Acutus Medical (AFIB) 10-Q 13 Nov 20 2020 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2020	Nov. 09, 2020
Cover [Abstract]
Document Type	10-Q
Entity Registrant Name	ACUTUS MEDICAL, INC.
Amendment Flag	false
Document Period End Date	Sep. 30, 2020
Document Fiscal Period Focus	Q3
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	Yes
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 $0.001 per share
Trading Symbol	AFIB
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		27,846,083

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 58,302	$ 9,452
Marketable securities, short-term	99,742	62,351
Restricted cash	150	150
Accounts receivable	1,893	263
Inventory	10,932	8,424
Prepaid expenses and other current assets	4,635	1,816
Total current assets	175,654	82,456
Marketable securities, long-term	8,789
Property and equipment, net	9,940	4,427
Right-of-use asset, net	1,838	2,341
Intangible assets, net	3,780	4,110
Goodwill	12,026	12,026
Other assets	482	95
Total assets	212,509	105,455
Current liabilities:
Accounts payable	4,723	3,882
Accrued liabilities	6,500	10,076
Contingent consideration, short-term	4,000	8,200
Operating lease liabilities, short-term	907	833
Common and preferred stock warrant liability		8,919
Total current liabilities	16,130	31,910
Operating lease liabilities, long-term	1,365	2,054
Long-term debt	38,762	38,244
Contingent consideration, long-term	3,600	5,700
Other long-term liabilities	8
Total liabilities	59,865	77,908
Commitments and contingencies (Note 12)
Stockholders' equity (deficit)
Preferred stock, $0.001 par value; 5,000,000 shares authorized as of September 30, 2020 and no shares authorized as of December 31, 2019; no shares issued and outstanding as of each of September 30, 2020 and December 31, 2019, respectively
Common stock, $0.001 par value; 260,000,000 shares authorized as of each of September 30, 2020 and December 31, 2019; 27,826,408 and 695,902 shares issued and outstanding as of September 30, 2020 and December 31, 2019, respectively	28	1
Additional paid-in capital	484,162	33,252
Accumulated deficit	(331,613)	(259,034)
Accumulated other comprehensive income (loss)	67	(30)
Total stockholders' equity (deficit)	152,644	(225,811)
Total liabilities, convertible preferred stock and stockholders' equity (deficit)	$ 212,509	105,455
Series A Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock		3,059
Series B Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock		40,685
Series C Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock		74,575
Series D Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock		$ 135,039

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	5,000,000	0
Preferred Stock, Shares Issued	0	0
Preferred Stock, Shares Outstanding	0	0
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	27,826,408	695,902
Common Stock, Shares, Outstanding	27,826,408	695,902
Series A Convertible Preferred Stock [Member]
Convertible Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Convertible Preferred Stock, Shares Authorized	0	3,848,696
Convertible Preferred Stock, Shares Issued	0	391,210
Convertible Preferred Stock, Shares Outstanding	0	391,210
Convertible Preferred Stock, Liquidation Preference, Value		$ 3,245
Series B Convertible Preferred Stock [Member]
Convertible Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Convertible Preferred Stock, Shares Authorized	0	30,032,100
Convertible Preferred Stock, Shares Issued	0	3,088,444
Convertible Preferred Stock, Shares Outstanding	0	3,088,444
Convertible Preferred Stock, Liquidation Preference, Value		$ 41,294
Series C Convertible Preferred Stock [Member]
Convertible Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Convertible Preferred Stock, Shares Authorized	0	48,184,000
Convertible Preferred Stock, Shares Issued	0	4,499,921
Convertible Preferred Stock, Shares Outstanding	0	4,499,921
Convertible Preferred Stock, Liquidation Preference, Value		$ 75,000
Series D Convertible Preferred Stock [Member]
Convertible Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Convertible Preferred Stock, Shares Authorized	0	90,000,000
Convertible Preferred Stock, Shares Issued	0	8,200,297
Convertible Preferred Stock, Shares Outstanding	0	8,200,297
Convertible Preferred Stock, Liquidation Preference, Value		$ 136,675

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Revenue	$ 3,173	$ 646	$ 5,890	$ 2,167
Costs and operating expenses:
Cost of products sold	5,141	2,267	10,998	6,878
Research and development	8,343	5,865	24,492	15,489
Selling, general and administrative	15,833	7,978	35,193	18,998
Change in fair value of contingent consideration	118	700	(1,466)	700
Total costs and operating expenses	29,435	31,810	69,217	57,065
Loss from operations	(26,262)	(31,164)	(63,327)	(54,898)
Other income (expense):
Change in fair value of warrant liability and embedded derivative	(3,683)	(3)	(5,555)	(608)
Loss on debt extinguishment		(49)		(1,447)
Interest income	23	525	393	733
Interest expense	(1,366)	(1,394)	(4,090)	(20,905)
Total other expense, net	(5,026)	(921)	(9,252)	(22,227)
Net loss	(31,288)	(32,085)	(72,579)	(77,125)
Other comprehensive income (loss)
Unrealized (loss) gain on marketable securities	(9)	40	(50)	47
Foreign currency translation adjustment	78	(45)	147	(57)
Comprehensive loss	$ (31,219)	$ (32,090)	$ (72,482)	$ (77,135)
Net loss per common share, basic and diluted	$ (1.95)	$ (47.21)	$ (12.36)	$ (115.66)
Weighted average shares outstanding, basic and diluted	16,080,467	679,591	5,870,861	666,823
License Acquired [Member]
Costs and operating expenses:
Research and development		$ 15,000		$ 15,000

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Convertible Preferred Stock and Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Series A Convertible Preferred Stock [Member]	Series B Convertible Preferred Stock [Member]	Series C Convertible Preferred Stock [Member]	Series D Convertible Preferred Stock [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) gain on marketable securities	47				47
Foreign currency translation adjustment	(57)				(57)
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									$ 66,567
Issuance of Series D convertible preferred stock for cash, net of issuance costs, Shares									4,091,819
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	76		76
Stock option exercises, shares		15,921
Stock-based compensation	2,174		2,174
Stock-based compensation, shares		11,449
Net loss	(77,125)			(77,125)
Ending balances at Sep. 30, 2019	(206,709)	$ 1	32,400	(239,120)	10
Ending balances, shares at Sep. 30, 2019						391,210	3,088,444	4,499,921	8,200,297
Ending balances at Sep. 30, 2019						$ 3,059	$ 40,685	$ 74,575	$ 135,043
Ending balances, shares at Sep. 30, 2019		684,024
Beginning balances at Jun. 30, 2019						$ 3,059	$ 40,685	$ 74,575	$ 106,702
Beginning balances, Shares at Jun. 30, 2019						391,210	3,088,444	4,499,921	6,418,437
Beginning balances at Jun. 30, 2019	(175,450)	$ 1	31,569	(207,035)	15
Beginning balances, Shares at Jun. 30, 2019		671,960
Unrealized (loss) gain on marketable securities	40				40
Foreign currency translation adjustment	(45)				(45)
Issuance of Series D convertible preferred stock for cash, net of issuance costs									$ 28,341
Issuance of Series D convertible preferred stock for cash, net of issuance costs, Shares									1,781,860
Stock option exercises	19		19
Stock option exercises, shares		7,452
Stock-based compensation	812		812
Stock-based compensation, shares		4,612
Net loss	(32,085)			(32,085)
Ending balances at Sep. 30, 2019	(206,709)	$ 1	32,400	(239,120)	10
Ending balances, shares at Sep. 30, 2019						391,210	3,088,444	4,499,921	8,200,297
Ending balances at Sep. 30, 2019						$ 3,059	$ 40,685	$ 74,575	$ 135,043
Ending balances, shares at Sep. 30, 2019		684,024
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) gain on marketable securities	(50)				(50)
Foreign currency translation adjustment	147				147
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
Conversion of convertible preferred stock into common stock upon IPO	260,555	$ 17	260,538			$ (3,059)	$ (40,685)	$ (74,575)	$ (142,236)
Conversion of convertible preferred stock into common stop upon IPO, shares		16,572,935				(391,210)	(3,088,444)	(4,499,921)	(8,593,360)
Issuance of common stock for cash, net of issuance costs of $16,361	166,286	$ 10	166,276
Issuance of common stock for cash, net of issuance cost of $16,361, shares		10,147,058
Reclassification of warrant liability to stockholders' equity	14,474		14,474
Stock option exercises	350		350
Stock option exercises, shares		92,223
Stock-based compensation	9,272		9,272
Stock-based compensation, shares		318,290
Net loss	(72,579)			(72,579)
Ending balances at Sep. 30, 2020	152,644	$ 28	484,162	(331,613)	67
Ending balances, shares at Sep. 30, 2020						0	0	0	0
Ending balances, shares at Sep. 30, 2020		27,826,408
Beginning balances at Jun. 30, 2020						$ 3,059	$ 40,685	$ 74,575	$ 142,236
Beginning balances, Shares at Jun. 30, 2020						391,210	3,088,444	4,499,921	8,593,360
Beginning balances at Jun. 30, 2020	(263,971)	$ 1	36,355	(300,325)	(2)
Beginning balances, Shares at Jun. 30, 2020		775,403
Unrealized (loss) gain on marketable securities	(9)				(9)
Foreign currency translation adjustment	78				78
Conversion of convertible preferred stock into common stock upon IPO	260,555	$ 17	260,538			$ (3,059)	$ (40,685)	$ (74,575)	$ (142,236)
Conversion of convertible preferred stock into common stop upon IPO, shares		16,572,935				(391,210)	(3,088,444)	(4,499,921)	(8,593,360)
Issuance of common stock for cash, net of issuance costs of $16,361	166,286	$ 10	166,276
Issuance of common stock for cash, net of issuance cost of $16,361, shares		10,147,058
Reclassification of warrant liability to stockholders' equity	14,474		14,474
Stock option exercises	145		145
Stock option exercises, shares		27,661
Stock-based compensation	6,374		6,374
Stock-based compensation, shares		303,351
Net loss	(31,288)			(31,288)
Ending balances at Sep. 30, 2020	$ 152,644	$ 28	$ 484,162	$ (331,613)	$ 67
Ending balances, shares at Sep. 30, 2020						0	0	0	0
Ending balances, shares at Sep. 30, 2020		27,826,408

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Convertible Preferred Stock and Stockholders' Equity (Deficit) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Series D Convertible Preferred Stock [Member]
Payments of Stock Issuance Costs		$ 1,358		$ 1,632
Common Stock [Member]
Payments of Stock Issuance Costs	$ 16,361		$ 16,361

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash flows from operating activities
Net loss	$ (72,579)	$ (77,125)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense	1,754	1,676
Amortization of intangible assets	330	125
Stock-based compensation expense	9,272	2,174
Amortization of premiums/(accretion of discounts) on marketable securities, net	113	(100)
Amortization of debt issuance costs	518	17,438
Amortization of right-of-use assets	507	470
Research and development - license acquired		15,000
Gain on disposal of property and equipment		(1)
Loss on debt extinguishment		1,447
Change in fair value of warrant liability and embedded derivative	5,555	608
Change in fair value of contingent consideration	(1,466)	700
Changes in operating assets and liabilities, net of effect from business combination:
Accounts receivable	(1,630)	(697)
Inventory	(1,865)	(3,829)
Prepaid expenses and other current assets	(2,729)	(306)
Other assets	(387)	(8)
Accounts payable	753	2,873
Accrued liabilities	1,423	9,268
Operating lease liabilities	(615)	(536)
Other long-term liabilities	8
Net cash used in operating activities	(61,038)	(30,823)
Cash flows from investing activities
Purchases of available-for-sale marketable securities	(108,528)	(68,735)
Sales of available-for-sale marketable securities	17,095
Maturities of available-for-sale marketable securities	45,000	11,550
Purchases of property and equipment	(7,822)	(683)
Purchase of research and development license		(10,000)
Cash paid, net of cash acquired for the Rhythm Xience Acquisition		(3,000)
Net cash used in investing activities	(54,255)	(70,868)
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	(2,636)
Proceeds from issuance of convertible preferred stock, net of issuance costs		66,567
Proceeds from issuance of common stock upon IPO, net of issuance costs	166,286
Proceeds from stock options exercises	350	76
Net cash provided by financing activities	164,000	126,311
Effect of exchange rate changes on cash, cash equivalents and restricted cash	143	(50)
Net change in cash, cash equivalents and restricted cash	48,850	24,570
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	58,452	34,345
Supplemental disclosure of cash flow information:
Cash paid for interest	3,526	4,647
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	50	(47)
Warrants issued in conjunction with OrbiMed debt		872
Right-of-use assets exchanged for operating lease liabilities		2,978
Accrued purchase of research and development-license		5,000
Unpaid purchases of property and equipment	88	$ 35
Conversion of convertible preferred stock into common stock upon IPO	260,555
Reclassification of warrant liability to stockholders' equity	$ 14,474

Organization and Description of

Organization and Description of Business	9 Months Ended
	Sep. 30, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
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 received a cash payment in lieu of receiving fractional shares. Initial Public Offering On August 10, 2020, the Company issued 10,147,058 shares of common stock in an initial public offering (“IPO”), which included 1,323,529 shares of common stock issued upon the underwriters’ exercise in full 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. The Company received proceeds of $166.3 million from its IPO, net of underwriting discounts and commissions and other offering expenses. 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. 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 September 30, 2020 and December 31, 2019, the Company had an accumulated deficit of $331.6 million and $259.0 million, respectively, and working capital of $159.5 million and $50.5 million, respectively. The Company has historically funded its operations primarily through the sale of debt and equity securities, as well as other indebtedness. With the closing of the Company’s IPO, the Company’s current cash, cash equivalents and marketable securities 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 pandemic and the measures imposed to contain this pandemic disrupted the Company’s business. The effects of the pandemic began to decrease in late April 2020 as electrophysiology labs began reopening and procedure volumes began increasing as compared to COVID-19 related low points in March 2020. The Company could experience similar, or even more sustained, access restrictions or decreases in procedural activities as hospitals continue to deal with the COVID-19 pandemic. If cases of COVID-19 increase and hospitals again prioritize those patients, additional restrictions may be implemented which would adversely impact our business and financial results.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 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 and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period. Principles of Consolidation The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiary Acutus Medical NV (“Acutus NV”), which was incorporated under the laws of Belgium in August 2013. 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 September 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, cash equivalents and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statements of cash flows (in thousands): September 30, December 31, 2020 2019 (unaudited) Cash and cash equivalents $ 58,302 $ 9,452 Restricted cash 150 150 Total cash, cash equivalents and restricted cash $ 58,452 $ 9,602 Marketable Securities The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets. Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ equity (deficit) until their disposition or maturity. See “Fair Value Measurements” below. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method. Marketable securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ 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 nine-month periods ended September 30, 2020 and 2019. Concentrations of Credit Risk and Off-Balance Sheet Risk Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions, which, at times may exceed the 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 places its medical diagnostic equipment, AcQMap System, at customer sites under loan agreements and generates revenue from disposable products used with the AcQMap System. Disposable products include AcQMap Catheters and AcQGuide Steerable Sheaths. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company also sells the AcQMap System to customers along with software updates on a when-and-if-available basis and equipment service. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation. During the three months ended September 30, 2020, the Company entered into deferred equipment agreements that are generally structured such that the Company agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two to four years. The Company determined that the deferred equipment agreements include embedded sales-type leases. The Company allocates contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and non-lease components at contract inception. The Company expenses the cost of the device at the inception of the agreement and records a financial lease asset equal to the gross consideration allocated to the lease. The lease asset will be reduced by payments for minimum disposable purchases that are allocated to the lease. The following table sets forth the Company’s revenue for disposables and systems/service for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) Disposables $ 2,179 $ 643 $ 4,358 $ 2,155 Systems 965 — 1,485 — Service/Other 29 3 47 12 Total $ 3,173 $ 646 $ 5,890 $ 2,167 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 September 30, 2020 and December 31, 2019. In May 2020, the Company entered into bi-lateral distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the “Bi-Lateral Distribution Agreements”). Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non- exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a coexclusive right to distribute these products in Hong Kong. Each party will pay to the other party specified transfer prices on the sale of the other party’s products and, accordingly, will earn a distribution margin on the sale of the other party’s products. The following table provides revenue by geographic location for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) United States $ 1,867 $ 147 $ 3,195 $ 603 Europe 1,306 499 2,695 1,564 Total Revenue $ 3,173 $ 646 $ 5,890 $ 2,167 Inventory Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $37,000 and $0.3 million, for the three months ended September 30, 2020 and 2019, respectively, and $0.1 million and $0.5 million, for the nine months ended September 30, 2020 and 2019, respectively. 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 September 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 technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired in-process technology was classified as an indefinite-lived intangible asset, until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was classified as a finite-lived intangible and amortization for in-process technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite - 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 nine months ended September 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 income (loss) in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive loss. Lessee Leases Effective January 1, 2019, the Company accounts for its lessee leases under ASC 842, Leases In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election. Cost of Products Sold Cost of products sold includes raw materials, direct labor, manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products. Research and Development The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. Research and development expenses also include payments for the asset acquisition from Biotronik and VascoMed GmbH (collectively, the “Biotronik Parties”) for certain licenses of patents, technology, know-how rights and equipment (the “Biotronik Asset Acquisition”). Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials. Selling, General and Administrative Selling, general and administrative (“SG&A”) 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 nine months ended September 30, 2020 and 2019. As of September 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 September 30, 2020 and December 31, 2019 (in thousands): Fair Value Measured at September 30, 2020 (unaudited) Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Fair Value at September 30, 2020 Assets included in: Cash and cash equivalents Money market securities $ 53,063 $ — $ — $ 53,063 Marketable securities at fair value Corporate debt securities — 31,455 — 31,455 U.S. treasury securities — 14,361 — 14,361 Commercial paper — 53,926 — 53,926 Asset-backed securities — 8,789 — 8,789 Total fair value $ 53,063 $ 108,531 $ — $ 161,594 Liabilities included in: Contingent consideration $ — $ — $ 7,600 $ 7,600 Total fair value $ — $ — $ 7,600 $ 7,600 Fair Value Measured at December 31, 2019 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Fair Value at December 31, 2019 Assets included in: Cash and cash equivalents Money market securities $ 8,901 $ — $ — $ 8,901 Marketable securities at fair value Corporate debt securities — 28,224 — 28,224 Asset-backed securities — 17,121 — 17,121 U.S. treasury securities — 5,032 — 5,032 Commercial paper — 11,974 — 11,974 Total fair value $ 8,901 $ 62,351 $ — $ 71,252 Liabilities included in: Contingent consideration $ — $ — $ 13,900 $ 13,900 Common and preferred stock warrant liability — — 8,919 8,919 Total fair value $ — $ — $ 22,819 $ 22,819 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 marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets or liabilities, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments or debt, broker and dealer quotes, as well as other relevant economic measures. The following table presents changes in Level 3 liabilities measured at fair value for the nine months ended September 30, 2020 (in thousands): Common and Preferred Stock Warrant Liability Contingent Consideration Total Balance, December 31, 2019 $ 8,919 $ 13,900 $ 22,819 Payment of contingent consideration — (2,636 ) (2,636 ) Issuance of preferred stock for contingent consideration — (2,197 ) (2,197 ) Reclassification of warrant liability to stockholders' equity (14,474 ) — (14,474 ) Change in fair value 5,555 (1,466 ) 4,089 Balance, September 30, 2020 (unaudited) $ — $ 7,600 $ 7,600 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 has been estimated using a Monte Carlo simulation in the first quarter of 2019 and as an output of the Hybrid Method for the second and third quarter of 2019 and the first and second quarter of 2020. The underlying equity included in the Monte Carlo simulation and the Hybrid Method was determined based on the equity value implied from the preferred stock transactions and from examination of income and market approaches for measurement dates in which a preferred transaction was not applicable. Additionally, the expected IPO value was considered in the determination of the equity value. The fair value of the warrants was impacted by the model selected as well as assumptions surrounding unobservable inputs including the underlying equity value, risk-free interest rate, expected dividend yield, contractual term and expected volatility. On August 10, 2020 when the warrants were converted and became equity classified warrants, the fair value of the common and preferred stock warrant liability was estimated using a Black-Scholes model. The underlying equity included in the Black-Scholes model was based on the IPO share price of $18.00. The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the common and preferred stock warrant liability as of August 10, 2020 (date of conversion to equity classified warrants) and December 31, 2019 were as follows: August 10, December 31, 2020 2019 (unaudited) Risk-free interest rate 0.39% 1.59% - 1.60% Expected dividend yield — — Contractual term in years 7.8 - 8.8 0.7 - 1.0 Expected volatility 65.0% 60.0% - 110.5% The fair value of the contingent consideration from the acquisition of Rhythm Xience represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective earn-out period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales or earnings; (iii) risk-free 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 September 30, 2020 and December 31, 2019 were as follows: September 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 20.4% 11.8% Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock awards (“RSAs”), restricted stock units (“RSUs”) and restricted stock units with non-market performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs, RSUs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSAs and RSUs over the requisite service period. As the PSUs have a performance condition, compensation expense was recognized for each vesting tranche over the respective requisite service period of each tranche upon the IPO closing on August 10, 2020, when the Company’s management deemed it probable that the performance conditions were satisfied. The Company recognized a cumulative true-up adjustment related to PSUs once the conditions became probable of being satisfied as the related service period had been completed in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive loss based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See “Note 16—Stock-Based Compensation” below. 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 will more likely than not be realized assuming examination by the taxing

Asset Acquisition and Business

Asset Acquisition and Business Combination	9 Months Ended
	Sep. 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 nine months ended September 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 was accounted for as an asset acquisition as substantially all of the $15.0 million value transferred to Biotronik was allocated to intellectual property. On the acquisition date, the products licensed had not yet received regulatory approval and the intellectual property did not have an alternative use. Accordingly, the $15.0 million paid to Biotronik was immediately charged to research and development expense—licensed acquired in the condensed consolidated statement of operations and comprehensive 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 September 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 $2.2 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 contingent consideration liability of $13.4 million was based on the fair value of the contingent consideration liability at the acquisition date. During the nine months ended September 30, 2020, the Company issued 119,993 shares of Series D convertible preferred stock and paid $2.6 million of the contingent consideration for the achievement of certain regulatory milestones and revenue milestones. Additionally, the Company recorded a $0.1 million and $0.7 million increase for the three months ended September 30, 2020 and 2019, respectively, and a $1.5 million decrease and a $0.7 million increase for the nine months ended September 30, 2020 and 2019, respectively, to the fair value of the contingent consideration liability which is included in change in fair value of contingent consideration in the condensed consolidated statement of operations and comprehensive loss. As of September 30, 2020, the contingent consideration liability of $7.6 million is the fair value of the remaining payments due to the sellers of Rhythm Xience if certain additional regulatory approval milestones and revenue milestones are achieved.

Marketable Securities

Marketable Securities	9 Months Ended
	Sep. 30, 2020
Available For Sale Securities Fair Value To Amortized Cost Basis [Abstract]
Marketable Securities	Note 4—Marketable Securities Marketable securities consisted of the following as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 (unaudited) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Available-for-sale securities - short-term: Corporate debt securities $ 31,459 $ — $ (4 ) $ 31,455 U.S. treasury securities 14,362 — (1 ) 14,361 Commercial paper 53,926 — — 53,926 Total available-for-sale securities - short-term 99,747 — (5 ) 99,742 Asset-backed securities, long-term 8,789 — 8,789 Total available-for-sale securities $ 108,536 $ — $ (5 ) $ 108,531 December 31, 2019 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Available-for-sale securities - short-term: Corporate debt securities $ 28,204 $ 20 $ — $ 28,224 Asset-backed securities 17,108 13 — 17,121 U.S. treasury securities 5,020 12 — 5,032 Commercial paper 11,974 — — 11,974 Total available-for-sale securities $ 62,306 $ 45 $ — $ 62,351 As of December 31, 2019, all of the Company’s available-for-sale securities mature in one year or less. As of September 30, 2020, the Company’s available-for-sale securities classified as short-term of $99.7 million mature in one year or less and the available-for-sale securities classified as long-term of $8.8 million mature within two years.

Inventory

Inventory	9 Months Ended
	Sep. 30, 2020
Inventory Disclosure [Abstract]
Inventory	Note 5—Inventory Inventory as of September 30, 2020 and December 31, 2019 consisted of the following (in thousands): September 30, December 31, 2020 2019 (unaudited) Raw materials $ 5,980 $ 5,492 Work in process 864 1,605 Finished goods 4,088 1,327 Total inventory $ 10,932 $ 8,424

Lessor Sales-Type Leases

Lessor Sales-Type Leases	9 Months Ended
	Sep. 30, 2020
Leases [Abstract]
Lessor Sales-Type Leases	Note 6—Lessor Sales-Type Leases The Company recognizes revenue and costs, as well as a lease receivable, at the time embedded sales-type leases within its deferred equipment agreements commence. Lease revenue related to sales-type leases for each of the three and nine months ended September 30, 2020 was $0.7 million and is included within revenue in the accompanying condensed consolidated statements of operations and comprehensive loss. There was no lease revenue for the three and nine months ended September 30, 2019. Costs related to embedded leases within the Company’s deferred equipment agreements are included in cost of products sold in the accompanying condensed consolidated statements of operations and comprehensive loss. The Company has a short-term lease receivable of $0.3 million and a long-term lease receivable of $0.4 million included in prepaid expenses and other current assets and other assets, respectively, as of September 30, 2020. There was no lease receivable as of December 31, 2019. As of September 30, 2020, estimated future maturities of customer sales-type lease receivables for each of the following years are as follows (in thousands): Three months ending December 31, 2020 $ 68 Year ending December 31, 2021 273 Year ending December 31, 2022 254 Year ending December 31, 2023 46 Year ending December 31, 2024 27 Lease receivable $ 668

Property and Equipment, Net

Property and Equipment, Net	9 Months Ended
	Sep. 30, 2020
Property Plant And Equipment [Abstract]
Property and Equipment, Net	Note 7—Property and Equipment, Net The Company’s property and equipment, net, consisted of the following as of September 30, 2020 and December 31, 2019 (in thousands): September 30, December 31, 2020 2019 (unaudited) Medical diagnostic equipment $ 10,155 $ 5,492 Furniture and fixtures 388 159 Office equipment 1,391 1,321 Laboratory equipment and software 3,409 2,807 Leasehold improvements 600 507 Construction in process 141 306 Total property and equipment 16,084 10,592 Less: accumulated depreciation (6,144 ) (6,165 ) Property and equipment, net $ 9,940 $ 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 $0.8 million and $0.5 million for the three months ended September 30, 2020 and 2019, respectively, and $1.8 million and $1.7 million for the nine months ended September 30, 2020 and 2019, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2020
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Note 8—Goodwill and Intangible Assets The table below summarizes goodwill and intangible assets activities as of September 30, 2020 and December 31, 2019 (in thousands): Goodwill Intangible Assets Balance at December 31, 2019 $ 12,026 $ 4,110 Amortization expense — (330 ) Balance at September 30, 2020 (unaudited) $ 12,026 $ 3,780 Estimated Useful Weighted Average Remaining Life (in years) Life (in years) Intangible Assets Accumulated Amortization September 30, 2020 (unaudited) Developed technology 10 8.8 $ 4,200 $ (495 ) $ 3,705 Trademarks and trade names 0.5 — 60 (60 ) — Customer-related intangible 5 3.75 100 (25 ) 75 Total $ 4,360 $ (580 ) $ 3,780 Estimated Useful Weighted Average Remaining Life (in years) Life (in years) Intangible Assets Accumulated Amortization December 31, 2019 Developed technology 10 9.5 $ 3,600 $ (180 ) $ 3,420 In-process technology indefinite 600 — 600 Trademarks and trade names 0.5 — 60 (60 ) — Customer-related intangible 5 4.5 100 (10 ) 90 Total $ 4,360 $ (250 ) $ 4,110 Acquired in-process technology was classified as an indefinite-lived intangible asset until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was reclassified as developed technology and amortization began. The Company recorded amortization expense related to the above intangible assets of $0.1 million and $0.1 million for the three months ended September 30, 2020 and 2019, respectively, and $0.3 million and $0.1 million for the nine months ended September 30, 2020 and 2019, respectively. The following table shows the remaining amortization expense associated with amortizable intangible assets as of September 30, 2020 (in thousands): Developed Technology Customer- Related Intangible Total Amortization Three months ending December 31, 2020 $ 105 $ 5 $ 110 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 $ 3,705 $ 75 $ 3,780

Accrued Liabilities

Accrued Liabilities	9 Months Ended
	Sep. 30, 2020
Payables And Accruals [Abstract]
Accrued Liabilities	Note 9—Accrued Liabilities Accrued liabilities consisted of the following as of September 30, 2020 and December 31, 2019 (in thousands): September 30, December 31, 2020 2019 (unaudited) Payroll and related expenses $ 5,083 $ 3,785 Professional fees 290 188 Deferred revenue 290 311 Sales and use tax 140 151 Biotronik Asset Acquisition - accrued purchase price — 5,000 Other 697 641 Total accrued liabilities $ 6,500 $ 10,076

Debt

Debt	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Debt	Note 10—Debt Outstanding debt as of September 30, 2020 and December 31, 2019 consisted of the following (in thousands): September 30, December 31, 2020 2019 (unaudited) 2019 Credit Agreement (1) $ 44,550 $ 44,550 Total debt, gross 44,550 44,550 Less: Unamortized debt discount and fees (5,788 ) (6,306 ) Total long-term debt $ 38,762 $ 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 $16.67 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 $16.67 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 nine months ended September 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 converted 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	9 Months Ended
	Sep. 30, 2020
Leases [Abstract]
Operating Leases	Note 11—Operating Leases The Company leases approximately 50,800 square feet of office space for its corporate headquarters and manufacturing facility in Carlsbad, California under a 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 asset as it is not reasonably certain to be exercised. 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 asset as it is reasonably certain to be exercised. The following table summarizes quantitative information about the Company’s operating leases for the nine months ended September 30, 2020 and 2019 (dollars in thousands): Nine Months Ended September 30, 2020 2019 (unaudited) Operating cash flows from operating leases $ 760 $ 725 Right-of-use assets exchanged for operating lease liabilities $ — $ 2,978 Weighted average remaining lease term – operating leases (in years) 1.7 2.2 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 September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) Operating leases Operating lease cost $ 216 $ 216 $ 648 $ 648 Variable lease cost 73 65 238 169 Total rent expense $ 289 $ 281 $ 886 $ 817 As of September 30, 2020, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands): Three months ending December 31, 2020 $ 253 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 2,473 Less: present value discount (201 ) Operating lease liabilities $ 2,272

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2020
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 12—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	9 Months Ended
	Sep. 30, 2020
Warrants And Rights Note Disclosure [Abstract]
Warrants	Note 13—Warrants As of September 30, 2020 and December 31, 2019, the outstanding warrants to purchase the Company’s common stock were comprised of the following: Equity Upon Exercise September 30, December 31, (After Conversion) Exercise Price Expiration Date 2020 2019 (unaudited) Warrants issued in 2015 Common Stock $ 5.25 1/30/25 7,616 7,616 Warrants issued with 2018 Convertible Notes Common Stock $ 0.10 6/7/28 501,946 501,946 Warrants issued with 2018 Term Loan Common Stock $ 16.67 7/31/28 26,998 26,998 Warrants issued with 2019 Credit Agreement Common Stock $ 16.67 5/20/29 419,992 419,992 Total Warrants 956,552 956,552 The Company has no warrant activity for the nine months ended September 30, 2020. The remaining weighted average contractual life is 7.7 years as of September 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 $16.67 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 $16.67 per share. During 2018, in connection with the issuance of the 2018 Convertible Notes and the 2018 Term Loan, the Company issued ten-year warrants to purchase 501,946 shares of common stock with an exercise price of $0.10 per share and 26,998 shares of Series C convertible preferred stock with an exercise price of $16.67 per share, respectively. The warrants for Class C convertible preferred stock were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.67 per share. On August 10, 2020, in connection with the closing of the IPO, 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. 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. Prior to the IPO, in accordance with ASC 815, other than the warrants issued in 2015, the warrants were recorded as liabilities at fair value at the issuance date. Changes in the fair value were 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. On August 10, 2020, in connection with the closing of the IPO, the warrants recorded as liabilities no longer met the definition of a derivative. Accordingly, the fair value of the common and preferred stock warrant liability of $14.5 million was reclassified to stockholders’ equity (deficit) in the condensed consolidated balance sheet. 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’ equity (deficit) in the condensed consolidated balance sheets.

Convertible Preferred Stock

Convertible Preferred Stock	9 Months Ended
	Sep. 30, 2020
Temporary Equity [Abstract]
Convertible Preferred Stock	Note 14—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 stock issuance portion of the purchase consideration of the Biotronik Asset Acquisition. On August 10, 2020, in connection with the closing of the IPO, all of the 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. Redemption The convertible preferred stock was not unconditionally redeemable at the option of the holder thereof. However, the convertible preferred stock was contingently redeemable upon certain liquidation events. As redemption by the holders was not solely within the control of the Company, all of the outstanding convertible preferred stock was classified as temporary equity in the condensed consolidated balance sheets, prior to the conversion to common stock on August 10, 2020. Dividends The holders of shares of convertible preferred stock were entitled to receive dividends, out of any assets legally available therefore, prior and in preference to any declaration or payment of any dividend on the common stock of the Company, at the applicable dividend rate, payable on a pro rata pari passu Liquidation The holders of the Series D convertible preferred stock were entitled to receive a liquidation preference prior to any distribution to the holders of Series A convertible preferred stock, Series B convertible preferred stock and Series C convertible preferred stock (collectively the “Junior Preferred Stock”) and the holders of common stock, in the amount of the original issue price plus declared but 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 convertible, at the option of the holder thereof, at any time after the date of issuance of such share, into such number of fully paid and nonassessable shares of the Company’s common stock as was determined by dividing the original issue price, as adjusted, for such series by the applicable conversion price for such series in effect on the date the certificate is surrendered for conversion. The initial conversion price per share for each series of convertible preferred stock was the original issue price applicable to such series as follows: Series Conversion Price Series A convertible preferred stock $ 8.295 Series B convertible preferred stock $ 13.370 Series C convertible preferred stock $ 16.667 Series D convertible preferred stock $ 16.667 Each share of convertible preferred stock was automatically convertible into fully-paid, non-assessable shares of common stock at the conversion rate at the time in effect for such series of preferred stock immediately upon: (i) the date, or the occurrence of an event, specified by vote or written consent or agreement of the requisite investors; or (ii) the closing of the sale of shares of common stock to the public, at a price of at least $50.00 per share, as adjusted, in a firm-commitment underwritten public offering pursuant to an effective registration statement under the Securities Act of 1933, as amended, resulting in at least $50.0 million of net proceeds to the Company. As noted above, on August 10, 2020, all shares of Series A, Series B, Series C and Series D convertible preferred stock were converted into common stock.

Stockholders_ Equity (Deficit)

Stockholders’ Equity (Deficit)	9 Months Ended
	Sep. 30, 2020
Equity [Abstract]
Stockholders’ Equity (Deficit)	Note 15—Stockholders’ Equity (Deficit) 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 underwriters’ exercise in full 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. The Company received gross proceeds of $182.6 million from the IPO. Net of underwriting discounts and commission and other offering expenses, the Company received net proceeds of $166.3 million from the IPO. On August 10, 2020, in connection with the closing of the IPO, 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. 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. During the nine months ended September 30, 2020 and 2019, stock options to acquire 92,223 and 15,921 shares, respectively, were exercised for shares of common stock. The Company received approximately $0.4 million and $0.1 million for the exercise price of the stock options for the nine months ended September 30, 2020 and 2019, respectively.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Compensation	Note 16—Stock-Based Compensation 2020 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 5, 2020. As of September 30, 2020, 2,191,600 shares of common stock were authorized for issuance under the 2020 Plan and 1,101,996 shares remain available for issuance under the 2020 Plan. 2011 Equity Incentive Plan The Company’s 2011 Equity Incentive Plan (the “2011 Plan”) permits the granting of incentive stock options, non-statutory stock options, restricted stock, restricted stock units and other stock-based awards to employees, directors, officers and consultants. As of September 30, 2020, 2,823,333 shares of common stock were authorized for issuance under the 2011 Plan and no shares remain available for issuance under the 2011 Plan. No additional awards will be granted under the 2011 Plan. Shares that become available for issuance from the outstanding awards under the 2011 Plan due to forfeiture, or otherwise, will become available for issuance of future awards under the 2020 Plan. Stock Options The stock options generally vest over four years and have a ten-year contractual term. The fair value of each employee and non-employee stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The Company became publicly traded in August 2020 and lacks company-specific historical and implied volatility information. Therefore, it estimates its expected stock volatility based on the historical volatility of a set of publicly traded peer companies. Due to the lack of historical exercise history, the expected term of the Company’s stock options has been determined using the “simplified” method for awards. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is zero based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future. The following assumptions were used to estimate the fair value of stock option for the nine months ended September 30, 2020 and 2019: Nine Months Ended September 30, 2020 2019 (unaudited) Risk-free interest rate 0.4% - 0.9% 1.6% - 2.1% Expected dividend yield — — Expected term in years 7.0 6.4 - 10.0 Expected volatility 70% - 80% 80% The following table summarizes stock option activity during the nine months ended September 30, 2020: Stock Options Weighted Average Exercise Price Weighted Average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding as of December 31, 2019 2,041,205 $ 9.52 7.7 $ 7,857 Options granted 1,746,415 16.69 Option exercised (139,597 ) 7.24 Options forfeited (231,678 ) 11.91 Outstanding as of September 30, 2020 (unaudited) 3,416,345 $ 13.12 8.2 $ 57,110 Options vested and exercisable as of September 30, 2020 (unaudited) 1,310,459 $ 9.22 6.5 $ 26,974 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 September 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 nine months ended September 30, 2020 was $11.49. As of September 30, 2020, the total unrecognized compensation related to unvested stock option awards granted was $29.1 million, which the Company expects to recognize over a weighted average period of approximately 3.0 years. Performance-Based Restricted Stock Units and 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 was dependent upon the satisfaction of both a service condition and a performance condition, which is an IPO or a change of control. The Company began recording compensation expense related to the PSUs upon the declaration of the Company’s IPO becoming effective on August 5, 2020, as the performance conditions were satisfied. The compensation expense was determined using the original grant date fair value and is being recognized over the remaining service period. The Company’s PSU and RSU activity for the nine months ended September 30, 2020 was as follows: Number of Shares Weighted Average Grant Price Unvested as of December 31, 2019 567,509 $ 13.37 Granted 215,846 18.35 Forfeited (1,388 ) 18.00 Vested (285,375 ) 13.37 Unvested as of September 30, 2020 (unaudited) 496,592 $ 15.52 Restricted Stock The Company’s RSA activity for the nine months ended September 30, 2020 was as follows: Number of Shares Weighted Average Grant Price Unvested as of December 31, 2019 — $ — Granted 32,921 16.55 Vested (32,921 ) 16.55 Unvested as of September 30, 2020 (unaudited) — $ — The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) Cost of products sold $ 126 $ 56 $ 292 $ 162 Research and development 319 179 697 471 Selling, general and administrative 5,929 577 8,283 1,541 Total stock-based compensation $ 6,374 $ 812 $ 9,272 $ 2,174 Employee Stock Purchase Plan 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. As of September 30, 2020, there were no purchase of shares under the 2020 ESPP.

Net Loss Per Common Share

Net Loss Per Common Share	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Net Loss Per Common Share	Note 17—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: Nine Months Ended September 30, Shares issuable upon: 2020 2019 Conversion of Series A Preferred Stock — 391,210 Conversion of Series B Preferred Stock — 3,088,444 Conversion of Series C Preferred Stock — 4,499,921 Conversion of Series D Preferred Stock — 6,418,437 Exercise of stock options 3,416,345 1,751,616 Exercise of common stock warrants 956,552 509,562 Exercise of preferred stock warrants — 446,990 Vesting of PSUs and RSUs 496,592 — Total 4,869,489 17,106,180 For the nine months ended September 30, 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	9 Months Ended
	Sep. 30, 2020
Compensation And Retirement Disclosure [Abstract]
401(k) Retirement Plan	Note 18—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 nine months ended September 30, 2020 and 2019.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2020
Related Party Transactions [Abstract]
Related Party Transactions	Note 19—Related Party Transactions The Company licenses certain patent rights from a former 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 prior to the director’s resignation were $22,000 and $10,000 for the three months ended September 30, 2020 and 2019, respectively, and $61,000 and $32,000 for the nine months ended September 30, 2020 and 2019, respectively. Additionally, the former director and shareholder also works for one of the Company’s customers and can significantly influence the customer to purchase the Company’s product. Prior to the director’s resignation, the Company recorded sales to this customer of $8,000 and $50,000 for the three months ended September 30, 2020 and 2019, respectively, and $0.5 million and $0.2 million for the nine months ended September 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 $55,000 and $81,000 for the three months ended September 30, 2020 and 2019, respectively, and $0.1 million and $0.2 million for the nine months ended September 30, 2020 and 2019, respectively, in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services. With the completion of the IPO, the performance condition was satisfied for certain performance stock units granted to the director and chairman of the Company’s board of directors. The Company recorded $4.0 million of stock-based compensation expense for these awards for the three and nine months ended September 30, 2020 in SG&A expense in the condensed consolidated statements of operations and comprehensive loss. The Company had a consulting agreement with an officer of the Company in the prior year. The Company recorded $93,000 for the three months ended September 30, 2019, and $0.3 million for the nine months ended September 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 $0.2 million and $0.4 million for the three and nine months ended September 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 September 30, 2020. The Company recorded $1.4 million and $1.4 million for the three months ended September 30, 2020 and 2019, respectively, and $4.1 million and $2.1 million for the nine months ended September 30, 2020 and 2019, respectively, in interest expense related to these debt agreements.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 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 and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.
Principles of Consolidation	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 September 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, cash equivalents and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statements of cash flows (in thousands): September 30, December 31, 2020 2019 (unaudited) Cash and cash equivalents $ 58,302 $ 9,452 Restricted cash 150 150 Total cash, cash equivalents and restricted cash $ 58,452 $ 9,602
Marketable Securities	Marketable Securities The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets. Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ equity (deficit) until their disposition or maturity. See “Fair Value Measurements” below. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method. Marketable securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ 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 nine-month periods ended September 30, 2020 and 2019.
Concentrations of Credit Risk and Off-Balance Sheet Risk	Concentrations of Credit Risk and Off-Balance Sheet Risk Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions, which, at times may exceed the 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 places its medical diagnostic equipment, AcQMap System, at customer sites under loan agreements and generates revenue from disposable products used with the AcQMap System. Disposable products include AcQMap Catheters and AcQGuide Steerable Sheaths. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company also sells the AcQMap System to customers along with software updates on a when-and-if-available basis and equipment service. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation. During the three months ended September 30, 2020, the Company entered into deferred equipment agreements that are generally structured such that the Company agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two to four years. The Company determined that the deferred equipment agreements include embedded sales-type leases. The Company allocates contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and non-lease components at contract inception. The Company expenses the cost of the device at the inception of the agreement and records a financial lease asset equal to the gross consideration allocated to the lease. The lease asset will be reduced by payments for minimum disposable purchases that are allocated to the lease. The following table sets forth the Company’s revenue for disposables and systems/service for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) Disposables $ 2,179 $ 643 $ 4,358 $ 2,155 Systems 965 — 1,485 — Service/Other 29 3 47 12 Total $ 3,173 $ 646 $ 5,890 $ 2,167 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 September 30, 2020 and December 31, 2019. In May 2020, the Company entered into bi-lateral distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the “Bi-Lateral Distribution Agreements”). Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non- exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a coexclusive right to distribute these products in Hong Kong. Each party will pay to the other party specified transfer prices on the sale of the other party’s products and, accordingly, will earn a distribution margin on the sale of the other party’s products. The following table provides revenue by geographic location for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) United States $ 1,867 $ 147 $ 3,195 $ 603 Europe 1,306 499 2,695 1,564 Total Revenue $ 3,173 $ 646 $ 5,890 $ 2,167
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 basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $37,000 and $0.3 million, for the three months ended September 30, 2020 and 2019, respectively, and $0.1 million and $0.5 million, for the nine months ended September 30, 2020 and 2019, respectively.
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 September 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 technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired in-process technology was classified as an indefinite-lived intangible asset, until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was classified as a finite-lived intangible and amortization for in-process technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite -
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 nine months ended September 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 income (loss) in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive loss.
Lessee Leases	Lessee Leases Effective January 1, 2019, the Company accounts for its lessee leases under ASC 842, Leases In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election.
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 rights and equipment (the “Biotronik Asset Acquisition”). Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials.
Selling, General and Administrative	Selling, General and Administrative 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 nine months ended September 30, 2020 and 2019. As of September 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 September 30, 2020 and December 31, 2019 (in thousands): Fair Value Measured at September 30, 2020 (unaudited) Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Fair Value at September 30, 2020 Assets included in: Cash and cash equivalents Money market securities $ 53,063 $ — $ — $ 53,063 Marketable securities at fair value Corporate debt securities — 31,455 — 31,455 U.S. treasury securities — 14,361 — 14,361 Commercial paper — 53,926 — 53,926 Asset-backed securities — 8,789 — 8,789 Total fair value $ 53,063 $ 108,531 $ — $ 161,594 Liabilities included in: Contingent consideration $ — $ — $ 7,600 $ 7,600 Total fair value $ — $ — $ 7,600 $ 7,600 Fair Value Measured at December 31, 2019 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Fair Value at December 31, 2019 Assets included in: Cash and cash equivalents Money market securities $ 8,901 $ — $ — $ 8,901 Marketable securities at fair value Corporate debt securities — 28,224 — 28,224 Asset-backed securities — 17,121 — 17,121 U.S. treasury securities — 5,032 — 5,032 Commercial paper — 11,974 — 11,974 Total fair value $ 8,901 $ 62,351 $ — $ 71,252 Liabilities included in: Contingent consideration $ — $ — $ 13,900 $ 13,900 Common and preferred stock warrant liability — — 8,919 8,919 Total fair value $ — $ — $ 22,819 $ 22,819 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 marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets or liabilities, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments or debt, broker and dealer quotes, as well as other relevant economic measures. The following table presents changes in Level 3 liabilities measured at fair value for the nine months ended September 30, 2020 (in thousands): Common and Preferred Stock Warrant Liability Contingent Consideration Total Balance, December 31, 2019 $ 8,919 $ 13,900 $ 22,819 Payment of contingent consideration — (2,636 ) (2,636 ) Issuance of preferred stock for contingent consideration — (2,197 ) (2,197 ) Reclassification of warrant liability to stockholders' equity (14,474 ) — (14,474 ) Change in fair value 5,555 (1,466 ) 4,089 Balance, September 30, 2020 (unaudited) $ — $ 7,600 $ 7,600 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 has been estimated using a Monte Carlo simulation in the first quarter of 2019 and as an output of the Hybrid Method for the second and third quarter of 2019 and the first and second quarter of 2020. The underlying equity included in the Monte Carlo simulation and the Hybrid Method was determined based on the equity value implied from the preferred stock transactions and from examination of income and market approaches for measurement dates in which a preferred transaction was not applicable. Additionally, the expected IPO value was considered in the determination of the equity value. The fair value of the warrants was impacted by the model selected as well as assumptions surrounding unobservable inputs including the underlying equity value, risk-free interest rate, expected dividend yield, contractual term and expected volatility. On August 10, 2020 when the warrants were converted and became equity classified warrants, the fair value of the common and preferred stock warrant liability was estimated using a Black-Scholes model. The underlying equity included in the Black-Scholes model was based on the IPO share price of $18.00. The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the common and preferred stock warrant liability as of August 10, 2020 (date of conversion to equity classified warrants) and December 31, 2019 were as follows: August 10, December 31, 2020 2019 (unaudited) Risk-free interest rate 0.39% 1.59% - 1.60% Expected dividend yield — — Contractual term in years 7.8 - 8.8 0.7 - 1.0 Expected volatility 65.0% 60.0% - 110.5% The fair value of the contingent consideration from the acquisition of Rhythm Xience represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective earn-out period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales or earnings; (iii) risk-free 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 September 30, 2020 and December 31, 2019 were as follows: September 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 20.4% 11.8%
Stock-Based Compensation	Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock awards (“RSAs”), restricted stock units (“RSUs”) and restricted stock units with non-market performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs, RSUs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSAs and RSUs over the requisite service period. As the PSUs have a performance condition, compensation expense was recognized for each vesting tranche over the respective requisite service period of each tranche upon the IPO closing on August 10, 2020, when the Company’s management deemed it probable that the performance conditions were satisfied. The Company recognized a cumulative true-up adjustment related to PSUs once the conditions became probable of being satisfied as the related service period had been completed in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive loss based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See “Note 16—Stock-Based Compensation” below.
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 will 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 accounted for certain common stock warrants and convertible preferred stock warrants outstanding as a liability, in accordance with ASC 815, Derivatives and Hedging
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) In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes 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

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Summary of Cash and Cash Equivalents and Restricted Cash	The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statements of cash flows (in thousands): September 30, December 31, 2020 2019 (unaudited) Cash and cash equivalents $ 58,302 $ 9,452 Restricted cash 150 150 Total cash, cash equivalents and restricted cash $ 58,452 $ 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 nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) Disposables $ 2,179 $ 643 $ 4,358 $ 2,155 Systems 965 — 1,485 — Service/Other 29 3 47 12 Total $ 3,173 $ 646 $ 5,890 $ 2,167
Summary of Revenue from External Customers by Geographic Areas	The following table provides revenue by geographic location for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) United States $ 1,867 $ 147 $ 3,195 $ 603 Europe 1,306 499 2,695 1,564 Total Revenue $ 3,173 $ 646 $ 5,890 $ 2,167
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 September 30, 2020 and December 31, 2019 (in thousands): Fair Value Measured at September 30, 2020 (unaudited) Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Fair Value at September 30, 2020 Assets included in: Cash and cash equivalents Money market securities $ 53,063 $ — $ — $ 53,063 Marketable securities at fair value Corporate debt securities — 31,455 — 31,455 U.S. treasury securities — 14,361 — 14,361 Commercial paper — 53,926 — 53,926 Asset-backed securities — 8,789 — 8,789 Total fair value $ 53,063 $ 108,531 $ — $ 161,594 Liabilities included in: Contingent consideration $ — $ — $ 7,600 $ 7,600 Total fair value $ — $ — $ 7,600 $ 7,600 Fair Value Measured at December 31, 2019 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Fair Value at December 31, 2019 Assets included in: Cash and cash equivalents Money market securities $ 8,901 $ — $ — $ 8,901 Marketable securities at fair value Corporate debt securities — 28,224 — 28,224 Asset-backed securities — 17,121 — 17,121 U.S. treasury securities — 5,032 — 5,032 Commercial paper — 11,974 — 11,974 Total fair value $ 8,901 $ 62,351 $ — $ 71,252 Liabilities included in: Contingent consideration $ — $ — $ 13,900 $ 13,900 Common and preferred stock warrant liability — — 8,919 8,919 Total fair value $ — $ — $ 22,819 $ 22,819
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 nine months ended September 30, 2020 (in thousands): Common and Preferred Stock Warrant Liability Contingent Consideration Total Balance, December 31, 2019 $ 8,919 $ 13,900 $ 22,819 Payment of contingent consideration — (2,636 ) (2,636 ) Issuance of preferred stock for contingent consideration — (2,197 ) (2,197 ) Reclassification of warrant liability to stockholders' equity (14,474 ) — (14,474 ) Change in fair value 5,555 (1,466 ) 4,089 Balance, September 30, 2020 (unaudited) $ — $ 7,600 $ 7,600
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 liability as of August 10, 2020 (date of conversion to equity classified warrants) and December 31, 2019 were as follows: August 10, December 31, 2020 2019 (unaudited) Risk-free interest rate 0.39% 1.59% - 1.60% Expected dividend yield — — Contractual term in years 7.8 - 8.8 0.7 - 1.0 Expected volatility 65.0% 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 September 30, 2020 and December 31, 2019 were as follows: September 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 20.4% 11.8%

Asset Acquisition and Busines_2

Asset Acquisition and Business Combination (Tables)	9 Months Ended
	Sep. 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)	9 Months Ended
	Sep. 30, 2020
Available For Sale Securities Fair Value To Amortized Cost Basis [Abstract]
Summary of Marketable Securities	Marketable securities consisted of the following as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 (unaudited) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Available-for-sale securities - short-term: Corporate debt securities $ 31,459 $ — $ (4 ) $ 31,455 U.S. treasury securities 14,362 — (1 ) 14,361 Commercial paper 53,926 — — 53,926 Total available-for-sale securities - short-term 99,747 — (5 ) 99,742 Asset-backed securities, long-term 8,789 — 8,789 Total available-for-sale securities $ 108,536 $ — $ (5 ) $ 108,531 December 31, 2019 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Available-for-sale securities - short-term: Corporate debt securities $ 28,204 $ 20 $ — $ 28,224 Asset-backed securities 17,108 13 — 17,121 U.S. treasury securities 5,020 12 — 5,032 Commercial paper 11,974 — — 11,974 Total available-for-sale securities $ 62,306 $ 45 $ — $ 62,351

Inventory (Tables)

Inventory (Tables)	9 Months Ended
	Sep. 30, 2020
Inventory Disclosure [Abstract]
Summary of Inventory	Inventory as of September 30, 2020 and December 31, 2019 consisted of the following (in thousands): September 30, December 31, 2020 2019 (unaudited) Raw materials $ 5,980 $ 5,492 Work in process 864 1,605 Finished goods 4,088 1,327 Total inventory $ 10,932 $ 8,424

Lessor Sales-Type Leases (Table

Lessor Sales-Type Leases (Tables)	9 Months Ended
	Sep. 30, 2020
Leases [Abstract]
Estimated Future Maturities of Customer Sales-Type Lease Receivables	As of September 30, 2020, estimated future maturities of customer sales-type lease receivables for each of the following years are as follows (in thousands): Three months ending December 31, 2020 $ 68 Year ending December 31, 2021 273 Year ending December 31, 2022 254 Year ending December 31, 2023 46 Year ending December 31, 2024 27 Lease receivable $ 668

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	9 Months Ended
	Sep. 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 September 30, 2020 and December 31, 2019 (in thousands): September 30, December 31, 2020 2019 (unaudited) Medical diagnostic equipment $ 10,155 $ 5,492 Furniture and fixtures 388 159 Office equipment 1,391 1,321 Laboratory equipment and software 3,409 2,807 Leasehold improvements 600 507 Construction in process 141 306 Total property and equipment 16,084 10,592 Less: accumulated depreciation (6,144 ) (6,165 ) Property and equipment, net $ 9,940 $ 4,427

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 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 September 30, 2020 and December 31, 2019 (in thousands): Goodwill Intangible Assets Balance at December 31, 2019 $ 12,026 $ 4,110 Amortization expense — (330 ) Balance at September 30, 2020 (unaudited) $ 12,026 $ 3,780
Summary of Finite and Indefinite Lived Intangible Assets	Estimated Useful Weighted Average Remaining Life (in years) Life (in years) Intangible Assets Accumulated Amortization September 30, 2020 (unaudited) Developed technology 10 8.8 $ 4,200 $ (495 ) $ 3,705 Trademarks and trade names 0.5 — 60 (60 ) — Customer-related intangible 5 3.75 100 (25 ) 75 Total $ 4,360 $ (580 ) $ 3,780 Estimated Useful Weighted Average Remaining Life (in years) Life (in years) Intangible Assets Accumulated Amortization December 31, 2019 Developed technology 10 9.5 $ 3,600 $ (180 ) $ 3,420 In-process technology indefinite 600 — 600 Trademarks and trade names 0.5 — 60 (60 ) — Customer-related intangible 5 4.5 100 (10 ) 90 Total $ 4,360 $ (250 ) $ 4,110
Summary Of Remaining Amortization Expense	The following table shows the remaining amortization expense associated with amortizable intangible assets as of September 30, 2020 (in thousands): Developed Technology Customer- Related Intangible Total Amortization Three months ending December 31, 2020 $ 105 $ 5 $ 110 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 $ 3,705 $ 75 $ 3,780

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)	9 Months Ended
	Sep. 30, 2020
Payables And Accruals [Abstract]
Summary Of Accrued Liabilities	Error extracting Word content

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2020
Debt Instruments [Abstract]
Summary Of Outstanding Debt	Outstanding debt as of September 30, 2020 and December 31, 2019 consisted of the following (in thousands): September 30, December 31, 2020 2019 (unaudited) 2019 Credit Agreement (1) $ 44,550 $ 44,550 Total debt, gross 44,550 44,550 Less: Unamortized debt discount and fees (5,788 ) (6,306 ) Total long-term debt $ 38,762 $ 38,244 (1) The 2019 Credit Agreement includes final payment fees of $4.6 million.

Operating Leases (Tables)

Operating Leases (Tables)	9 Months Ended
	Sep. 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 nine months ended September 30, 2020 and 2019 (dollars in thousands): Nine Months Ended September 30, 2020 2019 (unaudited) Operating cash flows from operating leases $ 760 $ 725 Right-of-use assets exchanged for operating lease liabilities $ — $ 2,978 Weighted average remaining lease term – operating leases (in years) 1.7 2.2 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 September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) Operating leases Operating lease cost $ 216 $ 216 $ 648 $ 648 Variable lease cost 73 65 238 169 Total rent expense $ 289 $ 281 $ 886 $ 817
Summary Of Future Minimum Payments Under The Non-cancelable Operating Leases	As of September 30, 2020, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands): Three months ending December 31, 2020 $ 253 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 2,473 Less: present value discount (201 ) Operating lease liabilities $ 2,272

Warrants (Tables)

Warrants (Tables)	9 Months Ended
	Sep. 30, 2020
Warrants And Rights Note Disclosure [Abstract]
Schedule of Outstanding Warrants to Purchase the Company's Common Stock	As of September 30, 2020 and December 31, 2019, the outstanding warrants to purchase the Company’s common stock were comprised of the following: Equity Upon Exercise September 30, December 31, (After Conversion) Exercise Price Expiration Date 2020 2019 (unaudited) Warrants issued in 2015 Common Stock $ 5.25 1/30/25 7,616 7,616 Warrants issued with 2018 Convertible Notes Common Stock $ 0.10 6/7/28 501,946 501,946 Warrants issued with 2018 Term Loan Common Stock $ 16.67 7/31/28 26,998 26,998 Warrants issued with 2019 Credit Agreement Common Stock $ 16.67 5/20/29 419,992 419,992 Total Warrants 956,552 956,552

Convertible Preferred Stock (Ta

Convertible Preferred Stock (Tables)	9 Months Ended
	Sep. 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 the original issue price applicable to such series as follows: Series Conversion Price Series A convertible preferred stock $ 8.295 Series B convertible preferred stock $ 13.370 Series C convertible preferred stock $ 16.667 Series D convertible preferred stock $ 16.667

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [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 nine months ended September 30, 2020 and 2019: Nine Months Ended September 30, 2020 2019 (unaudited) Risk-free interest rate 0.4% - 0.9% 1.6% - 2.1% Expected dividend yield — — Expected term in years 7.0 6.4 - 10.0 Expected volatility 70% - 80% 80%
Summary of Stock Option Activity	The following table summarizes stock option activity during the nine months ended September 30, 2020: Stock Options Weighted Average Exercise Price Weighted Average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding as of December 31, 2019 2,041,205 $ 9.52 7.7 $ 7,857 Options granted 1,746,415 16.69 Option exercised (139,597 ) 7.24 Options forfeited (231,678 ) 11.91 Outstanding as of September 30, 2020 (unaudited) 3,416,345 $ 13.12 8.2 $ 57,110 Options vested and exercisable as of September 30, 2020 (unaudited) 1,310,459 $ 9.22 6.5 $ 26,974
Schedule of PSU and RSA Activity	The Company’s PSU and RSU activity for the nine months ended September 30, 2020 was as follows: Number of Shares Weighted Average Grant Price Unvested as of December 31, 2019 567,509 $ 13.37 Granted 215,846 18.35 Forfeited (1,388 ) 18.00 Vested (285,375 ) 13.37 Unvested as of September 30, 2020 (unaudited) 496,592 $ 15.52
Schedule of RSA Activity	The Company’s RSA activity for the nine months ended September 30, 2020 was as follows: Number of Shares Weighted Average Grant Price Unvested as of December 31, 2019 — $ — Granted 32,921 16.55 Vested (32,921 ) 16.55 Unvested as of September 30, 2020 (unaudited) — $ —
Summary of the Total Stock-Based Compensation Expense for the Stock Options, PSUs 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, PSUs, RSUs and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 (unaudited) (unaudited) Cost of products sold $ 126 $ 56 $ 292 $ 162 Research and development 319 179 697 471 Selling, general and administrative 5,929 577 8,283 1,541 Total stock-based compensation $ 6,374 $ 812 $ 9,272 $ 2,174

Net Loss Per Common Share (Tabl

Net Loss Per Common Share (Tables)	9 Months Ended
	Sep. 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: Nine Months Ended September 30, Shares issuable upon: 2020 2019 Conversion of Series A Preferred Stock — 391,210 Conversion of Series B Preferred Stock — 3,088,444 Conversion of Series C Preferred Stock — 4,499,921 Conversion of Series D Preferred Stock — 6,418,437 Exercise of stock options 3,416,345 1,751,616 Exercise of common stock warrants 956,552 509,562 Exercise of preferred stock warrants — 446,990 Vesting of PSUs and RSUs 496,592 — Total 4,869,489 17,106,180

Organization and Description _2

Organization and Description of Business - Additional Information (Detail) $ / shares in Units, $ in Thousands	Aug. 10, 2020USD ($)$ / sharesshares	Jul. 28, 2020	Sep. 30, 2020USD ($)shares	Dec. 31, 2019USD ($)shares
Date of incorporation			Mar. 25, 2011
Reverse stock split			common stock and convertible preferred stock on a 9.724-for-one basis
Reverse stock split ratio		9.724
Share price | $ / shares	$ 18
Proceeds from issuance of common stock upon IPO, net of issuance costs | $	$ 166,300		$ 166,286
Common stock shares outstanding	26,719,993		27,826,408	695,902
Accumulated deficit | $			$ (331,613)	$ (259,034)
Working capital deficit | $			$ 159,500	$ 50,500
Series A Convertible Preferred Stock [Member]
Conversion of stock shares converted	391,210
Series B Convertible Preferred Stock [Member]
Conversion of stock shares converted	3,088,444
Series C Convertible Preferred Stock [Member]
Conversion of stock shares converted	4,499,921
Series D Convertible Preferred Stock [Member]
Shares issued during the period,shares			273,070
Conversion of stock shares converted	8,593,360
Class of warrants number of securities called by the warrants or rights	446,990
Exercise price of each warrant | $ / shares	$ 16.67
IPO [Member]
Shares issued during the period,shares	10,147,058
Proceeds from issuance of common stock upon IPO, net of issuance costs | $	$ 166,300
Over-Allotment Option [Member]
Shares issued during the period,shares	1,323,529
Over-Allotment Option [Member] | Maximum [Member]
Shares issued during the period,shares	1,323,529

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional information (Detail)	3 Months Ended		9 Months Ended
	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)SegmentReportingUnit	Sep. 30, 2019USD ($)	Aug. 10, 2020$ / shares	Dec. 31, 2019USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segment | Segment			1
Other-than-temporary impairments related to marketable securities			$ 0	$ 0
Cash, FDIC insured amount	$ 250,000		250,000
Inventory Write-down	37,000	$ 300,000	100,000	500,000
Allowance for uncollectible accounts	0		$ 0			$ 0
Number of reporting unit | ReportingUnit			1
Impairment of property and equipment or intangible assets	0	$ 0	$ 0	$ 0
Interest or penalties charged in relation to the unrecognized tax benefits	$ 0		$ 0
IPO [Member]
Summary Of Significant Accounting Policies [Line Items]
Share price | $ / shares					$ 18
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Customers payment period			30 days
Property and equipment, estimated useful lives			3 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Customers payment period			60 days
Contracts with customers, expected duration	1 year		1 year
Property and equipment, estimated useful lives			5 years
Deferred Equipment Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Cash, FDIC insured amount			$ 0
Deferred Equipment Agreements [Member] | Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Contract term			2 years
Deferred Equipment Agreements [Member] | Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Contract term			4 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Summary of Cash and Cash Equivalents and Restricted Cash (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019	Sep. 30, 2019	Dec. 31, 2018
Accounting Policies [Abstract]
Cash and cash equivalents	$ 58,302	$ 9,452
Restricted cash	150	150
Total cash, cash equivalents and restricted cash	$ 58,452	$ 9,602	$ 34,345	$ 9,775

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 3,173	$ 646	$ 5,890	$ 2,167
Disposables [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	2,179	643	4,358	2,155
Systems [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	965		1,485
Product and Service, Other [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 29	$ 3	$ 47	$ 12

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Summary of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 3,173	$ 646	$ 5,890	$ 2,167
United States [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	1,867	147	3,195	603
Europe [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 1,306	$ 499	$ 2,695	$ 1,564

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Assets
Total Assets Fair Value	$ 161,594	$ 71,252,000
Liabilities
Total Liabilities Fair Value	7,600	22,819,000
Contingent Consideration [Member]
Liabilities
Total Liabilities Fair Value	7,600	13,900,000
Common and Preferred Stock Warrant Liability [Member]
Liabilities
Total Liabilities Fair Value		8,919,000
Fair Value, Inputs, Level 1 [Member]
Assets
Total Assets Fair Value	53,063	8,901,000
Fair Value, Inputs, Level 2 [Member]
Assets
Total Assets Fair Value	108,531	62,351,000
Fair Value, Inputs, Level 3 [Member]
Liabilities
Total Liabilities Fair Value	7,600	22,819,000
Fair Value, Inputs, Level 3 [Member] | Contingent Consideration [Member]
Liabilities
Total Liabilities Fair Value	7,600	13,900,000
Fair Value, Inputs, Level 3 [Member] | Common and Preferred Stock Warrant Liability [Member]
Liabilities
Total Liabilities Fair Value		8,919,000
Money Market Securities [Member]
Assets
Money market securities	53,063	8,901,000
Money Market Securities [Member] | Fair Value, Inputs, Level 1 [Member]
Assets
Money market securities	53,063	8,901,000
Corporate Debt Securities [Member]
Assets
Marketable securities	31,455	28,224,000
Corporate Debt Securities [Member] | Fair Value, Inputs, Level 2 [Member]
Assets
Marketable securities	31,455	28,224,000
US Treasury Securities [Member]
Assets
Marketable securities	14,361	5,032,000
US Treasury Securities [Member] | Fair Value, Inputs, Level 2 [Member]
Assets
Marketable securities	14,361	5,032,000
Commercial Paper [Member]
Assets
Marketable securities	53,926	11,974,000
Commercial Paper [Member] | Fair Value, Inputs, Level 2 [Member]
Assets
Marketable securities	53,926	11,974,000
Asset-backed Securities [Member]
Assets
Marketable securities	8,789	17,121,000
Asset-backed Securities [Member] | Fair Value, Inputs, Level 2 [Member]
Assets
Marketable securities	$ 8,789	$ 17,121,000

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Reclassification of warrant liability to stockholders' equity	$ 14,474		$ 14,474
Change in fair value of contingent consideration	118	$ 700	(1,466)	$ 700
Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Balance, December 31, 2019			22,819
Payment of contingent consideration			(2,636)
Issuance of preferred stock for contingent consideration			(2,197)
Reclassification of warrant liability to stockholders' equity			(14,474)
Change in fair value of contingent consideration			4,089
Balance, September 30, 2020 (unaudited)	7,600		7,600
Common and Preferred Stock Warrant Liability [Member] | Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Balance, December 31, 2019			8,919
Reclassification of warrant liability to stockholders' equity			(14,474)
Change in fair value of contingent consideration			5,555
Contingent Consideration [Member] | Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Balance, December 31, 2019			13,900
Payment of contingent consideration			(2,636)
Issuance of preferred stock for contingent consideration			(2,197)
Change in fair value of contingent consideration			(1,466)
Balance, September 30, 2020 (unaudited)	$ 7,600		$ 7,600

Summary of Significant Accou_10

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]	Aug. 10, 2020	Dec. 31, 2019
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	0.0039
Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	0.650
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		0.0159
Minimum [Member] | Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	7 years 9 months 18 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		0.600
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		0.0160
Maximum [Member] | Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	8 years 9 months 18 days	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		1.105

Summary of Significant Accou_11

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]	Sep. 30, 2020	Dec. 31, 2019
Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.0020	0.0160
Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.204	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	0.010	0.010
Maximum [Member] | Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.020	0.020

Asset Acquisition and Busines_3

Asset Acquisition and Business Combination - Additional Information (Detail) - USD ($) $ in Thousands	Jun. 18, 2019	Feb. 29, 2020	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Business Acquisition [Line Items]
Research and development expense			$ 8,343	$ 5,865	$ 24,492	$ 15,489
Goodwill			12,026		12,026		$ 12,026
Payments for contingent consideration					2,636
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
Date of business acquisition	Jun. 18, 2019
Goodwill			12,026		12,026
Contingent consideration liability	$ 7,600		13,400		13,400
Payments for contingent consideration					2,600
Business combination contingent consideration liability change in amount			$ 100	$ 700	(1,500)	$ 700
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		$ 2,200

Asset Acquisition and Busines_4

Asset Acquisition and Business Combination - Purchase Price Allocation (Detail) - USD ($) $ in Thousands	Jun. 18, 2019	Sep. 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	$ (7,600)	(13,400)
Cash consideration	$ 3,000	$ 3,000

Marketable Securities - Summary

Marketable Securities - Summary of Marketable Securities (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	$ 108,536	$ 62,306
Gross Unrealized Gains		45
Gross Unrealized Losses	(5)
Fair Value	108,531	62,351
short-term debt [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	99,747
Gross Unrealized Losses	(5)
Fair Value	99,742
Corporate Debt Securities [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	31,459	28,204
Gross Unrealized Gains		20
Gross Unrealized Losses	(4)
Fair Value	31,455	28,224
US Treasury Securities [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	14,362	5,020
Gross Unrealized Gains		12
Gross Unrealized Losses	(1)
Fair Value	14,361	5,032
Commercial Paper [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	53,926	11,974
Fair Value	53,926	11,974
Asset-backed Securities [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost	8,789	17,108
Gross Unrealized Gains		13
Fair Value	$ 8,789	$ 17,121

Marketable Securities - Additio

Marketable Securities - Additional Information (Detail)	Sep. 30, 2020USD ($)
short-term debt [Member]
Schedule Of Available For Sale Securities [Line Items]
Available-for-sale Securities	$ 99,700
Debt securities, available-for-sale, maturity	1 year
Long-term debt [Member]
Schedule Of Available For Sale Securities [Line Items]
Available-for-sale Securities	$ 8,800
Debt securities, available-for-sale, maturity	2 years

Inventory - Summary of Inventor

Inventory - Summary of Inventory (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Inventory Disclosure [Abstract]
Raw materials	$ 5,980	$ 5,492
Work in process	864	1,605
Finished goods	4,088	1,327
Total inventory	$ 10,932	$ 8,424

Lessor Sales-Type Leases - Addi

Lessor Sales-Type Leases - Additional Information (Detail) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Lessor Lease Description [Line Items]
Lease revenue	$ 700,000	$ 0	$ 700,000	$ 0
Sales-type Lease, Income, Comprehensive Income [Extensible List]	us-gaap:RevenueFromContractWithCustomerExcludingAssessedTax		us-gaap:RevenueFromContractWithCustomerExcludingAssessedTax
Lease receivable					$ 0
Prepaid Expenses and Other Current Assets [Member]
Lessor Lease Description [Line Items]
Lease receivable	$ 300,000		$ 300,000
Other Assets [Member]
Lessor Lease Description [Line Items]
Lease receivable	$ 400,000		$ 400,000

Lessor Sales-Type Leases - Esti

Lessor Sales-Type Leases - Estimated Future Maturities of Customer Sales-Type Lease Receivables (Detail) $ in Thousands	Sep. 30, 2020USD ($)
Leases [Abstract]
Three months ending December 31, 2020	$ 68
Year ending December 31, 2021	273
Year ending December 31, 2022	254
Year ending December 31, 2023	46
Year ending December 31, 2024	27
Lease receivable	$ 668

Property and Equipment, Net - S

Property and Equipment, Net - Summary Of Property And Equipment, Net (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 16,084	$ 10,592
Less: accumulated depreciation	(6,144)	(6,165)
Property and equipment, net	9,940	4,427
Medical diagnostic equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	10,155	5,492
Furniture and fixtures [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	388	159
Office equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,391	1,321
Laboratory equipment and software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	3,409	2,807
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	600	507
Construction in process [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 141	$ 306

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Property Plant And Equipment [Abstract]
Depreciation	$ 800	$ 500	$ 1,754	$ 1,676

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Summary Of Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill	$ 12,026		$ 12,026		$ 12,026
Intangible Assets - Balance at December 31, 2019			4,110
Amortization expense	(100)	$ (100)	(330)	$ (125)
Intangible Assets - Balance at September 30, 2020	$ 3,780		$ 3,780

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Summary of Finite and Indefinite Lived Intangible Assets (Detail) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Finite And Indefinite Lived Intangible Assets [Line Items]
Finite Intangible Assets	$ 3,780	$ 4,110
Intangible Assets, Gross	4,360	4,360
Accumulated Amortization	(580)	(250)
Intangible Assets	$ 3,780	4,110
In-process Technology [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Indefinite-lived Intangible Assets, Gross		600
Indefinite-lived Intangible Assets		$ 600
Developed Technology [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Estimated Useful Life (in Years)	10 years	10 years
Weighted Average Remaining Life (in Years)	8 years 9 months 18 days	9 years 6 months
Finite Intangible Assets, Gross	$ 4,200	$ 3,600
Finite Intangible Assets, Accumulated Amortization	(495)	(180)
Finite Intangible Assets	$ 3,705	$ 3,420
Trademarks and Trade Names [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Estimated Useful Life (in Years)	6 months	6 months
Finite Intangible Assets, Gross	$ 60	$ 60
Finite Intangible Assets, Accumulated Amortization	$ (60)	$ (60)
Customer-Related Intangible [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Estimated Useful Life (in Years)	5 years	5 years
Weighted Average Remaining Life (in Years)	3 years 9 months	4 years 6 months
Finite Intangible Assets, Gross	$ 100	$ 100
Finite Intangible Assets, Accumulated Amortization	(25)	(10)
Finite Intangible Assets	$ 75	$ 90

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 100	$ 100	$ 330	$ 125

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Summary of remaining amortization expense associated with amortizable intangible assets (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Finite Lived Intangible Assets [Line Items]
Three months ending December 31, 2020	$ 110
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
Finite Intangible Assets	3,780	$ 4,110
Developed Technology [Member]
Finite Lived Intangible Assets [Line Items]
Three months ending December 31, 2020	105
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
Finite Intangible Assets	3,705	3,420
Customer-Related Intangible [Member]
Finite Lived Intangible Assets [Line Items]
Three months ending December 31, 2020	5
Year ending December 31, 2021	20
Year ending December 31, 2022	20
Year ending December 31, 2023	20
Year ending December 31, 2024	10
Finite Intangible Assets	$ 75	$ 90

Accrued Liabilities - Summary O

Accrued Liabilities - Summary Of Accrued Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Payables And Accruals [Abstract]
Payroll and related expenses	$ 5,083	$ 3,785
Professional fees	290	188
Deferred revenue	290	311
Sales and use tax	140	151
Biotronik Asset Acquisition - accrued purchase price		5,000
Other	697	641
Total accrued liabilities	$ 6,500	$ 10,076

Debt - Summary Of Outstanding D

Debt - Summary Of Outstanding Debt (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 44,550	$ 44,550
Less: Unamortized debt discount and fees	(5,788)	(6,306)
Total long-term debt	38,762	38,244
Two Thousand And Nineteen Convertible Notes [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 44,550	$ 44,550

Debt - Additional Information (

Debt - Additional Information (Detail) - USD ($)	Jun. 12, 2019	May 20, 2019	Sep. 30, 2020	Dec. 31, 2020	Aug. 10, 2020	Jun. 30, 2020	Dec. 31, 2019
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Debt instrument, face amount		$ 37,000,000
Debt instrument, interest rate		13.00%
Long-term debt, date date		Dec. 31, 2019
Minimum qualified equity financing amount	$ 23,000,000
Series D Convertible Preferred Stock [Member]
Debt Instrument [Line Items]
Class of warrants number of securities called by the warrants or rights					446,990
Class of warrants, exercise price					$ 16.67
Series D Convertible Preferred Stock [Member] | 2019 Convertible Notes [Member]
Debt Instrument [Line Items]
Proceeds from issuance of convertible preferred stock, net of issuance costs	$ 37,000,000
Two Thousand And Nineteen Credit Agreement [Member]
Debt Instrument [Line Items]
Debt instrument, fee amount			$ 4,600,000				$ 4,600,000
Debt instrument, interest rate			7.75%
Warrants liability fair value			$ 900,000
Class of warrants number of securities called by the warrants or rights			419,992
Debt instrument, direct fees			$ 1,200,000
Two Thousand And Nineteen Credit Agreement [Member] | Series C Convertible Preferred Stock [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate term			7.75% plus LIBOR
Class of warrants, exercise price			$ 16.67
Two Thousand And Nineteen Credit Agreement [Member] | Series D Convertible Preferred Stock [Member]
Debt Instrument [Line Items]
Class of warrants, exercise price			$ 16.67
Two Thousand And Nineteen Credit Agreement [Member] | Senior Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument, fee amount			$ 4,600,000
Debt instrument, face amount		$ 70,000,000
Proceeds from senior term loan		$ 40,000,000
Long-term debt, date date			May 20, 2024
Debt instrument, Initial debt discount before inception			$ 6,700,000
Two Thousand And Nineteen Credit Agreement [Member] | Senior Term Loan [Member] | Specified Training Revenue Level One [Member]
Debt Instrument [Line Items]
Debt instrument unused borrowing capacity						$ 10,000,000
Two Thousand And Nineteen Credit Agreement [Member] | Senior Term Loan [Member] | Specified Training Revenue Level Two [Member]
Debt Instrument [Line Items]
Debt instrument unused borrowing capacity				$ 20,000,000
Default Event [Member] | Senior Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate, increase (decrease)			10.00%

Operating Leases - Additional I

Operating Leases - Additional Information (Detail)	9 Months Ended
	Sep. 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	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Lessee Disclosure [Abstract]
Operating cash flows from operating leases	$ 760	$ 725
Right-of-use assets exchanged for operating lease liabilities		$ 2,978
Weighted average remaining lease term – operating leases (in years)	1 year 8 months 12 days	2 years 2 months 12 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		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Operating leases
Operating lease cost	$ 216	$ 216	$ 648	$ 648
Variable lease cost	73	65	238	169
Total rent expense	$ 289	$ 281	$ 886	$ 817

Operating Leases - Summary Of F

Operating Leases - Summary Of Future Minimum Payments Under The Non-Cancelable Operating Leases (Detail) $ in Thousands	Sep. 30, 2020USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
Three months ending December 31, 2020	$ 253
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	2,473
Less: present value discount	(201)
Operating lease liabilities	$ 2,272

Warrants - Schedule of Outstand

Warrants - Schedule of Outstanding Warrants to Purchase the Company's Common Stock (Detail) - $ / shares	9 Months Ended
	Sep. 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
Common Stock [Member] | Warrants Issued in 2015 [Member]
Class of Warrant or Right [Line Items]
Equity Upon Exercise (After Conversion)	Common Stock
Exercise Price	$ 5.25
Expiration Date	Jan. 30, 2025
Class of Warrant or Right, Outstanding	7,616	7,616
Common Stock [Member] | Warrants Issued with 2018 Convertible Notes [Member]
Class of Warrant or Right [Line Items]
Equity Upon Exercise (After Conversion)	Common Stock
Exercise Price	$ 0.10		$ 0.10
Expiration Date	Jun. 7, 2028
Class of Warrant or Right, Outstanding	501,946	501,946
Common Stock [Member] | Warrants Issued with 2018 Term Loan [Member]
Class of Warrant or Right [Line Items]
Equity Upon Exercise (After Conversion)	Common Stock
Exercise Price	$ 16.67
Expiration Date	Jul. 31, 2028
Class of Warrant or Right, Outstanding	26,998	26,998
Common Stock [Member] | Warrants Issued with 2019 Credit Agreement [Member]
Class of Warrant or Right [Line Items]
Equity Upon Exercise (After Conversion)	Common Stock
Exercise Price	$ 16.67
Expiration Date	May 20, 2029
Class of Warrant or Right, Outstanding	419,992	419,992

Warrants - Additional Informati

Warrants - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2020	Aug. 10, 2020	Dec. 31, 2019	Dec. 31, 2018
Class of Warrant or Right [Line Items]
Weighted average remaining contractual life of warrants	7 years 8 months 12 days
Common and preferred stock warrant liability			$ 8,919
ASC 815 [Member]
Class of Warrant or Right [Line Items]
Common and preferred stock warrant liability		$ 14,500
Series D Convertible Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Class of warrants number of securities called by the warrants or rights		446,990
Exercise price of each warrant		$ 16.67
Warrants Issued with 2019 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
Exercise price of each warrant			$ 16.67
Warrants Issued with 2019 Credit Agreement [Member] | Common Stock [Member]
Class of Warrant or Right [Line Items]
Exercise price of each warrant	$ 16.67
Warrants Issued with 2018 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
Exercise price of each warrant	0.10			$ 0.10
Common and preferred stock warrant liabilities, Fair value inputs				10 years
Warrants Issued with 2018 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
Exercise price of each warrant				$ 16.67
Warrants Issued with 2018 Term Loan [Member] | Common Stock [Member]
Class of Warrant or Right [Line Items]
Exercise price of each warrant	$ 16.67

Convertible Preferred Stock - A

Convertible Preferred Stock - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	Aug. 10, 2020	Feb. 29, 2020	Sep. 30, 2020
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] | Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity [Member] | Minimum [Member]
Temporary Equity [Line Items]
Sale of stock consideration received			$ 50
Series A Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Conversion of stock shares converted	391,210
Series B Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Conversion of stock shares converted	3,088,444
Series C Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Conversion of stock shares converted	4,499,921
Series D Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Conversion of stock shares converted	8,593,360
Redeemable Convertible Series A Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared			$ 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
Redeemable Convertible Series C Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared			$ 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)	Sep. 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' Equity (Deficit)

Stockholders' Equity (Deficit) - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Aug. 10, 2020	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Class of Stock [Line Items]
Net proceeds from IPO	$ 166,300			$ 166,286
Common stock shares authorized	260,000,000	260,000,000		260,000,000		260,000,000
Temporary equity shares authorized	5,000,000
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				$ 350	$ 76
Common Stock [Member]
Class of Stock [Line Items]
Stock options shares exercised during the period		27,661	7,452	92,223	15,921
Amended and Restated Certificate of Incorporation [Member]
Class of Stock [Line Items]
Common stock shares authorized						220,000,000
Common stock par or stated value per share						$ 0.001
IPO [Member]
Class of Stock [Line Items]
Shares issued during the period,shares	10,147,058
Gross proceeds from IPO	$ 182,600
Net proceeds from IPO	$ 166,300
Over-Allotment Option [Member]
Class of Stock [Line Items]
Shares issued during the period,shares	1,323,529
IPO And Over Allotment [Member]
Class of Stock [Line Items]
Stock issue share price per unit	$ 18

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	9 Months Ended
	Jun. 30, 2019	Sep. 30, 2020	Aug. 10, 2020
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		$ 11.49
Unrecognized compensation related to stock options not vested		$ 29.1
Share based compensation non vested award period for recognition		3 years
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	215,846
Share based compensation by share based payment arrangement instruments other than options granted weighted average grant date fair value	$ 13.37	$ 18.35
2020 Equity Incentive Plan [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance		2,191,600
Share based payment arrangement number of shares available for issuance		1,101,996
2011 Plan [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance		2,823,333
Share based payment arrangement number of shares available for issuance		0
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
2020 ESPP [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance			387,063
Share based payment arrangement, shares purchased		0

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Estimate of the Fair Value of Stock Option (Detail)	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Schedule Of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Risk-free interest rate, minimum	0.40%	1.60%
Risk-free interest rate, maximum	0.90%	2.10%
Expected term in years	7 years
Expected volatility		80.00%
Expected volatility, minimum	70.00%
Expected volatility, maximum	80.00%
Minimum [Member]
Schedule Of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Expected term in years		6 years 4 months 24 days
Maximum [Member]
Schedule Of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Expected term in years		10 years

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock Option Activity (Detail) - Stock Option [Member] $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 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	1,746,415
Option exercised | shares	(139,597)
Options forfeited | shares	(231,678)
Stock options outstanding as of September 30, 2020 (unaudited) | shares	3,416,345	2,041,205
Options vested and exercisable as of September 30, 2020 (unaudited) | shares	1,310,459
Weighted average exercise price outstanding as of December 31, 2019 | $ / shares	$ 9.52
Options granted | $ / shares	16.69
Option exercised | $ / shares	7.24
Options forfeited | $ / shares	11.91
Weighted average exercise price outstanding as of September 30, 2020 | $ / shares	13.12	$ 9.52
Weighted average exercise price of options vested and exercisable as of September 30, 2020 (unaudited) | $ / shares	$ 9.22
Weighted average remaining contractual life outstanding	8 years 2 months 12 days	7 years 8 months 12 days
Weighted average remaining contractual life of options vested and exercisable as of September 30, 2020 (unaudited)	6 years 6 months
Aggregate intrinsic value outstanding | $	$ 57,110	$ 7,857
Aggregate intrinsic value options vested and exercisable as of September 30, 2020 (unaudited) | $	$ 26,974

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of PSU and RSA Activity (Detail) - Performance Based Restricted Stock Units [Member] - $ / shares	1 Months Ended	9 Months Ended
	Jun. 30, 2019	Sep. 30, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares Unvested as of December 31, 2019		567,509
Granted	567,509	215,846
Forfeited		(1,388)
Vested		(285,375)
Number of shares Unvested as of September 30, 2020 (unaudited)		496,592
Weighted Average Grant Price Unvested as of December 31, 2019		$ 13.37
Granted	$ 13.37	18.35
Forfeited		18
Vested		13.37
Weighted Average Grant Price Unvested as of September 30, 2020 (unaudited)		$ 15.52

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of RSA Activity (Detail) - Restricted Stock [Member]	9 Months Ended
	Sep. 30, 2020$ / sharesshares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Granted of shares | shares	32,921
Vested of shares | shares	(32,921)
Granted of weighted average grant price | $ / shares	$ 16.55
Vested of weighted average grant price | $ / shares	$ 16.55

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of the Total Stock-Based Compensation Expense for the Stock Options, PSUs and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 6,374	$ 812	$ 9,272	$ 2,174
Cost of Sales [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	126	56	292	162
Research and Development Expense [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	319	179	697	471
Selling, General and Administrative Expenses [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 5,929	$ 577	$ 8,283	$ 1,541

Net Loss Per Common Share - Sum

Net Loss Per Common Share - Summary of Calculation of the Diluted Net Loss per Common Share (Detail) - shares	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable	4,869,489	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
Conversion of Series B Preferred Stock [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable		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
Conversion of Series D Preferred Stock [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable		6,418,437
Exercise of Stock Options [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable	3,416,345	1,751,616
Exercise of Common Stock Warrants [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable	956,552	509,562
Exercise of Preferred Stock Warrants [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable		446,990
Vesting of PSUs and RSUs [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable	496,592

401(k) Retirement Plan - Additi

401(k) Retirement Plan - Additional Information (Detail) - USD ($)	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Four Zero One K Retirement Plan [Member]
Defined Contribution Plan Disclosure [Line Items]
Employer contribution to defined benefit plan	$ 0	$ 0

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Related Party Transaction [Line Items]
Stock-based compensation expense	$ 6,374,000	$ 812,000	$ 9,272,000	$ 2,174,000
Selling, General and Administrative Expenses [Member]
Related Party Transaction [Line Items]
Stock-based compensation expense	5,929,000	577,000	8,283,000	1,541,000
Former Director and Shareholder [Member] | Patent Rights from Former Director and Shareholder [Member]
Related Party Transaction [Line Items]
Royalty expense	22,000	10,000	$ 61,000	32,000
Former Director and Shareholder [Member] | Patent Rights from Former 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	8,000	50,000	$ 500,000	200,000
Director and the Chairman [Member] | Selling, General and Administrative Expenses [Member] | Performance Stock Units [Member]
Related Party Transaction [Line Items]
Stock-based compensation expense	4,000,000		4,000,000
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	55,000	81,000	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		93,000		300,000
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		200,000		400,000
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	$ 1,400,000	$ 1,400,000	$ 4,100,000	$ 2,100,000