Acutus Medical (AFIB) 10-Q 18 Sep 20 2020 Q2 Quarterly report Financial data

Cover Page

Cover Page - shares	6 Months Ended
	Jun. 30, 2020	Sep. 17, 2020
Cover [Abstract]
Document Type	10-Q
Entity Registrant Name	ACUTUS MEDICAL, INC.
Amendment Flag	false
Document Period End Date	Jun. 30, 2020
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001522860
Document Quarterly Report	true
Document Transition Report	false
Document Fiscal Year Focus	2020
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Current Reporting Status	No
Entity Interactive Data Current	Yes
Entity Shell Company	false
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	2210 Faraday Ave.
Entity Address, Address Line Two	Suite 100,
Entity File Number	001-39430
Entity Tax Identification Number	45-1306615
Entity Address, City or Town	Carlsbad
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92008
City Area Code	442
Local Phone Number	232-6080
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	AFIB
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		27,826,408

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
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
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)
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
Series A Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock	3,059	3,059
Series B Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock	40,685	40,685
Series C Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock	74,575	74,575
Series D Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock	$ 142,236	$ 135,039

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Common Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Common Stock, Shares Authorized	260,000,000	260,000,000
Common Stock, Shares, Issued	775,403	695,902
Common Stock, Shares, Outstanding	775,403	695,902
Series A Convertible Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	3,848,696	3,848,696
Preferred Stock, Shares Issued	391,210	391,210
Preferred Stock, Shares Outstanding	391,210	391,210
Preferred Stock, Liquidation Preference, Value	$ 3,245	$ 3,245
Series B Convertible Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	30,032,100	30,032,100
Preferred Stock, Shares Issued	3,088,444	3,088,444
Preferred Stock, Shares Outstanding	3,088,444	3,088,444
Preferred Stock, Liquidation Preference, Value	$ 41,294	$ 41,294
Series C Convertible Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	48,184,000	48,184,000
Preferred Stock, Shares Issued	4,499,921	4,499,921
Preferred Stock, Shares Outstanding	4,499,921	4,499,921
Preferred Stock, Liquidation Preference, Value	$ 75,000	$ 75,000
Series D Convertible Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	90,000,000	90,000,000
Preferred Stock, Shares Issued	8,593,360	8,200,297
Preferred Stock, Shares Outstanding	8,593,360	8,200,297
Preferred Stock, Liquidation Preference, Value	$ 157,348	$ 136,675

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Statement of Comprehensive Income [Abstract]
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

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Series A Convertible Preferred Stock [Member]	Series B Convertible Preferred Stock [Member]	Series C Convertible Preferred Stock [Member]	Series D Convertible Preferred Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Beginning balances at Dec. 31, 2018		$ 3,059	$ 40,685	$ 74,575
Beginning balances, Shares at Dec. 31, 2018		388,558	3,088,444	4,499,921
Beginning balances at Dec. 31, 2018	$ (131,824)					$ 1	$ 30,150	$ (161,995)	$ 20
Beginning balances, Shares at Dec. 31, 2018						656,654
Unrealized loss 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					$ 38,226
Issuance of Series D convertible preferred stock for cash, net of issuance costs of $274, Shares					2,309,959
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 2018 Convertible Notes and 2019 Convertible Notes, Shares					4,108,478
Stock option exercises	57						57
Stock option exercises, Shares						8,469
Stock-based compensation	1,362						1,362
Stock-based compensation, Shares						6,837
Net loss	(45,040)							(45,040)
Ending balances at Jun. 30, 2019		$ 3,059	$ 40,685	$ 74,575	$ 106,702
Ending balances, shares at Jun. 30, 2019		391,210	3,088,444	4,499,921	6,418,437
Ending balances at Jun. 30, 2019	(175,450)					$ 1	31,569	(207,035)	15
Ending balances, shares at Jun. 30, 2019						671,960
Beginning balances at Mar. 31, 2019		$ 3,059	$ 40,685	$ 74,575
Beginning balances, Shares at Mar. 31, 2019		391,210	3,088,444	4,499,921
Beginning balances at Mar. 31, 2019	(145,973)					$ 1	30,709	(176,690)	7
Beginning balances, Shares at Mar. 31, 2019						656,654
Unrealized loss 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					$ 38,226
Issuance of Series D convertible preferred stock for cash, net of issuance costs of $274, Shares					2,309,959
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 2018 Convertible Notes and 2019 Convertible Notes, Shares					4,108,478
Stock option exercises	57						57
Stock option exercises, Shares						8,469
Stock-based compensation	803						803
Stock-based compensation, Shares						6,837
Net loss	(30,345)							(30,345)
Ending balances at Jun. 30, 2019		$ 3,059	$ 40,685	$ 74,575	$ 106,702
Ending balances, shares at Jun. 30, 2019		391,210	3,088,444	4,499,921	6,418,437
Ending balances at Jun. 30, 2019	(175,450)					$ 1	31,569	(207,035)	15
Ending balances, shares at Jun. 30, 2019						671,960
Beginning balances at Dec. 31, 2019		$ 3,059	$ 40,685	$ 74,575	$ 135,039
Beginning balances, Shares at Dec. 31, 2019		391,210	3,088,444	4,499,921	8,200,297
Beginning balances at Dec. 31, 2019	(225,811)					$ 1	33,252	(259,034)	(30)
Beginning balances, Shares at Dec. 31, 2019						695,902
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					$ 5,000
Issuance of Series D convertible preferred stock for the Biotronik Asset Purchase, Shares					273,070
Issuance of Series D convertible preferred stock for the contingent consideration related to the Rhythm Xience Acquisition					$ 2,197
Issuance of Series D convertible preferred stock for the contingent consideration related to the Rhythm Xience Acquisition, Shares					119,993
Stock option exercises	205						205
Stock option exercises, Shares						64,562
Stock-based compensation	2,898						2,898
Stock-based compensation, Shares						14,939
Net loss	(41,291)							(41,291)
Ending balances at Jun. 30, 2020		$ 3,059	$ 40,685	$ 74,575	$ 142,236
Ending balances, shares at Jun. 30, 2020		391,210	3,088,444	4,499,921	8,593,360
Ending balances at Jun. 30, 2020	(263,971)					$ 1	36,355	(300,325)	(2)
Ending balances, shares at Jun. 30, 2020						775,403
Beginning balances at Mar. 31, 2020		$ 3,059	$ 40,685	$ 74,575	$ 142,236
Beginning balances, Shares at Mar. 31, 2020		391,210	3,088,444	4,499,921	8,593,360
Beginning balances at Mar. 31, 2020	(242,222)					$ 1	34,993	(277,132)	(84)
Beginning balances, Shares at Mar. 31, 2020						710,841
Unrealized loss on marketable securities	(14)								(14)
Foreign currency translation adjustment	96								96
Stock option exercises	205						205
Stock option exercises, Shares						64,562
Stock-based compensation	1,157						1,157
Net loss	(23,193)							(23,193)
Ending balances at Jun. 30, 2020		$ 3,059	$ 40,685	$ 74,575	$ 142,236
Ending balances, shares at Jun. 30, 2020		391,210	3,088,444	4,499,921	8,593,360
Ending balances at Jun. 30, 2020	$ (263,971)					$ 1	$ 36,355	$ (300,325)	$ (2)
Ending balances, shares at Jun. 30, 2020						775,403

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' Equity (Parenthetical) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019
Payments of Financing Costs [Abstract]
Payments of Stock Issuance Costs	$ 274	$ 274

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 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	0
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

Organization and Description of

Organization and Description of Business	6 Months Ended
	Jun. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	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. Reverse Stock Split 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”), 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 issued 10,147,058 shares of common stock in an ”), which included 1,323,529 shares of common stock issued upon the underwriters’ exercise in full of to the pu blic 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 The Company has limited revenue, has incurred operating losses since inception and expects to continue to incur significant operating losses for at least the next several years and may never become profitable. As of June 30, 2020 and December 31, 2019, the Company had an accumulated deficit of $300.3 million and $259.0 million, respectively, and working capital of $15.1 million and With the closing of the Company’s IPO, the Company’s current cash and cash equivalents are sufficient to fund operations for at least the next 12 months. However, the Company may need to raise additional funds through one or more of the following: issuance of additional debt, equity or both. Until such time, if ever, 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 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 COVID-19 COVID-19 COVID-19

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	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 S-X. 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. 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, 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 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 in one operating 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, 2020 and December 31, 2019, exceeded federally insured limits. Restricted cash serves as collateral for the Company’s corporate credit card program. The following table reconciles cash and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statements of cash flows (in thousands): June 30, 2020 December 31, (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 considers its debt securities to be available-for-sale Available-for-sale available-for-sale Securities that are classified as available-for-sale available-for-sale available-for-sale 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’ 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. 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 loss for the six-month 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 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 Federal 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. Revenue from Contracts with Customers The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers • 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. The Company usually when-and-if-available 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 The Company’s contracts only include fixed consideration. There are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days. 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, thus the customer obtains control and revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination. The installation and delivery of the AcQMap system 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. 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, but is not limited to, transactions where the specific performance obligations are sold separately, list prices, and offers to customers. 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 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, 2020 and December 31, 2019. In May 2020, the Company entered into bi-lateral “Bi-Lateral Bi-Lateral non- The following table provides revenue by geographic location for the three and six months ended June 30, 2020 and 2019 (in thousands): 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-out 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, 2020 and December 31, 2019. 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 Intangible assets consist of acquired developed technology, acquired in-process in-process in-process in-process - 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 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, 2020 and 2019, the Company determined that there was no impairment of property and equipment or intangible assets. Foreign Currency Translation and Transactions The assets, liabilities and results of operations of Acutus NV are measured using their functional currency, the Euro, which is the currency of the primary foreign economic environment in which this subsidiary operates. Upon consolidating this entity with the Company, its assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and its revenues and expenses are translated at the weighted-average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating this entity’s 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. Leases Effective January 1, 2019, the Company accounts for its leases under ASC 842, Leases right-of-use right-of-use right-of-use In calculating the right-of-use non-lease 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 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”) 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 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 been used in determining the inputs used in measuring fair value: 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 are financial instruments whose values are determined 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 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, 2020 and 2019. As of June 30, 2020 and December 31, 2019, 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. 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, 2020 and December 31, 2019 (in thousands): Fair Value Measured at June 30, 2020 (unaudited) Quoted Prices in Significant Other Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 21,544 $ — $ — $ 21,544 Marketable securities at fair value U.S. treasury securities — 5,037 — 5,037 Total fair value $ 21,544 $ 5,037 $ — $ 26,581 Liabilities included in: Contingent consideration $ — $ — $ 7,500 $ 7,500 Common and preferred stock warrant liability — — 10,791 10,791 Total fair value $ — $ — $ 18,291 $ 18,291 Fair Value Measured at December 31, 2019 Quoted Prices in Significant Other Significant Fair Value at 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 The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets. 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 The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2020 (in thousands): Common and Contingent 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 Unrealized gains and losses associated with liabilities within 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 second quarter the first and second June 30, 2020 December 31, 2019 (unaudited) Risk-free interest rate 0.15 0.18 1.59 1.60 Expected dividend yield — — Contractual term in years 0.2 - 0.5 0.7 - 1.0 Expected volatility 67.0 123.0 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 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, non-market true-up non-employee’s Income Taxes Income taxes are recorded in accordance with ASC 740, Income Taxes , 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, in accordance with ASC 815, Derivatives and Hedging re-measurement Asset Acquisitions (Research and Development—License Acquired) The Company accounts 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, Business Combinations Business Combinations The Company accounts for business acquisitions using the acquisition method of accounting based on 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 represents 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. Accounting Pronouncements to Be Adopted In June 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2016-13, Financial Instruments – Credit Losses (Topic 326) available-for-sale off-balance In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes No. 2019-12 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 held-to-maturity.

Asset Acquisition and Business

Asset Acquisition and Business Combination	6 Months Ended
	Jun. 30, 2020
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]
Asset Acquisition and Business Combination	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 licenses to the Biotronik Parties’ patents, whereby the Company acquired certain manufacturing equipment and obtained from 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 granted to the Company, the Company made cash payments totaling $10.0 million during the year ended December 31, 2019, and issued 273,070 shares of Series D convertible preferred stock with an implied value of $5.0 million during the six months ended June 30, 2020. The implied value of $5.0 million was recorded as an accrued liability as of December 31, 2019. In accordance with ASC 805, the Biotronik Asset Acquisition wa loss in July 2019. Additional contingent milestone payments of up to $10.0 million are to 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, 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 regulatory milestones and revenue milestones. In accordance with ASC 805, the Rhythm Xience Acquisition is accounted for as a business combination. Purchase Price Allocation The following table summarizes 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 synergies 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 was the

Marketable Securities

Marketable Securities	6 Months Ended
	Jun. 30, 2020
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Marketable Securities	Note 4—Marketable Securities Marketable securities consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 (unaudited) Amortized Cost Gross Unrealized Gross Unrealized Fair Value Available-for-sale securities - short-term : U.S. treasury securities $ 5,033 $ 4 $ — $ 5,037 Total available-for-sale $ 5,033 $ 4 $ — $ 5,037 December 31, 2019 Amortized Gross Gross Fair 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 $ 62,306 $ 45 $ — $ 62,351 As of June 30, 2020 and December 31, 2019, all of the Company’s available-for-sale

Inventory

Inventory	6 Months Ended
	Jun. 30, 2020
Inventory Disclosure [Abstract]
Inventory	Note 5—Inventory Inventory as of June 30, 2020 and December 31, 2019 consisted of the following (in thousands): June 30, 2020 December 31, (unaudited) Raw materials $ 6,468 $ 5,492 Work in process 1,353 1,605 Finish goods 4,445 1,327 Total inventory $ 12,266 $ 8,424

Property and Equipment, Net

Property and Equipment, Net	6 Months Ended
	Jun. 30, 2020
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Note 6—Property and Equipment, Net The Company’s property and equipment, net, consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 December 31, (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, 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. Depreciation expense was $0.6 million and $0.5 million for the three months ended June 30, 2020 and 2019, respectively, and $1.0 million and $1.1 million for the six months ended June 30, 2020 and 2019, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Note 7—Goodwill and Intangible Assets The table below summarizes goodwill and intangible assets activities as of June 30, 2020 and December 31, 2019 (in thousands): 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 Estimated Useful Life Weighted Average Life Intangible Accumulated June 30, (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 Estimated Weighted Intangible Accumulated December 31, Developed technology 10 9.5 $ 3,600 $ (180 ) $ 3,420 In-process 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 in-process in-process The following table shows the remaining amortization expense associated with amortizable intangible assets as of June 30, 2020 (in thousands): Developed Customer-Related Total 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 — 1,920 Total $ 3,810 $ 80 $ 3,890

Accrued Liabilities

Accrued Liabilities	6 Months Ended
	Jun. 30, 2020
Payables and Accruals [Abstract]
Accrued Liabilities	Note 8—Accrued Liabilities Accrued liabilities consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 December 31, (unaudited) Biotronik Asset Acquisition - accrued purchase price $ — $ 5,000 Payroll and related expenses 3,869 3,785 Professional fees 1,850 188 Deferred revenue 88 311 Other 1,229 792 Total accrued liabilities $ 7,036 $ 10,076

Debt

Debt	6 Months Ended
	Jun. 30, 2020
Debt Disclosure [Abstract]
Debt	Note 9—Debt Outstanding debt as of June 30, 2020 and December 31, 2019 consisted of the following (in thousands): June 30, December 31, (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 Credit Agreement On May 20, 2019, the Company entered into a Credit Agreement (the “2019 Credit Agreement”). The 2019 Credit Agreement provided the Company with a senior term loan facility in aggregate principal amount of $70.0 million, of which the Company borrowed $40.0 million upon closing. Of the remaining amount of the facility, $10.0 million was available for borrowing by the Company on or prior to June 30, 2020 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. 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 2019 Credit Agreement bears interest per annum at 7.75% plus LIBOR for such interest period and the principal amount of term loans outstanding under the 2019 Credit Agreement is due on May 20, 2024. The 2019 Credit Agreement provides for final payment fees of an additional $4.6 million that are due upon prepayment or on the maturity date or upon acceleration. Upon the occurrence and during an event of default, which includes 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. 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 to the Company’s ability to enter into fundamental transactions, incur additional indebtedness, grant liens, pay any dividend or make any distributions to its holders, make investments and merge or consolidate with any other person or engage in transactions with its affiliates, but does not include any financial covenants, other than a minimum liquidity requirement. As of and for the six months ended June 30, 2020 and 2019, the Company was in compliance with all such covenants. 2019 Convertible Notes On May 20, 2019, the Company sold and issued $37.0 million in aggregate principal amount 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 preferred stock 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 debt that is cancelled or converted into preferred stock in the equity financing), which occurred on June 12, 2019. In accordance with ASC 480, Distinguishing Liabilities from Equity

Operating Leases

Operating Leases	6 Months Ended
	Jun. 30, 2020
Leases [Abstract]
Operating Leases	Note 10—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 noncancelable operating lease that expires on December 31, 2022. 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 The Company also leases approximately 3,900 square feet of office space in Zaventem, Belgium under a noncancelable operating lease that expires on December 31. 2021. 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 The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 2020 and 2019 (dollars in thousands): Six Months Ended June 30, 2020 2019 (unaudited) Operating cash flows used in operating leases $ 507 $ 477 Right-of-use $ — $ 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 % The following table provides the components of the Company’s lease cost (in thousands): 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, future minimum payments under the non-cancelable 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

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 11—Commitments and Contingencies The Company is not a party to any material legal proceedings and 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.

Warrants

Warrants	6 Months Ended
	Jun. 30, 2020
Warrants and Rights Note Disclosure [Abstract]
Warrants	Note 12—Warrants As of June 30, 2020 and December 31, 2019, the outstanding warrants to purchase the Company’s common stock were comprised of the following: Equity Upon Exercise Exercise Expiration June 30, December 31, (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 convertibl $ 16.67 7/31/28 26,998 26,998 Warrants issued with 2019 Credit Agreement Series D convertible $ 16.67 5/20/29 419,992 419,992 Total Warrants 956,552 956,552 The Company has no warrant activity for the six months ended June 30, 2020. The remaining weighted average contractual life is 7.9 years as of June 30, 2020. 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 The Company’s warrants provide the holder the option to purchase a specified number of shares for a specified price. The holder may exercise the warrant in cash or 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 than the warrants issued in 2015, the warrants are recorded as liabilities at fair value at the issuance date. Changes in the fair value are recognized in change in fair value of warrant liability and embedded derivative in the condensed consolidated statements of operations and comprehensive loss at the end of each reporting period. 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.

Convertible Preferred Stock

Convertible Preferred Stock	6 Months Ended
	Jun. 30, 2020
Temporary Equity [Abstract]
Convertible Preferred Stock	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 related to 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 was was Dividends The holders of shares of convertible preferred stock were pro rata pari passu was were Liquidation The holders of the Series D convertible preferred stock were unpaid dividends on such shares (the “Series D Liquidation Preference”). The holders of 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 was Series Conversion 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 convertible non-assessable proceeds to the Company. On August 10, 2020, in connection with the closing 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 d 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 conversion 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 Any director may be removed during his or her term of office, either with or without cause, by, and only by, the affirmative vote 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.

Stockholders' Deficit

Stockholders' Deficit	6 Months Ended
	Jun. 30, 2020
Equity [Abstract]
Stockholders' Deficit	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. 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 amended and restated the Company’s authorized shares of common stock to 260,000,000 and authorized shares of undesignated preferred stock to 5,000,000. During the six months ended June 30, 2020 and 2019, stock options to acquire 64,562 and 8,469 shares, respectively, were exercised for shares of common stock. The Company received approximately $0.2 million and $0.1

Stock-Based Compensation

Stock-Based Compensation	6 Months Ended
	Jun. 30, 2020
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	Note 15—Stock-Based Compensation The Company’s 2011 Equity Incentive Plan (the “2011 Plan”) permits the granting of incentive stock options, non-statutory Stock Options The stock options generally vest over four years and have a ten-year non-employee The following assumptions were used to estimate the fair value of stock option for the six months ended June 30, 2020 and 2019: 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 summarizes stock option activity during the six months ended June 30, 2020: Stock Options Weighted Average Weighted Average Aggregate 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 1,138,429 $ 8.34 6.1 $ 11,037 The aggregate intrinsic value in the above table is calculated as the difference between the fair value of the Company’s common stock as of June 30, 2020 and the exercise price of the stock options. The weighted-average grant date fair value per share for the stock option awards granted during the six months ended June 30, 2020 was $14.81. As of June 30, 2020, the total unrecognized compensation related to unvested stock option awards granted was $13.8 million, which the Company expects to recognize over a weighted-average period of approximately 2.8 years. Restricted Stock The Company’s RSA activity for the six months ended June 30, 2020 was as follows: Number of Shares Weighted Average Unvested as of December 31, 2019 — $ — Granted 14,945 14.81 Vested (14,945 ) 14.81 Unvested as of June 30, 2020 (unaudited) — $ — The following table summarizes the total stock-based compensation expense for the stock options and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three and six months ended June 30, 2020 and 2019 (in thousands): 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 Performance-Based Restricted Stock Units In June 2019, the Company granted 567,509 PSUs, with a grant date fair value of $13.37. Vesting of the PSUs is dependent upon the satisfaction of both a service condition and a performance condition, which is an initial public offering or a change of control. As the performance conditions for the PSU were not considered probable as of June 30, 2020 and 2019, no compensation expense related to these awards has been recorded for the three and six months ended June 30, 2020 and 2019.

Net Loss Per Common Share

Net Loss Per Common Share	6 Months Ended
	Jun. 30, 2020
Earnings Per Share [Abstract]
Net Loss Per Common Share	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 of 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 be anti-dilutive due to the Company’s net loss. Since the Company had a net loss in the periods presented, basic and diluted net loss per common share are the same. 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: 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.

401(k) Retirement Plan

401(k) Retirement Plan	6 Months Ended
	Jun. 30, 2020
Retirement Benefits [Abstract]
401(k) Retirement Plan	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 not provide any contributions to the 401(k) retirement savings plan for the six months ended June 30, 2020 and 2019.

Related Party Transactions

Related Party Transactions	6 Months Ended
	Jun. 30, 2020
Related Party Transactions [Abstract]
Related Party Transactions	Note 18—Related Party Transactions The Company licenses certain patent rights from a director and shareholder. The license agreement provides for royalty payments to the shareholder of 3% of net product sales, as defined in the agreement. Royalties earned were $16,000 and $11,000 for the three months ended June 30, 2020 and 2019 and $37,000 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 and $0.1 million for the six months ended June 30, 2020 and 2019, respectively. The Company has a consulting 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 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, Orbimed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P. entered into the 2019 Credit Agreement with the Company in 2019 for a total of $70.0 million with $40.0 million being drawn as of June 30, 2020. 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 these debt agreements.

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2020
Subsequent Events [Abstract]
Subsequent Events	Note 19—Subsequent Events The Company has completed an evaluation of all subsequent events through September 1 8 Reverse Stock Split 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 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 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. 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. On August 10, 2020, options to purchase 850,217 shares of common stock, 211,251 restricted stock units and 17,976 restricted stock awards under the 2020 Plan were awarded to certain employees and consultants of 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.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Basis of Presentation	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 S-X.
Principles of Consolidation	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. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates and Assumptions	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, 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 expenses that are not readily apparent from other sources. Actual results could differ from those estimates.
Segments	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 in one operating segment.
Cash and Cash Equivalents and Restricted Cash	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, 2020 and December 31, 2019, exceeded federally insured limits. Restricted cash serves as collateral for the Company’s corporate credit card program. The following table reconciles cash and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statements of cash flows (in thousands): June 30, 2020 December 31, (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	Marketable Securities The Company considers its debt securities to be available-for-sale Available-for-sale available-for-sale Securities that are classified as available-for-sale available-for-sale available-for-sale 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’ 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. 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 loss for the six-month
Deferred Offering Costs	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	Concentrations of Credit Risk and Off-Balance 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 Federal 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.
Revenue from Contracts with Customers	Revenue from Contracts with Customers The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers • 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. The Company usually when-and-if-available 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 The Company’s contracts only include fixed consideration. There are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days. 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, thus the customer obtains control and revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination. The installation and delivery of the AcQMap system 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. 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, but is not limited to, transactions where the specific performance obligations are sold separately, list prices, and offers to customers. 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 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, 2020 and December 31, 2019. In May 2020, the Company entered into bi-lateral “Bi-Lateral Bi-Lateral non- The following table provides revenue by geographic location for the three and six months ended June 30, 2020 and 2019 (in thousands): 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 Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost (first-in, first-out
Accounts Receivable	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, 2020 and December 31, 2019.
Property and Equipment, Net	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	Intangible Assets Intangible assets consist of acquired developed technology, acquired in-process in-process in-process in-process -
Goodwill	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
Impairment of Long-Lived Assets	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, 2020 and 2019, the Company determined that there was no impairment of property and equipment or intangible assets.
Foreign Currency Translation and Transactions	Foreign Currency Translation and Transactions The assets, liabilities and results of operations of Acutus NV are measured using their functional currency, the Euro, which is the currency of the primary foreign economic environment in which this subsidiary operates. Upon consolidating this entity with the Company, its assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and its revenues and expenses are translated at the weighted-average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating this entity’s 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.
Leases	Leases Effective January 1, 2019, the Company accounts for its leases under ASC 842, Leases right-of-use right-of-use right-of-use In calculating the right-of-use non-lease
Cost of Products Sold	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	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 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 Selling, general and administrative (“SG&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	Fair Value Measurements 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 been used in determining the inputs used in measuring fair value: 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 are financial instruments whose values are determined 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 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, 2020 and 2019. As of June 30, 2020 and December 31, 2019, 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. 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, 2020 and December 31, 2019 (in thousands): Fair Value Measured at June 30, 2020 (unaudited) Quoted Prices in Significant Other Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 21,544 $ — $ — $ 21,544 Marketable securities at fair value U.S. treasury securities — 5,037 — 5,037 Total fair value $ 21,544 $ 5,037 $ — $ 26,581 Liabilities included in: Contingent consideration $ — $ — $ 7,500 $ 7,500 Common and preferred stock warrant liability — — 10,791 10,791 Total fair value $ — $ — $ 18,291 $ 18,291 Fair Value Measured at December 31, 2019 Quoted Prices in Significant Other Significant Fair Value at 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 The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets. 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 The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2020 (in thousands): Common and Contingent 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 Unrealized gains and losses associated with liabilities within 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 second quarter the first and second June 30, 2020 December 31, 2019 (unaudited) Risk-free interest rate 0.15 0.18 1.59 1.60 Expected dividend yield — — Contractual term in years 0.2 - 0.5 0.7 - 1.0 Expected volatility 67.0 123.0 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 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	Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, non-market true-up non-employee’s
Income Taxes	Income Taxes Income taxes are recorded in accordance with ASC 740, Income Taxes , 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	Warrant Liability The Company accounts for certain common stock warrants and convertible preferred stock warrants outstanding as a liability, in accordance with ASC 815, Derivatives and Hedging re-measurement
Asset Acquisitions (Research and Development—License Acquired)	Asset Acquisitions (Research and Development—License Acquired) The Company accounts 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, Business Combinations
Business Combinations	Business Combinations The Company accounts for business acquisitions using the acquisition method of accounting based on 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 represents 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.
Accounting Pronouncements to Be Adopted	Accounting Pronouncements to Be Adopted In June 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2016-13, Financial Instruments – Credit Losses (Topic 326) available-for-sale off-balance In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes No. 2019-12 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 held-to-maturity.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2020
Summary Of Significant Accounting Policies [Line Items]
Summary of Cash and Cash Equivalents and Restricted Cash	Restricted cash serves as collateral for the Company’s corporate credit card program. The following table reconciles cash and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statements of cash flows (in thousands): June 30, 2020 December 31, (unaudited) Cash and cash equivalents $ 24,295 $ 9,452 Restricted cash 150 150 Total cash, cash equivalents and restricted cash $ 24,445 $ 9,602
Summary of Disaggregation of Revenue	The following table sets forth the Company’s revenue for disposables and systems/service for the three and six months ended June 30, 2020 and 2019 (in thousands): 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
Summary of Revenue from External Customers by Geographic Areas	The following table provides revenue by geographic location for the three and six months ended June 30, 2020 and 2019 (in thousands): 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
Summary of Fair Value, Liabilities Measured on Recurring Basis	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, 2020 and December 31, 2019 (in thousands): Fair Value Measured at June 30, 2020 (unaudited) Quoted Prices in Significant Other Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 21,544 $ — $ — $ 21,544 Marketable securities at fair value U.S. treasury securities — 5,037 — 5,037 Total fair value $ 21,544 $ 5,037 $ — $ 26,581 Liabilities included in: Contingent consideration $ — $ — $ 7,500 $ 7,500 Common and preferred stock warrant liability — — 10,791 10,791 Total fair value $ — $ — $ 18,291 $ 18,291 Fair Value Measured at December 31, 2019 Quoted Prices in Significant Other Significant Fair Value at 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
Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2020 (in thousands): Common and Contingent 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
Weighted-average unobservable inputs to measure contingent consideration	The weighted-average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the common and preferred stock warrant liabilities as of June 30, 2020 and December 31, 2019 were as follows: June 30, 2020 December 31, 2019 (unaudited) Risk-free interest rate 0.15 0.18 1.59 1.60 Expected dividend yield — — Contractual term in years 0.2 - 0.5 0.7 - 1.0 Expected volatility 67.0 123.0 60.0 110.5
Weighted-average unobservable inputs to measure contingent consideration	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

Asset Acquisition and Busines_2

Asset Acquisition and Business Combination (Tables)	6 Months Ended
	Jun. 30, 2020
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]
Summary of Purchase Price Allocation To The Assets Acquired and Liabilities Assumed	The following table summarizes 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

Marketable Securities (Tables)

Marketable Securities (Tables)	6 Months Ended
	Jun. 30, 2020
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Summary of Marketable Securities	Marketable securities consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 (unaudited) Amortized Cost Gross Unrealized Gross Unrealized Fair Value Available-for-sale securities - short-term : U.S. treasury securities $ 5,033 $ 4 $ — $ 5,037 Total available-for-sale $ 5,033 $ 4 $ — $ 5,037 December 31, 2019 Amortized Gross Gross Fair 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 $ 62,306 $ 45 $ — $ 62,351

Inventory (Tables)

Inventory (Tables)	6 Months Ended
	Jun. 30, 2020
Inventory Disclosure [Abstract]
Summary of Inventory	Inventory as of June 30, 2020 and December 31, 2019 consisted of the following (in thousands): June 30, 2020 December 31, (unaudited) Raw materials $ 6,468 $ 5,492 Work in process 1,353 1,605 Finish goods 4,445 1,327 Total inventory $ 12,266 $ 8,424

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	6 Months Ended
	Jun. 30, 2020
Property, Plant and Equipment [Abstract]
Summary of Property and Equipment, Net	The Company’s property and equipment, net, consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 December 31, (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

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Summary Of Goodwill And Intangible Assets Activities	The table below summarizes goodwill and intangible assets activities as of June 30, 2020 and December 31, 2019 (in thousands): 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 Estimated Useful Life Weighted Average Life Intangible Accumulated June 30, (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 Estimated Weighted Intangible Accumulated December 31, Developed technology 10 9.5 $ 3,600 $ (180 ) $ 3,420 In-process 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
Summary Of Remaining Amortization Expense	The following table shows the remaining amortization expense associated with amortizable intangible assets as of June 30, 2020 (in thousands): Developed Customer-Related Total 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 — 1,920 Total $ 3,810 $ 80 $ 3,890

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)	6 Months Ended
	Jun. 30, 2020
Payables and Accruals [Abstract]
Summary Of Accrued Liabilities	Accrued liabilities consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 December 31, (unaudited) Biotronik Asset Acquisition - accrued purchase price $ — $ 5,000 Payroll and related expenses 3,869 3,785 Professional fees 1,850 188 Deferred revenue 88 311 Other 1,229 792 Total accrued liabilities $ 7,036 $ 10,076

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2020
Debt Instruments [Abstract]
Summary Of Outstanding Debt	Outstanding debt as of June 30, 2020 and December 31, 2019 consisted of the following (in thousands): June 30, December 31, (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.

Operating Leases (Tables)

Operating Leases (Tables)	6 Months Ended
	Jun. 30, 2020
Leases [Abstract]
Summary Of Quantitative Information About Operating Leases	The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 2020 and 2019 (dollars in thousands): Six Months Ended June 30, 2020 2019 (unaudited) Operating cash flows used in operating leases $ 507 $ 477 Right-of-use $ — $ 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 %
Summary Of Components Of Lease Cost	The following table provides the components of the Company’s lease cost (in thousands): 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
Summary Of Future Minimum Payments Under The Non-cancelable Operating Leases	As of June 30, 2020, future minimum payments under the non-cancelable 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

Warrants (Tables)

Warrants (Tables)	6 Months Ended
	Jun. 30, 2020
Warrants and Rights Note Disclosure [Abstract]
Schedule of Outstanding Warrants to Purchase the Company's Common Stock	As of June 30, 2020 and December 31, 2019, the outstanding warrants to purchase the Company’s common stock were comprised of the following: Equity Upon Exercise Exercise Expiration June 30, December 31, (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 convertibl $ 16.67 7/31/28 26,998 26,998 Warrants issued with 2019 Credit Agreement Series D convertible $ 16.67 5/20/29 419,992 419,992 Total Warrants 956,552 956,552

Convertible Preferred Stock (Ta

Convertible Preferred Stock (Tables)	6 Months Ended
	Jun. 30, 2020
Temporary Equity [Abstract]
Schedule of Initial Conversion Price per Share for each Series of Convertible Preferred Stock	The initial conversion price per share for each series of convertible preferred stock was Series Conversion 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

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2020
Share-based Payment Arrangement [Abstract]
Schedule of Estimate of the Fair Value of Stock Option	The following assumptions were used to estimate the fair value of stock option for the six months ended June 30, 2020 and 2019: 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%
Summary of Stock Option Activity	The following table summarizes stock option activity during the six months ended June 30, 2020: Stock Options Weighted Average Weighted Average Aggregate 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 1,138,429 $ 8.34 6.1 $ 11,037
Schedule of RSA Activity	The Company’s RSA activity for the six months ended June 30, 2020 was as follows: Number of Shares Weighted Average Unvested as of December 31, 2019 — $ — Granted 14,945 14.81 Vested (14,945 ) 14.81 Unvested as of June 30, 2020 (unaudited) — $ —
Summary of the Total Stock-Based Compensation Expense for the Stock Options and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss	The following table summarizes the total stock-based compensation expense for the stock options and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three and six months ended June 30, 2020 and 2019 (in thousands): 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

Net Loss Per Common Share (Tabl

Net Loss Per Common Share (Tables)	6 Months Ended
	Jun. 30, 2020
Earnings Per Share [Abstract]
Summary of Calculation of the Diluted Net Loss per Common Share	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: 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

Organization and Description _2

Organization and Description of Business - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Aug. 10, 2020	Jul. 28, 2020	Jun. 30, 2020	Dec. 31, 2019
Common stock shares outstanding			775,403	695,902
Accumulated deficit			$ (300,325)	$ (259,034)
Working capital deficit			$ 15,100	$ 50,500
Subsequent Event [Member]
Reverse stock split		common stock and convertible preferred stock on a 9.724-for-one basis
Share price	$ 18
Common stock shares outstanding	26,719,993
IPO [Member] | Subsequent Event [Member]
Shares issued during the period,shares	10,147,058
Over-Allotment Option [Member] | Subsequent Event [Member]
Shares issued during the period,shares	1,323,529
Series A Convertible Preferred Stock [Member] | Subsequent Event [Member]
Conversion of stock shares converted	391,210
Series B Convertible Preferred Stock [Member] | Subsequent Event [Member]
Conversion of stock shares converted	3,088,444
Series C Convertible Preferred Stock [Member] | Subsequent Event [Member]
Conversion of stock shares converted	4,499,921
Series D Convertible Preferred Stock [Member]
Shares issued during the period,shares			273,070
Series D Convertible Preferred Stock [Member] | Subsequent Event [Member]
Conversion of stock shares converted	8,593,360
Excercise price of each warrant	$ 16.67
Class of warrants number of securities called by the warrants or rights	446,990

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Summary of Cash and Cash Equivalents and Restricted Cash (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019	Jun. 30, 2019	Dec. 31, 2018
Summary Of Significant Accounting Policies [Line Items]
Cash and cash equivalents	$ 24,295	$ 9,452
Restricted cash	150	150
Total cash, cash equivalents and restricted cash	$ 24,445	$ 9,602	$ 68,206	$ 9,775

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Total	$ 1,134	$ 734	$ 2,717	$ 1,521
Disposables [Member]
Summary Of Significant Accounting Policies [Line Items]
Total	1,122	730	2,179	1,512
Systems [Member]
Summary Of Significant Accounting Policies [Line Items]
Total			520
Product and Service, Other [Member]
Summary Of Significant Accounting Policies [Line Items]
Total	$ 12	$ 4	$ 18	$ 9

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Summary of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 1,134	$ 734	$ 2,717	$ 1,521
United States
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	559	221	1,328	456
Europe [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 575	$ 513	$ 1,389	$ 1,065

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Assets
Total Assets Fair Value	$ 26,581	$ 71,252
Liabilities
Total Liabilities Fair Value	18,291	22,819
Contingent Consideration [Member]
Liabilities
Total Liabilities Fair Value	7,500	13,900
Common and Preferred Stock Warrant Liability [Member]
Liabilities
Total Liabilities Fair Value	10,791	8,919
money Market Securities [Member]
Assets
Cash and cash equivalents, fair value disclosure	21,544	8,901
Corporate Debt Securities [Member]
Assets
Marketable securities		28,224
Asset-backed Securities [Member]
Assets
Marketable securities		17,121
US Treasury Securities [Member]
Assets
Marketable securities	5,037	5,032
Commercial Paper [Member]
Assets
Marketable securities		11,974
Fair Value, Inputs, Level 1 [Member]
Assets
Marketable securities	21,544
Total Assets Fair Value		8,901
Fair Value, Inputs, Level 1 [Member] | money Market Securities [Member]
Assets
Cash and cash equivalents, fair value disclosure	21,544	8,901
Fair Value, Inputs, Level 2 [Member]
Assets
Marketable securities	5,037
Total Assets Fair Value		62,351
Fair Value, Inputs, Level 2 [Member] | Corporate Debt Securities [Member]
Assets
Marketable securities		28,224
Fair Value, Inputs, Level 2 [Member] | Asset-backed Securities [Member]
Assets
Marketable securities		17,121
Fair Value, Inputs, Level 2 [Member] | US Treasury Securities [Member]
Assets
Marketable securities	5,037	5,032
Fair Value, Inputs, Level 2 [Member] | Commercial Paper [Member]
Assets
Marketable securities		11,974
Fair Value, Inputs, Level 3 [Member]
Liabilities
Total Liabilities Fair Value	18,291	22,819
Fair Value, Inputs, Level 3 [Member] | Contingent Consideration [Member]
Liabilities
Total Liabilities Fair Value	7,500	13,900
Fair Value, Inputs, Level 3 [Member] | Common and Preferred Stock Warrant Liability [Member]
Liabilities
Total Liabilities Fair Value	$ 10,791	$ 8,919

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Detail) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2020
Summary Of Significant Accounting Policies [Line Items]
Change in fair value	$ (635)	$ 1,584
Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Beginning Balance, December 31, 2019		22,819
Payment of contingent consideration		(2,619)
Issuance of preferred stock for contingent consideration		(2,197)
Change in fair value		288
Ending Balance, June 30, 2020	18,291	18,291
Common and Preferred Stock Warrant Liability [Member] | Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Beginning Balance, December 31, 2019		8,919
Change in fair value		1,872
Ending Balance, June 30, 2020	10,791	10,791
Contingent Consideration [Member] | Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Beginning Balance, December 31, 2019		13,900
Payment of contingent consideration		(2,619)
Issuance of preferred stock for contingent consideration		(2,197)
Change in fair value		(1,584)
Ending Balance, June 30, 2020	$ 7,500	$ 7,500

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Summary of Weighted Average Fair Value Assumptions on Common and Preferred Stock Warrant Liabilities (Detail) - Fair Value, Inputs, Level 3 [Member]	Jun. 30, 2020	Dec. 31, 2019
Minimum [Member] | Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	0.0015	0.0159
Minimum [Member] | Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	2 months 12 days	8 months 12 days
Minimum [Member] | Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	0.67	0.6
Maximum [Member] | Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	0.0018	0.016
Maximum [Member] | Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	6 months	1 year
Maximum [Member] | Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	1.23	1.105

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Summary of Weighted Average Fair Value Assumptions on Contingent Consideration (Detail) - Fair Value, Inputs, Level 3 [Member] - Rhythm Xience [Member]	Jun. 30, 2020yr	Dec. 31, 2019yr
Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.002	0.016
Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.183	0.118
Minimum [Member] | Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	1	1
Maximum [Member] | Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	2	2

Summary of Significant Accou_11

Summary of Significant Accounting Policies - Additional information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Accounting Policies [Abstract]
Inventory Write-down	$ 100	$ 100	$ 100	$ 200
Cash, FDIC insured amount	$ 250		$ 250

Asset Acquisition and Busines_3

Asset Acquisition and Business Combination - Purchase Price Allocation (Detail) - USD ($) $ in Thousands	Jun. 18, 2019	Jun. 30, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill		$ 12,026	$ 12,026
Rhythm Xience [Member]
Business Acquisition [Line Items]
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	$ (7,500)	(13,400)
Cash consideration	$ 3,000	$ 3,000

Asset Acquisition and Busines_4

Asset Acquisition and Business Combination - Additional Information (Detail) - USD ($) $ in Thousands	Jun. 18, 2019	Feb. 29, 2020	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Business Acquisition [Line Items]
Research and development expense			$ 8,176	$ 5,247	$ 16,149	$ 9,624
Goodwill			12,026		12,026		$ 12,026
Payments for contingent consideration					2,619
Biotronik Asset Acquisition [Member]
Business Acquisition [Line Items]
Consideration paid in cash							10,000
Equity interests issued and issuable							$ 5,000
Consideration transferred					15,000
Potential milestone payments payable			10,000		10,000
Biotronik Asset Acquisition [Member] | Intellectual Property [Member]
Business Acquisition [Line Items]
Research and development expense					15,000
Rhythm Xience [Member]
Business Acquisition [Line Items]
Consideration paid in cash	$ 3,000				3,000
Contingent consideration liability	$ 7,500		13,400		13,400
Date of business acquisition	Jun. 18, 2019
Goodwill			12,026		12,026
Payments for contingent consideration					2,600
Business combination contingent consideration liability change in amount			$ 600	$ 0	1,600	$ 0
Rhythm Xience [Member] | Earnout Consideration [Member]
Business Acquisition [Line Items]
Potential milestone payments payable	$ 17,000
Series D Convertible Preferred Stock [Member] | Biotronik Asset Acquisition [Member]
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable							273,070
Equity interests issued and issuable					$ 5,000
Series D Convertible Preferred Stock [Member] | Rhythm Xience [Member]
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable					119,993
Series D Convertible Preferred Stock [Member] | Rhythm Xience [Member] | Earnout Consideration [Member]
Business Acquisition [Line Items]
Equity interests issued and issuable		$ 2,000

Marketable Securities - Summary

Marketable Securities - Summary of Marketable Securities (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 5,033	$ 62,306
Gross Unrealized Gains	4	45
Fair Value	5,037	62,351
U.S. treasury securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	5,033	5,020
Gross Unrealized Gains	4	12
Fair Value	$ 5,037	5,032
Corporate debt securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		28,204
Gross Unrealized Gains		20
Fair Value		28,224
Asset-backed securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		17,108
Gross Unrealized Gains		13
Fair Value		17,121
Commercial paper [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		11,974
Fair Value		$ 11,974

Inventory - Summary of Inventor

Inventory - Summary of Inventory (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Inventory [Line Items]
Raw materials	$ 6,468	$ 5,492
Work in process	1,353	1,605
Finish goods	4,445	1,327
Total inventory	$ 12,266	$ 8,424

Property and Equipment, Net - S

Property and Equipment, Net - Summary Of Property And Equipment, Net (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 13,022	$ 10,592
Less: accumulated depreciation	(5,438)	(6,165)
Property and equipment, net	7,584	4,427
Medical diagnostic equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	7,180	5,492
Furniture and fixtures [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	388	159
Office equipment [Membre]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,377	1,321
Laboratory equipment and software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	3,380	2,807
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	595	507
Construction in process [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 102	$ 306

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Property, Plant and Equipment [Abstract]
Depreciation	$ 600	$ 500	$ 978	$ 1,142

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Summary Of Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Indefinite-lived Intangible Assets [Line Items]
Goodwill	$ 12,026		$ 12,026		$ 12,026
Intangible Assets, Gross	4,360		4,360		4,360
Intangible Assets - Balance at December 31, 2019			4,110
Accumulated Amortization	(470)		(470)		(250)
Amortization expense	(100)	$ 0	(220)	$ 0
Intangible Assets - Balance at June 30, 2020	3,890		$ 3,890		$ 4,110
Developed technology [Member]
Indefinite-lived Intangible Assets [Line Items]
Estimated Useful Life			10 years		10 years
Weighted Average Remaining Life			9 years 1 month 6 days		9 years 6 months
Intangible Assets, Gross	4,200		$ 4,200		$ 3,600
Intangible Assets - Balance at December 31, 2019			3,420
Accumulated Amortization	(390)		(390)		(180)
Intangible Assets - Balance at June 30, 2020	3,810		$ 3,810		3,420
In-process technology [Member]
Indefinite-lived Intangible Assets [Line Items]
Intangible Assets					$ 600
Trademarks and trade names [Member]
Indefinite-lived Intangible Assets [Line Items]
Estimated Useful Life			6 months		6 months
Intangible Assets, Gross	60		$ 60		$ 60
Accumulated Amortization	(60)		$ (60)		$ (60)
Customer-related intangible [Member]
Indefinite-lived Intangible Assets [Line Items]
Estimated Useful Life			5 years		5 years
Weighted Average Remaining Life			4 years		4 years 6 months
Intangible Assets, Gross	100		$ 100		$ 100
Intangible Assets - Balance at December 31, 2019			90
Accumulated Amortization	(20)		(20)		(10)
Intangible Assets - Balance at June 30, 2020	$ 80		$ 80		$ 90

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 100	$ 0	$ 220	$ 0

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Summary of remaining amortization expense associated with amortizable intangible assets (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	May 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2020	$ 220
Year ending December 31, 2021	440
Year ending December 31, 2022	440
Year ending December 31, 2023	440
Year ending December 31, 2024	430
Thereafter	1,920
Total	3,890	$ 4,110	$ 4,110
Developed technology [Member]
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2020	210
Year ending December 31, 2021	420
Year ending December 31, 2022	420
Year ending December 31, 2023	420
Year ending December 31, 2024	420
Thereafter	1,920
Total	3,810		3,420
Customer-Related Intangible [Member]
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2020	10
Year ending December 31, 2021	20
Year ending December 31, 2022	20
Year ending December 31, 2023	20
Year ending December 31, 2024	10
Thereafter	0
Total	$ 80		$ 90

Accrued Liabilities - Summary O

Accrued Liabilities - Summary Of Accrued Liabilities (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Payables and Accruals [Abstract]
Biotronik Asset Acquisition—accrued purchase price		$ 5,000
Payroll and related expenses	$ 3,869	3,785
Professional fees	1,850	188
Deferred revenue	88	311
Other	1,229	792
Total accrued liabilities	$ 7,036	$ 10,076

Debt - Additional Information (

Debt - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	Jun. 12, 2019	May 20, 2019	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Convertible Notes Payable
Debt Instrument [Line Items]
Debt instrument, face amount		$ 37
Debt instrument, interest rate		13.00%
Long-term debt, date date		Dec. 31, 2019
Debt conversion converted instrument amount	$ 23
Series D Convertible Preferred Stock | 2019 Convertible Notes
Debt Instrument [Line Items]
Proceeds from issuance of convertible preferred stock, net of issuance costs	$ 37
Two Thousand And Nineteen Credit Agreement
Debt Instrument [Line Items]
Debt instrument, fee amount			$ 4.6		$ 4.6
Warrants liability fair value			$ 0.9
Class of warrants number of securities called by the warrants or rights			419,992
Warrant liability and direct fees			$ 1.2
Two Thousand And Nineteen Credit Agreement | Series C Convertible Preferred Stock
Debt Instrument [Line Items]
Debt instrument, interest rate term			7.75% plus LIBOR
Class of warrants, exercise price			$ 16.667
Two Thousand And Nineteen Credit Agreement | Series D Convertible Preferred Stock
Debt Instrument [Line Items]
Class of warrants, exercise price			$ 16.667
Two Thousand And Nineteen Credit Agreement | Senior Term Loan
Debt Instrument [Line Items]
Debt instrument, face amount		$ 70
Proceeds from senior term loan		$ 40
Long-term debt, date date			May 20, 2024
Debt instrument, fee amount			$ 4.6
Debt instrument, Initial debt discount before inception			6.7
Two Thousand And Nineteen Credit Agreement | Senior Term Loan | Specified Training Revenue Level One
Debt Instrument [Line Items]
Debt instrument unused borrowing capacity			$ 10
Two Thousand And Nineteen Credit Agreement | Senior Term Loan | Specified Training Revenue Level Two
Debt Instrument [Line Items]
Debt instrument unused borrowing capacity				$ 20
Default Event | Senior Term Loan
Debt Instrument [Line Items]
Debt instrument, interest rate, increase (decrease)			10.00%

Debt - Summary Of Outstanding D

Debt - Summary Of Outstanding Debt (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 44,550	$ 44,550
Less: Unamortized debt discount and fees	(5,992)	(6,306)
Total long-term debt	38,558	38,244
Two Thousand And Nineteen Convertible Notes [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 44,550	$ 44,550

Operating Leases - Additional I

Operating Leases - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2020ft²
Lessee, Lease, Description [Line Items]
Office space	50,800
Corporate Office Space and Manufacturing Facility
Lessee, Lease, Description [Line Items]
Lease expiration date	Dec. 31, 2022
Office Space And Manufacturing Facility
Lessee, Lease, Description [Line Items]
Operating lease option to extend renewal term description	five-year term
Office Space Zaventem Belgium
Lessee, Lease, Description [Line Items]
Office space	3,900
Lease expiration date	Dec. 31, 2021
Operating lease option to extend renewal term description	three-year term

Operating Leases - Summary Of Q

Operating Leases - Summary Of Quantitative Information About Operating Leases (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Lessee Disclosure [Abstract]
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 year 9 months 18 days	2 years 3 months 18 days
Weighted-average discount rate – operating leases	7.00%	7.00%

Operating Leases - Summary Of C

Operating Leases - Summary Of Components Of Lease Cost (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Operating leases
Operating lease cost	$ 216	$ 216	$ 432	$ 432
Variable lease cost	92	40	165	104
Total rent expense	$ 308	$ 256	$ 597	$ 536

Operating Leases - Summary Of F

Operating Leases - Summary Of Future Minimum Payments Under The Non-Cancelable Operating Leases (Detail) $ in Thousands	Jun. 30, 2020USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
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

Warrants - Additional Informati

Warrants - Additional Information (Detail) - $ / shares	6 Months Ended
	Jun. 30, 2020	Dec. 31, 2019	Dec. 31, 2018
Class of Warrant or Right [Line Items]
Weighted average remaining contractual life of warrants	7 years 10 months 24 days
Warrants Issued in with Two Thousand and Nineteen Credit Agreement [Member] | Redeemable Convertible Series D Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Class of warrants number of securities called by the warrants or rights		419,992
Excercise price of each warrant	$ 16.67	$ 16.667
Warrants Issued in Two Thousand and Eighteen with Convertible Notes [Member] | Common Stock [Member]
Class of Warrant or Right [Line Items]
Class of warrants number of securities called by the warrants or rights			501,946
Excercise price of each warrant	0.10		$ 0.10
Term of warrants			10 years
Warrants Issued in Two Thousand and Eighteen Term Loan [Member] | Redeemable Convertible Series D Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Class of warrants number of securities called by the warrants or rights			26,998
Excercise price of each warrant	$ 16.67		$ 16.667

Warrants - Schedule of Outstand

Warrants - Schedule of Outstanding Warrants to Purchase the Company's Common Stock (Detail) - $ / shares	6 Months Ended
	Jun. 30, 2020	Dec. 31, 2019	Dec. 31, 2018
Class of Warrant or Right [Line Items]
Class of Warrant or Right, Outstanding	956,552	956,552
Warrants Issued in Two Thousand and Fifteen [Member] | Common Stock [Member]
Class of Warrant or Right [Line Items]
Warrant or Right, Reason for Issuance, Description	Common Stock
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 5.25
Warrants and Rights Outstanding, Maturity Date	Jan. 30, 2025
Class of Warrant or Right, Outstanding	7,616	7,616
Warrants Issued in Two Thousand and Eighteen with Convertible Notes [Member] | Common Stock [Member]
Class of Warrant or Right [Line Items]
Warrant or Right, Reason for Issuance, Description	Common Stock
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 0.10		$ 0.10
Warrants and Rights Outstanding, Maturity Date	Jun. 7, 2028
Class of Warrant or Right, Outstanding	501,946	501,946
Warrants Issued in Two Thousand and Eighteen Term Loan [Member] | Redeemable Convertible Series D Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Warrant or Right, Reason for Issuance, Description	Series D convertible preferred
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 16.67		$ 16.667
Warrants and Rights Outstanding, Maturity Date	Jul. 31, 2028
Class of Warrant or Right, Outstanding	26,998	26,998
Warrants Issued in with Two Thousand and Nineteen Credit Agreement [Member] | Redeemable Convertible Series D Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Warrant or Right, Reason for Issuance, Description	Series D convertible preferred
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 16.67	$ 16.667
Warrants and Rights Outstanding, Maturity Date	May 20, 2029
Class of Warrant or Right, Outstanding	419,992	419,992

Convertible Preferred Stock - A

Convertible Preferred Stock - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	6 Months Ended	12 Months Ended
	Feb. 29, 2020	Jun. 30, 2020	Dec. 31, 2019
Firm Underwritten Commitment [Member] | Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity [Member]
Temporary Equity [Line Items]
Stock issue share price per unit		$ 50
Firm Underwritten Commitment [Member] | Minimum [Member] | Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity [Member]
Temporary Equity [Line Items]
Sale of stock consideration received		$ 50
Redeemable Convertible Series A Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared		$ 0.68	$ 0.68
Redeemable Convertible Series B Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared		1.07	1.07
Redeemable Convertible Series C Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared		$ 1.36	$ 1.36
Rhythm xcience acquisition [Member] | Redeemable Convertible Series D Preferred Stock [Member]
Temporary Equity [Line Items]
Business combination contingent consideration shares issued shares	119,993
Business combination contingent consideration shares issued value	$ 2.2
Biotonik Asset Acquisition [Member] | Redeemable Convertible Series D Preferred Stock [Member]
Temporary Equity [Line Items]
Business combination contingent consideration shares issued shares	273,070
Business combination contingent consideration shares issued value	$ 5

Convertible Preferred Stock - S

Convertible Preferred Stock - Schedule of Initial Conversion Price Per Share for each Series of Convertible Preferred Stock (Detail)	Jun. 30, 2020$ / shares
Redeemable Convertible Series A Preferred Stock [Member]
Disclosure of Conversion Price of Temporary Equity into Permanent Equity [Line Items]
Temporary Equity Initial Conversion Price Per Share	$ 8.295
Redeemable Convertible Series B Preferred Stock [Member]
Disclosure of Conversion Price of Temporary Equity into Permanent Equity [Line Items]
Temporary Equity Initial Conversion Price Per Share	13.370
Redeemable Convertible Series C Preferred Stock [Member]
Disclosure of Conversion Price of Temporary Equity into Permanent Equity [Line Items]
Temporary Equity Initial Conversion Price Per Share	16.667
Redeemable Convertible Series D Preferred Stock [Member]
Disclosure of Conversion Price of Temporary Equity into Permanent Equity [Line Items]
Temporary Equity Initial Conversion Price Per Share	$ 16.667

Stockholders' Deficit - Additio

Stockholders' Deficit - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019	Aug. 10, 2020
Class of Stock [Line Items]
Common stock shares authorised	260,000,000		260,000,000		260,000,000
Common stock par or stated value per share	$ 0.001		$ 0.001		$ 0.001
Common stock voting rights					one voting right
Proceeds from the exercise of stock options			$ 205	$ 57
Common Stock [Member]
Class of Stock [Line Items]
Stock options shares excercised during the period	64,562	8,469	64,562	8,469
Subsequent Event [Member]
Class of Stock [Line Items]
Common stock shares authorised						260,000,000
Temporary equity shares authorised						5,000,000
Amended and Restated Certificate of Incorporation [Member]
Class of Stock [Line Items]
Common stock shares authorised					220,000,000
Common stock par or stated value per share					$ 0.001

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($)	1 Months Ended	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based compensation by share based payment arrangement weighted average fair value per share of stock options granted				$ 14.81
Unrecognised compensation realting to stock options not vested		$ 13,800,000		$ 13,800,000
Share based compensation non vested award period of recognition				2 years 9 months 18 days
Share based compensation by share based payment arrangement instruments other than options granted				14,945
Share based compensation by share based payment arrangement instruments other than options granted weighted average grant date fair value				$ 14.81
Allocated share based compensation expense		1,157,000	$ 803,000	$ 2,898,000	$ 1,362,000
Performance Based Restricted Stock Units [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based compensation by share based payment arrangement instruments other than options granted	567,509
Share based compensation by share based payment arrangement instruments other than options granted weighted average grant date fair value	$ 13.37
Allocated share based compensation expense		$ 0	$ 0	$ 0	$ 0
2011 Plan [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance		3,858,099		3,858,099
Share based payment arrangement number of shares available for issuance		390,912		390,912
Share based compensation by share based payment arrangement stock options vesting term				4 years
Share based compensation by share based payment arrangement stock options contractual term				10 years

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Estimate of the Fair Value of Stock Option (Detail)	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Schedule of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Risk-free interest rate	0.90%
Risk-free interest rate minimum		2.00%
Risk-free interest rate maximum		2.10%
Expected term in years	7 years
Expected volatility	70.00%	80.00%
Maximum [Member]
Schedule of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Expected term in years		10 years
Minimum [Member]
Schedule of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Expected term in years		6 years 4 months 17 days

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock Option Activity (Detail) - Stock Option [Member] $ / shares in Units, $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2020USD ($)$ / sharesshares	Dec. 31, 2019USD ($)$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options outstanding as of December 31, 2019 | shares	2,041,205
Options granted | shares	867,031
Option exercised | shares	(111,936)
Options forfeited | shares	(200,213)
Stock options outstanding as of June 30, 2020 | shares	2,596,087	2,041,205
Options vested and exercisable as of June 30, 2020 (unaudted) | shares	1,138,429
Weighted average exercise price outstanding as of December 31, 2019 | $ / shares	$ 9.52
Options granted | $ / shares	14.81
Option exercised | $ / shares	7.73
Options forfeited | $ / shares	12.01
Weighted average exercise price outstanding as of June 30, 2020 | $ / shares	11.17	$ 9.52
Weighted average exercise price of options vested and exercisable as of June 30, 2020 (unaudted) | $ / shares	$ 8.34
Weighted average remaining contractual life outstanding as of December 31, 2019	7 years 9 months 18 days	7 years 8 months 12 days
Weighted average remaining contractual life outstanding as of June 30, 2020	7 years 9 months 18 days	7 years 8 months 12 days
Weighted average remaining contractual life of options vested and exercisable as of June 30, 2020 (unaudted)	6 years 1 month 6 days
Aggregate intrinsic value outstanding as of December 31, 2019 | $	$ 7,857
Aggregate intrinsic value outstanding as of June 30, 2020 | $	17,816	$ 7,857
Aggregate intrinsic value options vested and exercisable as of June 30, 2020 (unaudted) | $	$ 11,037

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of RSA Activity (Detail)	6 Months Ended
	Jun. 30, 2020$ / sharesshares
Share-based Payment Arrangement [Abstract]
Granted of shares | shares	14,945
Vested of shares | shares	(14,945)
Granted of weighted average grant price | $ / shares	$ 14.81
Vested of weighted average grant price | $ / shares	$ 14.81

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of the Total Stock-Based Compensation Expense for the Stock Options and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 1,157	$ 803	$ 2,898	$ 1,362
Cost of Sales [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	58	54	166	106
Research and Development Expense [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	167	150	378	292
Selling, General and Administrative Expenses [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 932	$ 599	$ 2,354	$ 964

Net Loss Per Common Share - Sum

Net Loss Per Common Share - Summary of Calculation of the Diluted Net Loss per Common Share (Detail) - shares	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	20,125,574	17,106,180
Conversion of Series A Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	391,210	391,210
Conversion of Series B Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	3,088,444	3,088,444
Conversion of Series C Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	4,499,921	4,499,921
Conversion of Series D Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	8,593,360	6,418,437
Exercise of Stock Options [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	2,596,087	1,751,616
Exercise of Common Stock Warrants [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	509,562	509,562
Exercise of Preferred Stock Warrants [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	446,990	446,990

401(k) Retirement Plan - Additi

401(k) Retirement Plan - Additional Information (Detail) - USD ($)	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Four Zero One K Retirement Plan [Member]
Employer contribution to defined benefit plan	$ 0	$ 0

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Director and Shareholder [Member] | Patent Rights from Director and Shareholder [Member]
Related Party Transaction [Line Items]
Royalty expense	$ 16,000	$ 11,000	$ 37,000	$ 23,000
Director and Shareholder [Member] | Patent Rights from Director and Shareholder [Member] | Royalty Expenses [Member]
Related Party Transaction [Line Items]
Royalty expense as a percentage of net sales			3.00%
Beneficial Customer [Member] | Sales [Member]
Related Party Transaction [Line Items]
Revenue from related parties	200,000		$ 500,000	100,000
Director and the Chairman [Member] | Consulting Agreement [Member] | Selling, General and Administrative Expenses [Member]
Related Party Transaction [Line Items]
Consulting fees incurred for related party	47,000,000	74,000,000	100,000	200,000
Officer [Member] | Consulting Agreement [Member] | Selling, General and Administrative Expenses [Member]
Related Party Transaction [Line Items]
Consulting fees incurred for related party		94,000,000	200
Current Director and Officer [Member] | Consulting Agreement [Member] | Selling, General and Administrative Expenses [Member]
Related Party Transaction [Line Items]
Consulting fees incurred for related party		100,000		200,000
Orbimed Royalty Oppurtunities Two LP and Deerfield Private Design Fund LP [Member] | 2019 Credit Agreement [Member]
Related Party Transaction [Line Items]
Line of credit maximum borrowing capacity					$ 70,000,000
Line of credit cumulative drawdowns till date	40,000,000		40,000,000
Interest expenses related party	$ 1,300,000	$ 600,000	$ 2,700,000	$ 600,000

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) - $ / shares	Aug. 10, 2020	Jul. 28, 2020	Jun. 30, 2020	Dec. 31, 2019
Subsequent Event [Line Items]
Common stock shares outstanding			775,403	695,902
Share based compensation by share based payment arrangement options equity instruments other than options in period			14,945
Series D Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Shares issued during the period,shares			273,070
Subsequent Event [Member]
Subsequent Event [Line Items]
Common stock shares outstanding	26,719,993
Reverse stock split		common stock and convertible preferred stock on a 9.724-for-one basis
Subsequent Event [Member] | Two Thousand And Twenty Plan [Member]
Subsequent Event [Line Items]
Shares of common stock were reserved for issuance	2,193,360
Subsequent Event [Member] | Common Stock [Member] | Two Thousand And Twenty Plan [Member]
Subsequent Event [Line Items]
Share based compensation by share based payment arrangement options grants in period	850,217
Shares of common stock were authorized	387,063
Subsequent Event [Member] | Restricted Stock Units (RSUs) [Member] | Two Thousand And Twenty Plan [Member]
Subsequent Event [Line Items]
Share based compensation by share based payment arrangement options equity instruments other than options in period	211,251
Subsequent Event [Member] | Restricted Stock Awards [Member] | Two Thousand And Twenty Plan [Member]
Subsequent Event [Line Items]
Share based compensation by share based payment arrangement options equity instruments other than options in period	17,976
Subsequent Event [Member] | Series A Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Coversion of shares as result of conversion of temporary equity into permanent equity	391,210
Subsequent Event [Member] | Series B Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Coversion of shares as result of conversion of temporary equity into permanent equity	3,088,444
Subsequent Event [Member] | Series C Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Coversion of shares as result of conversion of temporary equity into permanent equity	4,499,921
Subsequent Event [Member] | Series D Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Coversion of shares as result of conversion of temporary equity into permanent equity	8,593,360
Class of warrants number of securities called by the warrants or rights	446,990
Excercise price of each warrant	$ 16.67
Subsequent Event [Member] | Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Reverse stock split		9.724-for-one basis
Subsequent Event [Member] | IPO [Member]
Subsequent Event [Line Items]
Shares issued during the period,shares	10,147,058
Subsequent Event [Member] | Over-Allotment Option [Member]
Subsequent Event [Line Items]
Shares issued during the period,shares	1,323,529
Subsequent Event [Member] | IPO And Over Allotment [Member]
Subsequent Event [Line Items]
Stock issue share price per unit	$ 18