) tax credit carryforwards. Valuation allowances are provided if,
,
based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized.

The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. To date, there have been no interest or penalties charged in relation to the unrecognized tax benefits.

Warrant Liability
The Company accounts for certain common stock warrants and convertible preferred stock warrants outstanding as a liability at fair value, determined using the Black-Scholes option pricing model, on the consolidated balance sheets in accordance with ASC 815,
Derivatives and Hedging
(“
(“ASC 815”), at fair value. This. The liability is subject to
re-measurement
at each reporting period until exercised, and any change in fair value is recognized in the condensed consolidated statements of operations and comprehensive loss.
16

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Asset Acquisitions (Research and Development—License Acquired)
The Company accountsincome (loss). See Note 13—Warrants for asset acquisitions, where substantially all of the fair value of the assets acquired is concentrated in a group of similar assets (i.e., intellectual property) and therefore the acquisitions do not constitute a business, in accordance with ASC 805,
additional details.
Business Combinations
(“ASC 805”), under the asset acquisition method. Under the asset acquisition method of accounting, the Company is required to fair value the assets transferred. The cost of the assets acquired, including transaction costs, is allocated to the individual assets acquired based on their relative fair values and does not give rise to goodwill.
Business Combinations
The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805,Business Combinations (“ASC 805”), which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in the acquisition. Goodwill representsis calculated as the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Subsequent adjustments to fair value of any contingent consideration are recorded to the Company’s condensed consolidated statements of operations and comprehensive loss.
Recently Adopted Accounting Pronouncements to Be Adopted
In June 2016,
the Financial Accounting Standards Board (“FASB”)FASB issued Accounting Standards Update (“ASU”) 
ASU No. 2016-13,
Financial Instruments – Credit Losses (Topic 326)
("ASU 2016-13"). The ASU 2016-13 sets forth a “current expected credit loss” model which requires the Company to measure all expected credit losses for financial instruments held at the reporting date based on historical experience, current conditions and reasonable supportable forecasts. This replaces the existing incurred loss model and is applicable to the measurement of credit losses on financial assets measured at amortized cost,
available-for-sale
debt securities and applies to certain
off-balance
sheet credit exposures. This ASU
16


2016-13 is effective for smaller reporting companies in calendar year 2023. The Company is currently assessingadopted the guidance in the first quarter of 2023 with no material impact on the condensed consolidated financial statements.
Note 3—Sale of Business
On June 30, 2022, the Company completed the First Closing in accordance with the Asset Purchase Agreement with Medtronic, pursuant to which the Company agreed to sell to Medtronic certain transseptal access and sheath assets which make up the Company's left-heart access portfolio (and which comprised the Rhythm Xience product line acquired as part of the adoptionRhythm Xience acquisition). The assets transferred to Medtronic upon the First Closing (the “Assets”) include patents, trademarks, patent and trademark applications, know-how, copyrights, prototypes and other intellectual property owned or licensed by the Company, business records and documents (including regulatory and clinical materials) and manufacturing equipment related to the AcQCross® line of this ASUsheath-compatible septal crossing devices, AcQGuide® MINI integrated crossing device and sheath, AcQGuide® FLEX Steerable Introducer with integrated transseptal dilator and needle, and AcQGuide® VUE steerable sheaths (the “Products”).

Pursuant to the Asset Purchase Agreement, Medtronic paid $50.0 million at the First Closing, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure indemnification obligations of the Company under the Asset Purchase Agreement, which the Company has recorded as restricted cash on its condensed consolidated financial statements.balance sheets.
In December 2019, the FASB issued ASU
No. 2019-12,
Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes
, which is intended to simplify various aspects related to accounting for income taxes. ASU
No. 2019-12
removes certain exceptions to the general principles in ASC 740 and also clarifies and amends existing guidance to improve consistent application. This guidance is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2020, with early adoption permitted. The Company is currently evaluatingalso eligible to receive the impact of this standard on its condensed consolidated financial statements.
In March 2020, the FASB issued ASU No.
2020-04,
 Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting
, which provides temporary optional guidance to ease the potential burden in accounting for reference rate reform. The new guidance provides optional expedients and exceptions for applying U.S. GAAP to transactions affected by reference rate reform if certain criteria are met. These transactions include: contract modifications, hedging relationships and sale or transfer of debt securities classified as
held-to-maturity.
Entities may apply the provisions of the new standard as of the beginning of the reporting period when the election is made (i.e., as early as the first quarter 2020). Unlike other topics, the provisions of this update are only available until December 31, 2022, when the reference rate replacement activity is expected to have been completed. The Company is currently evaluating the impact of this standard on its condensed consolidated financial statements and has yet to elect an adoption date.
Note 3—Asset Acquisition and Business Combination
Biotronik Asset Acquisition
In July 2019, the Company entered into a License and Distribution Agreement with the Biotronik Parties to obtain certain licensesfollowing contingent cash consideration pursuant to the Biotronik Parties’ patents, wherebyAsset Purchase Agreement:

(i)    $20.0 million upon the Company acquiredCompany’s completion, to the reasonable satisfaction of Medtronic, of certain manufacturing equipment and obtained fromconditions set forth in the Biotronik Parties a license under certain patents and technology to develop, commercialize, distribute and manufacture the AcQBlate Force ablation catheters and Qubic Force device. In exchange for the rights grantedAsset Purchase Agreement relating to the Company becoming a qualified supplier of Medtronic for the Products, including demonstration of ISO 14971:2019 compliance, completion of certain test method validations and compliance with certain other reporting requirements (the “OEM Earnout”);
(ii)    $17.0 million upon the earlier of (A) the Second Closing (as defined below) or (B) the Company’s initial submission for CE Mark certification of the Products under the European Union Medical Devices Regulation, to the reasonable satisfaction of a third-party regulatory consultant, subject to certain other conditions as set forth in the Asset Purchase Agreement (the “Transfer Earnout”); and
(iii)    amounts equal to 100%, 75%, 50% and 50%, respectively, of quarterly Net Sales (as defined in the Asset Purchase Agreement) from sales of the Products achieved by Medtronic over each year of a four-year period beginning on the first full quarter after Medtronic’s first commercial sale of a Product and achievement of the OEM Earnout.

The $20.0 million OEM Earnout was achieved in October 2022 and payment was received in November 2022, of which $1.6 million is held in escrow and recorded as restricted cash on the condensed consolidated balance sheets. The $17.0 million Transfer Earnout was achieved in December 2022 and payment was received in January 2023, of which $1.4 million is held in escrow and recorded as restricted cash on the condensed consolidated balance sheets. During the six months ended June 30, 2023, $3.4 million was earned under item (iii) and recorded as a receivable on the condensed consolidated balance sheet as of June 30, 2023.

With the achievement of the OEM Earnout Conditions (as defined in the Asset Purchase Agreement) and upon notice from Medtronic, Medtronic became the Company's exclusive distributor of the Products under the Distribution Agreement.

The Company made cash payments totaling $10.0recorded a net gain of $79.5 million during the year ended December 31, 2019,2022 related to the sale of business to Medtronic, calculated as the difference between the non-contingent consideration received, less direct transaction costs and issued 273,070 sharesthe net carrying amount of Series D convertible preferred stock with an implied value of $5.0 million duringthe assets sold.

The Company recorded the following amounts for the six months ended June 30, 2020. The implied value2023, resulting in a net gain of $5.0$3.3 million was recordedrelated to the sale of business to Medtronic, calculated as an accrued liability as of December 31, 2019. In accordance with ASC 805, the Biotronik Asset Acquisition
wa
s accounted for as an asset acquisition as substantially all ofdifference between the $15.0 million value transferred to Biotronik was allocated to intellectual property. On the acquisition date, the products licensed had not yet received regulatory approval and the intellectual property did not have an alternative use. Accordingly, the $15.0 million paid to Biotronik was immediately charged to research and development expense—licensed acquired in the condensed consolidated statement of operations and comprehensivenon-contingent consideration earned, less direct transaction costs (in thousands):
loss in July 2019.
17

Acutus Medical, Inc. and Subsidiaries
Six Months Ended
June 30, 2023
(unaudited)
Percentage of Product Net Sales Earnout accrued as of June 30, 2023$3,381 
Transaction costs(102)
          Gain on sale of business, net$3,279 
Notes to Condensed Consolidated Financial Statements

(Unaudited)
Additional contingent milestone payments of up to $10.0 million are toThe net gain on sale will be made to the Biotronik Parties contingent upon certain regulatory approvals and first commercial sale. In further consideration of the rights granted, beginning with the Company’s first commercial sale of the first force sensing ablation catheter within the licensed product line, the Company will also make per unit royalty payments. The Company has determined that as of the acquisition date and as of June 30, 2020 and December 31, 2019,adjusted in future periods by the contingent milestone and royalty payments are not probable and estimable and therefore have not been recorded as a liability. Upon regulatory approval of the Company’s force sensing ablation catheter in Europe, the milestone payments will be capitalized and amortized, and the royalty payments will be recorded as cost of products sold as sales of catheters are recognized.
Rhythm Xience Business Combination
On June 18, 2019 (the “Acquisition Date”), the Company acquired an integrated family of transseptal crossing and steerable introducer systems through its acquisition of Rhythm Xience for $3.0 million in cash in exchange for all of the stock of Rhythm Xience (the “Rhythm Xience Acquisition”). The cash payment did not include the potential $17.0 million in earn out consideration, of which $2.0 million was paid with the issuance of Series D convertible preferred stock in February 2020 and the remainder is to be paid based on the achievement of certain regulatorythe predetermined milestones and revenue milestones. In accordance with ASC 805, the Rhythm Xience Acquisition ismentioned above. The sale was accounted for as a derecognition of a group of assets that is a business combination.
Purchase Price Allocation
The following table summarizespursuant to ASC 810 - Consolidation, with the allocation of the purchase price to the assets acquired and liabilities assumed for the Rhythm Xience Acquisition (in thousands):
Accounts receivable, net
  $3 
Prepaid expenses and other current assets
   8 
Property and equipment, net
   3 
Intangible assets
   4,360 
Goodwill
   12,026 
Contingent consideration
   (13,400
  
 
 
 
Cash consideration
  
$
3,000
 
  
 
 
 
The Company recorded $12.0 million of goodwill that arose out of synergiesresulting gain classified as operating income within loss from the Rhythm Xience Acquisition. The Company does not expect goodwill to be deductible for tax purposes.
As part of Rhythm Xience Acquisition, the Company recorded a contingent consideration liability for potential additional payments due to the sellers of Rhythm Xience if certain regulatory approval milestones and revenue milestones are achieved.
The initial
contingent consideration liability of $13.4 million
was
basedoperations on the fair value of the contingent consideration liability at the acquisition date. During the six months ended June 30, 2020, the Company issued 119,993 shares of Series D convertible preferred stock and paid $2.6 million of the contingent consideration for the achievement of certain regulatory milestones and revenue milestones. Additionally, the Company recorded a $0.6 million increase and a $1.6 million decrease to the fair value of the contingent consideration liability for the three and six months ended June 30, 2020, respectively, which is included in change in fair value of contingent consideration in
the
condensed consolidated statementstatements of operations and comprehensive loss. There was 0 change in fair value ofincome (loss). The sale did not represent a strategic shift having a major effect on the contingent consideration liability recorded for the threeCompany's operations and six months ended June 30, 2019. As of June 30, 2020, the contingent consideration liability of $7.5 million is the fair value of the remaining payments due to the sellers of Rhythm Xience if certain additional regulatory approval milestonesfinancial results and, revenue milestones are achieved.
18
consequently, did not qualify as a discontinued operation.

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note 4—Marketable Securities
Marketable securities consisted of the following as of June 30, 20202023 and December 31, 20192022 (in thousands):
June 30, 2023 (unaudited)
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair Value
Available-for-sale securities - short-term:
U.S. treasury securities$10,943 $$(2)$10,942 
Commercial paper19,265 — — 19,265 
Yankee debt securities1,256 — (2)1,254 
Total available-for-sale securities - short-term31,464 (4)31,461 
     Total available-for-sale securities$31,464 $$(4)$31,461 
   
June 30, 2020 (unaudited)
 
   
Amortized Cost
   
Gross Unrealized
Gains
   
Gross Unrealized
Losses
   
Fair Value
 
Available-for-sale securities - short-term
:
        
U.S. treasury securities
  $5,033   $4   $—     $5,037 
  
 
 
   
 
 
   
 
 
   
 
 
 
Total
available-for-sale
securities
  $5,033   $4   $—     $5,037 
  
 
 
   
 
 
   
 
 
   
 
 
 

   December 31, 2019 
   
Amortized
 
Cost
   
Gross
 
Unrealized
Gains
   
Gross
 
Unrealized
Losses
   
Fair
 
Value
 
Available-for-sale securities - short-term:
        
Corporate debt securities
  $28,204   $20   $—     $28,224 
Asset-backed securities
   17,108    13    —      17,121 
U.S. treasury securities
   5,020    12    —      5,032 
Commercial paper
   11,974    —      —      11,974 
  
 
 
   
 
 
   
 
 
   
 
 
 
Total
available-for-sale
securities
  $62,306   $45   $—     $62,351 
  
 
 
   
 
 
   
 
 
   
 
 
 
December 31, 2022
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair Value
Available-for-sale securities - short-term:
U.S. treasury securities$26,906 $$(12)$26,897 
Commercial paper3,200 — 3,202 
Yankee debt securities14,764 — — 14,764 
Total available-for-sale securities - short-term44,870 (12)44,863 
     Total available-for-sale securities$44,870 $$(12)$44,863 
As of June 30, 20202023, the Company’s available-for-sale securities classified as short-term of $31.5 million mature in 1 year or less and there were none held long-term. As of December 31, 2019, all2022, the Company’s available-for-sale securities classified as short-term of the Company’s
available-for-sale
securities$44.9 million mature in one1 year or less.less and there were none held long-term.
18

Note 5—Inventory
Inventory as of June 30, 20202023 and December 31, 20192022 consisted of the following (in thousands):
  
June 30,

2020
   
December 31,
2019
 June 30,
2023
December 31,
2022
  
(unaudited)
     (unaudited)
Raw materials
  $6,468   $5,492 Raw materials$10,452 $9,179 
Work in process
   1,353    1,605 Work in process2,189 2,025 
Finish goods
   4,445    1,327 
  
 
   
 
 
Finished goodsFinished goods3,030 2,123 
Total inventory
  $12,266   $8,424 Total inventory$15,671 $13,327 
  
 
   
 
 
Note 6—Lessor Sales-Type Leases
The Company recognizes revenue and costs, as well as leases receivable, at the commencement of embedded sales-type leases within its deferred equipment agreements. Lease revenue related to sales-type leases was $0.5 million and $0.2 million for both the three and six months ended June 30, 2023 and 2022, respectively. Costs related to embedded leases within the Company’s deferred equipment agreements are included in cost of products sold in the condensed consolidated statements of operations and comprehensive income (loss).
As of June 30, 2023 and December 31, 2022, a balance of $0.8 million and $0.6 million, respectively, for short-term leases receivable is recorded in prepaid expenses and other current assets on the condensed consolidated balance sheets, and a balance of $0.3 million and $0.5 million, respectively, for long-term leases receivable is recorded in other assets related to sales-type leases.
The following table is an estimation of maturities of customer sales-type lease receivables for each of the following years as of June 30, 2023 (in thousands):
Total Maturities
Six months ending December 31, 2023$414 
Year ending December 31, 2024524 
Year ending December 31, 2025194 
     Total maturities of customer sales-type leases$1,132 
19

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note 6—7—Property and Equipment, Net
The Company’s property and equipment, net, consisted of the following as of June 30, 20202023 and December 31, 20192022 (in thousands):
June 30,
2023
December 31,
2022
(unaudited) 
Medical diagnostic equipment$15,289 $14,826 
Furniture and fixtures452 432 
Office equipment1,561 1,556 
Laboratory equipment and software5,226 5,148 
Leasehold improvements608 580 
Construction in process1,691 2,166 
Total property and equipment24,827 24,708 
Less: accumulated depreciation(17,582)(15,487)
Property and equipment, net$7,245 $9,221 

   
June 30,

2020
   
December 31,
2019
 
   
(unaudited)
     
Medical diagnostic equipment
  $7,180   $5,492 
Furniture and fixtures
   388    159 
Office equipment
   1,377    1,321 
Laboratory equipment and software
   3,380    2,807 
Leasehold improvements
   595    507 
Construction in process
   102    306 
  
 
 
   
 
 
 
Total property and equipment
   13,022    10,592 
Less: accumulated depreciation
   (5,438   (6,165
  
 
 
   
 
 
 
Property and equipment, net
  $7,584   $4,427 
  
 
 
   
 
 
 
Property and equipment includes certain medical diagnostic equipment and AcQMap Systems located at customer premises. The Company retains the ownership of the equipment and has the right to remove the equipment if it is not being used according to expectations. The Company records the cost of equipment to cost of sales on the condensed consolidated statements of
19

operations and comprehensive income (loss) when it is subsequently sold or the Company enters into a sales-type lease agreement. See Note 6 - Lessor Sales-Type Leases for additional details.
Depreciation expense was $0.6$1.2 million and $0.5$1.6 million for the three months ended June 30, 20202023 and 2019,2022, respectively, and $1.0$2.5 million and $1.1$3.1 million for the six months ended June 30, 20202023 and 2019,2022, respectively.
Note 7—Goodwill and 8—Intangible Assets
The following table below summarizes goodwill andpresents intangible assets activitiesactivity for the six months ended June 30, 2023 (in thousands):
Intangible
Assets
Balance, December 31, 2022$1,583 
Amortization expense(100)
Balance, June 30, 2023 (unaudited)$1,483 

Intangible Assets
The tables below present the details of intangible assets as of June 30, 20202023 and December 31, 2019 (in2022 (dollars in thousands):
June 30, 2023Estimated
Useful
Life
(in years)
Weighted
Average
Remaining
Life
(in years)
Intangible
Assets
Accumulated
Amortization
Balance
(unaudited)
Licensed intangibles10.07.4$2,000 $(517)$1,483 
     Total intangible assets$2,000 $(517)$1,483 
   
Goodwill
   
Intangible Assets
 
Balance at December 31, 2019
  $12,026   $4,110 
Amortization expense
   —      (220
  
 
 
   
 
 
 
Balance at June 30, 2020 (unaudited)
  $12,026   $3,890 
  
 
 
   
 
 
 
December 31, 2022Estimated
Useful
Life
(in years)
Weighted
Average
Remaining
Life
(in years)
Intangible
Assets
Accumulated
Amortization
Balance
Licensed intangibles10.07.92,000 (417)1,583 
     Total intangible assets$2,000 $(417)$1,583 

   
Estimated Useful

Life
(in years)
  
Weighted Average
Remaining

Life
(in years)
  
Intangible
Assets
   
Accumulated
Amortization
  
June 30,
2020
 
                
(unaudited)
 
Developed technology
  10  9.1  $4,200   $(390 $3,810 
Trademarks and trade names
  0.5  —     60    (60  —   
Customer-related intangible
  5  4   100    (20  80 
      
 
 
   
 
 
  
 
 
 
Total
      $4,360   $(470 $3,890 
      
 
 
   
 
 
  
 
 
 
20

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
   
Estimated
Useful
Life
(in years)
   
Weighted
Average
Remaining
Life
(in years)
   
Intangible
Assets
   
Accumulated
Amortization
  
December 31,
2019
 
Developed technology
   10    9.5   $3,600   $(180 $3,420 
In-process
technology
   indefinite      600    —     600 
Trademarks and trade names
   0.5    —      60    (60  —   
Customer-related intangible
   5    4.5    100    (10  90 
      
 
 
   
 
 
  
 
 
 
Total
      $4,360   $(250 $4,110 
      
 
 
   
 
 
  
 
 
 
Acquired
in-process
technology was classified as an indefinite-lived intangible asset until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the
in-process
technology was classified as a finite-lived intangible and amortization for
in-process
technology began. The Company recorded $0.1 million and $0.2 million of amortization expense related to the above intangible assets of $0.1 million and $0.2 million for the three months ended June 30, 2023 and 2022, respectively, and $0.1 million and $0.3 million for the six months ended June 30, 2020,2023 and 2022, respectively. There was 0 amortization expense related to the above intangible assets for the three and six months ended June 30, 2019.
The following table showspresents the remainingfuture amortization expense associated with amortizable intangible assets as of June 30, 20202023 (in thousands):
Total
Amortization
Six months ending December 31, 2023$100 
Year ending December 31, 2024200 
Year ending December 31, 2025200 
Year ending December 31, 2026200 
Year ending December 31, 2027200 
Thereafter583 
     Total future amortization$1,483 
   
Developed
Technology
    
Customer-Related

Intangible
   
Total
Amortization
 
Six months ending December 31, 2020
  $210    $10   $220 
Year ending December 31, 2021
   420     20    440 
Year ending December 31, 2022
   420     20    440 
Year ending December 31, 2023
   420     20    440 
Year ending December 31, 2024
   420     10    430 
Thereafter
   1,920     0      1,920 
  
 
 
    
 
 
   
 
 
 
Total
  $3,810    $80   $3,890 
  
 
 
    
 
 
   
 
 
 

21
20

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note 8—9—Accrued Liabilities
Accrued liabilities consisted of the following as of June 30, 20202023 and December 31, 20192022 (in thousands):
  
June 30,

2020
   
December 31,
2019
 June 30,
2023
December 31,
2022
  
(unaudited)
     (unaudited)
Biotronik Asset Acquisition - accrued purchase price
  $—     $5,000 
Payroll and related expenses
   3,869    3,785 
Compensation and related expensesCompensation and related expenses$5,327 $6,919 
Professional fees
  
1,850
   
188
 Professional fees261 126 
Deferred revenue
   88    311 Deferred revenue342 326 
Sales and use taxSales and use tax304 639 
Clinical studiesClinical studies371 390 
Clinician Council payableClinician Council payable240 216 
Accrued royaltiesAccrued royalties234 159 
Accrued restructuringAccrued restructuring173 45 
Accrued contingent consideration paymentAccrued contingent consideration payment1,923 — 
Other
   1,229    792 Other584 866 
  
 
   
 
 
Total accrued liabilities
  $7,036   $10,076  Total accrued liabilities$9,759 $9,686 
  
 
   
 
 
Note 9—10—Debt
Outstanding debt as of June 30, 20202023 and December 31, 20192022 consisted of the following (in thousands):
June 30,
2023
December 31,
2022
(unaudited)
2022 Credit Agreement(1)
$36,750 $36,776 
Total outstanding debt, gross36,750 36,776 
Less: Unamortized debt discount and fees(2,116)(2,342)
Total outstanding debt, long-term$34,634 $34,434 
   
June 30,
2020
   
December 31,
2019
 
   
(unaudited)
     
2019 Credit Agreement
(1)
  $44,550   $44,550 
  
 
 
   
 
 
 
Total debt, gross
   44,550    44,550 
Less: Unamortized debt discount and fees
   (5,992   (6,306
  
 
 
   
 
 
 
Total long-term debt
  $38,558   $38,244 
  
 
 
   
 
 
 
(1) 
The 2019 Credit Agreement includes final payment fees of $4.6 million.
2019(1)The 2022 Credit Agreement
includes final payment fees of $1.8 million.
2022 Amended and Restated Credit Agreement
On May 20, 2019,June 30, 2022, the Company entered into aamended and restated its prior debt facility. The amended and restated credit agreement (the "2022 Credit Agreement (the “2019 Credit Agreement”Agreement"). The 2019 Credit Agreement provided the is with new lenders consisting of certain affiliates of Deerfield Management Company with a senior term loan facility in(collectively referred to as “Deerfield”) and is for an aggregate principal amount of $70.0$35.0 million of whichand has a 5-year term. Proceeds from the Company borrowed $40.0 million upon closing. Of2022 Credit Agreement, along with cash on hand, were used to repay the remaining amount of theprior debt facility $10.0 million was available for borrowing by the Company on or priorand to June 30, 2020pay related fees and $20.0 million is available for borrowing by the Company on or prior to December 31, 2020, in each case subject to the achievement of specified trailing revenue levels. expenses.

The Company did not achieve the trailing revenue levels to draw the $10.0 million by June 30, 2020 but the $20.0 million remains available for borrowing on or prior to December 31, 2020 if the specified trailing revenue levels are met. The 20192022 Credit Agreement bears an annual interest per annum at 7.75%of 9% plus LIBOR for such interest period andthe one-month adjusted term Secured Overnight Financing Rate (applying a 2.5% minimum rate). From date of closing, amortization payments are due as follows:

15% of the principal amountdue at the end of term loans outstanding undermonth 36;
15% of the 2019principal due at the end of month 48; and
70% due at the end of month 60.

The 2022 Credit Agreement is due on May 20, 2024.subject to prepayment penalties. The 20192022 Credit Agreement provides for final payment fees of an additional $4.6$1.8 million that are due upon prepayment, or on the maturity date or upon acceleration.
The 2022 Credit Agreement is secured by a first-priority perfected lien on and security interest in substantially all of the Company’s existing and after-acquired tangible and intangible assets, subject to certain exceptions noted therein.

Upon the occurrence
21

The 2022 Credit Agreement is subject to certain customary affirmative covenants, representations and during an event of default, which includeswarranties and other terms and conditions. It also contains certain customary negative covenants, including, but is not limited to, payment default, covenant default or the occurrence of a material adverse change, the lenders may declare all outstanding principal and accrued and unpaid interest immediately due and payable, all unfunded commitments would be terminated, there would be an increase in the applicable interest rate by 10.0% per annum, and the lenders would be entitled to exercise their other rights and remedies provided for under the 2019 Credit Agreement. Additionally, the lenders may request repayment of a portion of obligations outstanding under the 2019 Credit Agreement to the extent of the Company’s receipt of any (i) net casualty proceeds or (ii) net asset sales proceeds, as defined. These acceleration and early payment features are an embedded derivative that is separately measured from the loan host instrument and classified with the loan host instrument.
22

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
In connection with the issuance of the 2019 Credit Agreement, the Company issued liability-classified warrants with a fair value of $0.9 million to purchase 419,992 shares of Series C convertible preferred stock at $16.667 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.667 per share.
The initial recognition of the warrant liability and direct fees of $1.2 million and final payment fees of $4.6 million for the 2019 Credit Agreement resulted in a discount of $6.7 million, which is being amortized to interest expense over the term of the 2019 Credit Agreement using the effective interest method.
The Company’s obligations under the 2019 Credit Agreement are secured by substantially all of its assets, including its intellectual property, and is guaranteed by Acutus NV. The 2019 Credit Agreement contains customary affirmative and negative covenants, including with respect torestrictions on the Company’s ability and that of its subsidiaries to enter into fundamental transactions,merge and consolidate with other companies, incur additional indebtedness, grant liens or security interests on assets, pay any dividenddividends or make any distributions to its holders, make investments and mergeother restricted payments, sell or consolidate with any other personotherwise transfer assets or engage inenter into transactions with its affiliates, but does not include any financial covenants, other than a minimum liquidity requirement.affiliates. As of and for the six months ended June 30, 2020 and 2019,2023, the Company was in compliance with all such covenants.
2019 Convertible Notes
On May 20, 2019,In addition, the 2022 Credit Agreement includes customary events of default and other provisions that could require all amounts due thereunder to become immediately due and payable, either automatically or at the option of the lenders, if the Company sold andfails to comply with the terms.

In connection with entering into the 2022 Credit Agreement, the Company entered into a warrant purchase agreement (the "2022 Warrant Purchase Agreement") with Deerfield, pursuant to which the Company issued $37.0 million into Deerfield warrants to purchase up to an aggregate principal amount3,779,018 shares of convertible promissory notes (the “2019 Convertible Notes”). The 2019 Convertible Notes bore interest at 13% per annum and were due on December 31, 2019. The 2019 Convertible Notes, including accrued interest, automatically convert into preferredthe Company's common stock at an exercise price of $1.1114 per warrant share for a period of eight years following issuance (the "2022 Warrants").

The 2022 Warrants represent a freestanding financial instrument and are conditionally puttable at the lowest price per share paid by a cash investor in a qualified equity financing of at least $23.0 million (excluding the principal of any debtholder’s option upon an event that is cancelled or converted into preferred stock inoutside of the equity financing), which occurred on June 12, 2019. In accordance withCompany’s control. Therefore, the 2022 Warrants are classified as liability pursuant to ASC 480
, Distinguishing Liabilities from Equity
, the 2019 Convertible Notes were recorded as share-settled debtinitially and subsequently recognized at fair value. As the 2019 Convertible Notes converted to Series D convertible preferred stock on June 12, 2019, the initial proceeds of $37.0 million is thevalue, with changes in fair value recognized in the statements of operations and the settlement valuecomprehensive loss. Refer to Fair Value Measurements in Note 2 - Summary of the 2019 Convertible Notes.Significant Accounting Policies and Note 13 - Warrants for more information.
Note 10—11—Operating Leases
The Company leases approximately 50,800 square feet of office space for its corporate headquarters and manufacturing facility in Carlsbad, California under a noncancelablenon-cancelable operating lease that expires on December 31, 2022.2027. The lease is subject to variable charges for common area maintenance and other costs that are determined annually based on actual costs. The base rent is subject to an annual increase each year. The Company has a renewal option for an additional five-year term upon the expiration date of the lease, which has been excluded from the calculation of the
right-of-use
asset as it is not reasonably certain to be exercised.
TheAdditionally, the Company also leases approximately 3,900 square feet of office space in Zaventem, Belgium under a noncancelablenon-cancelable operating lease that expires on December 31. 2021.31, 2024. The lease is subject to variable charges that are determined annually for common area maintenance and other costs based on actual costs, and base rent is subject to an annual increase each year based on an index rate. The Company has a renewal option for an additional three-year term upon the expiration date of the lease, which has been included in the calculation of the
right-of-use
asset as it is reasonably certain to be exercised.
The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 20202023 and 20192022 (dollars in thousands):
Six Months Ended June 30,
20232022
(unaudited)
Operating cash flows from operating leases$281$365
Weighted average remaining lease term – operating leases (in years)4.43.3
Weighted average discount rate – operating leases6.9%7.0%

   
Six Months Ended June 30,
 
   
2020
  
2019
 
   
(unaudited)
 
Operating cash flows used in operating leases
  $507  $477 
Right-of-use
assets exchanged for operating lease liabilities
  $—    $2,978 
Weighted-average remaining lease term – operating leases
   1.8 years   2.3 years 
Weighted-average discount rate – operating leases
   7.0  7.0
23

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
The following table provides the components of the Company’s operating lease costexpense for the three and six months ended June 30, 2023 and 2022 (in thousands):

Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
(unaudited)(unaudited)
Operating leases
Operating lease cost$252 $246 $503 $493 
Variable lease cost81 63 162 140 
Total operating lease expense$333 $309 $665 $633 
22
   
Three Months Ended June 30,
   
Six Months Ended June 30,
 
   
2020
   
2019
   
2020
   
2019
 
   
(unaudited)
   
(unaudited)
 
Operating leases
        
Operating lease cost
  $216   $216   $432   $432 
Variable lease cost
   92    40    165    104 
  
 
 
   
 
 
   
 
 
   
 
 
 
  
 
 
   
 
 
   
 
 
   
 
 
 
Total rent expense
  $308   $256   $597   $536 
  
 
 
   
 
 
   
 
 
   
 
 
 

As of June 30, 2020,2023, future minimum payments under the
non-cancelable
operating leases under ASC 842 were as follows (in thousands):
Six months ending December 31, 2020
  $507 
Year ending December 31, 2021
   1,044 
Year ending December 31, 2022
   1,074 
Year ending December 31, 2023
   51 
Year ending December 31, 2024
   51 
  
 
 
 
Total
   2,727 
Less: present value discount
   (251
  
 
 
 
Operating lease liabilities
  $
 
2,476 
  
 
 
 
Six months ending December 31, 2023$49 
Year ending December 31, 20241,159 
Year ending December 31, 20251,151 
Year ending December 31, 20261,185 
Year ending December 31, 20271,221 
Total4,765 
Less: present value discount(620)
Operating lease liabilities$4,145 

Note 11—12—Commitments and Contingencies
The Company and certain of its current and former officers have been named as defendants in two putative securities class action lawsuits filed in the United States District Court for the Southern District of California on February 14, 2022 and March 23, 2022. On July 19, 2022, the court consolidated the two actions, appointed a lead plaintiff and appointed lead counsel for the proposed class. On September 16, 2022, the lead plaintiff filed a consolidated amended complaint. The defendants thereafter filed a motion to dismiss. Due to the complex nature of the legal and factual issues involved in these class action matters, the outcome is not a party topresently determinable and any material legal proceedings andloss is not aware of any pending or threatened claims. From time to time however, the Company may be subject to various legal proceedings and claims that arise in the ordinary course of its business activities.
neither probable nor reasonably estimable.
Note 12—13—Warrants
As of June 30, 20202023 and December 31, 2019,2022, the outstanding warrants to purchase the Company’s common stock were comprisedconsisted of the following:
Exercise PriceExpiration DateJune 30,
2023
December 31,
2022
(unaudited)
Warrants issued in 2015$5.25 1/30/253,808 3,808 
Warrants issued with 2018 Convertible Notes$0.10 6/7/28346,689 346,689 
Warrants issued with 2018 Term Loan$16.67 7/31/2826,998 26,998 
Warrants issued with 2019 Credit Agreement$16.67 5/20/29419,992 419,992 
Warrants issued with 2022 Credit Agreement$1.11 6/30/303,779,018 3,779,018 
Total Warrants4,576,505 4,576,505 
   
Equity Upon
Exercise
   
Exercise
 
Price
   
Expiration
 
Date
   
June 30,
2020
   
December 31,
2019
 
               
(unaudited)
     
Warrants issued in 2015
   Common Stock   $5.25    1/30/25    7,616    7,616 
Warrants issued with 2018 Convertible Notes
   Common Stock   $0.10    6/7/28    501,946    501,946 
Warrants issued with 2018 Term Loan
   Series D convertible
preferred
 
 
  $16.67    7/31/28    26,998    26,998 
Warrants issued with 2019 Credit Agreement
   Series D convertible
preferred
 
 
  $16.67    5/20/29    419,992    419,992 
        
 
 
   
 
 
 
Total Warrants
         956,552    956,552 
        
 
 
   
 
 
 

24

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
The Company hasThere was no warrant activity forduring the six months ended June 30, 2020. The remaining weighted average contractual life is 7.9 years as of June 30, 2020.
2023.
Warrants Classified as Liabilities
During 2019, in connection with the Company’s entry into the 2019 Credit Agreement, the Company issued warrants to purchase 419,992 shares of its Series C convertible preferred stock with an exercise price of $16.667 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.667 per share. During 2018, in connection with the issuance of the 2018 Convertible Notes and the 2018 Term Loan, the Company issued
ten-year
warrants to purchase 501,946 shares of common stock with an exercise price of $0.10 per share and 26,998 shares of Series C convertible preferred stock with an exercise price of $16.667 per share, respectively. The warrants for Class C convertible preferred stock were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.667 per share.
The Company’s warrants provide the holder the option to purchase a specified number of shares for a specified price.price within a specified duration or upon the occurrence of a specific event. The holder may exercise the warrant ineither by cash payment or by exercise pursuant to a cashless exercise whereby a calculated number of shares are withheld upon exercise to satisfy the exercise price. The warrants do not provide the holder any voting rights until the warrants are exercised. In the event of conversion of the Company’s convertible preferred stock into common shares, the warrants become exercisable into common shares of the Company’s stock, subject to certain adjustments.

In accordance with ASC 815, other than480, the warrants issued in 2015, the warrants2022 Warrants are recorded as liabilities at fair value aton the issuance date.condensed consolidated balance sheets as a warrant liability. Changes in the fair value are recognized inas a change in fair value of warrant liability and embedded derivative in the condensed consolidated statements of operations and comprehensive loss atincome (loss). For the endsix months ended June 30, 2023, a favorable fair value change of each reporting period.
$0.8 million was recognized.
Warrants Classified as Equity

In accordance with ASC 815, the warrants issued in 2015 do not meet the definition of a derivative and are classified in stockholders’ deficit in the condensed consolidated balance sheets.
Note 13—Convertible Preferred Stock
In February 2020, the Company issued 119,993 shares of its Series D convertible preferred stock with an implied value of $2.2 million in connection with a contingent consideration payment relatedthe Series A Common Equivalent Preferred Stock Exchange Agreements (as defined below), four warrant holders are limited to exercising their warrants such that following any such exercise, the Rhythm Xience Acquisition.
In February 2020, the Company issued 273,070 shares of its Series D convertible preferred stock with an implied value of $5.0 million for the final purchase consideration of the Biotronik Asset Acquisition.
Redemption
The convertible preferred stock
was
not unconditionally redeemable at the option of the holder thereof. However, the convertible preferred stock
was
contingently redeemable upon certain liquidation events. As redemption by the holders
was
not solely within the control of the Company, all of the outstanding convertible preferred stock is classified as temporary equity in the condensed consolidated balance sheets.
Dividends
The holdersnumber of shares of convertible preferredcommon stock
were
entitled to receive dividends, out beneficially owned by such holder cannot exceed 4.9% of any assets legally available therefore, prior and in preference to any declaration or payment of any dividend on the outstanding common stock of the Company (two of the holders may, at their option and upon sufficient prior written notice to the applicable dividend rate, payable on a
pro rata
,
pari passu
basis when, asCompany, increase such percentage to 9.9%). In the event the common share limit has been met and if declared by the Company’s boardholder chooses to exercise their warrants, the holder can sell any common stock they hold. Therefore, the amendment to the warrant agreements does not restrict the holder from fully exercising the warrants under the original terms of directors. The dividend rate
was
$0.68 per annum for each share of Series A convertible preferred stock, $1.07 per annum for each share of Series B convertible preferred stock and $1.36 per annum for each share of Series C convertible preferred stock and Series D convertible preferred stock, as adjusted. The dividend rights
were
not cumulative.the warrant agreements.
Liquidation
The holders of the Series D convertible preferred stock
were
entitled to receive a liquidation preference prior to any distribution to the holders of Series A convertible preferred stock, Series B convertible preferred stock and Series C convertible preferred stock (collectively the “Junior Preferred Stock”) and the holders of common stock, in the amount of the original issue price plus declared but
25
23

Acutus Medical, Inc. and Subsidiaries
Note 14—Stockholders’ Equity
Series A Common Equivalent Preferred Stock
NotesIn August 2021, the Company entered into exchange agreements (the “Exchange Agreements”) with four investors pursuant to Condensed Consolidated Financial Statements
(Unaudited)
unpaid dividends on such shares (the “Series D Liquidation Preference”). The holders ofwhich the Junior Preferred Stock were entitled to receive a liquidation preference prior to any distribution to the holders of common stock, after payment of the Series D Liquidation Preference, in the amount of the applicable original issue price plus declared but unpaid dividends on such shares.
Conversion
Each share of preferred stock
was
convertible, at the option of the holder thereof, at any time after the date of issuance of such share, into such number of fully paid and nonassessableinvestors exchanged 6,665,841 shares of the Company’s common stock for 6,666 shares of a new series of non-voting convertible preferred stock of the Company designated as is determined by dividing the original issue price, as adjusted, for such series by the applicable conversion price for such series in effect on the date the certificate is surrendered for conversion. The initial conversion price“Series A Common Equivalent Preferred Stock,” par value $0.001 per share for each series of convertible preferred stock
was
the original issue price applicable to such series as follows:
Series
  
Conversion
Price
 
Series A convertible preferred stock
  $8.295 
Series B convertible preferred stock
  $13.370 
Series C convertible preferred stock
  $16.667 
Series D convertible preferred stock
  $16.667 
Each share of convertible preferred stock
was
automatically
convertible
into fully-paid,
non-assessable
shares of common stock at the conversion rate at the time in effect for such series of preferred stock immediately upon: (i) the date, or the occurrence of an event, specified by vote or written consent or agreement of the requisite investors; or (ii) the closing of the sale of shares of common stock to the public, at a price of at least $50.00 per share, as adjusted, in a firm-commitment underwritten public offering pursuant to an effective registration statement under the Securities Act of 1933, as amended, resulting in at least $50 million of net
proceeds to the Company.
On August 10, 2020, in(the "Preferred Stock"). In connection with the closingissuance of the IPO each outstanding share of Series A, B, C and D convertible preferred stock converted into one share of common stock.
Voting Rights
Holders of convertible preferred stock
had
the right to one vote for each share of common stock into which such preferred stock could then be converted, and with respect to such vote, such holder ha
d
 full voting rights and powers equalPreferred Stock pursuant to the voting rightsExchange Agreements, on August 23, 2021, the Company filed a Certificate of Designation of Preferences, Rights and powers of the holders of common stock.
As long as any shares of Series D convertible preferred stock were outstanding, the holders of such shares of Series D convertible preferred stock (voting exclusively as a separate series) were entitled to elect one director. As long as any shares of Series C convertible preferred stock were outstanding, the holders of such shares of Series C convertible preferred stock (voting exclusively as a separate series) were entitled to elect three directors. As long as any shares of Series A convertible preferred stock or Series B convertible preferred stock were outstanding, the holders of such shares (voting together as a single class and not as separate series, and on an as converted basis) were entitled to elect four directors. The holders of outstanding common stock were entitled to elect one director, prior to the conversionLimitations of the Series A B, C and D convertible preferred stock. The holders of convertible preferred stock and common stock (voting together as a single class and not as separate series, and on an
as-converted
basis) were entitled to elect any remaining directors.
Any director may be removed during his or her term of office, either with or without cause, by, and only by, the affirmative voteCommon Equivalent Preferred Stock of the holders of the shares of the class or series of stock entitled to elect such director or directors, given either at a special meeting of such stockholders duly called for that purpose or pursuant to a written consent of stockholders, and any vacancy thereby created may be filled by the holders of that class or series of stock represented at the meeting or pursuant to written consent.
Note 14—Stockholders’ Deficit
As of December 31, 2019, the Company’s Amended and Restated Certificate of Incorporation authorized the issuance of 220,000,000 shares of common stock, $0.001 par value per share. Each share of common stock is entitled to one voting right. Common stock owners are entitled to dividends when funds are legally available and declared by the Board.
26

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
On August 10, 2020, the Company filed an amended and restated certificate of incorporation (the “A&R Certificate”) with the Secretary of State of the State of Delaware. The A&R Certificate amendedPreferred Stock ranks senior to the common stock with respect to rights on the distribution of assets on any voluntary or involuntary liquidation, dissolution or winding up of the affairs of the Company, having a liquidation preference equal to its par value of $0.001 per share. The Preferred Stock will participate equally and restatedratably on an as-converted basis with the Company’s authorizedholders of common stock in all cash dividends paid on the common stock. The Preferred Stock is non-voting.
Upon election, each holder may convert each share of Preferred Stock into 1,000 shares of common stock, except to 260,000,000 and authorizedthe extent that following such conversion the number of shares of undesignated preferredcommon stock held by such holder, its affiliates and any other persons whose beneficial ownership of common stock would be aggregated with such holder’s for purposes of Section 13(d) of the Exchange Act including shares held by any “group” (as defined in Section 13(d) of the Securities Exchange Act of 1934, as amended (the "Exchange Act") and applicable regulations of the Securities and Exchange Commission ("SEC")) of which such holder is a member, but excluding shares beneficially owned by virtue of the ownership of securities or rights to 5,000,000.
acquire securities that have limitations on the right to convert, exercise or purchase similar to the limitation set forth in the Series A Certificate of Designation, exceeds 4.9% (or, at the election of the holders, OrbiMed Private Investments IV, LP or OrbiMed Royalty Opportunities II, LP, made by delivering at least 61 days advance written notice to the Company of its intention to increase the beneficial ownership cap applicable to such holder, 9.9%) of the total number of shares of common stock then issued and outstanding.
Common Stock
During the six months ended June 30, 20202023 and 2019,2022, stock options to acquire 64,5623,218 shares and 8,46935,478 shares, respectively, were exercised for shares of the Company's common stock. The Company received approximately $0.2stock with proceeds of less than $0.1 million and $0.1
million, forrespectively. Additionally in conjunction with the exercise price of the stock options for2020 Employee Stock Purchase Plan (the "2020 ESPP"), during the six months ended June 30, 20202023 and 2019,2022, 45,162 shares and 94,226 shares, respectively, of common stock were issued for consideration of less than $0.1 million and $0.2 million, respectively.
During the six months ended June 30, 2023 and 2022, the Company issued 603,534 shares and 262,273 shares, respectively, of common stock upon vesting of RSUs.
Note 15—Stock-Based Compensation
2022 Inducement Equity Incentive Plan
The 2022 Inducement Equity Incentive Plan (the “2022 Plan”), which permits the granting of nonstatutory stock options, RSUs, RSAs, stock appreciation rights, performance share units ("PSUs"), performance shares and other equity-based awards to employees, directors and consultants, became effective on March 30, 2022. As of June 30, 2023, 6,000,000 shares of common stock were authorized for issuance under the 2022 Plan, of which 5,758,412 remain available for issuance under the 2022 Plan.
2020 Equity Incentive Plan
The 2020 Equity Incentive Plan (the “2020 Plan”), which permits the granting of nonstatutory stock options, RSAs, RSUs, stock appreciation rights, PSUs, performance shares and other equity-based awards to employees, directors and consultants became effective on August 5, 2020. As of June 30, 2023, 5,573,491 shares of common stock were authorized for issuance under the 2020 Plan, including 1,142,186 additional shares that were authorized on January 1, 2023. As of June 30, 2023, 1,515,992 shares remain available for issuance under the 2020 Plan.
2011 Equity Incentive Plan
The Company’s 2011 Equity Incentive Plan (the “2011 Plan”) permits the granting of incentive stock options,
non-statutory
stock options, restricted stock, restricted stock unitsRSAs, RSUs and other stock-based awards to employees, directors, officers and consultants. As of June 30, 2020, 3,858,0992023, 1,244,731 shares of common stock were authorized for issuance under the 2011 Plan and 390,912no shares remain available for issuance under the 2011 Plan. No additional awards will be granted under the 2011 Plan. Shares that become available for issuance from the outstanding awards under the 2011 Plan due to forfeiture, or otherwise, will become available for issuance from future awards under the 2020 Plan.
24

Stock Options
The stockStock options granted generally vest over four years and have a
ten-year
contractual term. The fair value of each employee and
non-employee
stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The Company is a private company as of June 30,Company's common stock became publicly traded in August 2020 and lacks company-specific historical and implied volatility information. Therefore, itthe Company estimates its expected stock volatility based on the historical volatility of a set of publicly traded set of peer companies. Due to the lack of historical exercise history, the expected term of the Company’s stock options has been determined using the “simplified” method for awards. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is zero based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future.
The following assumptions were used to estimate the fair value of stock optionoptions for the six months ended June 30, 20202023 and 2019:
2022:
Six Months Ended June 30,
20232022
(unaudited)
Risk-free interest rate3.91% - 4.27%1.76% - 3.35%
Expected dividend yield
Expected term in years5.5 - 5.65.5 - 6.0
Expected volatility75% - 85%75% - 90%
   
Six Months Ended June 30,
 
   
2020
  
2019
 
   
(unaudited)
 
Risk-free interest rate
   0.90%   
2.0% - 2.1
%
 
Expected dividend yield
   —     —   
Expected term in years
   7.0   6.38 - 10.00 
Expected volatility
   70.0%   80.0% 
The following table summarizesCompany's stock option activity duringfor the six months ended June 30, 2020:
2023 was as follows:
   
Stock Options
  
Weighted Average
Exercise Price
   
Weighted Average
Remaining
Contractual Life
(in years)
   
Aggregate
Intrinsic
 
Value
(in
 
thousands)
 
Outstanding as of December 31, 2019
   2,041,205  $9.52    7.7   $7,857 
Options granted
   867,031   14.81        
Option exercised
   (111,936  7.73     
Options forfeited
   (200,213  12.01         
  
 
 
  
 
 
   
 
 
   
 
 
 
Outstanding as of June 30, 2020 (unaudited)
   2,596,087  $11.17    7.8   $17,816 
  
 
 
  
 
 
   
 
 
   
 
 
 
Options vested and exercisable as of June 30, 2020 (unaud
i
ted)
   1,138,429  $8.34    6.1   $11,037 
  
 
 
  
 
 
   
 
 
   
 
 
 
27


Table of Contents
Stock
Options
Weighted
Average
Exercise
Price
Weighted
Average
Remaining
Contractual
Life (in years)
Aggregate
Intrinsic
Value
(in thousands)
Outstanding as of December 31, 20222,898,821 $6.83 6.9$79 
Options granted735,580 1.30 
Options exercised(3,218)1.34 $
Options forfeited(269,868)9.30 
Outstanding as of June 30, 2023 (unaudited)3,361,315 $5.43 4.9$53 
Options vested and exercisable as of June 30, 2023 (unaudited)2,216,938$7.49 3.1$45 
Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
TheFor options in the money, the aggregate intrinsic value for options outstanding in the above table is calculated asrepresents the product of the number of options outstanding multiplied by the difference between the per share fair value of the Company’s common stock
on the last day of the fiscal period, which was $0.89 and $1.15 as of June 30, 2020
2023 and December 31, 2022, respectively, and the exercise priceprice. The aggregate intrinsic value for options exercised in the above table represents the product of the number of options exercised multiplied by the difference between the per share fair value of the Company’s stock options.on the date of exercise and the exercise price. The weighted-averageweighted average grant date fair value per share for the stock option awards granted during the six months ended June 30, 20202023 was $14.81.$0.88. As of June 30, 2020,2023, the total unrecognized compensation related to unvested stock option awards granted was $13.8$3.3 million, which the Company expects to recognize over a weighted-average period of approximately 2.81.5 years.
25

Restricted Stock Units (RSUs)
The Company’s RSARSU activity for the six months ended June 30, 20202023 was as follows:
Number
of Shares
Weighted
Average
Grant Price
Unvested as of December 31, 20221,659,898 $4.17 
Granted1,795,520 1.33 
Forfeited(257,446)5.26 
Vested(774,950)2.53 
Unvested as of June 30, 2023 (unaudited)2,423,022 $2.47 
   
Number of Shares
   
Weighted Average
Grant Price
 
Unvested as of December 31, 2019
   —     $—   
Granted
   14,945    14.81 
Vested
   (14,945   14.81 
  
 
 
   
 
 
 
Unvested as of June 30, 2020 (unaudited)
   —     $—   
  
 
 
   
 
 
 
As of June 30, 2023, there was $4.6 million of unrecognized compensation related to unvested RSUs, which the Company expects to recognize over a weighted-average period of approximately 1.8 years.
Employee Stock Purchase Plan
The 2020 ESPP permits individual employees to purchase shares of the Company’s common stock from amounts accumulated under payroll deductions. The 2020 ESPP became effective on August 5, 2020, wherein 645,105 shares of common stock were authorized. Additional shares of common stock are allocated to the 2020 ESPP by the determination of the Compensation Committee of the Company’s Board of Directors, in its sole discretion, and by evergreen provisions in the plan authorization.Automatically authorized in 2023 were 252,042 shares under the plan's evergreen provision. As of June 30, 2023, 669,017 shares are available for purchase under the Company's 2020 ESPP.
The 2020 ESPP is implemented in consecutive offering periods with a new offering period commencing on the first trading day on or after May 15 and November 15 of each year and terminating on the last trading day on or before November 14 and May 14, respectively. On each purchase date, which falls on the last date of each offering period, 2020 ESPP participants will purchase shares of common stock at a price per share equal to 85% of the lesser of (1) the fair market value per share of the common stock on the offering date or (2) the fair market value of the common stock on the purchase date. The occurrence and duration of offering periods under the 2020 ESPP are subject to the determinations of the Compensation Committee of the Company’s Board of Directors, in its sole discretion.
The fair value of the 2020 ESPP shares used in determining compensation expense is estimated using the Black-Scholes option pricing model.
Total Stock-Based Compensation
The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs, RSAs and RSAsESPP expense recorded in the condensed consolidated statements of operations and comprehensive lossincome (loss) for the three and six months ended June 30, 20202023 and 20192022 (in thousands):
Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
(unaudited)(unaudited)
Cost of products sold$153 $225 $228 $451 
Research and development336 554 682 1,068 
Selling, general and administrative1,245 1,802 2,729 4,094 
Total stock-based compensation$1,734 $2,581 $3,639 $5,613 

Note 16—Net Loss Per Common Share
   
Three Months Ended June 30,
   
Six Months Ended June 30,
 
   
2020
   
2019
   
2020
   
2019
 
   
(unaudited)
   
(unaudited)
 
Cost of products sold
  $58   $54   $166   $106 
Research and development
   167    150    378    292 
Selling, general and administrative
   932    599    2,354    964 
  
 
 
   
 
 
   
 
 
   
 
 
 
Total stock-based compensation
  $1,157   $803   $2,898   $1,362 
  
 
 
   
 
 
   
 
 
   
 
 
 
The Company calculates basic and diluted net income (loss) per share attributable to common stockholders in conformity with the two-class method required for participating securities as the application of the if-converted method is not more dilutive. The two-class method requires income available to common stockholders for the period to be allocated between common stock and
Performance-Based Restricted Stock Units26

participating securities based upon their respective rights to receive dividends as if all income for the period had been distributed.
The Company considers its convertible preferred stock and its warrants to be participating securities. In June 2019,accordance with the Company granted 567,509 PSUs, with a grant date fair valuetwo-class method, net income (loss) is adjusted for earnings allocated to these participating securities and the related number of $13.37. Vestingoutstanding shares of the PSUs is dependent uponparticipating securities have been excluded from the satisfactioncomputation of both a service conditionbasic and a performance condition, which is an initial public offering or a changediluted net loss per share attributable to common stockholders. The convertible preferred stock does not contractually require the holders of control.such shares to participate in the Company’s losses. As the performance conditions for the PSUsuch, where applicable, net losses were not considered
probable
as
of June 30, 2020 and 2019,
0 compensation expense relatedallocated to these awards has been recordedsecurities.
Basic net income (loss) per share attributable to common stockholders is computed using net income (loss) attributable to common stockholders divided by the weighted average number of common shares outstanding during the period. Diluted net income (loss) per share attributable to common stockholders represents net income (loss) attributable to common stockholders divided by the weighted average number of common shares outstanding during the period, including the effects of any dilutive securities outstanding. Basic and diluted net loss per common share attributable to common stockholders are the same for the three and six months ended June 30, 20202023 and 2019.
28

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note 16—Net Loss Per Common Share
Basic net loss per common share is computed by dividing net loss attributable to common stockholders by the weighted-average number ofall potential shares of common stock outstanding for the period. Diluted net loss per common share excludes the potential impact of the Company’s convertible preferred stock, common stock options and warrants because their effect would behave been anti-dilutive due to the Company’sCompany's net loss. Since

The following table presents the Company had a net loss in the periods presented,calculation of basic and diluted net lossincome (loss) per share attributable to common stockholders, as well as the calculation of basic and diluted weighted average number of common shares used to compute net income (loss) per share are the same.
attributable to common stockholders (in thousands except share and per share amounts):

Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
(unaudited)(unaudited)
Net income (loss)$(18,346)$5,718 $(34,661)$(34,299)
Net income allocated to participating securities— (1,197)— — 
Net income (loss) available to common stockholders$(18,346)$4,521 $(34,661)$(34,299)
Basic weighted average number of shares outstanding29,039,732 28,339,362 28,902,808 28,229,338 
Dilutive effect of stock options— 10,067 — — 
Diluted weighted average number of shares outstanding29,039,732 28,349,429 28,902,808 28,229,338 
Basic net income (loss) per common share$(0.63)$0.16 $(1.20)$(1.22)
Diluted net income (loss) per common share$(0.63)$0.16 $(1.20)$(1.22)
The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:
Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
(unaudited)(unaudited)
Shares issuable upon:
Conversion of Series A Common Equivalent Preferred Stock6,665,841 6,665,841 6,665,841 6,665,841 
Exercise of common stock warrants4,576,505 4,576,505 4,576,505 4,576,505 
Exercise of stock options2,216,938 3,915,381 2,216,938 3,925,448 
Vesting of RSUs and RSAs2,423,022 1,767,655 2,423,022 1,767,655 
Issuance of shares under 2020 ESPP61,361 — 61,361 — 
Total potentially dilutive securities15,943,667 16,925,382 15,943,667 16,935,449 
   
Six Months Ended June 30,
 
   
2020
   
2019
 
Shares issuable upon conversion of Series A Preferred Stock
   391,210    391,210 
Shares issuable upon conversion of Series B Preferred Stock
   3,088,444    3,088,444 
Shares issuable upon conversion of Series C Preferred Stock
   4,499,921    4,499,921 
Shares issuable upon conversion of Series D Preferred Stock
   8,593,360    6,418,437 
Shares issuable upon exercise of stock options
   2,596,087    1,751,616 
Shares issuable upon exercise of common stock warrants
   509,562    509,562 
Shares issuable upon exercise of preferred stock warrants
   446,990    446,990 
  
 
 
   
 
 
 
Total
   20,125,574    17,106,180 
  
 
 
   
 
 
 

For the six months ended June 30, 2020 and 2019, the PSUs are not included in the above table as awards with performance conditions are not included in the calculation of diluted earnings per share until the performance conditions for the PSU are considered probable.
Note 17—401(k) Retirement Plan
The Company has a 401(k) retirement savings plan that provides retirement benefits to substantially all full-time U.S. employees. Eligible employees may contribute a percentage of their annual compensation, subject to Internal Revenue Service limitations. The Company did 0t provide anyprovided no contributions to the 401(k) retirement savings plan for the three and six months ended June 30, 20202023 and 2019.2022.
27

Note 18—Related Party Transactions
Consulting Agreement
The Company licenses certain patent rights fromhas a director and shareholder.consulting agreement with the chairman of the Company’s Board of Directors. The license agreement provides for royalty paymentsCompany recorded less than $0.1 million of expense related to the shareholder of 3% of net product sales, as defined in the agreement. Royalties earned were $16,000 and $11,000agreement for both the three months ended June 30, 20202023 and 20192022, and $37,000less than $0.1 million and $23,000 for the six months ended June 30, 2020 and 2019, respectively. Additionally, the director and shareholder also works for one of the Company’s customers and can significantly influence the customer to purchase the Company’s product. The Company recorded sales to this customer of $0.2 million for the three months ended June 30, 2020 and $0.5 million andapproximately $0.1 million for the six months ended June 30, 20202023 and 2019,2022, respectively.

Credit Agreements
The Company has a consultingCompany's prior credit agreement with a director and chairman of the Company’s board of directors. The Company recorded $47,000 and $74,000 for the three months ended June 30, 2020 and 2019, respectively, and $0.1 million and $0.2 million for the six months ended June 30, 2020 and 2019, respectively, in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services.
The Company had a consulting agreement with an officer of(the "2019 Credit Agreement") was between the Company in the prior year. The Company recorded $94,000 for the three months ended June 30, 2019, and $0.2 million for the six months ended June 30, 2019 in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services.
The Company had a consulting arrangement with a current director and officer of the Company, prior to his full-time employment. The Company recorded $0.1 million and $0.2 million for the three and six months ended June 30, 2019, respectively in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services.
Multiple preferred stock shareholders entered into the 2018 and 2019 Convertible Notes that also contained detached warrants. Additionally, Orbimedrelated parties OrbiMed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P. entered into, and provided for a loan of up to $70.0 million with a maturity date of May 20, 2024. On June 30, 2022, the loan balance of $40.0 million was repaid in full out of the proceeds of the 2022 Credit Agreement. The 2022 Credit Agreement with related parties Deerfield Private Design Fund III, L.P. and Deerfield Partners, L.P. replaced the 2019 Credit Agreement withand provides for an aggregate principal amount of $35.0 million and a maturity date five years from the Company inclosing of the loan. Refer to Note 10 - Debt for additional details.

The liability for the loan balance related to the 2022 Credit Agreement and the 2019 for a total of $70.0Credit Agreement recorded on the Company's consolidated balance sheets was $34.4 million with $40.0and $40.4 million being drawn as of June 30, 2020.December 31, 2022 and 2021, respectively. The Company recorded $1.3 million and $0.6 million for the three months ended June 30, 2020 and 2019, respectively, and $2.7 million and $0.6 million for the six months ended June 30, 2020 and 2019, respectively, in interest expense related to thesethe debt agreements.
on the consolidated statements of operations and comprehensive loss of $5.1 million and $5.7 million for the years ended December 31, 2022 and 2021, respectively.

29
Warrants

Acutus Medical, Inc. and Subsidiaries
Notes to Condensed Consolidated Financial Statements
(Unaudited)
Note 19—Subsequent Events
The Company has completed an evaluation of all subsequent events through September 1
8
, 2020 to ensure that these condensed consolidated financial statements include appropriate disclosure of events both recognized inIn connection with the condensed consolidated financial statements and events which occurred but were not recognized in the condensed consolidated financial statements. Except as described below,2022 Credit Agreement, the Company has concluded that no subsequent event has occurred that requires disclosure.
Reverse Stock Split
The Company’s board of directors approved a reverse split ofentered into the 2022 Warrant Purchase Agreement with Deerfield, pursuant to which the Company issued warrants for the purchase up to an aggregate 3,779,018 shares of the Company’s common stock and convertible preferred stock on a
9.724-for-one basis
, which was effected on July 28, 2020. The par value and the number of authorized shares of the convertible preferred stock and common stock were not adjusted in connection with the Reverse Stock Split. All references to common stock, convertible preferred stock, warrants to purchase common stock, warrants to purchase convertible preferred stock, options to purchase common stock, restricted stock units, restricted stock awards, share data, per share data and related information contained in the condensed consolidated financial statements have been retrospectively adjusted to reflect the effect of the Reverse Stock Split for all periods presented. No fractional shares of the Company’s common stock were issued in connection with the Reverse Stock Split. Any fractional share resulting from the Reverse Stock Split was rounded down to the nearest whole share, and any stockholder entitled to a fractional share as a result of the Reverse Stock Split will receive a cash payment in lieu of receiving fractional shares.
Initial Public Offering
On August 10, 2020, the Company issued 10,147,058 shares of common
stock in its IPO, which included 1,323,529 shares of common stock issued upon the exercise in full by the underwriters of an option to purchase, at the public offering price less underwriting discounts and commissions, up to an additional
1,323,529 shares.
The price to the public for each share was
$18.00.
On August 10, 2020, in connection with the closing of the IPO, 391,210 shares of Series A, 3,088,444 shares of Series B, 4,499,921 shares of Series C and 8,593,360 shares of Series D convertible preferred stock, respectively, automatically converted into an equal number of shares of common stock and the warrants to purchase 446,990 shares of Series D convertible preferred stock were automatically converted to an equal number of warrants to purchase common stock at an exercise price of $16.67$1.1114 per share.
share for a period of eight years following issuance. Refer to Note 13 -Warrants for additional details.
Registration Rights Agreement
As a resultOn June 30, 2022, in connection with the issuance of the IPO,2022 Warrants, the underwriters’ exerciseCompany also entered into a registration rights agreement (the “Registration Rights Agreement”) with Deerfield, pursuant to which the Company filed a shelf registration statement on Form S-3 with the SEC to register the resale of certain securities held by Deerfield and their option, andaffiliates (the “Registrable Securities”). In addition, for a period of five years following the conversionsexecution of the Series A, B, CRegistration Rights Agreement, or until all Registrable Securities are registered or no longer subject to restrictions on transfer (whichever is earlier), Deerfield will hold certain “piggy-back” registration rights with respect to registration statements filed during such period. The Company will generally pay all reasonable expenses incidental to its obligations and D convertible preferred stock, the Company’s total number of outstanding shares increased by
26,719,993
immediately following the closing of the IPO.
Equity Incentive Plan
The 2020 Equity Incentive Plan (“2020 Plan”) which permits the granting of nonstatutory stock options, restricted stock, restricted stock units, stock appreciation rights, performance units, performance shares and other equity-based awards to employees, directors and consultants became effective on August 10, 2020 and 2,193,360 shares of common stock were reserved for issuance under the 2020 Plan.
Registration Rights Agreement, other than underwriting discounts and commissions and such other charges.
Note 19—Subsequent Events
On August 10, 2020, options4, 2023, the Company and Deerfield entered into Amendment No. 1, dated August 4, 2023 (“Amendment No.1”) to purchase 850,217 sharesthe 2022 Credit Agreement. Pursuant to Amendment No. 1, the 2022 Credit Agreement was amended to decrease the amount of common stock, 211,251 restricted stock units and 17,976 restricted stock awardscash the Company is required to maintain pursuant to the minimum liquidity covenant in the 2022 Credit Agreement to $5,000,000 for a period of 18 months, at which point the amount required under the 2020 Plan were awardedminimum liquidity covenant shall increase to $20,000,000 (or, if certain employees and consultants ofconditions are met, $10,000,000), in exchange for a fee paid by the Company.

The 2020 Employee Stock Purchase Plan (“2020 ESPP”) which permits employees to purchase shares of the Company’s common stock became effective on August 10, 2020 and 387,063 shares of common stock were authorized for sale under the 2020 ESPP.
3028

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
You should read the following discussion and analysis of our financial condition and results of operations together with our condensed consolidated financial statements and related notes and other financial information included elsewhere in this Form
10-Q.
Some of the information contained in this discussion and analysis or set forth elsewhere in this Form
10-Q,
including information with respect to our plans and strategy for our business, includes “forward-looking statements” within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”).Act. In some cases, you can identify these statements by forward-looking words such as “may,” “will,” “expect,” “believe,” “anticipate,” “intend,” “could,” “should,” “estimate,”“estimate” or “continue,” and similar expressions or variations. Such forward-looking statements are subject to risks, uncertainties and other factors that could cause actual results and the timing of certain events to differ materially from future results expressed or implied by such forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, those identified below, and those discussed in the section titled “Risk Factors” included in this Form
10-Q.
10-Q and in the section titled "Risk Factors" in Part I, Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2022. The forward-looking statements in this Form
10-Q
represent our views as of the date of this Form
10-Q.
Except as may be required by law, we assume no obligation to update these forward-looking statements or the reasons that results could differ from these forward-looking statements. You should, therefore, not rely on these forward-looking statements as representing our views as of any date subsequent to the date of this Form
10-Q.
Overview
We are an arrhythmia management company focused on improving the way cardiac arrhythmias are diagnosed and treated. Despite several decades of effort by the incumbents in this field, the clinical and economic challenges associated with arrhythmia treatment continue to be a huge burden for patients, providers and payors. We are committed to advancing the field of electrophysiology with a unique array of products and technologies which will enable more physicians to treat more patients more effectively and efficiently. Through internal product development, acquisitions and global partnerships, we have established a global sales presence delivering a broad portfolio of highly differentiated electrophysiology products. Our goal is to provide our customers with a complete solution for catheter-based treatment of cardiac arrhythmias in each of our geographic markets.
Our product portfolio includes novel access catheters,sheaths, diagnostic and mapping catheters, conventional and contact force ablation catheters (currently available only in our European markets), mapping and imaging consoles and accessories, as well as supporting algorithms and software programs. Our foundational and most highly differentiated product is our AcQMap imagingImaging and mapping system. Our paradigm-shifting AcQMapMapping System, which offers a novelparadigm-shifting approach to mapping the drivers and maintainers of arrhythmias with unmatched speed and precision. With the ability to rapidly and accurately identify ablation targets and to confirm both ablation success and procedural completion, we believe our AcQMap System addresses thea significant primary unmet need in electrophysiology procedures today.
We were incorporated in the Statestate of Delaware on March 25, 2011 and are headquartered in Carlsbad, California. Early versions of our AcQMap System and certain related accessory products have been used in the United States since May 2018 and Western Europe since July 2016 in a limited, pilot launch capacity, where our focus was on optimizing workflow and validating our value proposition. We fully commenced the launch of our commercial-grade console and software products in the first quarter of 2020. Critical to our launch wereand future market adoption are a series of recent strategic transactions, and regulatory approvals, including: FDAand clinical trial milestones including the following: ongoing development and expansion of our Bi-Lateral Distribution Agreements with Biotronik, Food and Drug Administration (the “FDA”) 510(k) clearance and CE Mark of our second-generation AcQMap console and SuperMap software suite; the addition of an integrated family of transseptal crossing and steerable introducer systems to our product portfolio through our acquisition of Rhythm Xience, Inc., or Rhythm Xience; and the acquisitioncompletion of enrollment in our U.S. clinical study for the AcQBlate Force Sensing Ablation Catheter and System.
In June 2022, we completed the First Closing of the sale of our AcQBlate Force sensing product line from Biotronik SE & Co. KG, or Biotronik. Sinceleft-heart access portfolio to Medtronic as described further below. On November 3, 2022, we announced our full launch,achievement of the OEM Earnout Conditions (as defined in the Asset Purchase Agreement) set forth in the Asset Purchase Agreement. Further on December 1, 2022, Medtronic qualified us as an OEM supplier, and accordingly, we have continuedmanufacture the Products exclusively for Medtronic and will do so for a period of up to enhance our product portfoliofour years until such time that Medtronic transfers the Products to a dedicated manufacturing facility and global presence by entering into
bi-lateral
distribution agreements with Biotronikbecomes the manufacturer of record. Additionally, on December 21, 2022, we achieved a $17.0 million Transfer Earnout as set forth in May 2020, which added a full suitethe Asset Purchase Agreement. See
Contingent Consideration Relating to Sale of diagnostic and ablation catheters to our product portfolio and significantly expanded our international distribution and market development capabilities.Left-heart Access Portfolio, below.
31

The diagram below depicts a chronology of these and other key events since our inception:
We market our electrophysiology products worldwide to hospitals and electrophysiologists that treat patients with arrhythmias. We have strategically developed a direct selling presence in the United States and select markets in Western Europe where cardiac ablation is a standard of care and third-party reimbursement is well-established. In these markets, we install our AcQMap console and workstation with customer accounts and then sell our disposable products to those accounts for use with our system. In other international markets, we leverage our partnership with Biotronik to install our AcQMap console and
29

workstation with customer accounts and then to sell our disposable products to those accounts. Once an AcQMap console and workstation is established in a customer account, our revenue from that account becomes predominantly recurring in nature and derived from the sale of our portfolio of disposable products used with our system. Our currently marketed disposable products include access sheaths, transseptal crossing tools, diagnostic and mapping catheters, ablation catheters and accessories. We plan to leverage the geographically concentrated nature of procedure volumes and the recurring nature of our sales to drive an increasingly efficient commercial model.
For the six months ended June 30, 2023 and 2022, we generated revenue of $9.5 million and $7.8 million, respectively, of which 43% and 48%, respectively, was from customers located outside of the United States. Since our inception, we have generated significant losses. Our net loss was $34.7 million and $34.3 million for the six months ended June 30, 2023 and 2022, respectively. As of June 30, 2020,2023 and December 31, 2022, we had an accumulated deficit of $553.0 million and $518.3 million, respectively, and working capital of $69.1 million and $98.0 million, respectively.
Restructuring
In 2022, we completed an organizational workforce reduction and implemented additional cost reduction measures to reduce our operating expenses and optimize our cash resources. The restructuring was the result of a detailed review of our strategic priorities, the external environment, and cost structure and is intended to sharpen our focus and strengthen our financial position. As part of the restructuring, we intend to prioritize maximizing console utilization and procedure volume growth in targeted geographic regions, as well as a more focused scope of product development initiatives. In 2023, we continue to review and align company resources with our focused scope and strategic direction.
Contingent Consideration Relating to Sale of Left-heart Access Portfolio
On June 30, 2022, we completed the First Closing in accordance with the Asset Purchase Agreement with Medtronic, pursuant to which we agreed to sell to Medtronic certain transseptal access and sheath assets which make up our left-heart access portfolio (and which comprised the Rhythm Xience product line as part of the acquisition of Rhythm Xience). Pursuant to the Asset Purchase Agreement, Medtronic paid $50.0 million at the First Closing, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure our indemnification obligations under the Asset Purchase Agreement, which we recorded as restricted cash on our condensed consolidated balance sheets.
The Company is also eligible to receive the following contingent cash consideration pursuant to the Asset Purchase Agreement:
(i)    OEM Earnout: $20.0 million upon the Company’s completion, to the reasonable satisfaction of Medtronic, of certain conditions set forth in the Asset Purchase Agreement relating to the Company becoming a qualified supplier of Medtronic for the Products, including demonstration of ISO 14971:2019 compliance, completion of certain test method validations and compliance with certain other reporting requirements;
(ii)    Transfer Earnout: $17.0 million upon the earlier of (A) the Second Closing or (B) the Company’s initial submission for CE Mark certification of the Products under the European Union Medical Devices Regulation, to the reasonable satisfaction of a third-party regulatory consultant, subject to certain other conditions as set forth in the Asset Purchase Agreement; and
(iii)    Net Sales Earnouts: Amounts equal to 100%, 75%, 50% and 50%, respectively, of quarterly Net Sales (as defined in the Asset Purchase Agreement) from sales of the Products achieved by Medtronic over each year of a four-year period beginning on the first full quarter after Medtronic’s first commercial organization consistedsale of 60 individuals with substantial applicable medical device, salesa Product and clinical experience,achievement of the OEM Earnout.
The $20.0 million OEM Earnout was achieved in October 2022 and payment was received in November 2022, of which $1.6 million is held in escrow and recorded as restricted cash on the condensed consolidated balance sheets. The $17.0 million Transfer Earnout was achieved in December 2022 and payment was received in January 2023, of which $1.4 million is held in escrow and recorded as restricted cash on the condensed consolidated balance sheets. During the six months ended June 30, 2023, $3.4 million was earned under item (iii) and recorded as a receivable on the condensed consolidated balance sheet as of June 30, 2023.
With the achievement of the OEM Earnout Conditions (as defined in the Asset Purchase Agreement) and upon notice from Medtronic, Medtronic became the Company's exclusive distributor of the Products under the Distribution Agreement.
A Second Closing would occur on a date determined by Medtronic, but no later than the fourth anniversary of the First Closing, subject to the satisfaction of customary closing conditions (the "Second Closing"). Upon the Second Closing, Medtronic will
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acquire certain additional assets relating to the Products, primarily supplier agreements and permits and design and specification files required for Medtronic to become the manufacturer of record of the Products.
Key Business Metrics
We regularly review a number of operating and financial metrics, including sales managers, sales representativesthe following key business metrics, to evaluate our business, measure our performance, identify trends affecting our business, formulate financial projections and mappers. Over time,make strategic decisions. We believe that the following metrics are representative of our current business. However, we plan to selectively add highly qualified personnel toanticipate these metrics may change or may be substituted for additional or different metrics as our commercial organization with a strategic mix of sales representativesbusiness grows and mappers to cover the concentrated group of hospitalsas we introduce new products.
Installed Base
Our mapping and therapy platform is enabled by our AcQMap console that we install at customer sites globally. We believe perform the majority of the cardiac ablation procedures in our direct markets.
Our revenue has historically consisted predominantly of salesinstalled base is a key driver of our business model, enabling utilization and disposable products (principallypull-through. We define our mapping cathetersinstalled base as the cumulative number of AcQMap consoles and related access sheaths, and to a lesser extent our transseptal crossing tools, ablation catheters and other accessories), as we generally loaned our first-generation AcQMap console and workstation to our customers without charge to facilitate the use of our disposable products. Beginning in late 2019, we began toworkstations placed into service at customer sites. We install our second-generation AcQMap console and workstation with customers under evaluation contracts. Under these evaluation contracts, we place our AcQMap console and workstation with customers for no upfront fee to the customer during the applicable evaluation period and seek to reach agreement with the customer for the purchase of the console and workstation in the form of a contractual commitment to purchase a minimum amount of our disposable products or a cash purchase. In addition,Beginning in 2022, we have also generatedstarted to remove and reposition low utilization AcQMap consoles, which has resulted in a small portion of our revenue from service agreements with our customers.
We currently manufacture our novel access sheaths, transseptal crossing tools, diagnostic and mapping catheters, ablation catheters, mapping and imaging consoles and accessories at our approximately 50,800 square foot facilitydecrease in Carlsbad, California. This facility provides approximately 15,750 square feet of space for our production and distribution operations, including manufacturing, quality control and storage. In addition, we stock inventory of raw materials, components and finished goods at our facility in Carlsbad and, to a limited extent, with our sales representatives, who travel to our customers’ locations as part of their sales efforts. We rely on a single or limited number of suppliers for certain raw materials and components, and we generally have no long-term supply arrangements with our suppliers, as we generally order on a purchase order basis. Furthermore, we rely on third parties to manufacture certain products we offer our customers as part of our product portfolio, including Biotronik for diagnostic and ablation catheters, radiofrequency, or RF, generators and irrigation pumps, Innovative Health for reprocessed diagnostic catheters and MedFact for robotic navigation enabled ablation catheters.
As of June 30, 2020, we have completed three clinical trials that collectively evaluated 223 subjects across 16 centers in multiple countries. We are currently conducting two post-market trials to provide physicians with additional safety and effectiveness data on the use of our AcQMap System, and we are planning two investigational device exemption, or IDE, trials to support regulatory approval of our AcQBlate Force ablation catheters. Our ongoing and planned trials are anticipated to involve an aggregate of over 700 subjects in at least 35 centersinstalled base in the United States, and internationally. We expect to provide data readouts from these ongoing and planned trials at various points in time through 2023.
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For the six months ended June 30, 2020, and 2019, we generated revenue of $2.7 million and $1.5 million, respectively, of which 51% and 70%, respectively, was from customers locatedbut an increase outside of the United States. Since our inception, we have generated significant losses. Our net loss was $41.3 million and $45.0 million for the six months ended June 30, 2020 and 2019, respectively. Astotal installed base as of June 30, 20202023 and December 31, 2019, we had an accumulated deficit of $300.4 million and $259.0 million, respectively, and working capital of $15.1 million and $50.5 million, respectively. Prior to our initial public offering (“IPO”) on August 10, 2020, our operations have been financed primarily by aggregate net proceeds from the sale of our convertible preferred stock and principal of our converted debt of $253.9 million, as well as other indebtedness.
We intend to continue to make significant investments in our sales and marketing organization. We believe increasing the number of sales representatives and expanding our international marketing programs will help facilitate further adoption of our products among existing customer accounts as well as broaden awareness of our products to new accounts. We also expect to continue to make substantial investments in our ongoing clinical trials and in additional clinical trials that are designed to provide clinical evidence of the safety and effectiveness of our existing and future generations of products. We expect to continue to make investments in research and development and regulatory affairs to develop future generations of products based on our technology, supported with appropriate regulatory submissions. We may2022 is set forth in the future seek to acquire or invest in additional businesses, products or technologies that we believe could complement or expand our portfolio, enhance our technical capabilities or otherwise offer growth opportunities. We will also incur costs as a public company that we have not previously incurred or have previously incurred at lower rates, including increased costs for employee-related expenses, director and officer insurance premiums, audit and legal fees, investor relations fees, fees to members of our board of directors and expenses for compliance with public-company reporting requirements under the Exchange Act and rules implemented by the SEC, as well as Nasdaq rules. Because of these and other factors, we expect to continue to incur substantial net losses and negative cash flows from operations for at least the next several years.
table below:
Biotronik Agreements
As of June 30,
20232022
(unaudited)
Acutus
U.S.27 37 
Outside the U.S.51 38 
Total Acutus net system placements78 75 
Biotronik License AgreementProcedure Volumes
In July 2019, we entered into the Biotronik License Agreement with Biotronik and VascoMed GmbH, or VascoMed (who we refer to together as the Biotronik Parties), whereby we acquired certain manufacturing equipment and obtained from the Biotronik Parties a license under certain patents and technology to develop, commercialize, distribute and manufacture our AcQBlate Force ablation catheters and Qubic Force device. We refer to this transaction as the Biotronik Asset Acquisition. Pursuant to the Biotronik License Agreement, we paid Biotronik a $3.0 million upfront fee at the time the agreement was signed, as well as a technology transfer fee consisting of $7.0 million in cash in December 2019 and $5.0 million in shares of our Series D convertible preferred stock in February 2020.
The Biotronik License Agreement also requires that we pay the Biotronik Parties certain milestone payments as follows: (i) $2.0 million upon receipt of marketing approval for the sale of our AcQBlate Force ablation catheters in Europe; (ii) $5.0 million upon the receipt of marketing approval for the sale of our AcQBlate Force ablation catheters in the United States; and (iii) $3.0 million upon the first commercial sale of our AcQBlate Force ablation catheters in the United States. We are also required to pay the Biotronik Parties unit-based royalties on any sales we make of our AcQBlate Force ablation catheters following commercialization.
Bi-Lateral
Distribution Agreements
In May 2020, we entered into more expansive
bi-lateral
distribution agreements with Biotronik. We refer to these agreements as the
Bi-Lateral
Distribution Agreements and our relationship with Biotronik as the Acutus/Biotronik Global Alliance for Electrophysiology. Pursuant to our
Bi-Lateral
Distribution Agreements, we obtained a
non-exclusive
license to distribute a range of Biotronik’s therapeutic electrophysiology products and accessories (including the AlCath family of RF ablation catheters) in the United States, Canada, China, Hong Kong and multiple Western European countries under our own private label. Moreover, if an IDE clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, we will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if we cover the cost of the IDE or other clinical trial and we conduct such study within a specified period. We also obtained a
non-exclusive
license to distribute a range of Biotronik’s diagnostic electrophysiology products and accessories in each of the foregoing territories under our own private label.
Pursuant to the
Bi-Lateral
Distribution Agreements, Biotronik has also agreed to distribute our products, including our AcQMap System, our Qubic Force device and our disposable products (including our AcQBlate Force catheters) and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. We also granted Biotronik a
co-exclusive
right to distribute these products in Hong Kong. Biotronik is required to use our branding with respect to the AcQMap console and workstation, but retains the right to distribute our disposable products and accessories under its private label. Each party will pay to the other party specified transfer prices on the sale of the other party’s products under the
Bi-Lateral
Distribution Agreements and, accordingly, will earn a distribution margin on the sale of the other party’s products.
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Key Business Metric
We regularly review a number of operating and financial metrics, including the following key business metric, to evaluate our business, measure our performance, identify trends affecting our business, formulate financial projections and make strategic decisions. We believe that the following metric is representative of our current business. However, we anticipate this metric may change or may be substituted for additional or different metrics as our business grows and as we introduce new products.
Installed Base
Once an AcQMap console and workstation is established in a customer account, our revenue from that account becomes predominantly recurring in nature and derived from the sale of our portfolio of disposable products used with our system. We believe our installed base is oneProcedure volumes and the utilization of the key indicators of our ability to drive customer adoption of our products. We define our installed base as the cumulative number of AcQMap consoles and workstations placed into service at customer sites. Beginning in late 2019, we began to install our second-generation AcQMap console and workstation with customers under evaluation contracts. Under these evaluation contracts, we place our AcQMap console and workstation with customers for no upfront fee towill be the customer during the applicable evaluation period and seek to reach agreement with the customer for purchase of the console and workstation in the form of a contractual commitment to purchase a minimum amountprimary driver of our disposable products or a cash purchase. business over the long-term.
Our total installed base as of June 30, 2020 and 2019 is set forth in the table below:
   
As of June 30,
 
   
2020
   
2019
 
   
(unaudited)
 
Acutus Direct
  
US
   20    8 
Europe
   18    18 
  
 
 
   
 
 
 
Total Acutus Direct
   38    26 
Biotronik
   —      —   
  
 
 
   
 
 
 
Total net system placements
   38    26 
  
 
 
   
 
 
 
Our net increase in installed baseprocedure volumes for the three and six months ended June 30, 20202023 and 2019 is2022 are set forth in the table below:
   
Three Months Ended June 30,
   
Six Months Ended June 30,
 
   
2020
   
2019
   
2020
   
2019
 
   
(unaudited)
   
(unaudited)
 
Acutus Direct
    
US
   7    1    10    3 
Europe
   —      2    1    2 
  
 
 
   
 
 
   
 
 
   
 
 
 
Total Acutus Direct
   7    3    11    5 
Biotronik
   —      —      —      —   
  
 
 
   
 
 
   
 
 
   
 
 
 
Total net system placements
   7    3    11    5 
  
 
 
   
 
 
   
 
 
   
 
 
 
Three Months Ended June 30,Six Months Ended June 30,
2023202220232022
(unaudited)(unaudited)
Procedure volumes5844811,035948
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Growth in our quarterly installed base can fluctuate due to a number of factors, including the commercial effectiveness of our sales representatives and strategic partners such as Biotronik, and the procurement and budgeting cycles of many of our customers, especially those where unused funds may be forfeited or future budgets may be reduced if purchases are not made by their fiscal year end. We also believe the timing of installations has been impacted and will continue to be impacted by the timing of product introductions and transitions. In addition, the growth of our market in certain geographic regions and our continued efforts to service these regions impact unit volumes quarter to quarter.
Factors Affecting Our Performance
There are a number of factors that have impacted, and we believe will continue to impact, or that we expect to impact, our results of operations and growth. These factors include:
Market Acceptance.
.
The growth of our business will depend substantially on our ability to increase our installed base. Once an AcQMap console and workstation is established in a customer account, our revenue from that account becomes predominantly recurring in nature and derived from the sale of our portfolio of disposable products used with our system.
Our ability to increase our installed base will depend on our ability to gain broader acceptance of our AcQMap System by continuing to make physicians and other hospital staff aware of the benefits of the AcQMap System, thereby generating increased demand for system installations and the frequency of use of our disposable products. Although we are attempting to
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increase our installed base through our established relationships and focused sales efforts, we cannot provide assurance that our efforts will be successful.
Commercial Organization Size and Effectiveness
.
As of June 30, 2020,2023, our commercial organization consisted of 6047 individuals with substantial applicable medical device, sales and clinical experience, includingwhich is comprised of sales representatives, sales managers, sales representativesmappers and mappers.marketing personnel. We intend to continue to make significant investments in our commercial organization by increasing the number of ourin training, development, continuing education, and targeted increases in sales representatives, sales managers and mappers as well as by expanding our global marketing and training programs, to help facilitate further adoption of our products among existing and new customer accounts. The rate ateffectiveness with which we growmanage our commercial organization, and the speed at which newly hired personnel become effectivecontribute to business performance, and the impact of turnover can impact our revenue growth or our costs incurred in anticipation of such growth.
Strategic Partnerships and Acquisitions
.
We have in the past, and may in the future, enter into strategic partnerships and acquire complementary businesses, products or technologies. For example, we have entered into strategic partnerships with Innovative Healthacquired our AcQBlate Force Sensing Ablation System from Biotronik in July 2019 and Stereotaxis and, most recently, we entered into our Global Alliance for Electrophysiology with Biotronik in May 2020. In addition, as part of the Asset Purchase Agreement with Medtronic, we added an integrated familywill be their OEM supplier of transseptal crossing and steerable introducer systemsthe Products for up to our product portfolio through our acquisition of Rhythm Xience in June 2019 and acquired our AcQBlate Force sensing product line from Biotronik in July 2019. the next four years.
Our strategic partnerships and acquisitions have helped us establish a global sales presence delivering a broad portfolio of highly differentiated electrophysiology products. Our ability to grow our revenue will depend substantially on our ability to leverage our strategic partnerships and acquisitions to achieve distribution at a global scale, broaden our product portfolio and enable and accelerate global connectivity.
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Continued Investment in Innovation
.
Our business strategy relies significantly on innovation to develop and introduce new products and to differentiate our products from our competitors. For example,Research and development continued to provide both new products as well as generational improvements to the current product lines through the release of multiple versions of software and disposable products including significant improvements to our mapping system hardware. Additionally, research efforts evolved into development projects for advanced therapies, improved navigational accuracy and enhanced mapping capabilities.
We expect our investments in 2019, our research and development team released five new disposable products, two hardware products, including a major generational update to our AcQMap System, and 15 software updates. We expect our research and development expenditures to increasedecrease as we make additional investments to support our growth strategies.have a focused scope on key product development initiatives. We plan to increase our research and development expenditures with internal initiatives, as well as potentially licensing or acquiring technology from third parties. We also expect expenditures associated with our manufacturing organization to grow over time as production volume increases and we bring new products to market. Our internal and external investments will be focused on initiatives that we believe will offer the greatest opportunity for growth and profitability. With a significant investment in research and development, a strong focus on innovation and a well-managed innovation process, we believe we can continue to innovate and grow.
Introducing additional, innovative products is also expected to help support our existing installed base and help drive demand for additional installations of our system. If, however, our future innovations are not successful in meeting customers’ needs or prove to be too costly relative to their perceived benefit, we may not be successful. Moreover, as cost of products sold, operating expenses and capital expenditures fluctuate over time, we may experience short-term, negative impacts to our results of operations and cash flows, but we are undertaking such investments in the belief that they will contribute to long-term growth.
Product and Geographic Mix;Mix and Timing
.
Our financial results, including our gross margins, may fluctuate from period to period due to a variety of factors, including: average selling prices; production volumes; the cost of direct materials; the timing of customer orders or medical procedures and the timing and number of system installations; the number of available selling days in a particular period, which can be impacted by a number of factors such as holidays or days of severe inclement weather in a particular geography; the mix of products sold and the geographic mix of where products are sold; the level of reimbursement available for our products; discounting practices; manufacturing costs; product yields; headcount;headcount and cost-reduction strategies. For example, gross margins on the sale of our products by our direct selling organization in the United States and Western Europe are higher than gross margins on the sale of our products by Biotronik in other parts of the world. Moreover, gross margins on the sale of our proprietary products are generally higher than gross margins on the sale of products we source through our strategic partnerships with third parties.
Future selling prices and gross margins for our products may fluctuate due to a variety of other factors, including the introduction by others of competing products or the attempted integration by third parties of capabilities similar to ours into
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their existing products. We aim to mitigate downward pressure on our selling prices by increasing the value proposition offered by our products through innovation. While we have not yet experienced significant seasonality in our results, it is not uncommon in our industry to experience seasonally weaker revenue during the summer months and
end-of-year
holiday season.
Regulatory Approvals/Approvals / Clearances and Timing and Efficiency of New Product Introductions
.
In May 2022, we completed enrollment in our U.S. IDE study for the AcQBlate Force Sensing Ablation System for use in right atrial flutters. We are seekingfiled for PMA in the second half of 2022. In December 2022, we announced receipt of MDR CE mark of the AcQMap 3D Imaging and Mapping catheter. In July 2022, we announced approval of the AcQMap High Resolution Imaging and Mapping System and the AcQMap 3D Imaging and Mapping Catheter in Japan.
In May 2021, we received FDA clearance andapproval to initialize an atrial fibrillation IDE trial in the United States with the AcQBlate Force Sensing Ablation System. Additionally, we received CE Mark approval for a broad suite of electrophysiology products that includes the next-generation AcQGuide MAX and AcQGuide VUE large bore delivery sheaths and the next-generation AcQMap Mapping Catheter in May 2021. Further, we received CE Mark in December 2020 in Europe for the use of our AcQBlate Force ablation cathetersSensing Ablation System and Qubic Force deviceare seeking FDA PMA for this system in the United States, and Europe, as well as regulatory clearance or approval of our other pipeline products in the United States and in international markets.
Our ability to grow our revenue will depend on our obtaining necessary regulatory approvals or clearances for our products. In addition, as we introduce new products, we expect to build our inventory of components and finished goods in advance of sales, which may cause quarterly and annual fluctuations in our results of operations.
Competition
Competition
. Our industry is intensely competitive, subject to rapid change and significantly affected by new product introductions and other market activities of industry participants. Our most significant competitors are large, well-capitalized companies. We must continue to successfully compete considering our competitors’ existing and future products and related pricing and their resources to successfully market to the physicians who could use our products. PublicationsPublication of clinical results by us, our competitors and other third parties can also have a significant influence on whether, and the degree to which, we are able to gain market share and increase utilization of our products.
Global Supply Chain Disruption
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COVID-19
Pandemic
. Beginning in early March 2020, the
COVID-19
pandemicraw and packing materials and the measures imposed to contain this pandemic disruptedcost of labor, transportation and are expected to continue to impact our business. For example, on March 19, 2020, the Executive Department of the State of California issued Executive Order
N-33-20,
ordering all individuals in the State of California to stay home or at their place of residence except as needed to maintain continuity of operations of the federal critical infrastructure sectors. Our primary operations are located in Carlsbad, California. As a result of such order, the majority of our employees have telecommuted, whichoperating supplies. In addition, it is possible that we may impact certain of our operations over the near term and long term. Moreover, beginning in March 2020, access to hospitalsbe negatively affected from unexpected delays resulting from global supply-chain disruptions and other customer sites was restricted to essential personnel, which negatively impacted our ability to install our AcQMap consoles and workstations in new accounts and for our sales representatives and mappers to promote the useadverse global conditions, including supply shortages of our products with physicians. Moreover, hospitalskey electronic components and other therapeutic centers suspended many elective procedures, resultingraw materials, vendor disruptions related to COVID-19, extended lead times for raw material procurement, or geopolitical factors that could restrict the manufacturing and delivery of raw materials or other components.
Variability in a significantly reduced volume of procedures using our products. In addition, all clinical trials in Europe were suspended with
follow-upsOperating Results
for clinical trials done via telecom, and we believe enrollment timing in our planned clinical trials will be slowed due to
COVID-19
driven delayed access to enrollment sites. As a result of the interruptions to our business due to
COVID-19,
we enacted a cash conservation program, which included delaying certain
non-critical
capital expenditures and other projects and implementing a hiring freeze, headcount reductions and temporary compensation reductions (through August 2020). Although the effects of the pandemic began to decrease in late April 2020 as electrophysiology labs began reopening and procedure volumes began increasing as compared to
COVID-19
related low points in March 2020, the magnitude of the impact of the
COVID-19
pandemic on our productivity, results of operations and financial position, and its disruption to our business and our clinical programs and timelines, will depend, in part, on the length and severity of these restrictions and on our ability to conduct business in the ordinary course. Quarantines,
shelter-in-place
and similar government orders have also impacted, and may continue to impact, our third-party manufacturers and suppliers, and could in turn adversely impact the availability or cost of materials, which could disrupt our supply chain.
In addition, we may experience meaningful variability in our quarterlyyearly revenue and gross profit/loss as a result of a number of factors, including, but not limited to: inventory write-offs and write-downs; costs, benefits and timing of new product introductions; the availability and cost of components and raw materials; and fluctuations in foreign currency exchange rates.rates, inflation rates and interest rates; and our ability to realize the benefits of our recent corporate restructuring. We continue to take proactive steps to recover and mitigate inflationary cost pressures through our overall pricing efforts and by managing our costs through efficiency, labor productivity, and investments in technology. These efforts may not be successful for various reasons, including the pace of inflation. Additionally, we may experience quarters in which our costs and operating expenses, in particular our research and development expenses, fluctuate depending on the stage and timing of product development.
While certain of these factors may present significant opportunities for us, they allalso pose significant risks and challenges that we must address. See the section titled “Risk Factors” for more information.
Components of Results of Operations
Revenue
Our revenue consists of: (i) revenue from the sale of our disposable products; (ii) revenue from the sale, rental, or leasing of systems; and (ii) systems and service(iii) service/other revenue. In the United States and select markets in Western Europe where we have developed a direct selling presence, we install our AcQMap console and workstation with our customer accounts and then generate revenue from the sale of our disposable products to these accounts for use with our system. We also generate revenue from the direct sale of our AcQMap console into hospital accounts as well as revenue through long-term customer commitments on disposable purchases. In addition, we generate revenue under our Distribution Agreement with Medtronic, as Medtronic’s exclusive OEM
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supplier of the left-heart access products sold to Medtronic under the Asset Purchase Agreement. In other international markets, we leverage our partnership with Biotronik to install our AcQMap console and workstation with customer accounts and then generate revenue from Biotronik’s sale of our disposable products to these accounts for use with our system. Our currently marketed disposable products include access sheaths, transseptal crossing tools, diagnostic and mapping catheters, ablation catheters and accessories.
Our revenue has historically consisted predominantly of sales of our disposable products (principally our mapping catheters and related access sheaths, and to a lesser extent our transseptal crossing tools, ablation catheters and other accessories), as we generally loaned our first-generation AcQMap console and workstation to our customers without charge to facilitate the use of our disposable products. Beginning in late 2019, we began to install our second-generation AcQMap console and workstation with customers under evaluation contracts. Under these evaluation contracts, we place our second-generation AcQMap console and workstation with customers for no upfront fee to the customer during the applicable evaluation period and seek to reach agreement with the customer for purchase of the console and workstation in the form of a contractual commitment to purchase a minimum amount of our disposable products or a cash purchase. When a sale of a second-generation AcQMap system is made, the sale includes installation of the equipment, software updates and maintenance, and equipment service. Evaluation contracts are not accounted for as sales under Accounting Standards Codification, or ASC, 606,
Revenue from Contracts with Customers
. In addition, we also generate a small portion of our revenue from service agreements. Revenue is recognized when the customer obtains control of the promised goods or services, generally at a point in time, and is recognized in an amount that reflects the consideration that we expect to receive in exchange for those goods or services. For the six months ended June 30, 20202023 and 2019,2022, approximately 51%43% and 70%48%, respectively, of our sales were sold outside of the United States. Additionally, for the six months ended June 30, 2023 and 2022, approximately 20% and 23% of our sales were denominated in currencies other than U.S. dollars, primarily in Euros and the British Pound Sterling, or GBP.Sterling. Our revenue is subject to fluctuation based on the foreign currency in which our products are sold.
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Costs and Operating Expenses
Cost of Products Sold
Cost of products sold consist primarily of raw materials, direct labor, manufacturing overhead associated with the production and sale of our disposable products and, to a more limited extent, production and depreciation of our AcQMap console and workstation that we install with our customer accounts. We depreciate equipment over a three-year period. Cost of products sold also includes expenditures for warranty, field service, freight, royalties and inventory reserve provisions. We expect cost of products sold to increase in absolute dollars in future periods as our revenue increases.
Gross profit is calculated as revenue less cost of products sold. Gross margin is gross profit expressed as a percentage of revenue. Our gross margins may fluctuate from period to period due to a variety of factors, including: average selling prices; production volumes; the cost of direct materials; the timing of customer orders or medical procedures and the timing and number of system installations; the number of available selling days in a particular period, which can be impacted by a number of factors such as holidays or days of severe inclement weather in a particular geography; the mix of products sold and the geographic mix of where products are sold; the level of reimbursement available for our products; discounting practices; manufacturing costs; product yields; headcount; and cost-reduction strategies. For example, gross margins on the sale of our products by our direct selling organization in the United States and Western Europe are higher than gross margins on the sale of our products by Biotronik in other parts of the world. Moreover, gross margins on the sale of our proprietary products are generally higher than gross margins on the sale of products we source through our strategic partnerships with third parties. Future selling prices and gross margins for our products may fluctuate due to a variety of other factors, including the introduction by others of competing products or the attempted integration by third parties of capabilities similar to ours into their existing products. We aim to mitigate downward pressure on our selling prices by increasing the value proposition offered by our products through innovation.
In addition, we have experienced negative gross margins in recent periods as a result of significant investments in our infrastructure to support our commercial launch and to enable our production volumes to scale as our business grows. We expect our gross margins to increase over the long term to the extent we are successful in increasing our sales volume and are therefore able to leverage our fixed costs. We intend to use our design, engineering and manufacturing capabilities to further advance and improve the efficiency of our manufacturing processes, which, if successful, we believe will reduce costs and enable us to increase our gross margins. Such manufacturing cost improvement efforts may involve moving production of key subassemblies in house, volume driven supplier cost reductions and process redesigns. While we expect gross margins to increase over the long term, they will likely fluctuate from quarter to quarter as we continue to introduce new products and adopt new manufacturing processes and technologies.
Research and Development Expenses
Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, materials costs, allocated rent and facilities costs and depreciation.
Research and development expenses related to possible future products are expensed as incurred. We also accrue and expense costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials.
WeTo align resources with our current strategic direction, we implemented an organizational workforce reduction and other cost reduction measures. Due to this strategic realignment, we expect our research and development expenses to increasemoderate in absolute dollars forin the foreseeable future, though they may vary from period to period as a percentage of revenue, as we hire additional research and development personnel, as well as continue to develop new products, enhance existing products and technologies and perform activities related to obtaining additional regulatory approvals or clearances.upcoming years.
Research and Development Expenses—License Acquired
In July 2019, we entered into the Biotronik License Agreement with the Biotronik Parties in connection with the Biotronik Asset Acquisition. In accordance with ASC 805,
Business Combinations
, the Biotronik Asset Acquisition was accounted for as an asset acquisition as substantially all of the $15.0 million in value transferred to Biotronik was allocated to intellectual property. On the acquisition date, the products licensed had not yet received regulatory approval and the intellectual property did not have an alternative use. Accordingly, the $15.0 million paid to Biotronik was immediately charged to research and development expenses—license acquired in our consolidated statement of operations and comprehensive loss in July 2019. Additional contingent milestone payments of up to $10.0 million are to be made to the Biotronik Parties upon certain regulatory approvals and first commercial sale, as described above. In further consideration of the rights granted, beginning with our first commercial sale of the first force sensing ablation catheter within the licensed product line, we will also make per unit royalty payments. We have determined that as of the acquisition date and as of June 30, 2020 and December 31, 2019, the contingent milestone and royalty payments are not probable and estimable and therefore have not been recorded as a liability. Upon regulatory approval of our force sensing ablation catheter in Europe, the milestone payments will be capitalized and amortized, and the royalty payments will be recorded as cost of products sold as sales of catheters are recognized.
38

Selling, General and Administrative Expenses
Selling, general and administrativeSG&A expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs.
WeTo align resources with our current strategic direction, we implemented an organizational workforce reduction and are implementing additional cost reduction measures. Due to this on-going strategic realignment, we expect our selling, general and administrativeSG&A expenses to increasedecrease in absolute dollars forin the foreseeable future, though they may varyupcoming years.
Goodwill Impairment
During the year ended December 31, 2022, our management assessed qualitative factors and determined it was more likely than not that the fair value of the goodwill was less than its carrying amount. In performing a quantitative impairment test, we determined that goodwill was fully impaired. Consequently, a one-time expense was recorded to goodwill impairment reflecting the elimination of goodwill from the consolidated balance sheets.
Restructuring Expenses
In 2022, we undertook an organizational workforce reduction and have implemented additional cost reduction measures. Our restructuring expenses consist of severance expenses related to employees affected by the organizational workforce reduction.
Change in Fair Value of Contingent Consideration
The change in fair value of contingent consideration relates to our June 2019 acquisition of Rhythm Xience. The acquisition included potential earnout considerations based on the achievement of certain regulatory and revenue milestones. The value of such contingencies is estimated and recorded on the consolidated balance sheets and are adjusted to fair value each period with
34

increases and decreases in the estimated fair value of the contingent consideration earn-out recognized in the condensed consolidated statements of operations and comprehensive income (loss). The earnout period under the Rhythm Xience acquisition agreement concluded on June 19, 2023. Accordingly, no contingent consideration liability was recorded at fair value on the condensed consolidated balance sheet as of June 30, 2023.
Gain on Sale of Business
Gain on sale of business consists of the value of consideration received by us in excess of the book value of assets transferred to period asthe buyer and net of direct selling costs. In 2022, we completed the First Closing of the sale of certain assets to Medtronic whereby the value received was in excess of the book value of the assets transferred, resulting in a recognized gain of $79.5 million. Gain on sale of business also consists of consideration contingent upon the satisfaction of certain contractual conditions. Associated with the sale and included in the above recognized gain, in 2022, we achieved both an OEM Earnout entitling us to $20.0 million and a Transfer Earnout entitling us to $17.0 million in contingent consideration.
Additionally, over the next four years, we expect to receive a percentage of revenue, asMedtronic's quarterly commercial sales of the Products, ranging from 100% in the first year to 50% in the fourth year. In 2023, we expand our sale force and increasehave recognized an estimated gain of $3.4 million related to the numberNet Sales Earnouts. Refer to Note 3 - Sale of our mappers, increase our professional education and physician training, as well as to support our expanded infrastructure and incur increased costs associated with operating as a public company. These increases are expected to include increased costsBusiness for fees to members of our board of directors, increased employee-related expenses, and increased director and officer insurance premiums, audit and legal fees, investor relations fees and expenses for compliance with public company reporting requirements under the Exchange Act and rules implemented by the SEC, as well as stock exchange rules.more information.
In connection with our IPO, certain performance-based restricted stock awards vested as the completion of our IPO constituted the relevant performance condition. As a result, we expect to record an incremental stock-based compensation charge of $3.8 million as part of selling, general and administrative expenses for the quarter ending September 30, 2020 in our condensed consolidated financial statements.
Other Income (Expense)
Change in Fair Value of Warrant Liability
We accounted for certain of our freestanding warrantsWarrants meeting specific conditions are required to purchase shares of our common stock and preferred stockbe recorded as liabilities at fair value.value on the condensed consolidated balance sheets. We accounted for certain featuresissued warrants associated with various recorded transactions, some of which meet these specific conditions. The change in fair value of warrant liability recorded on our consolidated results of operations and comprehensive loss reflect changes in the fair value of these recorded liabilities.
Under the terms of our convertible notes2022 Credit Agreement effective June 30, 2022, we issued in 2018, orwarrants meeting the 2018 Convertible Notes (which were converted into sharesconditions for treatment as a liability. The recorded fair value of our Series D convertible preferred stock in 2019), that were determinedthe liability associated with such warrants is adjusted each reporting period with an entry to be an embedded derivative requiring bifurcation and separate accounting at fair value. The warrants and embedded derivative were subject
to re-measurement at
each balance sheet date with gains and losses reported in ourthe condensed consolidated statements of operations and comprehensive loss.
Loss on Debt Extinguishment
During 2019, we repaid the entire principal amount of our loan under our loan and security agreement with Oxford Finance LLC, or the 2018 Term Loan. We recorded a loss on debt extinguishment income (loss). Refer to Note 13 - Warrants for the write off of deferred financing fees, the prepayment penalty and related fees upon our prepayment of this loan.more information.
Interest Income
Interest income consists primarily of interest earned on our cash, cash equivalents and marketable securities.
Interest Expense
Interest expense for the six months ended June 30, 2023 primarily relates to our: (i)interest paid on our 2022 Credit Agreement with Orbimed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P., or the 2019 Credit Agreement; (ii) 2018 Term Loan, which was repaid during 2019; (iii) 2018 Convertible Notes; and (iv) convertible notes issued in 2019, or the 2019 Convertible Notes. Our 2018 Convertible Notes and our 2019 Convertible Notes were converted into shares of our Series D convertible preferred stock during 2019.
Agreement. Refer to Note 10 - Debt for more information.
39
35

Results of Operations for the Three Months Ended June 30, 20202023 and 2019
2022
The results of operations presented below should be reviewed in conjunction with our condensed consolidated financial statements and related notes included elsewhere in this quarterly report on Form
10-Q.
The following table sets forth our results of operations for the three months ended June 30, 20202023 and 2019:2022:
  
Three Months Ended June 30,
   
Change
 Three Months Ended June 30,Change
(dollars in thousands)  
2020
   
2019
   
$
   
%
 (dollars in thousands)20232022$%
  
(Unaudited)
         (unaudited)
Revenue
(2)(1)
  $1,134   $734   $400    54$5,289 $4,076 $1,213 30 %
Costs of products sold(2)
Costs of products sold(2)
8,063 9,697 (1,634)(17)%
Gross profitGross profit(2,774)(5,621)2,847 (51)%
Costs and operating expenses:
        
Costs of products sold
(1)
   2,663    2,435    228    9
Research and development
(1)
   8,176    5,247    2,929    56
Selling, general and administrative
(1)
   9,125    6,927    2,198    32
Operating expenses (income):Operating expenses (income):
Research and development(2)
Research and development(2)
6,799 7,935 (1,136)(14)%
Selling, general and administrative(2)
Selling, general and administrative(2)
9,284 14,143 (4,859)(34)%
RestructuringRestructuring463 — 463 100%
Change in fair value of contingent consideration
   635    —      635    NM Change in fair value of contingent consideration(77)948 (1,025)(108)%
  
 
   
 
   
 
   
 
 
Total operating expenses
   20,599    14,609    5,990    41
  
 
   
 
   
 
   
 
 
Loss from operations
   (19,465   (13,875   (5,590   40
Gain on sale of businessGain on sale of business(2,072)(43,575)41,503 (95)%
Total operating expenses (income)Total operating expenses (income)14,397 (20,549)34,946 (170)%
Income (loss) from operationsIncome (loss) from operations(17,171)14,928 (32,099)(215)%
Other income (expense):
        Other income (expense):
Change in fair value of warrant liability and embedded derivative
   (2,453   (1,446   (1,007   70
Loss on debt extinguishment
   —      (1,398   1,398    (100%) Loss on debt extinguishment— (7,947)7,947 (100)%
Change in fair value of warrant liabilityChange in fair value of warrant liability(604)— (604)100%
Interest income
   95    143    (48   (34%) Interest income824 27 797 2952 %
Interest expense
   (1,370   (13,769   12,399    (90%) Interest expense(1,395)(1,290)(105)%
  
 
   
 
   
 
   
 
 
Total other expense, net
   (3,728   (16,470   12,742    (77%) 
  
 
   
 
   
 
   
 
 
Net loss
  $(23,193  $(30,345  $7,152    (24%) 
  
 
   
 
   
 
   
 
 
Total other income (expense), netTotal other income (expense), net(1,175)(9,210)8,035 (87)%
(Loss) income before income taxes(Loss) income before income taxes$(18,346)$5,718 $(24,064)(421)%
Income tax benefitIncome tax benefit$— $— $— *
Net (loss) incomeNet (loss) income$(18,346)$5,718 $(24,064)(421)%
Other comprehensive income (loss)
        Other comprehensive income (loss)
Unrealized gain (loss) on marketable securities
   (14   6    (20   NM Unrealized gain (loss) on marketable securities(8)18 (26)(144)%
Foreign currency translation adjustment
   96    2    94    NM Foreign currency translation adjustment(85)(387)302 (78)%
  
 
   
 
   
 
   
 
 
Comprehensive loss
  $(23,111  $(30,337  $7,226    (24%) 
  
 
   
 
   
 
   
 
 
Comprehensive income (loss)Comprehensive income (loss)$(18,439)$5,349 $(23,788)(445)%
NM* - Not meaningful
(1) The following table sets forth our revenue for disposables, systems, and service/other for the three months ended June 30, 2023 and 2022 (in thousands):
Three Months Ended June 30,
20232022
(unaudited)
Disposables$3,914 $3,334 
Systems691 346 
Service/Other684 396 
Total revenue$5,289 $4,076 

(1)
The following table sets forth the stock-based compensation expense included in our results of operations for the three months ended June 30, 2020 and 2019:
   
Three Months Ended June 30,
 
   
2020
   
2019
 
   
(unaudited)
 
Cost of products sold
  $58   $54 
Research and development
   167    150 
Selling, general and administrative
   932    599 
  
 
 
   
 
 
 
Total stock-based compensation
  $1,157   $803 
  
 
 
   
 
 
 
4036

(2)
The following table sets forth our revenue for disposables and systems/service for the three months ended June 30, 2020 and 2019:
The following table provides revenue by geographic location for the three months ended June 30, 2023 and 2022 (in thousands):
Three Months Ended June 30,
20232022
(unaudited)
United States$3,125 $2,037 
Outside the United States2,164 2,039 
Total revenue$5,289 $4,076 
(2)The following table sets forth the stock-based compensation expense included in our results of operations for the three months ended June 30, 2023 and 2022 (in thousands):
Three Months Ended June 30,
20232022
(unaudited)
Cost of products sold$153 $225 
Research and development336 554 
Selling, general and administrative1,245 1,802 
Total stock-based compensation$1,734 $2,581 
   
Three Months Ended June 30,
 
   
2020
   
2019
 
   
(Unaudited)
 
Acutus Direct
    
Disposables
  $899   $705 
Systems
   —      —   
Service/Other
   12    4 
  
 
 
   
 
 
 
Total Acutus direct revenue
   911    709 
Distribution agreements
   223    25 
  
 
 
   
 
 
 
Total revenue
  $1,134   $734 
  
 
 
   
 
 
 
   
Three Months Ended June 30,
 
   
2020
   
2019
 
   
(Unaudited)
 
Acutus Direct
  
United States
  $544   $221 
Europe
   367    488 
  
 
 
   
 
 
 
Total Acutus direct revenue
   911    709 
  
 
 
   
 
 
 
Distribution Agreements
    
United States
   15    —   
Europe
   208    25 
  
 
 
   
 
 
 
Total revenue through distribution
   223    25 
  
 
 
   
 
 
 
          
Total revenue
  $1,134   $734 
  
 
 
   
 
 
 
Revenue
Revenue was $1.1$5.3 million for the three months ended June 30, 2020,2023, compared to $0.7$4.1 million for the three months ended June 30, 2019.2022. This increase of $0.4$1.2 million, or 54%30%, was primarily attributable to a $0.4 millionan increase in purchasethe volume of disposable sales and sales from left-heart access products through our disposable products used in electrophysiology procedures as a result of a higher installed base,partner Medtronic, as well as slightly higher average selling prices on certainan increase of our disposable products.
Revenue, classified by the major geographic areas$0.3 million in which our products are shipped, was $0.6 million for the United Statesboth service/other and $0.6 million for all other countries in the three months ended June 30, 2020, compared to $0.2 million for the United States and $0.5 million for all other countries for the comparative period in 2019.capital revenue.
Costs and Operating Expenses
Cost of Products Sold
Cost of products sold was $2.7$8.1 million for the three months ended June 30, 2020,2023, compared to $2.4$9.7 million for the three months ended June 30, 2019.2022. This increasedecrease of $0.2$1.6 million, or 9%17%, was primarily attributable to a $0.2 million increaseimprovements in warranty and field service expense to support the higher installed base.manufacturing efficiencies. Gross margin was negative 135%52% for the three months ended June 30, 20202023, compared to negative 232%138% for the three months ended June 30, 2019. This improvement in gross margin was primarily attributable to increased sales volume of our disposable products.
2022.
Research and Development Expenses
Research and development expenses were $8.2$6.8 million for the three months ended June 30, 2020,2023, compared to $5.2$7.9 million for the three months ended June 30, 2019.2022. This increasedecrease of $2.9$1.1 million, or 56%14%, was primarily attributable to $0.9 millionthe decrease in increasedproject related spend and compensation and related costs from higher headcount,as a result of an organizational realignment and $2.0 millionreduction in increased materials and supplies costs related to higher engineering project spending.workforce completed in 2022.
Selling, General and Administrative Expenses
Selling, general and administrativeSG&A expenses were $9.1$9.3 million for the three months ended June 30, 2020,2023, as compared to $6.9$14.1 million for the three months ended June 30, 2019.2022. This increasedecrease of $2.2$4.9 million, or 32%34%, was primarily attributable to $3.1 milliona decrease in increased compensation and related costs due to our investmentas a result of the reduction in our commercial organizationworkforce completed in support of our full commercial launch in the United States in the first quarter of 2020. However, due to the2022.
COVID-19Restructuring
pandemic, the increase was offset by a $0.2 million decrease in consulting
Restructuringexpenses andwere $0.5 million decrease in general marketing expenses.
41

Tablefor the three months ended June 30, 2023 and consisted of Contentsseverance expenses for employees affected by an organizational workforce reduction that was made to align resources with the Company's current strategic direction.
Change in Fair Value of Contingent Consideration
For the three months ended June 30, 2020,2023 and 2022, we recorded a change in fair valuedecrease of contingent considerationless than $0.1 million and an increase of $0.6$0.9 million, respectively, for the increasechange in the fair value of the contingent consideration for the acquisition of Rhythm Xience.
The
37

earn-out period under the Rhythm Xience acquisition agreement concluded on June 19, 2023. Accordingly, the change in fair value of less than $0.1 million recorded in the current period was an adjustment to align the earn-out liability to the final consideration owed.
Gain on Sale of Business
A $43.6 million gain on sale was recognized during the three months ended June 30, 2022 upon the First Closing of the asset sale to Medtronic. During the three months ended June 30, 2023, the Company recognized an estimated gain on sale of $2.1 million related to Medtronic's left-heart access net sales earnouts.
Change in Fair Value of Warrant Liability
For the three months ended June 30, 2023 the fair value increased by $0.6 million. The change in fair value of the warrants is primarily due to an increase of the Company's share price as of June 30, 2023.
Other Income (Expense)Expense, Net
Other expense, net was $3.7$1.2 million for the three months ended June 30, 2020,2023, compared to $16.5$9.2 million for the three months ended June 30, 2019.2022. This decrease of $12.7$8.0 million or 77%, was primarily attributable to a decrease$7.9 million loss on debt extinguishment recognized during the three months ended June 30, 2022.
38

Results of Operations for the Six Months Ended June 30, 20202023 and 2019
2022
The results of operations presented below should be reviewed in conjunction with our condensed consolidated financial statements and related notes included elsewhere in this quarterly report on Form
10-Q.
The following table sets forth our results of operations for the six months ended June 30, 20202023 and 2019:2022:
  
Six Months Ended June 30,
   
Change
 Six Months Ended June 30,Change
  
2020
   
2019
   
$
   
%
 
(dollars in thousands)(dollars in thousands)20232022$%
  
(Unaudited)
         (unaudited)
Revenue
(2)(1)
  $2,717   $1,521   $1,196    79$9,458 $7,757 $1,701 22 %
Costs of products sold(2)
Costs of products sold(2)
14,852 16,638 (1,786)(11)%
Gross profitGross profit(5,394)(8,881)3,487 (39)%
Costs and operating expenses:
        
Costs of products sold
(1)
   5,857    4,611    1,246    27
Research and development
(1)
   16,149    9,624    6,525    68
Selling, general and administrative
(1)
   19,360    11,020    8,340    76
Operating expenses (income):Operating expenses (income):
Research and development(2)
Research and development(2)
12,916 15,938 (3,022)(19)%
Selling, general and administrative(2)
Selling, general and administrative(2)
18,849 28,528 (9,679)(34)%
Goodwill impairmentGoodwill impairment— 12,026 (12,026)(100)%
RestructuringRestructuring475 949 (474)(50)%
Change in fair value of contingent consideration
   (1,584   —      (1,584   NM Change in fair value of contingent consideration123 955 (832)(87)%
  
 
   
 
   
 
   
 
 
Total operating expenses
   39,782    25,255    14,527    58
  
 
   
 
   
 
   
 
 
Gain on sale of businessGain on sale of business(3,279)(43,575)40,296 (92)%
Total operating expenses (income)Total operating expenses (income)29,084 14,821 14,263 96 %
Loss from operations
   (37,065   (23,734   (13,331   56Loss from operations(34,478)(23,702)(10,776)45 %
Other income (expense):
        Other income (expense):
Change in fair value of warrant liability and embedded derivative
   (1,872   (605   (1,267   209
Loss on debt extinguishment
   —      (1,398   1,398    (100%) Loss on debt extinguishment— (7,947)7,947 (100)%
Change in fair value of warrant liabilityChange in fair value of warrant liability842 — 842 100%
Interest income
   370    208    162    78Interest income1,676 51 1,625 3186 %
Interest expense
   (2,724   (19,511   16,787    (86%) Interest expense(2,701)(2,701)— — %
  
 
   
 
   
 
   
 
 
Total other expense, net
   (4,226   (21,306   17,080    (80%) Total other expense, net(183)(10,597)10,414 (98)%
  
 
   
 
   
 
   
 
 
Net loss
  $(41,291  $(45,040  $3,749    (8%) 
  
 
   
 
   
 
   
 
 
(Loss) income before income taxes(Loss) income before income taxes$(34,661)$(34,299)$(362)%
Income tax benefitIncome tax benefit$— $— $— *
Net (loss) incomeNet (loss) income$(34,661)$(34,299)$(362)%
Other comprehensive income (loss)
        Other comprehensive income (loss)
Unrealized gain (loss) on marketable securities
   (41   7    (48   NM Unrealized gain (loss) on marketable securities(39)43 (110)%
Foreign currency translation adjustment
   69    (12   81    NM Foreign currency translation adjustment(26)(553)527 (95)%
  
 
   
 
   
 
   
 
 
Comprehensive loss
  $(41,263  $(45,045)  $3,782    (8%) Comprehensive loss$(34,683)$(34,891)$208 (1)%
  
 
   
 
   
 
   
 
 
NM* - Not meaningful
(1)The following table sets forth our revenue for disposables, systems, and service/other for the six months ended June 30, 2023 and 2022 (in thousands):
Six Months Ended June 30,
20232022
(unaudited)
Disposables$7,340 $6,545 
Systems691 346 
Service/Other1,427 866 
Total revenue$9,458 $7,757 

(1)
The following table sets forth the stock-based compensation expense included in our results of operations for the six months ended June 30, 2020 and 2019:
   
Six Months Ended June 30,
 
   
2020
   
2019
 
   
(unaudited)
 
Cost of products sold
  $166   $106 
Research and development
   378    292 
Selling, general and administrative
   2,354    964 
  
 
 
   
 
 
 
Total stock-based compensation
  $2,898   $1,362 
  
 
 
   
 
 
 
4239

(2)
The following table sets forth our revenue for disposables and systems/service for the six months ended June 30, 2020 and 2019:
The following table provides revenue by geographic location for the six months ended June 30, 2023 and 2022 (in thousands):
Six Months Ended June 30,
20232022
(unaudited)
United States$5,373 $4,060 
Outside the United States4,085 3,697 
Total revenue$9,458 $7,757 
(2)The following table sets forth the stock-based compensation expense included in our results of operations for the six months ended June 30, 2023 and 2022 (in thousands):
Six Months Ended June 30,
20232022
(unaudited)
Cost of products sold$228 $451 
Research and development682 1,068 
Selling, general and administrative2,729 4,094 
Total stock-based compensation$3,639 $5,613 
   
Six Months Ended June 30,
 
   
2020
   
2019
 
   
(unaudited)
 
Acutus Direct
    
Disposables
  $1,919   $1,487 
Systems
   520    —   
Service/Other
   18    9 
  
 
 
   
 
 
 
Total Acutus direct revenue
   2,457    1,496 
Distribution agreements
   260    25 
  
 
 
   
 
 
 
Total revenue
  $2,717   $1,521 
  
 
 
   
 
 
 
   
Six Months Ended June 30,
 
   
2020
   
2019
 
   
(unaudited)
 
Acutus Direct
    
United States
  $1,313   $456 
Europe
   1,144    1,040 
  
 
 
   
 
 
 
Total Acutus direct revenue
   2,457    1,496 
  
 
 
   
 
 
 
Distribution Agreements
    
United States
   15    —   
Europe
   245    25 
  
 
 
   
 
 
 
Total revenue through distribution
   260    25 
  
 
 
   
 
 
 
Total revenue
  $2,717   $1,521 
  
 
 
   
 
 
 
Revenue
Revenue was $2.7$9.5 million for the six months ended June 30, 2020,2023, compared to $1.5$7.8 million for the six months ended June 30, 2019.2022. This increase of $1.2$1.7 million, or 79%22%, was primarily attributable to $0.5 million of AcQMap systems sales and a $0.7 millionan increase in purchasethe volume of disposable sales, in alignment with increased procedure volumes, and increased sales from left-heart access products through our disposable products used in electrophysiology procedures as a result of a higher installed base,partner Medtronic, as well as slightly higher average selling prices on certainan increase of our disposable products.
Revenue, classified by the major geographic areas$0.6 million in which our products are shipped, was $1.3service/other revenue and an increase of $0.3 million for the United States and $1.4 million for all other countries in the three months ended June 30, 2020, compared to $0.5 million for the United States and $1.1 million for all other countries for the comparative period in 2019.capital revenue.
Costs and Operating Expenses
Cost of Products Sold
Cost of products sold was $5.9$14.9 million for the six months ended June 30, 2020,2023, compared to $4.6$16.6 million for the six months ended June 30, 2019.2022. This increasedecrease of $1.2$1.8 million, or 27%11%, was primarily attributable to $1.0 million due to an increaseimprovements in sales volume, and a $0.4 million increase in warranty and field service expense to support the higher installed base, partially offset by $0.2 million decrease in depreciation costs due to impairment of first generation systems at the end of 2019.manufacturing efficiencies. Gross margin was negative 116%57% for the six months ended June 30, 20202023, compared to negative 203%114% for the six months ended June 30, 2019. This improvement in gross margin was primarily attributable to increased sales volume of our disposable products.
2022.
Research and Development Expenses
Research and development expenses were $16.1$12.9 million for the six months ended June 30, 2020,2023, compared to $9.6$15.9 million for the six months ended June 30, 2019.2022. This increasedecrease of $6.5$3.0 million, or 68%19%, was primarily attributable to $2.9 millionthe decrease in increasedproject related spend and compensation and related costs from higher headcount,as a result of an organizational realignment and $3.6 millionreduction in increased materials and supplies costs related to higher engineering project spending.workforce completed in 2022.
Selling, General and Administrative Expenses
Selling, general and administrativeSG&A expenses were $19.4$18.8 million for the six months ended June 30, 2020,2023, as compared to $11.0$28.5 million for the six months ended June 30, 2019.2022. This increasedecrease of $8.3$9.7 million, or 76%34%, was primarily attributable to $7.6 milliona decrease in increasedprofessional fees and compensation and related costs due to our investmentas a result of the reduction in our commercial organizationworkforce completed in support2022.
Goodwill Impairment
Goodwill impairment expense was $12.0 million for the six months ended June 30, 2022, which consisted of a full impairment of our full commercial launchgoodwill balance.
Restructuring
Restructuringexpenseswere $0.5 million for the six months ended June 30, 2023, compared to $0.9 million for the six months ended June 30, 2022. This decrease of $0.5 million, or 50%, was primarily attributable to the organizational reduction in the United Statesworkforce that occurred in the first quarter of 2020, $0.6 million in increased consulting expenses and $0.2 million in increased general marketing expenses.early 2022.
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Change in Fair Value of Contingent Consideration
40

For the six months ended June 30, 2020,2023 and 2022, we recorded a change in fair valuedecrease of contingent consideration of $1.6$0.1 million and $1.0 million, respectively, for the decreasechange in the fair value of the contingent consideration for the acquisition of Rhythm Xience.
The earn-out period under the Rhythm Xience acquisition agreement concluded on June 19, 2023. Accordingly, the change in fair value recorded in the current period included an adjustment to align the earn-out liability to the final consideration owed.
Gain on Sale of Business
A $43.6 million gain on sale was recognized during the six months ended June 30, 2022 upon the First Closing of the asset sale to Medtronic. During the six months ended June 30, 2023, the Company recognized an estimated gain on sale of $3.3 million related to Medtronic's left-heart access net sales earnouts.
Change in Fair Value of Warrant Liability
For the six months ended June 30, 2023 the fair value increased by $0.8 million. The change in fair value of the warrants is primarily due to an increase of the Company's share price as of June 30, 2023.
Other Income (Expense)Expense, Net
Other expense, net was $4.2$0.2 million for the six months ended June 30, 2020,2023, compared to $21.3$10.6 million for the six months ended June 30, 2019.2022. This decrease of $17.1$10.4 million or 80%, was primarily attributable to a decrease of $16.8$7.9 million loss on debt extinguishment recognized during the six months ended June 30, 2022 as well as an increase in interest expense primarily related toincome earned from investments of $1.6 million during the 2019 Credit Agreementsix months ended June 30, 2023.
Liquidity, Capital Resources, and 2018 Convertible Notes.
Going Concern
Liquidity and Capital Resources
We have limited revenue, have incurred significant operating losses and negative cash flows from operations since our inception, and we anticipate that we will incur significant losses for at least the next several years. As of June 30, 20202023, and December 31, 2019,2022, we had cash, and cash equivalents, restricted cash and marketable securities of $29.3$61.5 million and $71.8$76.2 million, respectively. For the six months ended June 30, 20202023 and the years ended December 31, 2019 and 2018, our2022, net losses were $41.3 million, $97.0$34.7 million and $47.9$34.3 million, respectively, and our netnet cash used in operating activities was $35.5 million, $56.0$31.1 million and $33.8$50.7 million, respectively. WeAs of June 30, 2023, and December 31, 2022, we had an accumulated deficit of $300.3$553.0 million and $259.0$518.3 million, asrespectively, and working capital of June 30, 2020$69.1 million and December 31, 2019,$98.0 million, respectively.
Prior toSince raising $166.3 million from our initial public offering (“IPO”)IPO in August 2020, we have issued additional shares of common stock. From time to time, our operations had been financed primarily by aggregate net proceeds fromBoard of Directors authorizes the saleissuance of common stock for our convertible preferred stockstock-based compensation plans and principal offor our converted debt of $253.9 million, as well as other indebtedness. In June andESPP. Additionally, in July 2019, we completed an equity financing pursuant to which2021, we issued 8,200,297 shares of Series D convertible preferred stock in a private placement. The Series D convertible preferred stock issuance was comprised of: (i) 4,091,819 shares at $16.67 per share for cash proceeds of $66.6 million, net of fees of $1.6 million; and (ii) 1,884,565 shares at $13.33 per share (including a 20% discount) for the conversion of our 2018 Convertible Notes (and related accrued interest) and 2,223,913 shares at $16.67 per share for the conversion of our 2019 Convertible Notes (and related accrued interest), in an aggregate amount of $68.5 million, including the fair value of the embedded derivative of $6.3 million relating to the 20% discount for the conversion of the 2018 Convertible Notes. On August 10, 2020, we issued 10,147,0586,325,000 shares of common stock in our IPO,a public offering, which included 1,323,529825,000 shares of common stock issued upon the underwriter’s exercise in full by the underwriters of an option to purchase at the public offering price less underwriting discounts and commissions, up to an additional 1,323,529 shares.shares of common stock. The price to the public for each share was $18.00.
$14.00. We received gross proceeds of $88.6 million from the offering. Net of underwriting discounts and commission and other offering expenses, we received proceeds of $82.7 million.
Our future liquidity and capital funding requirements will depend on numerous factors, including:

On June 30, 2022, Medtronic paid us $50.0 million at the First Closing of the sale of our revenue growth;
left-heart access portfolio to Medtronic, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure our research and development efforts;
our sales and marketing activities;
our success in leveraging our strategic partnerships, including with Biotronik,indemnification obligations under the Asset Purchase Agreement. We achieved a $20.0 million OEM Earnout as well as entrance into any other strategic partnerships or strategic transactionsset forth in the future;
our abilityAsset Purchase Agreement on October 31, 2022, which was paid to raise additional funds to finance our operations;
the outcome, costs and timing of any clinical trial results for our current or future products;
the emergence and effect of competing or complementary products;
the availability and amount of reimbursement for procedures using our products;
44

our ability to maintain, expand and defend the scope of our intellectual property portfolio, including the amount and timing of any payments we may be required to make, or that we may receive, in connection with the licensing, filing, prosecution, defense and enforcement of any patents or other intellectual property rights;
our ability to retain our current employees and the need and ability to hire additional management and sales, scientific and medical personnel;
the terms and timing of any collaborative, licensing or other arrangements that we have or may establish;
debt service requirements;
the extent to which we acquire or invest in businesses, products or technologies; and
the impact of the
COVID-19
pandemic.
Our primary uses of capital are, and we expect will continue to be, investment in our commercial organization and related expenses, clinical research and development services, laboratory and related supplies, legal and other regulatory expenses, general administrative costs and working capital. In addition, we have acquired, and mayus in the future seek to acquire or invest in, additional businesses, products or technologies thatfourth quarter of 2022. Additionally, we believe could complement or expand our portfolio, enhance our technical capabilities or otherwise offer growth opportunities. For example, in June 2019, we acquired Rhythm Xience,achieved a medical device company specializing in the design and manufacture of transseptal crossing and steerable introducer systems, for $3.0 million in cash. The cash payment did not include the potential $17.0 million in earn out consideration to be paid basedTransfer Earnout as set forth under the Asset Purchase Agreement on the achievement of certain regulatory milestones and revenue milestones. In February 2020, we issued to the former owners of Rhythm Xience 119,993 shares of our Series D convertible preferred stock and paid them $2.6December 21, 2022. Accordingly, $17.0 million in connection with the regulatory and revenue milestones earned to date. In addition, pursuant to the Biotronik License Agreement, we paid Biotronik a $3.0 million upfront fee at the time the agreement was signed, as wellrecorded as a technology transfer fee consisting of $7.0 millionreceivable for the year ended December 31, 2022 and payment was received in cash in December 2019 and $5.0 million in shares of our Series D convertible preferred stock in February 2020. We are required to pay the Biotronik Parties up to $10.0 million upon the achievement of various regulatory and sales-related milestones, as well as unit-based royalties on any sales of force sensing catheters. We will also incur costs as a public company that we have not previously incurred or have previously incurred at lower rates.
January 2023.
With the closing of our IPO,Management believes our current cash, and cash equivalents and marketable securities are sufficient to fund operations for at least the next 12 months. However,To ensure that we willhave sufficient resources to fund operations, management continues to review cost improvement opportunities and pathways to reduce expenses and cash burn, while preserving the resources to invest in future growth.
In the future, we may need to raise additional funds through one or more of the following: issuance of additional debt and/or equity securities or both.otherwise. Until such time, if ever, that we can generate revenue sufficient to achieve profitability, we expect to finance our operations through equity or debt financings, which may not be available to us on the timing needed or on terms that we deem to be favorable. To the extent that we raise additional capital through the sale of equity or convertible debt securities, the ownership interest of our stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect the rights of common stockholders. Debt financing and preferred equity financing, if available, may involve agreements that include covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making
41

acquisitions or capital expenditures or declaring dividends. If we are unable to maintain sufficient financial resources, our business, financial condition, and results of operations will be materially and adversely affected. We may be required to delay, limit, reduce or terminate our product discovery and development activities or future commercialization efforts. There
Our future liquidity and capital funding requirements will depend on numerous factors, including:
our revenue growth;
our research and development efforts;
our sales and marketing activities;
our success in leveraging our strategic partnerships, including with Biotronik, as well as entrance into any other strategic partnerships or strategic transactions in the future;
Medtronic’s success in selling Products following the achievement of the OEM Earnout;
our ability to raise additional funds to finance our operations;
the outcome, costs and timing of any clinical trial results for our current or future products;
the emergence and effect of competing or complementary products;
the availability and amount of reimbursement for procedures using our products;
our ability to maintain, expand and defend the scope of our intellectual property portfolio, including the amount and timing of any payments we may be required to make, or that we may receive, in connection with the licensing, filing, prosecution, defense and enforcement of any patents or other intellectual property rights;
our ability to retain our current employees and the need and ability to hire additional management and sales, scientific and medical personnel;
the terms and timing of any collaboration, licensing or other arrangements that we have or may establish;
debt service requirements; and
the extent to which we acquire or invest in businesses, products or technologies.
Our primary uses of capital are, and we expect will continue to be, investment in our commercial organization and related expenses, clinical research and development services, laboratory and related supplies, legal and other regulatory expenses, general administrative costs and working capital. In addition, we have acquired, and may in the future seek to acquire or invest in, additional businesses, products or technologies that we believe could complement or expand our portfolio, enhance our technical capabilities or otherwise offer growth opportunities. For example, in June 2019, we acquired Rhythm Xience, a medical device company specializing in the design and manufacture of transseptal crossing and steerable introducer systems, for $3.0 million in cash. The cash payment did not include a potential $17.0 million in earn out consideration to be paid based on the achievement of certain regulatory and revenue milestones. In February 2020, we issued to the former owners of Rhythm Xience 119,993 shares of our Series D convertible preferred stock and paid them $2.5 million in the first quarter of 2020, and an additional $3.4 million and $1.3 million in 2021 and 2022, respectively, in connection with the regulatory and revenue milestones earned. The earnout period under the Rhythm Xience acquisition agreement concluded on June 19, 2023. No payments were made to Rhythm Xience during the six months ended June 30, 2023. However, the final earnout payment under the agreement, totaling $1.9 million, was made to Rhythm Xience in July 2023. In addition, pursuant to a license agreement with Biotronik, we paid Biotronik a $3.0 million upfront fee at the time the agreement was signed, as well as a technology transfer fee consisting of $7.0 million in cash in December 2019 and $5.0 million in shares of our Series D convertible preferred stock in February 2020. We are required to pay Biotronik and VascoMed GmbH (the “Biotronik Parties”) up to $10.0 million, of which $2.0 million has been paid as of June 30, 2023, upon the achievement of various regulatory and sales-related milestones, as well as unit-based royalties on any sales of Force Sensing Catheters. We also incur costs as a public company that we have not previously incurred or have previously incurred at lower rates. In addition, our recent corporate restructuring is intended to reduce our operating expensesandoptimizeourcashresources.BasedonthetimingofnotificationsundertheWARNAct,westartedrealizingthe benefits of our restructuring plan beginning late in the first quarter of 2022; however, there can be no assurance that we will be able to obtainrealize the needed financingbenefits of the restructuring on acceptable termsthe anticipated timeline, or at all.
Under ASC Subtopic 205-40, Presentation of Financial Statements—Going Concern, we have the responsibility to evaluate whether conditions and/or events could raise substantial doubt about our ability to meet our future financial obligations as they become due within one year after the date that the financial statements are issued. Going concern matters are more fully
42

discussed in Note 1, “Organization and Description of Business – Liquidity, Capital Resources and Going Concern” of our condensed consolidated financial statements.
Debt Obligations
During 2019, we repaid our 2018 Term Loan and our 2018 Convertible Notes and our 2019 Convertible Notes were converted into shares of our Series D convertible preferred stock.
On May 20, 2019,June 30, 2022, we entered into the 20192022 Credit Agreement.Agreement with related parties Deerfield Private Design Fund III, L.P. and Deerfield Partners, L.P. The 20192022 Credit Agreement provided us with a senior term loan facility in an aggregate principal amount of $70.0 million, of which we borrowed $40.0 million upon closing. Of the remaining $30.0 million, $10.0 million is no longer available for borrowing and $20.0 million is available for borrowing by us on or prior to December 31, 2020, subject to our achievement of specified trailing revenue levels.$35.0 million. The 20192022 Credit Agreement bears interest at the one-month adjusted term Secured Overnight Financing Rate, with a floor of 2.50% per annum, at 7.75% plus LIBOR for such interest period, and the9.00% per annum. The principal amount of the term loans outstanding underloan will be paid in installments with the 2019 Credit Agreement isfinal principal payment due on May 20, 2024.June 30, 2027. The 20192022 Credit Agreement can be prepaid but is subject to prepayment penalties. The 20192022 Credit Agreement provides for final payment fees of an additional $4.6$1.8 million that are due upon prepayment, on the maturity date or upon acceleration.
Proceeds from the 2022 Credit Agreement, along with cash on hand, were used to repay the 2019 Credit Agreement and to pay related fees and expenses and for working capital purposes.
The 2022 Credit Agreement contains certain customary negative covenants, including, but not limited to, restrictions on our ability and that of our subsidiaries to merge and consolidate with other companies, incur indebtedness, grant liens or security interests on assets, pay dividends or make other restricted payments, sell or otherwise transfer assets or enter into transactions with affiliates. The 2022 Credit Agreement provides that, upon the occurrence of certain events of default, our obligations thereunder may be accelerated. Such events of default include payment defaults to the lenders, material inaccuracies of representations and warranties, covenant defaults, cross-defaults to certain other indebtedness, voluntary and involuntary bankruptcy proceedings, certain money judgments, change of control events and other customary events of default. Our obligations under the 20192022 Credit Agreement are secured by substantially all of our assets, including our intellectual property, and is guaranteed by our subsidiary. The 2019 Credit Agreement contains customary affirmative and restrictive covenants, includingproperty.
45

with respect to our ability to enter into fundamental transactions, incur additional indebtedness, grant liens, pay any dividend or make any distributions to our holders, make investments and merge or consolidate with any other person or engage in transactions with our affiliates, but does not include any financial covenants, other than a minimum liquidity requirement.
In connection with our entryentering into the 20192022 Credit Agreement, we entered into the 2022 Warrant Purchase Agreement with Deerfield, pursuant to which we issued liability-classified warrants with a fair value of $0.9 million to purchase 419,992 shares of our Series C convertible preferred stock at $16.67 per share. These warrants were subsequently automatically converted intoDeerfield warrants to purchase up to an equal number of shares of our Series D convertible preferred stock at a price of $16.67 per share. Upon closing of our IPO, these warrants were automatically converted into warrants to purchase an equal number ofaggregate 3,779,018 shares of our common stock, par value $0.001 per share common stock, at aan exercise price of $16.67$1.1114 per share.warrant share for a period of eight years following the issuance thereof.
Cash Flows
The following table shows a summary of our cash flows for the six months ended June 30, 20202023 and 20192022 (in thousands):
Six Months Ended June 30,
20232022
(unaudited)
Net cash used in operating activities$(31,097)$(50,706)
Net cash provided by investing activities30,386 89,168 
Net cash used in financing activities(234)(11,643)
Effect of exchange rate changes on cash, cash equivalents and restricted cash(346)(323)
Net change in cash, cash equivalents and restricted cash$(1,291)$26,496 
   
Six Months Ended June 30,
 
   
2020
   
2019
 
   
(Unaudited)
 
Net cash used in operating activities
  $(34,761  $(22,084
Net cash provided by (used in) investing activities
   52,650    (17,424
Net cash (used in) provided by financing activities
   (3,115   97,951 
Effect of exchange rate changes on cash, cash equivalents and restricted cash   69    (12
  
 
 
   
 
 
 
Net change in cash, cash equivalents and restricted cash
  $14,843   $58,431 
  
 
 
   
 
 
 
Operating Activities
During the six months ended June 30, 2020,2023, operating activities used $34.8$31.1 million of cash, a decrease of $19.6 million from the six months ended June 30, 2022.This decrease was attributable to favorable changes in operating assets and liabilities of $3.3 million and non-cash items and reclasses of $16.7 million. The favorable change in operating assets and liabilities was primarily due to the $4.7 million Employee Retention Credit receivable refunded during the six months ended June 30, 2023, partially offset by an increase in inventory purchases of $3.4 million to meet customer demand and other changes in working capital. The changes in non-cash items and reclasses compared to the prior period were primarily due to the change in gain on sale of business of $40.3 million, offset by reduced stock-based compensation expense of $2.0 million, increased accretion of discounts on marketable securities of $1.3 million, and the goodwill impairment charge of $12.0 million and loss on debt extinguishment of $7.9 million recognized during the six months ended June 30, 2022.
Investing Activities
During the six months ended June 30, 2023, investing activities provided $30.4 million of cash, a decrease of $58.8 million from the six months ended June 30, 2022. This decrease was attributable to a decrease in net proceeds from the Medtronic left-heart access portfolio sale of $33.0 million compared to the prior period, an increase in purchases of marketable securities of $33.9 million compared to the prior period and a decrease in the sales of marketable securities of $13.1 million compared to the
43

prior period. This decrease was offset by an increase in the maturities of marketable securities of $20.5 million compared to the prior period and a decrease in purchase of property and equipment of $0.7 million compared to the prior period.
Financing Activities
During the six months ended June 30, 2023, financing activities used $0.2 million of cash, an increasea decrease of $12.7$11.4 million from the six months ended June 30, 2019.2022. This increase wasdecrease is primarily drivenattributable to the $11.2 million net cash outflow made during the six months ended June 30, 2022 to amend and restate the Company's 2019 debt facility.
Contractual Obligations and Commitments
We enter into agreements in the normal course of business with contract research organizations for clinical trials and with vendors for preclinical trials and other services and products for operating purposes which are cancellable at any time by a decreaseus, generally upon 30 days prior written notice.
Further, the agreement to acquire Rhythm Xience requires us to pay the former owners of Rhythm Xience up to $17.0 million in amortizationearn-out consideration based on the achievement of debt issuance costs, a decreasecertain regulatory and revenue milestones. In February 2020, we issued to the former owners of $1.6Rhythm Xience 119,993 shares of our Series D convertible preferred stock valued at $2.2 million and paid them $2.5 million in the fair valuefirst quarter of the contingent consideration and a decrease of $1.42020, an additional $3.4 million of loss on debt extinguishment. This increase was partially offset by a $3.7 million decrease in the net loss, a $1.5 million increase of stock-based compensation expense and $1.3 million increase in 2021 and 2022, respectively, in connection with the fair value of warrant liabilityregulatory and embedded derivative.
Investing Activities
Duringrevenue milestones earned. The earnout period under the Rhythm Xience acquisition agreement concluded on June 19, 2023. No payments were made to Rhythm Xience during the six months ended June 30, 2020, investing activities provided $52.72023. However, the final earnout payment under the agreement, totaling $1.9 million, of cash, an increase of $70.1 million from the six months ended June 30, 2019. This increase was attributablemade to an increase of maturities of marketable securities of $31.9 million, sales of marketable securities of $17.1 million, a decrease of $22.2 million of purchases of marketable securities and $3.0 million of cash paid for the Rhythm Xience acquisition, partially offset byin July 2023. In addition, pursuant to a $4.1license agreement with Biotronik, we issued to Biotronik $5.0 million increase in purchases of property and equipment.
Financing Activities
During the six months ended June 30, 2020, financing activities used $3.1 million of cash, a decrease of $101.1 million from the six months ended June 30, 2019. The primary financing activity for the six months ended June 30, 2020 was payment of contingent consideration related to the Rhythm Xience acquisition for the achievement of certain regulatory milestones and revenue targets. The primary financing activities for the six months ended June 30, 2019 included $40.0 million resulting from the closing of the 2019 Credit Agreement, $38.2 million from the issuance of shares of our Series D convertible preferred stock in June 2019February 2020, and $37.0we are required to pay the Biotronik Parties up to $10.0 million, from the issuance of the 2019 Convertible Notes in May 2019, partially offset by $17.3which $2.0 million in debt repayments related to the repaymenthas been paid as of the 2018 Term Loan and payments of issuance and extinguishment costs
Contractual Obligations and Commitments
During the six months ended June 30, 2020, there have been no material changes outside2023, upon the ordinary courseachievement of business to our contractual obligations from those disclosed in “Management’s Discussionvarious regulatory and Analysissales-related milestones, as well as unit-based royalties on any sales of Financial Condition and Results of Operations” included in the prospectus dated August 5, 2020 (the “Prospectus”) that forms a part of the Company’s Registration Statements on Form
S-1
(File
No. 333-239873),
as filed with the SEC pursuant to Rule 424(b)(4) promulgated under the Securities Act of 1933, as amended.
46
Force Sensing Catheters.

Off-Balance
Sheet Arrangements
As of June 30, 20202023 and December 31, 2019,2022, we did not have, and we do not currently have, any
off-balance
sheet arrangements, as defined in the SEC rules and regulations.
Critical Accounting Policies and Estimates
Management’s discussion and analysis of our financial condition and results of operations is based on our condensed consolidated financial statements, which have been prepared in accordance with U.S. generally accepted accounting principles, or U.S. GAAP. The preparation of these condensed consolidated financial statements requires us to make estimates and assumptions for the reported amounts of assets, liabilities, revenue and expenses. Our estimates are based on our historical experience and on various other factors that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions and any such differences may be material.
During the six months ended June 30, 2020,2023, there have been no material changes to our critical accounting policies and estimates from those disclosed in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” included in the Prospectus that forms a part of the Company’s Registration Statementsour annual report on Form
S-1
(File
No. 333-239873),
10-K for the year ended December 31, 2022, as filed with the SEC pursuant to Rule 424(b)(4) promulgated under the Securities Act of 1933, as amended.on March 24, 2023.
Our significant accounting policies are described in the Note 2 - Summary of Significant Accounting Policies to our condensed consolidated financial statements.
Recent Accounting Pronouncements
See Note 2 - Summary of Significant Accounting Policies to our condensed consolidated financial statements for a description of recent accounting pronouncements applicable to our condensed consolidated financial statements.
Item 3. Quantitative and Qualitative Disclosures about Market Risk
As a “smaller reporting company” as defined by Item 10 of Regulation
S-K,
the Company is we are not required to provide the information required by this item.
44

Item 4. Controls and Procedures
Disclosure Controls and Procedures
We maintain “disclosure controls and procedures,” as such term is defined in
Rules 13a-15(e)
and
15d-15(e)
under the Securities Exchange Act, of 1934, as amended (the “Exchange Act”), that are designed to ensure that information required to be disclosed by us in reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in Securities and Exchange CommissionSEC rules and forms, and that such information is accumulated and communicated to our management, including our Chief Executive Officer and our PrincipalChief Financial Officer, to allow timely decisions regarding required disclosure.
The design of any disclosure controls and procedures also is based in part upon certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions.
With respect to the quarter ended June 30, 2020,2023, under the supervision and with the participation of our management, we conducted an evaluation of the effectiveness of the design and operationsoperation of our disclosure controls and procedures. Based upon this evaluation, our Chief Executive Officer and PrincipalChief Financial Officer havehas concluded that our disclosure controls and procedures are effective. Management does not expect that our internal control over financial reporting will prevent or detect all errors and all fraud. A control system, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the control systemssystem are met. Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits of controls must be considered relative to their costs. Because of the inherent limitations in a cost-effective control system, no evaluation of internal control over financial reporting can provide absolute assurance that misstatements due to error or fraud will not occur or that all control issues and instances of fraud, if any, have been or will be detected.
Changes in Internal Control over Financial Reporting:
There were no changes in our internal control over financial reporting (as defined in Rules
13a-15(f)
and
15d-15(f)
under the Exchange Act) that occurred during the quarter ended June 30, 20202023 which have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
47
45

Part II. OTHER INFORMATION
Item 1. Legal Proceedings.
From time to time, we are involved in various legal proceedings, including litigation arising from the normal course of our business activities. We are not presently a party to any litigation the outcome of which, we believe, if determined adversely to us, would individually or taken together have a material adverse effect on our business, operating results, cash flows, or financial condition. We havealso received, and may from time to time receive, letters from third parties alleging patent infringement, violation of employment practices or trademark infringement, and we may in the future participate in litigation to defend ourselves. The results of any current or future litigation cannot be predicted with certainty, and regardless of the outcome, litigation can have an adverse impact on us because of defense and settlement costs, diversion of management resources and other factors.
Other than the matters listed below, we are not currently party to any pending legal proceedings that we believe would, individually or in the aggregate, have a material adverse effect on our financial condition, cash flows or results of operations.

We and certain of our current and former officers have been named as defendants in two putative securities class action lawsuits filed by stockholders in the United States District Court for the Southern District of California on February 15, 2022 and March 23, 2022. Plaintiffs allege violations of Section 10(b) of the Exchange Act and Rule 10b-5, and Section 20(a) of the Exchange Act. The complaints allege that the defendants made false and misleading statements about our business, prospects and operations. The putative claims are based upon statements made in filings made by us with the SEC, press releases and on earnings calls between May 13, 2021 and November 11, 2021. The lawsuits seek, among other relief, a determination that the alleged claims may be asserted on a class-wide basis, unspecified compensatory damages, attorney’s fees, other expenses and costs. On July 19, 2022, the court consolidated the two actions, appointed a lead plaintiff and appointed lead counsel for the proposed class. On September 16, 2022, the lead plaintiff filed a consolidated amended complaint. We thereafter filed a motion to dismiss.

Due to the complex nature of the legal and factual issues involved in these class action matters, the outcome is not presently determinable. If these matters were to proceed beyond the pleading stage, we could be required to incur substantial costs and expenses to defend these matters and/or be required to pay substantial damages or settlement costs, which could materially adversely affect our business, financial condition and results of operations.
Item 1A. Risk Factors
As of the date of this Quarterly Report on Form
10-Q,
there have been no material changes from the risk factors disclosed in our Prospectusannual report on Form 10-K for the year ended December 31, 2022, as filed by us with the SEC pursuant to Rule 424(b)(4) under the Securities Act, relating to our registration statement on Form
S-1
(File No. 333-239873).March 24, 2023. Any of these factors could result in a significant or material adverse effect on our result of operations or financial conditions. Additional risk factors not presently known to us or that we currently deem immaterial may also impair our business or results of operations. We may disclose changes to such factors or disclose additional factors from time to time in our future filings with the SEC.
Item 2. Recent Sales of Unregistered Securities.
(a) Sales of Unregistered Securities
Between April 1, 2020 andOn June 30, 2020:
2022, in connection with entering into the 2022 Credit Agreement, we entered into the 2022 Warrant Purchase Agreement with the lenders under the 2022 Credit Agreement (the “Lenders”), pursuant to which we issued to the Lenders warrants to purchase up to an aggregate 3,779,018 shares (the “2022 Warrant Shares”) of our common stock, par value $0.001 per share, at an exercise price of $1.1114 per 2022 Warrant Share for a period of eight years following the issuance thereof, on and soldsubject to the terms and conditions set forth in the warrants evidencing such rights.

The 2022 Warrants are exercisable on a cash or cashless (net exercise) basis, and are subject to a 4.9% beneficial ownership limitation, as well as certain other customary anti-dilution adjustments upon the occurrence of certain events such as stock splits, subdivisions, reclassifications or combinations of common stock. Upon the consummation of a “Major Transaction” (as defined in the 2022 Warrants), holders of the 2022 Warrants may elect to (i) have their 2022 Warrants redeemed by us for an amount equal to the Black-Scholes value of such warrant, in cash or, if applicable, in the form of the consideration paid to our current and former officers and employees an aggregatestockholders in a Major Transaction (i.e. securities or other property of 64,562 sharesthe buyer), or (ii) have such 2022 Warrants be assumed by the successor to us in a Major Transaction, if applicable. Holders of the 2022 Warrants are also entitled to participate in any dividends or distributions to holders of common stock uponat the exercise of options under our equity compensation plans at exercise prices ranging from $0.54time such dividends or distributions are paid to $1.06 per share, for an aggregate amount of $0.2 million.
such stockholders.

None of the foregoing transactions involved any underwriters, underwriting discounts or commissions, or any public offering. Unless otherwise stated, the sales of the above securities were deemed to be exempt from registrationThe 2022 Warrants and 2022 Warrant Shares issuable thereunder have not been registered under the Securities Act of 1933, as amended (the “Securities Act”) and were issued in reliance upona private placement pursuant to Section 4(a)(2) thereof. We relied on this exemption from registration based in part on representations made by the Lenders in the 2022 Warrant Purchase Agreement, including representations that each Lender was an “accredited investor” as defined in Regulation D of the Securities Act (or Regulation D promulgated thereunder) or Rule 701 promulgated under Section 3(b) Act.

The Warrant Purchase Agreement contains customary representations, warranties, and covenants made by us and the Lenders. Pursuant to the Warrant Purchase Agreement, we have agreed to indemnify the Lenders for losses arising from certain breaches
46

of the Securities Act as transactions by an issuer not involving any public offering or pursuant to benefit plans and contracts relating to compensation as provided under Rule 701. The recipients ofWarrant Purchase Agreement, the securities in each of these transactions represented their intentions to acquire the securities for investment only and not with a view to or for sale in connection with any distribution thereof, and appropriate legends were placed upon the stock certificates issued in these transactions.
(b) Use of Proceeds from Public Offering of Common Stock
The registration statement on Form
S-1
(File
No. 333-239873)
2022 Warrants and the registration statement on Form
S-1
(File
No. 333-241091)
filed pursuant to Rule 462(b) relating thereto, each relating to the IPO of shares of our common stock, became effective on August 5, 2020. The registration statements registered the offer and sale of 10,147,058 shares of our common stock (including 1,323,529 shares of our common stock that were subject to the underwriters’ over-allotment option). On August 10, 2020, we completed the sale of all 10,147,058 of the shares of our common stock registered thereunder at an initial public offering price of $18.00 per share for an aggregate offering price of approximately $182.6 million. The underwriters of the offering were J.P. Morgan Securities LLC, BofA Securities, Inc., William Blair & Company, L.L.C., Canaccord Genuity LLC and BTIG, LLC. Following the sale of the sharesrights agreement entered into in connection with the closing of the IPO, the offering terminated.Warrant Purchase Agreement.
We received net proceeds of approximately $166.3 million after deducting underwriting discountItem 5. Other Information.
On August 4, 2023, we and commissions of $12.8 million and offering costs of $3.5 million. No payments for such expenses were made directly or indirectly to (i) any of our officers or directors or their associates, (ii) any persons owning 10% or more of any class of our equity securities, or (iii) any of our affiliates.
We maintain the funds received from our IPO with our money market funds and marketable securities, pending their use. We intend to use the net proceeds from this offering to support our commercial expansion, including hiring additional commercial personnel, for the completion of all of our ongoing clinical trials, for our research and development activities, and the remainder, if any, for working capital and other general corporate purposes. We may also use a portion of the net proceeds of this offering for acquisitions or strategic transactions, though we have notDeerfield entered into any agreements or commitments with respectthat certain Amendment No. 1, dated August 4, 2023 (“Amendment No.1”) to any specific transactions and have no understandings or agreements with respectthe 2022 Credit Agreement. Pursuant to any such transactions at this time. There has been no material changeAmendment No. 1, the 2022 Credit Agreement was amended to decrease the amount of cash we are required to maintain pursuant to the minimum liquidity covenant in the planned use2022 Credit Agreement to $5,000,000 for a period of proceeds from our IPO from that described18 months, at which point the amount required under the minimum liquidity covenant shall increase to $20,000,000 (or, if certain conditions are met, $10,000,000), in the Prospectusexchange for a fee paid by us.

The foregoing description of Amendment No.1 does not purport to be complete and is qualified in its entirety by reference to Amendment No. 1, a copy of which is filed with the SEC pursuantas Exhibit 10.1 to Rule 424(b)(4).
this Quarterly Report on Form 10-Q and is incorporated by reference herein.
48
47

Item 6. Exhibits
Incorporated by Reference
Exhibit
No.
Exhibit DescriptionFormFile No.ExhibitFiling DateFiled
Herewith
3.18-K001-394303.1August 10, 2020
3.28-K001-394303.2August 10, 2020
3.38-K001-394303.1August 23, 2021
10.1X
31.1X
31.2X
32.1**X
32.2**X
101The following financial information from the Company’s Quarterly Report on Form 10-Q for the period ended June 30, 2023, formatted in Inline Extensible Business Reporting Language (XBRL): (i) the Condensed Consolidated Balance Sheets, (ii) the Condensed Consolidated Statements of Operations and Comprehensive Income (Loss), (iii) the Condensed Consolidated Statements of Stockholders’ Equity, (iv) the Condensed Consolidated Statements of Cash Flows, and (v) Notes to the Condensed Consolidated Financial Statements (filed herewith).
104Cover Page Interactive Data File (formatted as inline XBRL and contained in Exhibit 101)

**    The certifications furnished in Exhibits 32.1 and 32.2 hereto are deemed to accompany this Quarterly Report on Form 10-Q and will not be deemed “filed” for purposes of Section 18 of the Exchange Act, except to the extent that the registrant specifically incorporates them by reference.

      
Incorporated by Reference
Exhibit
No.
  
Exhibit Description
  
Form
  
File No.
  
Exhibit
  
Filing Date
  
Filed Herewith
  3.1  Amended and Restated Certificate of Incorporation of Acutus Medical, Inc.  8-K  001-39430  3.1  August 10,
2020
  
  3.2  Amended and Restated Bylaws of the Registrant Acutus Medical, Inc.  8-K  001-39430  3.2  August 10,
2020
  
10.1  Form of Indemnification Agreement between the Registrant and each of its directors and executive officers.  S-1  333-239873  10.12  July 15,
2020
  
10.2  2020 Equity Incentive Plan and forms of agreements thereunder.  S-1/A  333-239873  10.14  July 30,
2020
  
10.3  2020 Employee Stock Purchase Plan.  S-1/A  333-239873  10.15  July 30,
2020
  
10.4  Executive Incentive Compensation Plan.  S-1  333-239873  10.16  July 15,
2020
  
31.1  Certification of Chief Executive Officer of Acutus Medical, Inc. pursuant to Rule 13a-14(a)/15d-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.          X
31.2  Certification of Principal Financial Officer of Acutus Medical, Inc. pursuant to Rule 13a-14(a)/15d-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.          X
32.1*  Certification of Chief Executive Officer of Acutus Medical, Inc. pursuant to 18 U.S.C. §1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.          X
32.2*  Certification of Principal Financial Officer of Acutus Medical, Inc. pursuant to 18 U.S.C. §1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.          X
101  The following financial information from the Company’s Quarterly Report on Form
10-Q
for the period ended June 30, 2020, formatted in Inline Extensible Business Reporting Language (iXBRL): (i) the Condensed Consolidated Balance Sheets, (ii) the Condensed Consolidated Statements of Operations and Comprehensive Loss, (iii) the Condensed Consolidated Statements of Covertible Preferred Stock and Stockholders’ Deficit, (iv) the Condensed Consolidated Statements of Cash Flows, and (v) Notes to the Condensed Consolidated Financial Statements (filed herewith).
          
104  Cover Page Interactive Data File (formatted as inline XBRL and contained in Exhibit 101)          
49
48

*
The certifications furnished in Exhibit 32 hereto are deemed to accompany this Quarterly Report on Form
10-Q
and will not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, except to the extent that the registrant specifically incorporates it by reference.
50

SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
Acutus Medical, Inc.

(Registrant)
Date: September 18, 2020August 7, 2023By:By:/s/ Vince BurgessDavid H. Roman
Vince Burgess
David H. Roman
President, and Chief Executive Officer
and Director
(Principal Executive Officer)
Date: September 18, 2020August 7, 2023By:By:/s/ Gary W. DohertyTakeo Mukai
Gary W. Doherty
Takeo Mukai
Senior Vice President and
Chief Financial Officer

(Principal Financial and Accounting Officer)

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