LivaNova (LIVN) 10-Q 3 May 24 2024 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2024	Apr. 26, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
Document Transition Report	false
Entity File Number	001-37599
Entity Registrant Name	LivaNova PLC
Entity Incorporation, State or Country Code	X0
Entity Tax Identification Number	98-1268150
Entity Address, Address Line One	20 Eastbourne Terrace
Entity Address, City or Town	London
Entity Address, Country	GB
Entity Address, Postal Zip Code	W2 6LG
Country Region	44
City Area Code	0
Local Phone Number	203 325-0660
Title of 12(b) Security	Ordinary Shares - £1.00 par value per share
Trading Symbol	LIVN
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		54,151,745
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001639691

Condensed Consolidated Statemen

Condensed Consolidated Statements of (Loss) Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Net revenue	$ 294,912	$ 263,418
Cost of sales	87,522	89,335
Gross profit	207,390	174,083
Operating expenses:
Selling, general and administrative	129,863	124,129
Research and development	45,664	49,986
Other operating expenses	15,617	2,310
Operating income (loss)	16,246	(2,342)
Interest expense	(15,893)	(13,437)
Loss on debt extinguishment	(25,482)	0
Foreign exchange and other income/(expense)	(9,071)	25,547
(Loss) income before tax	(34,200)	9,768
Income tax expense	7,717	2,371
Loss from equity method investments	(26)	(27)
Net (loss) income	$ (41,943)	$ 7,370
Basic (loss) income per share (in dollars per share)	$ (0.78)	$ 0.14
Diluted (loss) income per share (in dollars per share)	$ (0.78)	$ 0.14
Shares used in computing basic (loss) income per share (in shares)	54,008	53,617
Shares used in computing diluted (loss) income per share (in shares)	54,008	53,900

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (41,943)	$ 7,370
Other comprehensive income:
Net change in unrealized loss on derivatives	0	(966)
Tax effect	0	0
Net of tax	0	(966)
Foreign currency translation adjustment	(17,323)	8,053
Total other comprehensive (loss) income	(17,323)	7,087
Total comprehensive (loss) income	$ (59,266)	$ 14,457

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current Assets:
Cash and cash equivalents	$ 309,191	$ 266,504
Restricted cash	306,492	311,368
Accounts receivable, net of allowance of $11,026 at March 31, 2024 and $12,019 at December 31, 2023	209,431	215,072
Inventories	153,176	147,887
Prepaid and refundable taxes	22,543	20,145
Prepaid expenses and other current assets	39,184	27,182
Total Current Assets	1,040,017	988,158
Property, plant and equipment, net	152,237	154,181
Goodwill	771,817	782,941
Intangible assets, net	253,927	261,178
Operating lease assets	50,260	50,845
Investments	22,675	22,843
Deferred tax assets	113,687	118,858
Long-term derivative assets	41,617	38,496
Other assets	13,365	12,063
Total Assets	2,459,602	2,429,563
Current Liabilities:
Current debt obligations	19,704	18,111
Accounts payable	75,944	80,845
Accrued liabilities and other	94,029	107,301
Current litigation provision liability	16,980	10,756
Taxes payable	29,761	23,340
Accrued employee compensation and related benefits	91,353	94,630
Total Current Liabilities	327,771	334,983
Long-term debt obligations	604,753	568,543
Contingent consideration	80,769	80,902
Deferred tax liabilities	10,974	11,567
Long-term operating lease liabilities	43,724	45,388
Long-term employee compensation and related benefits	17,062	17,254
Long-term derivative liabilities	104,920	45,569
Other long-term liabilities	48,092	47,729
Total Liabilities	1,238,065	1,151,935
Commitments and Contingencies
Stockholders’ Equity:
Ordinary Shares, £1.00 par value: unlimited shares authorized; 54,295,837 shares issued and 54,148,808 shares outstanding at March 31, 2024; 53,942,151 shares issued and 53,918,222 shares outstanding at December 31, 2023	82,975	82,533
Additional paid-in capital	2,192,676	2,189,517
Accumulated other comprehensive loss	(45,206)	(27,883)
Accumulated deficit	(1,008,427)	(966,484)
Treasury stock at cost, 147,029 ordinary shares at March 31, 2024; 23,929 ordinary shares at December 31, 2023	(481)	(55)
Total Stockholders’ Equity	1,221,537	1,277,628
Total Liabilities and Stockholders’ Equity	$ 2,459,602	$ 2,429,563

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) $ in Thousands	Mar. 31, 2024 USD ($) shares	Mar. 31, 2024 £ / shares	Dec. 31, 2023 USD ($) shares	Dec. 31, 2023 £ / shares
Statement of Financial Position [Abstract]
Allowance for doubtful accounts | $	$ 11,026		$ 12,019
Ordinary shares, par value (in pounds per share) | £ / shares		£ 1		£ 1
Ordinary shares issued (in shares)	54,295,837		53,942,151
Ordinary shares outstanding (in shares)	54,148,808		53,918,222
Treasury stock (in shares)	147,029		23,929

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Operating Activities:
Net (loss) income	$ (41,943)	$ 7,370
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Loss on debt extinguishment	25,482	0
Remeasurement of derivative instruments	11,598	(26,281)
Stock-based compensation	10,226	10,579
Depreciation	6,266	5,956
Amortization of debt issuance costs	4,900	5,019
Amortization of intangible assets	4,329	6,355
Deferred income tax expense (benefit)	4,800	(76)
Amortization of operating lease assets	2,544	2,642
Remeasurement of contingent consideration to fair value	(133)	4,827
Other	(534)	(108)
Changes in operating assets and liabilities:
Accounts receivable, net	1,991	7,558
Inventories	(8,146)	(11,342)
Other current and non-current assets	(8,945)	(3,838)
Accounts payable and accrued current and non-current liabilities	(15,576)	21,378
Taxes payable	6,887	972
Litigation provision liability	6,235	(10,254)
Net cash provided by operating activities	9,981	20,757
Investing Activities:
Purchases of property, plant and equipment	(6,398)	(7,685)
Purchase of investments	0	(5,136)
Other	35	1,337
Net cash used in investing activities	(6,363)	(11,484)
Financing Activities:
Proceeds from long-term debt obligations	335,513	0
Repayment of long-term debt obligations	(234,375)	(1,875)
Payment of debt extinguishment costs	(38,953)	0
Purchase of capped calls	(31,637)	0
Proceeds from unwind of capped calls	22,523	0
Payment of contingent consideration	(13,750)	0
Shares repurchased from employees for minimum tax withholding	(316)	(1,577)
Payment of debt issuance costs	(1,893)	0
Repayments of short-term borrowings (maturities greater than 90 days)	0	(1,974)
Other	35	191
Net cash provided by (used in) financing activities	37,147	(5,235)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(2,954)	3,302
Net increase in cash, cash equivalents and restricted cash	37,811	7,340
Cash, cash equivalents and restricted cash at beginning of period	577,872	515,618
Cash, cash equivalents and restricted cash at end of period	615,683	522,958
Proceeds from unwind of capped calls	$ 22,523	$ 0

Unaudited Condensed Consolidate

Unaudited Condensed Consolidated Financial Statements	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Unaudited Condensed Consolidated Financial Statements	Note 1. Unaudited Condensed Consolidated Financial Statements Basis of Presentation The accompanying condensed consolidated financial statements of LivaNova as of, and for the three months ended March 31, 2024 and 2023, have been prepared in accordance with U.S. GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 2023 has been derived from audited financial statements contained in LivaNova’s 2023 Form 10-K but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments considered necessary for a fair statement of the operating results of LivaNova and its subsidiaries for the three months ended March 31, 2024, and are not necessarily indicative of the results that may be expected for the year ending December 31, 2024. The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying LivaNova’s 2023 Form 10-K. Macroeconomic Environment The current macroeconomic environment, including foreign exchange volatility, inflationary pressures, geopolitical instability, and supply chain challenges, has impacted and may continue to impact LivaNova’s business and profitability. Furthermore, LivaNova continues to experience logistical, capacity, and labor constraints, though, to date, the Company’s supply of raw materials and the production and distribution of finished products have not been materially affected. The Company continues to respond to such challenges, and while LivaNova has business continuity plans in place, the impact of the ongoing challenges the Company is navigating, along with their potential escalation, may adversely affect its business. Cybersecurity Incident As previously disclosed, in November 2023, LivaNova detected a cybersecurity incident that resulted in a disruption of portions of the Company’s information technology systems. Promptly after detecting the issue, LivaNova began an investigation with assistance from external cybersecurity experts and coordinated with law enforcement. The Company implemented remediation measures to mitigate the impact of the incident. The Company continues to assess the nature and scope of the affected data and analyze its legal notification obligations, and the Company is notifying affected individuals and regulators as required by applicable law. The Company believes it contained the cybersecurity threat, though its mitigation efforts are ongoing. At this time, all of LivaNova’s manufacturing sites worldwide are operating at normal levels. The Company continues to assess the full impact of the cybersecurity event on its business, results of operations, cash flows and financial condition. Through March 31, 2024, LivaNova had incurred direct costs totaling $5.4 million in connection with this cybersecurity incident, including $2.8 million during the three months ended March 31, 2024. These costs primarily include external cybersecurity experts, legal counsel, and system restoration costs, and do not include business interruption or other non-direct costs. The Company expects to incur additional costs related to this incident in the future. LivaNova maintains insurance, including cyber insurance, which is subject to certain retentions and policy limitations that may serve to limit the amount that the insurers may pay the Company when a claim is submitted. LivaNova plans to file for reimbursement of covered costs related to this incident, but the Company’s insurance coverage may be insufficient to cover all costs and expenses related to this cybersecurity incident, and the insurance carrier may not cover all submitted costs and expenses related to this cybersecurity incident. Significant Accounting Policies LivaNova’s significant accounting policies are detailed below and in “Note 2. Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies” and “Note 3. Revenue Recognition” of LivaNova’s 2023 Form 10-K.

Restructuring

Restructuring	3 Months Ended
	Mar. 31, 2024
Restructuring and Related Activities [Abstract]
Restructuring	Note 2. Restructuring From time to time, LivaNova initiates restructuring plans to leverage economies of scale, streamline distribution and logistics, and strengthen operational and administrative effectiveness in order to reduce overall costs. On January 5, 2024, the Board of Directors of LivaNova PLC approved the 2024 Restructuring Plan to enhance the Company’s focus on its core Cardiopulmonary and Neuromodulation segments. The main component of this plan was to wind down the ACS segment, which the Company anticipates will be substantially complete by the end of 2024. LivaNova recognized restructuring expense under the 2024 Restructuring Plan of $9.2 million in other operating expenses on its condensed consolidated statements of (loss) income for the three months ended March 31, 2024. In connection with the 2024 Restructuring Plan, LivaNova expects to incur pre-tax restructuring charges in the range of approximately $15 million to $20 million. The anticipated charges are comprised of approximately $10 million to $12 million in severance expenses and retention bonuses and approximately $5 million to $8 million in other expenses, including lease termination, facilities remediation, and asset disposal expenses. LivaNova expects the majority of the severance expenses to be incurred in the first half of 2024. Retention bonuses will be earned over the period of service, which is expected to be over the full year of 2024. All future cash payments related to these restructuring charges are expected to be substantially paid out during 2024. These estimates are subject to change. The following table presents a reconciliation of the beginning and ending balance of the accruals and other reserves recorded in connection with LivaNova’s restructuring plans included in accounts payable, accrued liabilities and other, and accrued employee compensation and related benefits on the condensed consolidated balance sheets (in thousands): Employee Severance and Other Termination Costs Other Total Balance at December 31, 2023 (1) $ 911 $ — $ 911 Charges 7,251 1,974 9,225 Cash payments (2,092) (1,218) (3,310) Balance at March 31, 2024 $ 6,070 $ 756 $ 6,826 (1) Represents restructuring plans initiated prior to 2024. The following table presents restructuring expense by reportable segment (in thousands): Three Months Ended March 31, 2024 2023 Neuromodulation $ — $ 416 Other (1) 9,225 309 Total (2) $ 9,225 $ 725 (1) Other primarily includes restructuring expense not allocated to segments. (2) Restructuring expense is included in other operating expenses on the condensed consolidated statements of (loss) income.

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 3. Fair Value Measurements LivaNova reviews its fair value hierarchy classification on a quarterly basis. Changes in the ability to observe valuation inputs may result in a reclassification of levels for certain securities in the fair value hierarchy. There were no transfers between Level 1, Level 2, or Level 3 during the three months ended March 31, 2024 and 2023. Assets and Liabilities Measured at Fair Value on a Recurring Basis The following tables provide information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value as of March 31, 2024 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - freestanding instruments (FX) $ 1,295 $ — $ 1,295 $ — Derivative assets - capped call derivatives (2025 Notes) 8,010 — — 8,010 Derivative assets - capped call derivatives (2029 Notes) 33,607 — — 33,607 Convertible notes receivable 269 — — 269 $ 43,181 $ — $ 1,295 $ 41,886 Liabilities: Derivative liabilities - embedded exchange feature (2025 Notes) $ 10,632 $ — $ — $ 10,632 Derivative liabilities - embedded conversion feature (2029 Notes) 94,288 — — 94,288 Contingent consideration arrangement 80,769 — — 80,769 $ 185,689 $ — $ — $ 185,689 Fair Value as of December 31, 2023 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - capped call derivatives (2025 Notes) $ 38,496 $ — $ — $ 38,496 Convertible notes receivable 275 — — 275 $ 38,771 $ — $ — $ 38,771 Liabilities: Derivative liabilities - freestanding instruments (FX) $ 3,883 $ — $ 3,883 $ — Derivative liabilities - embedded exchange feature (2025 Notes) 45,569 — — 45,569 Contingent consideration arrangements 94,652 — — 94,652 $ 144,104 $ — $ 3,883 $ 140,221 The following table provides a reconciliation of the beginning and ending balances of LivaNova’s recurring fair value measurements, using significant unobservable inputs (Level 3) (in thousands): Capped Call Derivative Assets Capped Call Derivative Assets Convertible Notes Receivable Embedded Exchange Feature Derivative Liability Embedded Conversion Feature Derivative Liability Contingent Consideration Liability Arrangements As of December 31, 2023 $ 38,496 $ — $ 275 $ 45,569 $ — $ 94,652 Additions — 31,637 — — 87,457 — Cash receipt (22,524) — — — — — Payment — — — (36,915) — (13,750) Changes in fair value (7,962) 1,970 (6) 1,978 6,831 (133) Total at March 31, 2024 - long-term $ 8,010 $ 33,607 $ 269 $ 10,632 $ 94,288 $ 80,769 Embedded Features and Capped Call Derivatives In June 2020, the Company issued $287.5 million in notes due in 2025 and entered into related capped call transactions. In March 2024, the Company issued $345.0 million in notes due in 2029 and entered into related capped call transactions. The 2025 Notes include an embedded exchange feature that is bifurcated from the 2025 Notes and the 2029 Notes include an embedded conversion feature that is bifurcated from the 2029 Notes (we refer to such embedded features collectively as the “embedded derivative features”). In connection with the issuance of the 2029 Notes, the Company repurchased an aggregate principal amount of $230.0 million of the 2025 Notes and unwound a corresponding portion of the 2025 Capped Calls. Please refer to “Note 4. Financing Arrangements” for further details. The embedded derivative features are measured at fair value using a binomial lattice model and estimated discounted cash flows that utilize observable and unobservable market data. The Capped Call Transactions are measured at fair value using the Black-Scholes model utilizing observable and unobservable market data, including stock price, remaining contractual term, expected volatility, risk-free interest rate and expected dividend yield, as applicable. The embedded derivative features and Capped Call Transactions are classified as Level 3 because the Company uses historical volatility and implied volatility from actual options traded to determine expected stock price volatility, an unobservable input that is significant to the valuation. In general, an increase in LivaNova’s stock price or stock price volatility would increase the fair value of the embedded derivative features and Capped Call Transactions which would result in an increase in net expense. As the remaining time to the expiration of the derivatives decreases, the fair value of the derivatives decreases. The future impact of the derivatives on net income depends on how significant inputs such as stock price, stock price volatility and time to the expiration of the derivatives change in relation to other inputs. Changes in the fair value of the embedded derivative features and capped call derivatives are recognized in foreign exchange and other income/(expense) in the condensed consolidated statements of (loss) income. The following table presents the stock price volatility utilized in determining the fair value of LivaNova’s capped call derivative assets and embedded derivative liabilities as of March 31, 2024: March 31, 2024 Capped Call Derivative Assets (2025 Notes) Capped Call Derivative Assets (2029 Notes) Embedded Exchange Feature Derivative Liability (2025 Notes) Embedded Conversion Feature Derivative Liability (2029 Notes) Stock price volatility 38 % 36 % 38 % 36 % Contingent Consideration Arrangements The following table provides the fair value of Level 3 contingent consideration arrangements by acquisition (in thousands): March 31, 2024 December 31, 2023 ImThera $ 80,769 $ 80,902 ALung — 13,750 $ 80,769 $ 94,652 The ImThera business combination involved contingent consideration arrangements composed of potential cash payments upon the achievement of a certain regulatory milestone and a sales-based earnout associated with sales of products. The sales-based earnouts are valued using projected sales from LivaNova’s internal strategic plan. These arrangements are Level 3 fair value measurements and include the following significant unobservable inputs as of March 31, 2024: ImThera Acquisition Valuation Technique Unobservable Input Inputs Regulatory milestone-based payment Discounted cash flow Discount rate 8.2% Probability of payment 85% Projected payment year 2026 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 14.0% - 14.4% Credit risk discount rate 8.3% - 8.7% Revenue volatility 28.4% Probability of payment 85% Projected years of earnout 2026 - 2029

Financing Arrangements

Financing Arrangements	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Financing Arrangements	Note 4. Financing Arrangements The outstanding principal amount of long-term debt as of March 31, 2024 and December 31, 2023 was as follows (in thousands, except interest rates): March 31, 2024 December 31, 2023 Maturity Interest Rate Term Facilities $ 324,571 $ 328,459 July 2027 8.93% 2029 Notes 246,256 — March 2029 2.50% 2025 Notes 51,015 255,500 December 2025 3.00% Bank of America, U.S. 1,500 1,500 January 2025 8.09% Other 478 568 Total long-term facilities 623,820 586,027 Less current portion of long-term debt 19,067 17,484 Total long-term debt obligations $ 604,753 $ 568,543 Revolving Credit & Term Facilities The outstanding principal amount of LivaNova’s short-term unsecured revolving credit agreements and other agreements with various banks was $0.6 million as of each of March 31, 2024 and December 31, 2023 with an average interest rate of 4.94% and loan terms ranging from overnight to 364 days as of March 31, 2024. On March 8, 2024, LivaNova and LivaNova USA entered into Incremental Facility Amendment No. 3, which provides for LivaNova USA to obtain revolving commitments in an aggregate principal amount of $225 million. The $225 million revolving facility is subject to the terms and conditions of the 2021 First Lien Credit Agreement, as amended thereof, and will replace entirely the existing $125 million revolving facility under the 2021 First Lien Credit Agreement. The new $225 million revolving facility is available for working capital and other general corporate purposes and, if drawn, can be repaid at any time without premium or penalty. The new $225 million revolving facility matures on March 8, 2029. There were no outstanding borrowings under the revolving facilities under the 2021 First Lien Credit Agreement as of March 31, 2024 and December 31, 2023. The 2021 First Lien Credit Agreement, as amended, also contemplates the payment of certain commitment fees on the unused portion of the commitments, at a variable percentage based on the LivaNova’s Total Net Leverage Ratio. As of March 31, 2024 and December 31, 2023, the applicable commitment fee percentage was 0.5% per annum. The 2021 First Lien Credit Agreement, as amended, contains customary representations, warranties and covenants, including the requirement to maintain a Senior Secured First Lien Net Leverage Ratio of not more than 3.50 to 1.00, calculated as the ratio of Consolidated Senior Secured First Lien Net Indebtedness to Consolidated EBITDA, as defined in the credit agreement, for the period of four consecutive fiscal quarters ended on the calculation date and an Interest Coverage Ratio of not less than 2.00 to 1.00, calculated as the ratio of Consolidated EBITDA to Consolidated Interest Expense, both as defined in the credit agreement, for the period of four consecutive fiscal quarters ended on the calculation date. As of March 31, 2024, the Company was in compliance with the financial covenants contained in the 2021 First Lien Credit Agreement. Debt discounts and issuance costs related to the Initial Term Facility were $9.6 million. Amortization of debt discount and issuance costs for the Initial Term Facility was $0.5 million for the three months ended March 31, 2024 and is included in interest expense on the condensed consolidated statements of (loss) income. The unamortized discount and issuance costs related to the Initial Term Facility as of March 31, 2024 and December 31, 2023 were $6.3 million and $6.8 million, respectively. Issuance costs related to the Delayed Draw Term Facility were $1.6 million and were fully amortized as of December 31, 2023. Amortization of issuance costs for the Delayed Draw Term Facility was $0.5 million for the three months ended March 31, 2023 and is included in interest expense on the condensed consolidated statements of (loss) income. 2029 Notes Issuance and 2025 Notes Repurchase Transactions On March 8, 2024, LivaNova issued $345.0 million aggregate principal amount of 2.50% notes due 2029 by private placement to qualified institutional buyers pursuant to Rule 144A under the Securities Act, which included exercise in full of the initial purchasers’ option to purchase up to an additional $45.0 million principal amount of the 2029 Notes. The 2029 Notes are senior unsecured obligations of the Company. The Company used part of the proceeds from the issuance of the 2029 Notes to repurchase $230.0 million aggregate principal amount of the 2025 Notes in privately-negotiated transactions for an aggregate cash repurchase consideration of $270.5 million. The 2025 Notes Repurchase Transaction was treated as a debt extinguishment. The carrying value of the 2025 Notes which includes the unamortized debt issuance cost and discounts and the fair value of the embedded exchange feature were derecognized and the 2029 Notes issued were recognized at fair value. The difference between the consideration used to extinguish the 2025 Notes and the carrying value of the 2025 Notes (including unamortized debt discount and issuance cost) and fair value of the embedded exchange feature is recognized as an extinguishment loss of $25.5 million recorded through loss on debt extinguishment on LivaNova’s condensed consolidated statements of (loss) income. Any third-party costs incurred directly related to the 2025 Notes Repurchase Transaction were deferred and capitalized as additional debt issuance cost to be amortized on the 2029 Notes. Contemporaneously with the 2025 Notes Repurchase Transaction, the Company and the financial institutions party to the 2025 Capped Calls agreed to terminate a portion of the 2025 Capped Calls in a notional amount corresponding to the amount of 2025 Notes repurchased. The Company received $22.5 million in cash consideration, the fair value of the terminated portion, upon settlement. The terms of the remaining 2025 Capped Calls remain unchanged and continue to be classified as long-term derivative assets. 2029 Notes The sale of the 2029 Notes resulted in $332.1 million in net proceeds to the Company after deducting issuance costs. Interest is payable semiannually in arrears on March 15 and September 15. The effective interest rate of the 2029 Notes at March 31, 2024 was 9.78% . The 2029 Notes mature on March 15, 2029, unless earlier repurchased, redeemed or converted. Debt discounts and issuance costs related to the 2029 Notes were $99.6 million, including $87.5 million of discount related to the embedded conversion feature (discussed below), and $12.1 million new debt issuance costs to the 2029 Notes. Amortization of debt discount and issuance cost for the 2029 Notes was $0.9 million for the three months ended March 31, 2024, and is included in interest expense on the condensed consolidated statements of (loss) income. The unamortized debt issuance cost and discount related to the 2029 Notes as of March 31, 2024 was $98.7 million. Commencing after the calendar quarter ending on June 30, 2024 and prior to the close of business on the business day immediately preceding December 15, 2028, the 2029 Notes will be convertible only under the following circumstances: • During any calendar quarter commencing after the calendar quarter ending on June 30, 2024 (and only during such calendar quarter), if the last reported sale price of ordinary shares of the Company for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day; • At any time during the five day business period immediately after any ten • If the Company calls any or all of the 2029 Notes for redemption, at any time prior to the close of business on the scheduled trading day immediately preceding December 15, 2028; or • Upon the occurrence of specified corporate events (as set forth in the indenture governing the 2029 Notes). On or after December 15, 2028, holders of the 2029 Notes may convert their 2029 Notes at their option at any time until the close of business on the second Scheduled Trading Day (as defined in the indenture governing the 2029 Notes) immediately preceding the maturity date. There have been no changes to the initial conversion price of the 2029 Notes since issuance. During the three months ended March 31, 2024, the conditions for conversion were not met and, therefore, the 2029 Notes were not convertible during that period. The Company may redeem the 2029 Notes in whole or in part at its option on or after March 22, 2027, for cash if the last reported sale price per ordinary share has been at least 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading day period (including the last trading day of such period) ending on, and including, the trading day immediately preceding the date on which the Company provides notice of redemption. Additionally, the Company may redeem the 2029 Notes at its option, in whole but not in part, in connection with certain tax-related events. Holders of the 2029 Notes may require the Company to repurchase their 2029 Notes upon the occurrence of a Fundamental Change (as defined in the indenture governing the 2029 Notes) at a repurchase price equal to the principal amount thereof plus accrued and unpaid interest to, but excluding, the repurchase date. In addition, in connection with certain corporate events or if the Company issues a notice of redemption, the Company will, under certain circumstances, increase the conversion rate for holders who elect to convert their 2029 Notes in connection with such corporate event or during the relevant redemption period. The indenture governing the 2029 Notes contains customary terms and covenants, including that upon certain events of default occurring and continuing, either the Trustee (as defined in the indenture governing the 2029 Notes) or holders of at least 25% in aggregate principal amount of the 2029 Notes then outstanding may declare the entire principal amount of all the 2029 Notes, and accrued and unpaid interest on such 2029 Notes, to be immediately due and payable. Upon events of default in connection with specified bankruptcy events involving the Company, the 2029 Notes will become due and payable immediately. Embedded Conversion Feature The embedded conversion feature of the 2029 Notes requires bifurcation from the 2029 Notes and is accounted for as a derivative liability. The fair value of the 2029 Notes embedded conversion feature at the time of issuance was $87.5 million and was recorded as debt discount on the 2029 Notes. This discount is amortized as interest expense using the effective interest method over the term of the 2029 Notes together with other debt issuance cost and discounts. The 2029 Notes embedded conversion feature derivative is carried on the condensed consolidated balance sheets at its estimated fair value and is adjusted at the end of each reporting period, with the unrealized gain or loss reflected in foreign exchange and other income/(expense) in the condensed consolidated statements of (loss) income. The fair value of the embedded conversion feature derivative liability was $94.3 million as of March 31, 2024. 2029 Capped Calls In connection with pricing the 2029 Notes, the Company entered into privately negotiated capped call transactions with certain financial institutions. The 2029 Capped Calls have an initial strike price of $69.40, subject to certain adjustments, which corresponds to the initial conversion price of the 2029 Notes. The 2029 Capped Calls are subject to anti-dilution adjustments substantially similar to the 2029 Notes and cover the number of LivaNova’s ordinary shares underlying the 2029 Notes. The 2029 Capped Calls generally offset cash payments or the cash equivalent value of ordinary shares upon conversion if the market value per ordinary share is greater than the strike price, with such offset being subject to an initial cap price of $94.2840 per share. If the Company’s share price exceeds the cap price at the time of valuation in respect of a conversion, the proceeds under the 2029 Capped Calls would not fully offset the excess principal amount due to the holders of the 2029 Notes. The 2029 Capped Calls expire on March 15, 2029 and must be settled in cash. If the 2029 Capped Calls are early terminated, settlement occurs at their termination value, which is equal to their fair value at the time of the early termination. The 2029 Capped Calls are carried on the condensed consolidated balance sheets as a derivative asset at their estimated fair value and are adjusted at the end of each reporting period, with unrealized gain or loss reflected in foreign exchange and other income/(expense) in the condensed consolidated statements of (loss) income. The fair value of the 2029 Capped Calls was $33.6 million as of March 31, 2024. As of March 31, 2024, the 2029 Capped Calls were classified as long-term assets. 2025 Notes On June 17, 2020, LivaNova USA issued $287.5 million aggregate principal amount of 3.00% notes due 2025 by private placement to qualified institutional buyers pursuant to Rule 144A under the Securities Act. The 2025 Notes are senior unsecured obligations of the Company. The sale of the 2025 Notes resulted in $278.0 million in net proceeds to the Company after deducting issuance costs. Interest is payable semiannually in arrears on June 15 and December 15 of each year. On March 8, 2024, in connection with the issuance of the 2029 Notes, the Company used part of the net proceeds to repurchase $230.0 million aggregate principal amount of the 2025 Notes in privately negotiated transactions. Refer to the above section “2029 Notes Issuance and 2025 Notes Repurchase Transactions” for further information. The effective interest rate of the 2025 Notes at March 31, 2024 was 9.16%. The 2025 Notes mature on December 15, 2025 unless earlier exchanged, repurchased, or redeemed. Debt discounts and issuance costs related to the 2025 Notes were $82.0 million and included $75.0 million of discount attributable to the embedded exchange feature, discussed below, and $7.0 million of allocated issuance costs to the 2025 Notes related to legal, bank and accounting fees. Upon the closing of the 2025 Notes Repurchase Transaction in March 2024, the remaining unamortized debt discounts and issuance costs related to the 2025 Notes were $5.8 million. Amortization of debt discount and issuance costs for the 2025 Notes was $3.4 million and $3.8 million for the three months ended March 31, 2024 and 2023, respectively, and is included in interest expense on the condensed consolidated statements of (loss) income. The unamortized discount related to the 2025 Notes as of March 31, 2024 and December 31, 2023 was $6.5 million and $32.0 million, respectively. Holders of the 2025 Notes are entitled to exchange the 2025 Notes at any time during specified periods, at their option. This includes the right to exchange the 2025 Notes during any calendar quarter, if the last reported sale price of LivaNova’s ordinary shares, with a nominal value of £1.00 per share, is greater than or equal to 130% of the exchange price, or $79.27 per share for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter. The exchange condition was not satisfied on March 31, 2024. As a result, the Company has included its obligations from the 2025 Notes and the associated embedded exchange feature derivative as a long-term liability on the condensed consolidated balance sheet as of March 31, 2024. The 2025 Notes are exchangeable solely into cash and are not exchangeable into ordinary shares of LivaNova or any other security under any circumstances. The initial exchange rate for the 2025 Notes is 16.3980 ordinary shares per $1,000 principal amount of 2025 Notes (equivalent to an initial exchange price of $60.98 per share). The exchange rate is subject to adjustment in certain circumstances, as set forth in the indenture governing the 2025 Notes. There have been no changes to the initial exchange price of the 2025 Notes since issuance. During the three months ended March 31, 2024, the conditions allowing holders of the 2025 Notes to exchange were not met. The 2025 Notes were therefore not exchangeable during the three months ended March 31, 2024. The Company may redeem the 2025 Notes at its option on or after June 20, 2023 and prior to the 51 st scheduled trading day immediately preceding the maturity date, in whole or in part, if the last reported sale price per ordinary share has been at least 130% of the exchange price then in effect for at least 20 trading days (whether or not consecutive), including the trading day immediately preceding the date on which the Company provides notice of redemption, during any 30 consecutive trading day period ending on, and including, the trading day immediately preceding the date on which the Company provides notice of redemption, at a redemption price equal to 100% of the principal amount of the 2025 Notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. Additionally, the Company may redeem the 2025 Notes at its option, prior to their stated maturity, in whole but not in part, in connection with certain tax-related events. Embedded Exchange Feature The embedded exchange feature of the 2025 Notes requires bifurcation from the 2025 Notes and is accounted for as a derivative liability. The fair value of the 2025 Notes’ embedded exchange feature derivative at the time of issuance was $75.0 million and was recorded as debt discount on the 2025 Notes. This discount is amortized as interest expense using the effective interest method over the term of the 2025 Notes. The 2025 Notes’ embedded exchange feature derivative is carried on the condensed consolidated balance sheets at its estimated fair value and is adjusted at the end of each reporting period, with the unrealized gain or loss reflected in foreign exchange and other income/(expense) in the condensed consolidated statements of (loss) income. The fair value of the embedded exchange feature derivative liability was $10.6 million and $45.6 million as of March 31, 2024 and December 31, 2023, respectively. 2025 Capped Calls

Derivatives and Risk Management

Derivatives and Risk Management	3 Months Ended
	Mar. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives and Risk Management	Note 5. Derivatives and Risk Management Due to the global nature of LivaNova’s operations, the Company is exposed to FX fluctuations. Historically, LivaNova has entered into FX derivative contracts and interest rate swap contracts to reduce the impact of FX and interest rate fluctuations, respectively, on earnings and cash flow. LivaNova is also exposed to equity price risk in connection with its 2025 Notes and 2029 Notes, including exchange/conversion and settlement provisions based on the price of its ordinary shares at exchange/conversion or maturity of the 2025 Notes and 2029 Notes. The Capped Call Transactions associated with the 2025 Notes and 2029 Notes also include settlement provisions that are based on the price of LivaNova’s ordinary shares, subject to a capped price per share. LivaNova does not enter into derivative contracts for speculative purposes. LivaNova measures all outstanding derivatives each period end at fair value and reports the fair value as either financial assets or liabilities on the condensed consolidated balance sheets. At inception of the contract, the derivative is designated as either a freestanding derivative or a hedge. Derivatives that are not designated as hedging instruments are referred to as freestanding derivatives with changes in fair value included in earnings. These derivatives are intended to serve as economic hedges and follow the cash flows of the economic hedged item. The cash flows from these derivative contracts are reported as operating activities on LivaNova’s condensed consolidated statements of cash flows. If the derivative qualifies for hedge accounting, changes in the fair value of the derivative will be recorded in AOCI until the hedged item is recognized in earnings upon settlement/termination. Interest rate swap gains and losses in AOCI are reclassified to interest expense on LivaNova’s condensed consolidated statements of (loss) income. LivaNova evaluates hedge effectiveness at inception. LivaNova had no designated hedging instruments as of March 31, 2024 and December 31, 2023. Counterparty Credit Risk LivaNova is exposed to credit risk in the event of non-performance by the counterparties to the Company’s derivatives. The Option Counterparties are financial institutions. To limit LivaNova’s credit risk, the Company selected financial institutions with a minimum long-term investment grade credit rating. LivaNova’s exposure to the credit risk of the Option Counterparties is not secured by any collateral. If such an Option Counterparty becomes subject to insolvency proceedings, LivaNova will become an unsecured creditor in those proceedings, with a claim equal to the Company’s exposure at that time under the 2025 Capped Calls and/or 2029 Capped Calls, as applicable, with that Option Counterparty. To manage credit risk with respect to LivaNova’s other derivatives, the Company selects and periodically reviews counterparties based on credit ratings, limits its exposure with respect to each counterparty, and monitors their respective market positions. However, if one or more of these counterparties were in a liability position to the Company and were unable to meet their obligations, any transactions with the counterparty could be subject to early termination, which could result in substantial losses for the Company. Freestanding FX Derivative Contracts The gross notional amount of FX derivative contracts not designated as hedging instruments outstanding as of March 31, 2024 and December 31, 2023 was $160.0 million and $223.4 million, respectively. These derivative contracts are designed to offset the FX effects in earnings of various intercompany loans and trade receivables. LivaNova recorded net gains for these freestanding derivatives of $3.2 million for the three months ended March 31, 2024 and net losses of $1.3 million for three months ended March 31, 2023. These gains and losses are included in foreign exchange and other income/(expense) on LivaNova’s condensed consolidated statements of (loss) income. Cash Flow Hedges Historically, LivaNova entered into interest rate swaps associated with the Initial Term Facility, which qualified for and were designated as cash flow hedges. The Company’s outstanding interest rate swaps expired on April 6, 2023. LivaNova elected not to renew the interest rate swaps as interest expense associated with the Initial Term Facility is principally offset by holding a significant portion of the Initial Term Facility in a depository account, which earns a floating rate of interest. The pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in OCI and the amount reclassified to earnings from AOCI were as follows (in thousands): Three Months Ended March 31, 2023 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Loss Recognized in OCI Gain Reclassified from AOCI to Earnings Interest rate swap contracts Interest expense $ (433) $ 533 Balance Sheet Presentation LivaNova offsets fair value amounts associated with its derivative instruments that are executed with the same counterparty under master netting arrangements on the Company’s consolidated balance sheets. Master netting arrangements include a right to set off or net together purchases and sales of similar products in the settlement process. The following tables present the fair value and the location of derivative contracts reported on the condensed consolidated balance sheets as of March 31, 2024 and December 31, 2023 (in thousands): Asset Derivatives Liability Derivatives March 31, 2024 Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Derivatives Not Designated as Hedging Instruments: Capped call derivatives (2025 Notes) Long-term derivative assets $ 8,010 Capped call derivatives (2029 Notes) Long-term derivative assets 33,607 Embedded exchange feature (2025 Notes) Long-term derivative liabilities $ 10,632 Embedded exchange feature (2029 Notes) Long-term derivative liabilities 94,288 FX derivative contracts Prepaid expenses and other current assets 1,295 Total derivatives not designated as hedging instruments 42,912 104,920 Total derivatives $ 42,912 $ 104,920 Asset Derivatives Liability Derivatives December 31, 2023 Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Derivatives Not Designated as Hedging Instruments: Capped call derivatives (2025 Notes) Long-term derivative assets $ 38,496 FX derivative contracts Accrued liabilities and other $ 3,883 Embedded exchange feature (2025 Notes) Long-term derivative liabilities 45,569 Total derivatives not designated as hedging instruments 38,496 49,452 Total derivatives $ 38,496 $ 49,452 (1) For the classification of inputs used to evaluate the fair value of derivatives, refer to “Note 3. Fair Value Measurements.”

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 6. Commitments and Contingencies Saluggia Site Hazardous Substances LSM, formerly a subsidiary of Sorin, one of the companies that merged into LivaNova PLC in 2015, manages site services for the campus in Saluggia, Italy. In addition to being a former LivaNova manufacturing facility, the Saluggia campus is also the location of manufacturing facilities of third parties, a cafeteria for workers, and storage facilities for hazardous substances and equipment previously used in a nuclear research center, later turned nuclear medicine business, between the 1960s and the late 1990s. Pursuant to authorization from the Italian government, LSM performs ordinary maintenance, secures the facilities, monitors air and water quality and files applicable reports with the competent environmental authorities. In 2020, LSM received correspondence from ISIN requesting that, within five years, LSM demonstrate the financial capacity to meet its obligations under Italian law to clean and dismantle any contaminated buildings and equipment, as well as to deliver hazardous substances to a national repository. This repository will be built by the Italian government at a location and time yet to be determined. ISIN subsequently published Technical Guide n. 30, which identifies the technical criteria, and general safety and protection requirements for the design, construction, operation and dismantling of temporary storage facilities for the hazardous substances. In January 2021, a list of 67 potential sites for the national repository was published. Although there is no legal obligation to begin any work or deliver the hazardous substances, as the performance of these obligations is contingent on the construction of the as-yet unbuilt national repository, based on the aforementioned factors, the Company concluded its obligation to clean, dismantle, and deliver any hazardous substances to a national repository is probable and reasonably estimable. The estimated liability as of March 31, 2024 was €35.7 million ($38.6 million), which represented the low end of the estimated range of loss of €35.7 million ($38.6 million) to €45.5 million ($49.2 million). The estimated liability as of December 31, 2023 was €35.8 million ($39.7 million). SNIA Environmental Liability Sorin was created as a result of a spin-off from SNIA in 2004, and in 2015, Sorin was merged into LivaNova. SNIA subsequently became insolvent, and the Public Administrations sought compensation from SNIA in an aggregate amount of approximately $3.7 billion for remediation costs relating to the environmental damage at chemical sites previously operated by SNIA’s other subsidiaries. There are proceedings relating to the SNIA bankruptcy to which LivaNova is not a party in the Bankruptcy Court of Udine and the Bankruptcy Court of Milan. In 2011, the Bankruptcy Court of Udine held that the Public Administrations were not creditors of either SNIA or its subsidiaries in connection with their claims in the Italian insolvency proceedings. The Public Administrations appealed. In 2016, the Court of Udine rejected the appeal, and the Public Administrations appealed to the Supreme Court. Similarly, in 2014, the Bankruptcy Court of Milan held that the Public Administrations were not creditors of either SNIA or its subsidiaries. The Public Administrations appealed. In April 2022, Bankruptcy Court of Milan declared the Public Administrations to be a non-privileged creditor of SNIA for up to €454 million, and the Public Administrations appealed to the Supreme Court. In 2012, SNIA filed a civil action against Sorin in the Civil Court of Milan asserting joint liability of a parent and a spun-off company; the Public Administrations entered voluntarily into the proceeding, asking Sorin, as jointly liable with SNIA, to pay compensation for SNIA’s environmental damages. In 2016, the Court of Milan dismissed all legal actions of SNIA and of the Public Administrations further requiring the Public Administrations to pay Sorin €292,000 ($315,403 as of March 31, 2024) for legal fees. The Public Administrations appealed the 2016 Decision to the Court of Appeal. On March 5, 2019, the Court of Appeal issued a partial decision on the merits declaring Sorin/LivaNova jointly liable with SNIA for SNIA’s environmental liabilities in an amount up to the fair value of the net worth received by Sorin because of the Sorin spin-off, an estimated €572.1 million ($618.0 million as of March 31, 2024). LivaNova appealed the partial decision on liability to the Italian Supreme Court in August 2019. In 2021, the Court of Appeal delivered the remainder of its decision, ordering LivaNova to pay damages of €453.6 million ($489.9 million as of March 31, 2024). LivaNova appealed the decision on damages in December 2021. On February 21, 2022, the Court of Appeal notified the Company that it granted the Company a suspension with respect to the payment of damages until a decision has been reached on the appeal to the Italian Supreme Court. This suspension was subject to LivaNova providing a first demand bank guarantee of €270.0 million ($291.6 million as of March 31, 2024) within 30 calendar days, and on March 21, 2022, LivaNova delivered the guarantee, thereby satisfying the condition. Refer to “Note 12. Supplemental Financial Information” for information on the financing of the guarantee. In 2022, in response to one of a number of appeals asserted by LivaNova, the Supreme Court issued an ordinance, a procedural document, whereby the Supreme Court referred a question on interpretation of a European directive on demergers to the ECJ. Specifically, the ordinance asks the ECJ to provide a binding decision as to whether a company resulting from a demerger can be held jointly and severally liable not only for the established liabilities of the demerged company that were articulated at the time of demerger, but also for the environmental liabilities of the demerged company that materialized after the demerger which are derived from actions performed prior to the demerger. Following receipt of the binding decision from the ECJ, which is expected in 2024, the Supreme Court is expected to incorporate and issue a decision in response to all of the appeals of LivaNova and counter-appeals submitted by the Public Administrations. While the timing of the decisions by the ECJ and, subsequently, the Supreme Court are uncertain, the Company does not expect that the final decision from the Supreme Court will be issued until at least 2025. LivaNova has not recognized a liability in connection with this matter because any potential loss is not currently probable. On a separate, but related matter, in 2011, Caffaro, a SNIA subsidiary, sold its Brescia chemical business to Caffaro Brescia, a third party belonging to the Todisco group, and as part of the acquisition, Caffaro Brescia agreed to secure hydraulic barriers at the site and maintain existing environmental security measures. In 2020, Caffaro Brescia declared it was withdrawing from its agreement to maintain the environmental measures. In 2021, LivaNova (in addition to Caffaro Brescia, and other non-LivaNova entities) received an administrative order from the Italian Ministry of the Environment requiring the Company to ensure the maintenance of the environmental measures and to guarantee that such works remain fully operational, the annual management and maintenance for which is estimated at approximately €1 million per year. The receipt of the Order appears to be based on the aforementioned Court of Appeal decision regarding LivaNova’s alleged joint liability with SNIA for SNIA’s environmental liabilities. In February 2021, LivaNova disputed the grounds upon which the Order was based and appealed the Order in the Administrative Court in Brescia. On April 30, 2024, the Company learned that the Administrative Court in Brescia had dismissed the case. As a result, the Company considers this matter closed. Product Liability Litigation The Company continues to be involved in litigation involving LivaNova’s 3T device. The litigation includes the cases remaining in the MDL, various U.S. state court cases, and in jurisdictions outside the U.S. As of May 3, 2024, the Company was aware of approximately 65 filed and unfiled claims worldwide. The complaints generally seek damages and other relief based on theories of strict liability, negligence, breach of express and implied warranties, failure to warn, design and manufacturing defect, fraudulent and negligent misrepresentation or concealment, unjust enrichment, and violations of various state consumer protection statutes. During the three months ended March 31, 2024, LivaNova recorded an additional liability of $6.4 million, due to new information received about the nature of certain claims. At March 31, 2024 and December 31, 2023, the provision for these matters was $20.0 million and $13.9 million, respectively. While the amount accrued represents LivaNova’s best estimate for those filed and unfiled claims worldwide of which LivaNova is aware and believes are both probable and estimable at this time, the actual liability for resolution of these matters may vary from the Company’s provision. A provision for the remaining claims has not been recorded because a potential loss is not determined to be probable, or a potential loss or range of potential loss is not reasonably estimable at this time. The following table presents the changes in the carrying amount of the litigation provision liability for the three months ended March 31, 2024 (in thousands): Total litigation provision liability at December 31, 2023 $ 13,860 Payments (157) Adjustments (1) 6,392 FX and other (80) Total litigation provision liability at March 31, 2024 20,015 Less current portion of litigation provision liability at March 31, 2024 16,980 Long-term portion of litigation provision liability at March 31, 2024 (2) $ 3,035 (1) Adjustments to the litigation provision are included in other operating expenses on the condensed consolidated statements of (loss) income. (2) Included in other long-term liabilities on the condensed consolidated balance Italian MedTech Payback Measure As previously disclosed, in 2015, the Italian Parliament introduced rules regarding public contracts with the National Healthcare System for the supply of goods and services. In particular, the law introduced a “payback” measure requiring companies selling medical devices in Italy to repay a percentage of the healthcare expenditures exceeding the regional maximum caps for medical devices. In the intervening years since the rules were first issued, there has been considerable uncertainty about how the law will operate and what the exact timeline is for finalization. In August 2022, a decree was published which provided guidance and timetables for the rule. In response, LivaNova filed an appeal at the Administrative Court against the Decree of the Ministry of Health assessing the amount payable and against the MedTech Payback Guidelines. LivaNova also filed appeals against the regions requesting payments. In August 2023, the Administrative Court upheld LivaNova’s request to suspend the effect of the requests for payment by the regions, pending the decision by the court on the merits of the case. In November 2023, the Administrative Court, in a separate matter, asked the Constitutional Court whether the payback law is compliant with the Italian Constitution and pending the decision by the Constitutional Court, all cases brought by medical device companies in this matter are suspended. The Company has accrued for the “payback” law since 2015 based on market and product information. As of March 31, 2024 and December 31, 2023, the total amount reserved for this matter was $8.4 million and $8.2 million, respectively; however, the actual liability could vary. Other Matters Additionally, LivaNova is the subject of various pending or threatened legal actions and proceedings that arise in the ordinary course of LivaNova’s business. These matters are subject to many uncertainties and outcomes that are not predictable and that may not be known for extended periods of time. Since the outcome of these matters cannot be predicted with certainty, the costs associated with them could have a material adverse effect on LivaNova’s consolidated net income, financial position or liquidity.

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2024
Stockholders' Equity Note [Abstract]
Stockholders' Equity	Note 7. Stockholders' Equity The tables below present the condensed consolidated statements of stockholders’ equity as of and for the three months ended March 31, 2024 and 2023 (in thousands): Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive Loss Accumulated Deficit Total Stockholders' Equity (1) December 31, 2023 53,942 $ 82,533 $ 2,189,517 $ (55) $ (27,883) $ (966,484) $ 1,277,628 Issuance of shares — 440 — (440) — — — Stock-based compensation plans 354 2 3,159 14 — — 3,175 Net loss — — — — — (41,943) (41,943) Other comprehensive loss — — — — (17,323) — (17,323) March 31, 2024 54,296 $ 82,975 $ 2,192,676 $ (481) $ (45,206) $ (1,008,427) $ 1,221,537 Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive Loss Accumulated Deficit Total Stockholders' Equity (1) December 31, 2022 53,852 $ 82,424 $ 2,157,724 $ (375) $ (48,119) $ (984,030) $ 1,207,624 Stock-based compensation plans 2 — 5,204 56 — — 5,260 Net income — — — — — 7,370 7,370 Other comprehensive income — — — — 7,087 — 7,087 March 31, 2023 53,854 $ 82,424 $ 2,162,928 $ (319) $ (41,032) $ (976,660) $ 1,227,341 The following table presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net income for the three months ended March 31, 2024 and 2023 (in thousands): Change in Unrealized Loss on Derivatives Foreign Currency Translation Adjustments (Loss) Gain (1) Total December 31, 2023 $ — $ (27,883) $ (27,883) Other comprehensive loss before reclassifications, before tax — (17,323) (17,323) Tax benefit — — — Other comprehensive loss before reclassifications, net of tax — (17,323) (17,323) Net current-period other comprehensive loss, net of tax — (17,323) (17,323) March 31, 2024 $ — $ (45,206) $ (45,206) December 31, 2022 $ 966 $ (49,085) $ (48,119) Other comprehensive (loss) income before reclassifications, before tax (433) 8,053 7,620 Tax benefit — — — Other comprehensive (loss) income before reclassifications, net of tax (433) 8,053 7,620 Reclassification of gain from accumulated other comprehensive loss, before tax (533) — (533) Reclassification of tax benefit — — — Reclassification of gain from accumulated other comprehensive loss, after tax (533) — (533) Net current-period other comprehensive (loss) income, net of tax (966) 8,053 7,087 March 31, 2023 $ — $ (41,032) $ (41,032) (1) Taxes were not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned.

Stock-Based Incentive Plans

Stock-Based Incentive Plans	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Stock-Based Incentive Plans	Note 8. Stock-Based Incentive Plans Stock-Based Plans During the three months ended March 31, 2024, LivaNova issued stock-based compensatory awards with terms approved by the Compensation and Human Capital Management Committee of LivaNova’s Board of Directors. The awards with service conditions generally vest ratably over four years and are subject to forfeiture unless service conditions are met. The market performance-based awards that were issued cliff vest after three years subject to the rank of LivaNova’s total shareholder return for the three-year period ending December 31, 2026 relative to the total shareholder returns of the S&P Healthcare Equipment Select Constituents index. The adjusted free cash flow and return on invested capital operating performance-based awards that were issued, cliff vest after three years subject to the achievement of certain thresholds of cumulative results for the three-year period ending December 31, 2026. Compensation expense related to awards granted during 2024 for the three months ended March 31, 2024 was $0.1 million. Stock-Based Compensation Stock-based incentive plan compensation expense is as follows (in thousands): Three Months Ended March 31, 2024 2023 RSUs $ 5,074 $ 5,717 SARs 3,283 3,121 Market performance-based restricted stock units 1,059 881 Operating performance-based restricted stock units 448 570 Employee share purchase plan 362 290 Total stock-based compensation expense $ 10,226 $ 10,579 Stock-based compensation agreements issued during the three months ended March 31, 2024 representing potential shares and their weighted average grant date fair values by type is as follows (shares in thousands, fair value in dollars): Three Months Ended March 31, 2024 Shares Weighted Average Grant Date Fair Value Service-based SARs 697,124 $ 26.38 Service-based RSUs 336,423 $ 55.94 Market performance-based RSUs 60,104 $ 75.13 Operating performance-based RSUs 60,098 $ 55.94

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Note 9. Income Taxes LivaNova’s effective income tax rate for the three months ended March 31, 2024 was (22.6)% compared with 24.3% for the three months ended March 31, 2023. LivaNova’s effective income tax rate fluctuates based on, among other factors, changes in pretax income in countries with varying statutory tax rates, valuation allowances, tax credits and incentives. LivaNova continually assesses the realizability of its worldwide deferred tax asset and valuation allowance positions, and when the need arises, the Company establishes or releases valuation allowances accordingly. The decrease in the effective tax rate for the three months ended March 31, 2024, compared to the prior year period, was primarily attributable to changes in valuation allowances, year-over-year changes in income before tax in countries with varying statutory tax rates, and certain discrete tax items. LivaNova operates in multiple jurisdictions throughout the world, and its tax returns are periodically audited or subjected to review by tax authorities. As a result, there is an uncertainty in income taxes recognized in LivaNova’s financial statements. On July 11, 2023, the UK Act implemented the Pillar Two framework, providing a minimum effective tax rate of 15%, including both a multinational top-up tax and a domestic top-up tax for accounting periods beginning on or after December 31, 2023. The UK Act also included a transitional safe harbor election for accounting periods beginning on or before December 31, 2026. Draft UK legislation has also been published for a UTPR to be introduced, although not before accounting periods beginning on or after December 31, 2024. The UTPR is intended to ensure that amounts of multinational top-up tax that are not collected under foreign global minimum tax rules can, in certain circumstances, be collected instead in the UK. This minimum tax is treated as a period cost beginning in 2024 and has not had a material impact on the Company's financial results of operations for the current period. LivaNova will continue to monitor related guidance in the UK and other jurisdictions that impact LivaNova’s operations. Any material change in tax laws, regulations or policies, or their interpretation and enforcement, including with respect to the Pillar Two framework, could result in a higher effective tax rate and have a material impact on our consolidated statements of (loss) income or financial condition.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Earnings Per Share	Note 10. Earnings Per Share The following table presents basic and diluted earnings per share for the three months ended March 31, 2024 and 2023: Three Months Ended March 31, 2024 2023 Basic (loss) income per share $ (0.78) $ 0.14 Diluted (loss) income per share $ (0.78) $ 0.14 The following table presents the reconciliations of net (loss) income and weighted average shares outstanding used in the calculations of basic and diluted earnings per share for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 Numerator (1) : Net (loss) income - basic and diluted $ (41,943) $ 7,370 Denominator (1) : Weighted average shares outstanding - basic 54,008 53,617 Add: Dilutive effect of share-based compensation and convertible debt instruments (2) — 283 Weighted average shares outstanding - diluted 54,008 53,900 (1) For the three months ended March 31, 2024, the 2029 Notes were outstanding and potentially dilutive securities but were excluded from the computation of diluted earnings per share because their effect would have been anti-dilutive. (2) Excluded from the computation of diluted earnings per share were stock options, SARs and restricted share units totaling 4.6 million and 3.2 million for the three months ended March 31, 2024 and 2023, respectively, because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Informat

Geographic and Segment Information	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Geographic and Segment Information	Note 11. Geographic and Segment Information Segment Information LivaNova identifies operating segments based on how it manages, evaluates and internally reports its business activities to allocate resources, develop and execute its strategy and assess performance. Prior to the first quarter of 2024, LivaNova operated through three segments: Cardiopulmonary, Neuromodulation and ACS. During the first quarter of 2024, the Company reorganized its operating and reporting structure upon initiating the 2024 Restructuring Plan. This involved transitioning all ACS standalone cannulae and accessories, including ProtekDuo and transseptal (TandemHeart) cannulae, into its Cardiopulmonary segment. Operations for other ACS products, including LifeSPARC and Hemolung systems, will be discontinued by the end of 2024. For additional information, please refer to “Note 2. Restructuring.” This restructuring, along with changes in how the Company’s CODM regularly reviews information, allocates resources and assesses performance, resulted in modifications to LivaNova’s reportable segments. Specifically, the ACS segment is now included in “Other,” excluding the ACS standalone cannulae and accessories business, which is now included in the Cardiopulmonary reportable segment. As a result, LivaNova now has two reportable segments: Cardiopulmonary and Neuromodulation. Net revenue of the Company’s reportable segments includes revenues from the sale of products that each reportable segment develops and manufactures or distributes. The segment financial information presented herein reflects these changes for all periods presented. LivaNova’s Cardiopulmonary segment is engaged in the design, development, manufacture, marketing and selling of cardiopulmonary products, including heart-lung machines, oxygenators, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. LivaNova’s Neuromodulation segment is engaged in the design, development, manufacture, marketing and selling of devices that deliver neuromodulation therapy for treating DRE and DTD. Neuromodulation products include the VNS Therapy System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, and other accessories. It also includes the development and management of clinical testing of LivaNova’s aura6000 System for treating OSA. LivaNova’s Neuromodulation segment also includes costs associated with the Company’s former heart failure program, which the Company began winding down during the first quarter of 2023 and substantially completed winding down during the fourth quarter of 2023. LivaNova operates under three geographic regions: U.S., Europe, and Rest of World. The following table presents net revenue by operating segment and geographic region for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 Cardiopulmonary United States $ 50,577 $ 39,609 Europe (1) 40,926 36,385 Rest of World 64,388 59,750 155,891 135,744 Neuromodulation United States 105,929 94,489 Europe (1) 13,407 13,280 Rest of World 14,536 12,954 133,872 120,723 Other Revenue (2) 5,149 6,951 Totals United States 160,620 140,267 Europe (1) 54,341 49,643 Rest of World 79,951 73,508 Total (3) $ 294,912 $ 263,418 (1) Includes countries in Europe where the Company has a direct sales presence. Countries in Europe where sales are made through distributors are included in “Rest of World.” (2) Other revenue primarily includes revenue from the Company’s former ACS reportable segment, as discussed above, and rental income not allocated to segments. (3) No single customer represented over 10% of the Company’s consolidated net revenue. No country’s net revenue exceeded 10% of the Company’s consolidated revenue except for the U.S. LivaNova defines segment income as operating income before merger and integration expense, restructuring expense, amortization of intangible assets, as well as other income and expense not allocated to segments. Other income and expense not allocated to segments primarily includes the results of LivaNova’s former ACS reportable segment, as discussed above, and corporate expenses. The following table presents a reconciliation of segment income to consolidated (loss) income before tax for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 Cardiopulmonary $ 14,711 $ 9,174 Neuromodulation 46,678 27,006 Segment income 61,389 36,180 Other income/(expense) (1) (45,143) (38,522) Operating income (loss) 16,246 (2,342) Interest expense (15,893) (13,437) Loss on debt extinguishment (25,482) — Foreign exchange and other income/(expense) (9,071) 25,547 (Loss) income before tax $ (34,200) $ 9,768 (1) Other income/(expense) primarily includes non-allocated corporate expenses, amortization of intangible assets, rental income, and the results of LivaNova’s former ACS reportable segment, as discussed above. The following table presents assets by reportable segment as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Cardiopulmonary $ 943,405 $ 964,735 Neuromodulation 651,863 647,391 Other assets (1) 864,334 817,437 Total $ 2,459,602 $ 2,429,563 (1) Other assets primarily includes corporate assets not allocated to segments and the assets of LivaNova’s former ACS reportable segment. The following table presents capital expenditures by reportable segment for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 Cardiopulmonary $ 3,748 $ 4,798 Neuromodulation 276 359 Other capital expenditures (1) 2,423 2,694 Total $ 6,447 $ 7,851 (1) Other capital expenditures primarily includes corporate capital expenditures not allocated to segments and capital expenditures of LivaNova’s former ACS reportable segment. The following table presents changes in the carrying amount of goodwill by reportable segment for the three months ended March 31, 2024 (in thousands): Cardiopulmonary Neuromodulation Total December 31, 2023 $ 384,187 $ 398,754 $ 782,941 Foreign currency adjustments (11,124) — (11,124) March 31, 2024 $ 373,063 $ 398,754 $ 771,817 Geographic Information The following table presents property, plant and equipment, net by geographic region as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 United States $ 63,846 $ 62,701 Europe 82,833 85,606 Rest of World 5,558 5,874 Total $ 152,237 $ 154,181

Supplemental Financial Informat

Supplemental Financial Information	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Supplemental Financial Information	Note 12. Supplemental Financial Information The following table presents the components of inventories as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Raw materials $ 76,782 $ 81,878 Work-in-process 15,964 12,901 Finished goods 60,430 53,108 $ 153,176 $ 147,887 As of March 31, 2024 and December 31, 2023, inventories included adjustments totaling $25.0 million and $24.4 million, respectively, to record balances at lower of cost or net realizable value. The following table presents the components of accrued liabilities and other as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Legal and professional costs $ 19,961 $ 17,794 Operating lease liabilities 8,578 8,362 Italian medical device payback law 8,447 8,223 Contract liabilities 8,113 10,725 Interest payable 7,985 7,840 Provisions for agents, returns and other 6,705 4,464 Restructuring liability 4,601 911 Royalty accrual 4,146 4,441 Research and development costs 3,099 2,462 Contingent consideration — 13,750 Current derivative liabilities — 3,883 Other accrued expenses 22,394 24,446 $ 94,029 $ 107,301 As of March 31, 2024 and December 31, 2023, contract liabilities totaling $14.1 million and $15.3 million, respectively, were included in accrued liabilities and other long-term liabilities on the condensed consolidated balance sheets. The following table presents the items included in foreign exchange and other income/(expense) on the condensed consolidated statements of (loss) income for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 2025 Notes fair value adjustment (1) $ (1,978) $ 44,390 2029 Notes fair value adjustment (1) (6,831) — Capped call fair value adjustment (2025 Notes) (1) (7,962) (23,379) Capped call fair value adjustment (2029 Notes) (1) 1,970 — Foreign exchange rate fluctuations (922) 222 Interest income 7,021 4,536 Other (369) (222) Foreign exchange and other income/(expense) $ (9,071) $ 25,547 (1) Refer to “Note 3. Fair Value Measurements” The following table presents a reconciliation of cash, cash equivalents and restricted cash reported on the condensed consolidated balance sheets that sum to the total of the amounts shown on the condensed consolidated statements of cash flows as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Cash and cash equivalents $ 309,191 $ 266,504 Restricted cash (1) 306,492 311,368 Cash, cash equivalents and restricted cash $ 615,683 $ 577,872 (1) On March 18, 2022, LivaNova PLC, acting through its Italian branch, entered into an Indemnity Letter and an Account Pledge Agreement with Barclays, further to which Barclays issued the SNIA Litigation Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in USD in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. Cash collateral classified as restricted cash on the condensed consolidated balance sheet was $306.5 million and $311.4 million as of March 31, 2024 and December 31, 2023, respectively. Refer to “Note 6. Commitments and Contingencies.”

New Accounting Pronouncements

New Accounting Pronouncements	3 Months Ended
	Mar. 31, 2024
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	Note 13. New Accounting Pronouncements The following table provides a description of future adoptions of new accounting standards that may have an impact on LivaNova’s financial statements when adopted: Issue Date & Standard Description Adoption Assessment November 2023 This ASU expands public entities’ reportable segment disclosures by requiring disclosure of significant segment expenses that are regularly provided to the CODM and included in each reported measure of segment profit or loss, the amount and description of other segment items, and the title and position of the Company’s CODM, as well as an explanation of how the CODM uses the Company’s reported measures of segment profit or loss in assessing segment performance and deciding how to allocate resources. This ASU will be effective for annual periods beginning after December 15, 2023 and subsequent interim periods, on a retrospective basis. LivaNova is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. December 2023 ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures This ASU expands annual income tax disclosures primarily related to the rate reconciliation and income taxes paid. This ASU will be effective for annual periods beginning after December 15, 2024, on a prospective basis, with early adoption and retrospective application permitted. LivaNova is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net (loss) income	$ (41,943)	$ 7,370

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Unaudited Condensed Consolida_2

Unaudited Condensed Consolidated Financial Statements (Policies)	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed consolidated financial statements of LivaNova as of, and for the three months ended March 31, 2024 and 2023, have been prepared in accordance with U.S. GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 2023 has been derived from audited financial statements contained in LivaNova’s 2023 Form 10-K but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments considered necessary for a fair statement of the operating results of LivaNova and its subsidiaries for the three months ended March 31, 2024, and are not necessarily indicative of the results that may be expected for the year ending December 31, 2024. The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying LivaNova’s 2023 Form 10-K.
Restructuring	LivaNova initiates restructuring plans to leverage economies of scale, streamline distribution and logistics, and strengthen operational and administrative effectiveness in order to reduce overall costs.
Derivatives	If the derivative qualifies for hedge accounting, changes in the fair value of the derivative will be recorded in AOCI until the hedged item is recognized in earnings upon settlement/termination. Interest rate swap gains and losses in AOCI are reclassified to interest expense on LivaNova’s condensed consolidated statements of (loss) income. LivaNova evaluates hedge effectiveness at inception. LivaNova had no designated hedging instruments as of March 31, 2024 and December 31, 2023.
New Accounting Pronouncements	The following table provides a description of future adoptions of new accounting standards that may have an impact on LivaNova’s financial statements when adopted: Issue Date & Standard Description Adoption Assessment November 2023 This ASU expands public entities’ reportable segment disclosures by requiring disclosure of significant segment expenses that are regularly provided to the CODM and included in each reported measure of segment profit or loss, the amount and description of other segment items, and the title and position of the Company’s CODM, as well as an explanation of how the CODM uses the Company’s reported measures of segment profit or loss in assessing segment performance and deciding how to allocate resources. This ASU will be effective for annual periods beginning after December 15, 2023 and subsequent interim periods, on a retrospective basis. LivaNova is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. December 2023 ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures This ASU expands annual income tax disclosures primarily related to the rate reconciliation and income taxes paid. This ASU will be effective for annual periods beginning after December 15, 2024, on a prospective basis, with early adoption and retrospective application permitted. LivaNova is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures.

Restructuring (Tables)

Restructuring (Tables)	3 Months Ended
	Mar. 31, 2024
Restructuring and Related Activities [Abstract]
Reconciliation of Accruals and Other Reserves Related to Restructuring	The following table presents a reconciliation of the beginning and ending balance of the accruals and other reserves recorded in connection with LivaNova’s restructuring plans included in accounts payable, accrued liabilities and other, and accrued employee compensation and related benefits on the condensed consolidated balance sheets (in thousands): Employee Severance and Other Termination Costs Other Total Balance at December 31, 2023 (1) $ 911 $ — $ 911 Charges 7,251 1,974 9,225 Cash payments (2,092) (1,218) (3,310) Balance at March 31, 2024 $ 6,070 $ 756 $ 6,826 (1) Represents restructuring plans initiated prior to 2024.
Schedule of Restructuring Expense by Reportable Segment	The following table presents restructuring expense by reportable segment (in thousands): Three Months Ended March 31, 2024 2023 Neuromodulation $ — $ 416 Other (1) 9,225 309 Total (2) $ 9,225 $ 725 (1) Other primarily includes restructuring expense not allocated to segments. (2) Restructuring expense is included in other operating expenses on the condensed consolidated statements of (loss) income.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements on a Recurring Basis	The following tables provide information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value as of March 31, 2024 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - freestanding instruments (FX) $ 1,295 $ — $ 1,295 $ — Derivative assets - capped call derivatives (2025 Notes) 8,010 — — 8,010 Derivative assets - capped call derivatives (2029 Notes) 33,607 — — 33,607 Convertible notes receivable 269 — — 269 $ 43,181 $ — $ 1,295 $ 41,886 Liabilities: Derivative liabilities - embedded exchange feature (2025 Notes) $ 10,632 $ — $ — $ 10,632 Derivative liabilities - embedded conversion feature (2029 Notes) 94,288 — — 94,288 Contingent consideration arrangement 80,769 — — 80,769 $ 185,689 $ — $ — $ 185,689 Fair Value as of December 31, 2023 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - capped call derivatives (2025 Notes) $ 38,496 $ — $ — $ 38,496 Convertible notes receivable 275 — — 275 $ 38,771 $ — $ — $ 38,771 Liabilities: Derivative liabilities - freestanding instruments (FX) $ 3,883 $ — $ 3,883 $ — Derivative liabilities - embedded exchange feature (2025 Notes) 45,569 — — 45,569 Contingent consideration arrangements 94,652 — — 94,652 $ 144,104 $ — $ 3,883 $ 140,221
Reconciliation of Beginning and Ending Balances of Recurring Fair Value Measurements	The following table provides a reconciliation of the beginning and ending balances of LivaNova’s recurring fair value measurements, using significant unobservable inputs (Level 3) (in thousands): Capped Call Derivative Assets Capped Call Derivative Assets Convertible Notes Receivable Embedded Exchange Feature Derivative Liability Embedded Conversion Feature Derivative Liability Contingent Consideration Liability Arrangements As of December 31, 2023 $ 38,496 $ — $ 275 $ 45,569 $ — $ 94,652 Additions — 31,637 — — 87,457 — Cash receipt (22,524) — — — — — Payment — — — (36,915) — (13,750) Changes in fair value (7,962) 1,970 (6) 1,978 6,831 (133) Total at March 31, 2024 - long-term $ 8,010 $ 33,607 $ 269 $ 10,632 $ 94,288 $ 80,769
Summary of Stock Price Volatility, Fair Value, and Hypothetical Changes	The following table presents the stock price volatility utilized in determining the fair value of LivaNova’s capped call derivative assets and embedded derivative liabilities as of March 31, 2024: March 31, 2024 Capped Call Derivative Assets (2025 Notes) Capped Call Derivative Assets (2029 Notes) Embedded Exchange Feature Derivative Liability (2025 Notes) Embedded Conversion Feature Derivative Liability (2029 Notes) Stock price volatility 38 % 36 % 38 % 36 %
Schedule of Fair Value of Contingent Consideration Arrangements by Acquisition	The following table provides the fair value of Level 3 contingent consideration arrangements by acquisition (in thousands): March 31, 2024 December 31, 2023 ImThera $ 80,769 $ 80,902 ALung — 13,750 $ 80,769 $ 94,652
Significant Unobservable Inputs Related to Contingent Consideration	These arrangements are Level 3 fair value measurements and include the following significant unobservable inputs as of March 31, 2024: ImThera Acquisition Valuation Technique Unobservable Input Inputs Regulatory milestone-based payment Discounted cash flow Discount rate 8.2% Probability of payment 85% Projected payment year 2026 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 14.0% - 14.4% Credit risk discount rate 8.3% - 8.7% Revenue volatility 28.4% Probability of payment 85% Projected years of earnout 2026 - 2029

Financing Arrangements (Tables)

Financing Arrangements (Tables)	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Schedule of Long-term Debt	The outstanding principal amount of long-term debt as of March 31, 2024 and December 31, 2023 was as follows (in thousands, except interest rates): March 31, 2024 December 31, 2023 Maturity Interest Rate Term Facilities $ 324,571 $ 328,459 July 2027 8.93% 2029 Notes 246,256 — March 2029 2.50% 2025 Notes 51,015 255,500 December 2025 3.00% Bank of America, U.S. 1,500 1,500 January 2025 8.09% Other 478 568 Total long-term facilities 623,820 586,027 Less current portion of long-term debt 19,067 17,484 Total long-term debt obligations $ 604,753 $ 568,543

Derivatives and Risk Manageme_2

Derivatives and Risk Management (Tables)	3 Months Ended
	Mar. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Cash Flow Hedges Included in AOCI	The pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in OCI and the amount reclassified to earnings from AOCI were as follows (in thousands): Three Months Ended March 31, 2023 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Loss Recognized in OCI Gain Reclassified from AOCI to Earnings Interest rate swap contracts Interest expense $ (433) $ 533
Schedule of Fair Value of Derivative Instruments in Statement of Financial Position	The following tables present the fair value and the location of derivative contracts reported on the condensed consolidated balance sheets as of March 31, 2024 and December 31, 2023 (in thousands): Asset Derivatives Liability Derivatives March 31, 2024 Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Derivatives Not Designated as Hedging Instruments: Capped call derivatives (2025 Notes) Long-term derivative assets $ 8,010 Capped call derivatives (2029 Notes) Long-term derivative assets 33,607 Embedded exchange feature (2025 Notes) Long-term derivative liabilities $ 10,632 Embedded exchange feature (2029 Notes) Long-term derivative liabilities 94,288 FX derivative contracts Prepaid expenses and other current assets 1,295 Total derivatives not designated as hedging instruments 42,912 104,920 Total derivatives $ 42,912 $ 104,920 Asset Derivatives Liability Derivatives December 31, 2023 Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Derivatives Not Designated as Hedging Instruments: Capped call derivatives (2025 Notes) Long-term derivative assets $ 38,496 FX derivative contracts Accrued liabilities and other $ 3,883 Embedded exchange feature (2025 Notes) Long-term derivative liabilities 45,569 Total derivatives not designated as hedging instruments 38,496 49,452 Total derivatives $ 38,496 $ 49,452 (1) For the classification of inputs used to evaluate the fair value of derivatives, refer to “Note 3. Fair Value Measurements.”

Commitments and Contingencies (

Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Litigation Provision Liabilities	The following table presents the changes in the carrying amount of the litigation provision liability for the three months ended March 31, 2024 (in thousands): Total litigation provision liability at December 31, 2023 $ 13,860 Payments (157) Adjustments (1) 6,392 FX and other (80) Total litigation provision liability at March 31, 2024 20,015 Less current portion of litigation provision liability at March 31, 2024 16,980 Long-term portion of litigation provision liability at March 31, 2024 (2) $ 3,035 (1) Adjustments to the litigation provision are included in other operating expenses on the condensed consolidated statements of (loss) income. (2)

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2024
Stockholders' Equity Note [Abstract]
Schedule of Stockholders Equity	The tables below present the condensed consolidated statements of stockholders’ equity as of and for the three months ended March 31, 2024 and 2023 (in thousands): Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive Loss Accumulated Deficit Total Stockholders' Equity (1) December 31, 2023 53,942 $ 82,533 $ 2,189,517 $ (55) $ (27,883) $ (966,484) $ 1,277,628 Issuance of shares — 440 — (440) — — — Stock-based compensation plans 354 2 3,159 14 — — 3,175 Net loss — — — — — (41,943) (41,943) Other comprehensive loss — — — — (17,323) — (17,323) March 31, 2024 54,296 $ 82,975 $ 2,192,676 $ (481) $ (45,206) $ (1,008,427) $ 1,221,537 Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive Loss Accumulated Deficit Total Stockholders' Equity (1) December 31, 2022 53,852 $ 82,424 $ 2,157,724 $ (375) $ (48,119) $ (984,030) $ 1,207,624 Stock-based compensation plans 2 — 5,204 56 — — 5,260 Net income — — — — — 7,370 7,370 Other comprehensive income — — — — 7,087 — 7,087 March 31, 2023 53,854 $ 82,424 $ 2,162,928 $ (319) $ (41,032) $ (976,660) $ 1,227,341
Schedule of Accumulated Other Comprehensive Income (Loss)	The following table presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net income for the three months ended March 31, 2024 and 2023 (in thousands): Change in Unrealized Loss on Derivatives Foreign Currency Translation Adjustments (Loss) Gain (1) Total December 31, 2023 $ — $ (27,883) $ (27,883) Other comprehensive loss before reclassifications, before tax — (17,323) (17,323) Tax benefit — — — Other comprehensive loss before reclassifications, net of tax — (17,323) (17,323) Net current-period other comprehensive loss, net of tax — (17,323) (17,323) March 31, 2024 $ — $ (45,206) $ (45,206) December 31, 2022 $ 966 $ (49,085) $ (48,119) Other comprehensive (loss) income before reclassifications, before tax (433) 8,053 7,620 Tax benefit — — — Other comprehensive (loss) income before reclassifications, net of tax (433) 8,053 7,620 Reclassification of gain from accumulated other comprehensive loss, before tax (533) — (533) Reclassification of tax benefit — — — Reclassification of gain from accumulated other comprehensive loss, after tax (533) — (533) Net current-period other comprehensive (loss) income, net of tax (966) 8,053 7,087 March 31, 2023 $ — $ (41,032) $ (41,032) (1) Taxes were not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned.

Stock-Based Incentive Plans (Ta

Stock-Based Incentive Plans (Tables)	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of Stock-based Incentive Plans	Stock-based incentive plan compensation expense is as follows (in thousands): Three Months Ended March 31, 2024 2023 RSUs $ 5,074 $ 5,717 SARs 3,283 3,121 Market performance-based restricted stock units 1,059 881 Operating performance-based restricted stock units 448 570 Employee share purchase plan 362 290 Total stock-based compensation expense $ 10,226 $ 10,579 Stock-based compensation agreements issued during the three months ended March 31, 2024 representing potential shares and their weighted average grant date fair values by type is as follows (shares in thousands, fair value in dollars): Three Months Ended March 31, 2024 Shares Weighted Average Grant Date Fair Value Service-based SARs 697,124 $ 26.38 Service-based RSUs 336,423 $ 55.94 Market performance-based RSUs 60,104 $ 75.13 Operating performance-based RSUs 60,098 $ 55.94

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Schedule of Basic and Diluted Weighted-Average Shares Outstanding	The following table presents basic and diluted earnings per share for the three months ended March 31, 2024 and 2023: Three Months Ended March 31, 2024 2023 Basic (loss) income per share $ (0.78) $ 0.14 Diluted (loss) income per share $ (0.78) $ 0.14 The following table presents the reconciliations of net (loss) income and weighted average shares outstanding used in the calculations of basic and diluted earnings per share for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 Numerator (1) : Net (loss) income - basic and diluted $ (41,943) $ 7,370 Denominator (1) : Weighted average shares outstanding - basic 54,008 53,617 Add: Dilutive effect of share-based compensation and convertible debt instruments (2) — 283 Weighted average shares outstanding - diluted 54,008 53,900 (1) For the three months ended March 31, 2024, the 2029 Notes were outstanding and potentially dilutive securities but were excluded from the computation of diluted earnings per share because their effect would have been anti-dilutive. (2) Excluded from the computation of diluted earnings per share were stock options, SARs and restricted share units totaling 4.6 million and 3.2 million for the three months ended March 31, 2024 and 2023, respectively, because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Inform_2

Geographic and Segment Information (Tables)	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Revenue from External Customers by Geographic Areas	The following table presents net revenue by operating segment and geographic region for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 Cardiopulmonary United States $ 50,577 $ 39,609 Europe (1) 40,926 36,385 Rest of World 64,388 59,750 155,891 135,744 Neuromodulation United States 105,929 94,489 Europe (1) 13,407 13,280 Rest of World 14,536 12,954 133,872 120,723 Other Revenue (2) 5,149 6,951 Totals United States 160,620 140,267 Europe (1) 54,341 49,643 Rest of World 79,951 73,508 Total (3) $ 294,912 $ 263,418 (1) Includes countries in Europe where the Company has a direct sales presence. Countries in Europe where sales are made through distributors are included in “Rest of World.” (2) Other revenue primarily includes revenue from the Company’s former ACS reportable segment, as discussed above, and rental income not allocated to segments. (3)
Schedule of Segment Reporting Information, by Segment	The following table presents a reconciliation of segment income to consolidated (loss) income before tax for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 Cardiopulmonary $ 14,711 $ 9,174 Neuromodulation 46,678 27,006 Segment income 61,389 36,180 Other income/(expense) (1) (45,143) (38,522) Operating income (loss) 16,246 (2,342) Interest expense (15,893) (13,437) Loss on debt extinguishment (25,482) — Foreign exchange and other income/(expense) (9,071) 25,547 (Loss) income before tax $ (34,200) $ 9,768 (1) Other income/(expense) primarily includes non-allocated corporate expenses, amortization of intangible assets, rental income, and the results of LivaNova’s former ACS reportable segment, as discussed above. The following table presents assets by reportable segment as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Cardiopulmonary $ 943,405 $ 964,735 Neuromodulation 651,863 647,391 Other assets (1) 864,334 817,437 Total $ 2,459,602 $ 2,429,563 (1) Other assets primarily includes corporate assets not allocated to segments and the assets of LivaNova’s former ACS reportable segment. The following table presents capital expenditures by reportable segment for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 Cardiopulmonary $ 3,748 $ 4,798 Neuromodulation 276 359 Other capital expenditures (1) 2,423 2,694 Total $ 6,447 $ 7,851 (1) Other capital expenditures primarily includes corporate capital expenditures not allocated to segments and capital expenditures of LivaNova’s former ACS reportable segment.
Schedule of Goodwill by Segment	The following table presents changes in the carrying amount of goodwill by reportable segment for the three months ended March 31, 2024 (in thousands): Cardiopulmonary Neuromodulation Total December 31, 2023 $ 384,187 $ 398,754 $ 782,941 Foreign currency adjustments (11,124) — (11,124) March 31, 2024 $ 373,063 $ 398,754 $ 771,817
Long-lived Assets by Geographic Areas	The following table presents property, plant and equipment, net by geographic region as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 United States $ 63,846 $ 62,701 Europe 82,833 85,606 Rest of World 5,558 5,874 Total $ 152,237 $ 154,181

Supplemental Financial Inform_2

Supplemental Financial Information (Tables)	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Inventories	The following table presents the components of inventories as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Raw materials $ 76,782 $ 81,878 Work-in-process 15,964 12,901 Finished goods 60,430 53,108 $ 153,176 $ 147,887
Accrued Liabilities	The following table presents the components of accrued liabilities and other as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Legal and professional costs $ 19,961 $ 17,794 Operating lease liabilities 8,578 8,362 Italian medical device payback law 8,447 8,223 Contract liabilities 8,113 10,725 Interest payable 7,985 7,840 Provisions for agents, returns and other 6,705 4,464 Restructuring liability 4,601 911 Royalty accrual 4,146 4,441 Research and development costs 3,099 2,462 Contingent consideration — 13,750 Current derivative liabilities — 3,883 Other accrued expenses 22,394 24,446 $ 94,029 $ 107,301
Foreign Exchange and Other Gains (Losses)	The following table presents the items included in foreign exchange and other income/(expense) on the condensed consolidated statements of (loss) income for the three months ended March 31, 2024 and 2023 (in thousands): Three Months Ended March 31, 2024 2023 2025 Notes fair value adjustment (1) $ (1,978) $ 44,390 2029 Notes fair value adjustment (1) (6,831) — Capped call fair value adjustment (2025 Notes) (1) (7,962) (23,379) Capped call fair value adjustment (2029 Notes) (1) 1,970 — Foreign exchange rate fluctuations (922) 222 Interest income 7,021 4,536 Other (369) (222) Foreign exchange and other income/(expense) $ (9,071) $ 25,547 (1) Refer to “Note 3. Fair Value Measurements”
Schedule of Cash, Cash Equivalents and Restricted Cash	The following table presents a reconciliation of cash, cash equivalents and restricted cash reported on the condensed consolidated balance sheets that sum to the total of the amounts shown on the condensed consolidated statements of cash flows as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Cash and cash equivalents $ 309,191 $ 266,504 Restricted cash (1) 306,492 311,368 Cash, cash equivalents and restricted cash $ 615,683 $ 577,872 (1) On March 18, 2022, LivaNova PLC, acting through its Italian branch, entered into an Indemnity Letter and an Account Pledge Agreement with Barclays, further to which Barclays issued the SNIA Litigation Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in USD in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. Cash collateral classified as restricted cash on the condensed consolidated balance sheet was $306.5 million and $311.4 million as of March 31, 2024 and December 31, 2023, respectively. Refer to “Note 6. Commitments and Contingencies.”
Schedule of Cash, Cash Equivalents and Restricted Cash	The following table presents a reconciliation of cash, cash equivalents and restricted cash reported on the condensed consolidated balance sheets that sum to the total of the amounts shown on the condensed consolidated statements of cash flows as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 December 31, 2023 Cash and cash equivalents $ 309,191 $ 266,504 Restricted cash (1) 306,492 311,368 Cash, cash equivalents and restricted cash $ 615,683 $ 577,872 (1) On March 18, 2022, LivaNova PLC, acting through its Italian branch, entered into an Indemnity Letter and an Account Pledge Agreement with Barclays, further to which Barclays issued the SNIA Litigation Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in USD in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. Cash collateral classified as restricted cash on the condensed consolidated balance sheet was $306.5 million and $311.4 million as of March 31, 2024 and December 31, 2023, respectively. Refer to “Note 6. Commitments and Contingencies.”

New Accounting Pronouncements (

New Accounting Pronouncements (Tables)	3 Months Ended
	Mar. 31, 2024
Accounting Standards Update and Change in Accounting Principle [Abstract]
Schedule of New Accounting Pronouncements and Changes in Accounting Principles	Issue Date & Standard Description Adoption Assessment November 2023 This ASU expands public entities’ reportable segment disclosures by requiring disclosure of significant segment expenses that are regularly provided to the CODM and included in each reported measure of segment profit or loss, the amount and description of other segment items, and the title and position of the Company’s CODM, as well as an explanation of how the CODM uses the Company’s reported measures of segment profit or loss in assessing segment performance and deciding how to allocate resources. This ASU will be effective for annual periods beginning after December 15, 2023 and subsequent interim periods, on a retrospective basis. LivaNova is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. December 2023 ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures This ASU expands annual income tax disclosures primarily related to the rate reconciliation and income taxes paid. This ASU will be effective for annual periods beginning after December 15, 2024, on a prospective basis, with early adoption and retrospective application permitted. LivaNova is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures.

Unaudited Condensed Consolida_3

Unaudited Condensed Consolidated Financial Statements - Narrative (Details) - USD ($) $ in Millions	3 Months Ended	5 Months Ended
	Mar. 31, 2024	Mar. 31, 2024
Accounting Policies [Abstract]
Cybersecurity Incident Related Expenses	$ 2.8	$ 5.4

Restructuring - Narrative (Deta

Restructuring - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Restructuring Cost and Reserve [Line Items]
Charges	$ 9,225	$ 725
Employee Severance and Termination Costs
Restructuring Cost and Reserve [Line Items]
Charges	7,251
Other
Restructuring Cost and Reserve [Line Items]
Charges	1,974
2024 Restructuring Plan
Restructuring Cost and Reserve [Line Items]
Charges	9,200
2024 Restructuring Plan | Minimum
Restructuring Cost and Reserve [Line Items]
Expected cost	15,000
2024 Restructuring Plan | Maximum
Restructuring Cost and Reserve [Line Items]
Expected cost	20,000
2024 Restructuring Plan | Employee Severance and Termination Costs | Minimum
Restructuring Cost and Reserve [Line Items]
Expected cost	10,000
2024 Restructuring Plan | Employee Severance and Termination Costs | Maximum
Restructuring Cost and Reserve [Line Items]
Expected cost	12,000
2024 Restructuring Plan | Other | Minimum
Restructuring Cost and Reserve [Line Items]
Expected cost	5,000
2024 Restructuring Plan | Other | Maximum
Restructuring Cost and Reserve [Line Items]
Expected cost	$ 8,000

Restructuring - Reconciliation

Restructuring - Reconciliation of Accruals and Other Reserves Related to Restructuring (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Restructuring Reserve [Roll Forward]
Beginning liability balance	$ 911
Charges	9,225	$ 725
Cash payments	(3,310)
Ending liability balance	6,826
Employee Severance and Termination Costs
Restructuring Reserve [Roll Forward]
Beginning liability balance	911
Charges	7,251
Cash payments	(2,092)
Ending liability balance	6,070
Other
Restructuring Reserve [Roll Forward]
Beginning liability balance	0
Charges	1,974
Cash payments	(1,218)
Ending liability balance	$ 756

Restructuring - Restructuring E

Restructuring - Restructuring Expense by Reportable Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Restructuring Cost and Reserve [Line Items]
Charges	$ 9,225	$ 725
Operating Segments | Neuromodulation
Restructuring Cost and Reserve [Line Items]
Charges	0	416
Other
Restructuring Cost and Reserve [Line Items]
Charges	$ 9,225	$ 309

Fair Value Measurements - Asset

Fair Value Measurements - Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Assets:
Derivative Asset	$ 42,912	$ 38,496
Liabilities:
Derivative Liability	104,920	49,452
Contingent consideration	80,769	80,902
Capped Call
Assets:
Derivative Asset	8,000	38,500
Capped Call | 2029 Notes
Assets:
Derivative Asset	33,600
Derivatives Not Designated as Hedging Instruments:
Assets:
Derivative Asset	42,912	38,496
Liabilities:
Derivative Liability	104,920	49,452
Fair Value, Recurring
Assets:
Convertible notes receivable	269	275
Total assets	43,181	38,771
Liabilities:
Contingent consideration	80,769	94,652
Total liabilities	185,689	144,104
Fair Value, Recurring | Embedded Derivative Financial Instruments | 2025 Notes
Liabilities:
Derivative Liability	10,632	45,569
Fair Value, Recurring | Embedded Derivative Financial Instruments | 2029 Notes
Liabilities:
Derivative Liability	94,288
Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments: | Freestanding Instrument
Assets:
Derivative Asset	1,295
Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments: | Capped Call | 2025 Notes
Assets:
Derivative Asset	8,010	38,496
Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments: | Capped Call | 2029 Notes
Assets:
Derivative Asset	33,607
Fair Value, Recurring | Designated as Hedging Instrument | Foreign Exchange Contract
Liabilities:
Derivative Liability		3,883
Fair Value, Recurring | Level 1
Assets:
Convertible notes receivable	0	0
Total assets	0	0
Liabilities:
Contingent consideration	0	0
Total liabilities	0	0
Fair Value, Recurring | Level 1 | Embedded Derivative Financial Instruments | 2025 Notes
Liabilities:
Derivative Liability	0	0
Fair Value, Recurring | Level 1 | Embedded Derivative Financial Instruments | 2029 Notes
Liabilities:
Derivative Liability	0
Fair Value, Recurring | Level 1 | Derivatives Not Designated as Hedging Instruments: | Freestanding Instrument
Assets:
Derivative Asset	0
Fair Value, Recurring | Level 1 | Derivatives Not Designated as Hedging Instruments: | Capped Call | 2025 Notes
Assets:
Derivative Asset	0	0
Fair Value, Recurring | Level 1 | Derivatives Not Designated as Hedging Instruments: | Capped Call | 2029 Notes
Assets:
Derivative Asset	0
Fair Value, Recurring | Level 1 | Designated as Hedging Instrument | Foreign Exchange Contract
Liabilities:
Derivative Liability		0
Fair Value, Recurring | Level 2
Assets:
Convertible notes receivable	0	0
Total assets	1,295	0
Liabilities:
Contingent consideration	0	0
Total liabilities	0	3,883
Fair Value, Recurring | Level 2 | Embedded Derivative Financial Instruments | 2025 Notes
Liabilities:
Derivative Liability	0	0
Fair Value, Recurring | Level 2 | Embedded Derivative Financial Instruments | 2029 Notes
Liabilities:
Derivative Liability	0
Fair Value, Recurring | Level 2 | Derivatives Not Designated as Hedging Instruments: | Freestanding Instrument
Assets:
Derivative Asset	1,295
Fair Value, Recurring | Level 2 | Derivatives Not Designated as Hedging Instruments: | Capped Call | 2025 Notes
Assets:
Derivative Asset	0	0
Fair Value, Recurring | Level 2 | Derivatives Not Designated as Hedging Instruments: | Capped Call | 2029 Notes
Assets:
Derivative Asset	0
Fair Value, Recurring | Level 2 | Designated as Hedging Instrument | Foreign Exchange Contract
Liabilities:
Derivative Liability		3,883
Fair Value, Recurring | Level 3
Assets:
Convertible notes receivable	269	275
Total assets	41,886	38,771
Liabilities:
Contingent consideration	80,769	94,652
Total liabilities	185,689	140,221
Fair Value, Recurring | Level 3 | Embedded Derivative Financial Instruments | 2025 Notes
Liabilities:
Derivative Liability	10,632	45,569
Fair Value, Recurring | Level 3 | Embedded Derivative Financial Instruments | 2029 Notes
Liabilities:
Derivative Liability	94,288
Fair Value, Recurring | Level 3 | Derivatives Not Designated as Hedging Instruments: | Freestanding Instrument
Assets:
Derivative Asset	0
Fair Value, Recurring | Level 3 | Derivatives Not Designated as Hedging Instruments: | Capped Call | 2025 Notes
Assets:
Derivative Asset	8,010	38,496
Fair Value, Recurring | Level 3 | Derivatives Not Designated as Hedging Instruments: | Capped Call | 2029 Notes
Assets:
Derivative Asset	$ 33,607
Fair Value, Recurring | Level 3 | Designated as Hedging Instrument | Foreign Exchange Contract
Liabilities:
Derivative Liability		$ 0

Fair Value Measurements - Recon

Fair Value Measurements - Reconciliation of Recurring Fair Value Measurements (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
2025 Notes
Assets Measured on Recurring Basis
Changes in fair value	$ 1,978	$ (44,390)
2029 Notes
Assets Measured on Recurring Basis
Changes in fair value	6,831	0
Capped Call Derivative Assets (2025 Notes) | 2025 Notes
Assets Measured on Recurring Basis
Changes in fair value	7,962	23,379
Capped Call Derivative Assets (2025 Notes) | 2029 Notes
Assets Measured on Recurring Basis
Changes in fair value	(1,970)	$ 0
Fair Value, Recurring | Level 3
Liabilities Measured on Recurring Basis
Total at beginning period	94,652
Total at period end	80,769
Fair Value, Recurring | Level 3 | Embedded Exchange Feature Derivative Liability (2025 Notes) | 2025 Notes
Liabilities Measured on Recurring Basis
Total at beginning period	45,569
Additions	0
Cash receipt	0
Payment	(36,915)
Changes in fair value	1,978
Fair Value, Recurring | Level 3 | Embedded Exchange Feature Derivative Liability (2025 Notes) | 2025 Notes | Embedded Derivative Financial Instruments
Liabilities Measured on Recurring Basis
Total at period end	10,632
Fair Value, Recurring | Level 3 | Embedded Exchange Feature Derivative Liability (2025 Notes) | 2029 Notes
Liabilities Measured on Recurring Basis
Total at beginning period	0
Additions	87,457
Cash receipt	0
Payment	0
Changes in fair value	6,831
Fair Value, Recurring | Level 3 | Embedded Exchange Feature Derivative Liability (2025 Notes) | 2029 Notes | Embedded Derivative Financial Instruments
Liabilities Measured on Recurring Basis
Total at period end	94,288
Fair Value, Recurring | Level 3 | Contingent Consideration Liability Arrangements
Liabilities Measured on Recurring Basis
Total at beginning period	94,652
Additions	0
Cash receipt	0
Payment	(13,750)
Changes in fair value	(133)
Total at period end	80,769
Fair Value, Recurring | Level 3 | Capped Call Derivative Assets (2025 Notes) | 2025 Notes
Assets Measured on Recurring Basis
As of beginning period	38,496
Additions	0
Cash receipt	(22,524)
Payment	0
Changes in fair value	(7,962)
Fair Value, Recurring | Level 3 | Capped Call Derivative Assets (2025 Notes) | 2025 Notes | Capped Call
Assets Measured on Recurring Basis
Total at period end	8,010
Fair Value, Recurring | Level 3 | Capped Call Derivative Assets (2025 Notes) | 2029 Notes
Assets Measured on Recurring Basis
As of beginning period	0
Additions	31,637
Cash receipt	0
Payment	0
Changes in fair value	1,970
Fair Value, Recurring | Level 3 | Capped Call Derivative Assets (2025 Notes) | 2029 Notes | Capped Call
Assets Measured on Recurring Basis
Total at period end	33,607
Fair Value, Recurring | Level 3 | Convertible Notes Receivable
Assets Measured on Recurring Basis
As of beginning period	275
Additions	0
Cash receipt	0
Payment	0
Changes in fair value	(6)
Total at period end	$ 269

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - Senior Notes - USD ($)	Mar. 08, 2024	Jun. 30, 2020	Jun. 17, 2020
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Aggregate principal amount repurchased	$ 230,000,000
2025 Notes
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Debt instrument, face amount		$ 287,500,000	$ 287,500,000
Aggregate principal amount repurchased	230,000,000	230,000,000
2029 Notes
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Debt instrument, face amount	$ 345,000,000	$ 345,000,000

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Stock Price Volatility, Fair Value, and Hypothetical Changes (Details) - Measurement Input, Stock Price Volatility	Mar. 31, 2024
2025 Notes | Capped Call
Derivative Asset [Abstract]
Measurement input	0.38
2025 Notes | Embedded Derivative Financial Instruments
Derivative Liability [Abstract]
Measurement input	0.38
2029 Notes | Capped Call
Derivative Asset [Abstract]
Measurement input	0.36
2029 Notes | Embedded Derivative Financial Instruments
Derivative Liability [Abstract]
Measurement input	0.36

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Contingent Consideration by Acquisition (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 80,769	$ 80,902
Fair Value, Recurring
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	80,769	94,652
Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	80,769	94,652
Total fair value of Level 3 contingent consideration arrangements	80,769	94,652
ImThera | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	80,769	80,902
ALung | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 0	$ 13,750

Fair Value Measurements - Signi

Fair Value Measurements - Significant Unobservable Inputs (Details) - ImThera - Level 3	Mar. 31, 2024
Discounted cash flow | Discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.082
Discounted cash flow | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.85
Monte Carlo simulation | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.85
Monte Carlo simulation | Revenue volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.284
Minimum | Monte Carlo simulation | Risk-adjusted discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.140
Minimum | Monte Carlo simulation | Credit risk discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.083
Maximum | Monte Carlo simulation | Risk-adjusted discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.144
Maximum | Monte Carlo simulation | Credit risk discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.087

Financing Arrangements - Schedu

Financing Arrangements - Schedule of Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Mar. 08, 2024	Dec. 31, 2023	Jun. 17, 2020
Debt Instrument [Line Items]
Total long-term facilities	$ 623,820		$ 586,027
Less current portion of long-term debt	19,067		17,484
Total long-term debt obligations	$ 604,753		568,543
Bank of America, U.S.
Debt Instrument [Line Items]
Interest rate, stated percentage	8.09%
Term Loan
Debt Instrument [Line Items]
Total long-term facilities	$ 324,571		328,459
Interest rate, stated percentage	8.93%
Senior Notes | 2029 Notes
Debt Instrument [Line Items]
Total long-term facilities	$ 246,256		0
Interest rate, stated percentage	2.50%	2.50%
Senior Notes | 2025 Notes
Debt Instrument [Line Items]
Total long-term facilities	$ 51,015		255,500
Interest rate, stated percentage	3%			3%
Loans Payable | Bank of America, U.S.
Debt Instrument [Line Items]
Total long-term facilities	$ 1,500		1,500
Other
Debt Instrument [Line Items]
Total long-term facilities	$ 478		$ 568

Financing Arrangements - Narrat

Financing Arrangements - Narrative (Details)			3 Months Ended		12 Months Ended
	Mar. 08, 2024 USD ($)	Jun. 17, 2020 USD ($)	Mar. 31, 2024 USD ($) $ / shares	Mar. 31, 2023 USD ($)	Dec. 31, 2023 USD ($)	Mar. 31, 2024 £ / shares	Mar. 07, 2024 USD ($)	Aug. 13, 2021 USD ($)	Jun. 30, 2020 USD ($)
Debt Instrument [Line Items]
Amortization of debt issuance costs			$ 4,900,000	$ 5,019,000
Repayment of long-term debt obligations			234,375,000	1,875,000
Loss on debt extinguishment			25,482,000	0
Proceeds from long-term debt obligations			335,513,000	0
Derivative Liability			104,920,000		$ 49,452,000
Derivative Asset			42,912,000		38,496,000
Derivatives Not Designated as Hedging Instruments:
Debt Instrument [Line Items]
Derivative Liability			104,920,000		49,452,000
Derivative Asset			$ 42,912,000		38,496,000
Capped Call
Debt Instrument [Line Items]
Derivative, cap price per share | $ / shares			$ 100
Derivative Asset			$ 8,000,000		38,500,000
Capped Call | 2029 Notes
Debt Instrument [Line Items]
Conversion price (in dollars per share) | $ / shares			$ 69.40
Derivative, cap price per share | $ / shares			$ 94.2840
Derivative Asset			$ 33,600,000
Capped Call | 2029 Notes | Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments:
Debt Instrument [Line Items]
Derivative Asset			33,607,000
Capped Call | 2029 Notes | Level 3 | Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments:
Debt Instrument [Line Items]
Derivative Asset			33,607,000
Capped Call | 2025 Notes
Debt Instrument [Line Items]
Consideration received upon termination	$ 22,500,000
Capped Call | 2025 Notes | Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments:
Debt Instrument [Line Items]
Derivative Asset			8,010,000		38,496,000
Capped Call | 2025 Notes | Level 3 | Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments:
Debt Instrument [Line Items]
Derivative Asset			8,010,000		38,496,000
Embedded Derivative Financial Instruments | 2029 Notes | Fair Value, Recurring
Debt Instrument [Line Items]
Derivative Liability			94,288,000
Embedded Derivative Financial Instruments | 2029 Notes | Level 3 | Fair Value, Recurring
Debt Instrument [Line Items]
Derivative Liability			94,288,000
Embedded Derivative Financial Instruments | 2025 Notes | Fair Value, Recurring
Debt Instrument [Line Items]
Derivative Liability			10,632,000		45,569,000
Embedded Derivative Financial Instruments | 2025 Notes | Level 3 | Fair Value, Recurring
Debt Instrument [Line Items]
Derivative Liability			$ 10,632,000		45,569,000
Senior Notes
Debt Instrument [Line Items]
Aggregate principal amount repurchased	230,000,000
Senior Notes | 2029 Notes
Debt Instrument [Line Items]
Interest rate			9.78%
Line of credit, maximum borrowing capacity			$ 45,000,000
Debt discounts and issuance costs	99,600,000
Amortization of debt issuance costs	$ 900,000
Unamortized discount (premium), net			$ 98,700,000
Interest rate, stated percentage	2.50%		2.50%
Debt instrument, face amount	$ 345,000,000								$ 345,000,000
Proceeds from long-term debt obligations			$ 332,100,000
Unamortized discount	87,500,000
Debt issuance costs, net	$ 12,100,000
Redemption, threshold trading days	20 days		20 days
Redemption, threshold consecutive trading days	30 days		30 days
Redemption price, percentage of exchange price			130%
Business period	5 days
Threshold consecutive trading days preceding business period	10 days
Threshold percentage of stock price trigger	98%
Minimum holding percentage of aggregate principal amount	25%
Fair value of embedded derivative liability	$ 87,500,000		$ 94,300,000
Senior Notes | 2025 Notes
Debt Instrument [Line Items]
Interest rate			9.16%
Debt discounts and issuance costs		$ 82,000,000
Amortization of debt issuance costs			$ 3,400,000	$ 3,800,000
Unamortized discount (premium), net	5,800,000		$ 6,500,000		$ 32,000,000
Interest rate, stated percentage		3%	3%
Aggregate principal amount repurchased	230,000,000								230,000,000
Repayment of long-term debt obligations	$ 270,500,000
Debt instrument, face amount		$ 287,500,000							$ 287,500,000
Proceeds from long-term debt obligations		278,000,000
Unamortized discount		75,000,000
Debt issuance costs, net		$ 7,000,000
Redemption, threshold trading days			20 days
Redemption, threshold consecutive trading days			30 days
Redemption price, percentage of exchange price	130%		130%
Conversion price (in dollars per share) | $ / shares			$ 79.27
Redemption, threshold par value (in pounds per share) | £ / shares						£ 1
Option to exchange (in dollars per share) | $ / shares			$ 60.98
Redemption price, percentage			100%
Conversion ratio			0.016398
Revolving Credit Facility
Debt Instrument [Line Items]
Short-term Debt			$ 600,000
Line of credit, maximum borrowing capacity	$ 225,000,000						$ 125,000,000	$ 225,000,000
Commitment fee percentage			0.50%		0.50%
Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Debt discounts and issuance costs			$ 9,600,000
Amortization of debt issuance costs			500,000
Unamortized discount (premium), net			6,300,000		$ 6,800,000
Revolving Credit Facility | Line of Credit | Delayed Draw Term Facility
Debt Instrument [Line Items]
Debt discounts and issuance costs			1,600,000
Amortization of debt issuance costs			$ 500,000
Revolving Credit Facility | Maximum
Debt Instrument [Line Items]
Interest rate			4.94%
Debt instrument, term			364 days
Net leverage ratio, threshold for four consecutive fiscal quarters	3.50
Interest coverage ratio, threshold for four consecutive fiscal quarters	2

Derivatives and Risk Manageme_3

Derivatives and Risk Management - Narrative (Details) - Foreign Exchange Contract - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Derivative [Line Items]
Gain (loss) on derivative	$ 3.2	$ (1.3)
Derivatives Not Designated as Hedging Instruments:
Derivative [Line Items]
Notional amount	$ 160		$ 223.4

Derivatives and Risk Manageme_4

Derivatives and Risk Management - Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - Designated as Hedging Instrument - Cash Flow Hedging - Interest rate swap contracts - Interest Expense $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($)
Derivative Instruments, Gain (Loss) [Line Items]
Loss recognized in OCI	$ (433)
Gain Reclassified from AOCI to Earnings	$ 533

Derivatives and Risk Manageme_5

Derivatives and Risk Management - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Derivatives, Fair Value [Line Items]
Long-term derivative assets	$ 41,617	$ 38,496
Total derivatives	42,912	38,496
Long-term derivative liabilities	104,920	45,569
Current derivative liabilities	0	3,883
Total derivatives	104,920	49,452
Capped Call
Derivatives, Fair Value [Line Items]
Total derivatives	8,000	38,500
Capped Call | 2029 Notes
Derivatives, Fair Value [Line Items]
Total derivatives	33,600
Derivatives Not Designated as Hedging Instruments:
Derivatives, Fair Value [Line Items]
Total derivatives	42,912	38,496
Total derivatives	104,920	49,452
Derivatives Not Designated as Hedging Instruments: | Capped Call
Derivatives, Fair Value [Line Items]
Long-term derivative assets		38,496
Derivatives Not Designated as Hedging Instruments: | Capped Call | 2025 Notes
Derivatives, Fair Value [Line Items]
Long-term derivative assets	8,010
Derivatives Not Designated as Hedging Instruments: | Capped Call | 2029 Notes
Derivatives, Fair Value [Line Items]
Long-term derivative assets	33,607
Derivatives Not Designated as Hedging Instruments: | Embedded Derivative Financial Instruments
Derivatives, Fair Value [Line Items]
Long-term derivative liabilities		45,569
Derivatives Not Designated as Hedging Instruments: | Embedded Derivative Financial Instruments | 2025 Notes
Derivatives, Fair Value [Line Items]
Long-term derivative liabilities	10,632
Derivatives Not Designated as Hedging Instruments: | Embedded Derivative Financial Instruments | 2029 Notes
Derivatives, Fair Value [Line Items]
Long-term derivative liabilities	94,288
Derivatives Not Designated as Hedging Instruments: | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Long-term derivative assets	$ 1,295
Current derivative liabilities		$ 3,883

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) € in Thousands, $ in Thousands

1 Months Ended

3 Months Ended

12 Months Ended

Feb. 21, 2022 EUR (€)

Jan. 31, 2021 EUR (€) repository_site

Mar. 31, 2024 EUR (€)

Mar. 31, 2024 USD ($)

Dec. 31, 2020

Dec. 31, 2016 EUR (€)

May 03, 2024 claim

Mar. 31, 2024 USD ($)

Dec. 31, 2023 EUR (€)

Dec. 31, 2023 USD ($)

Apr. 30, 2022 EUR (€)

Nov. 30, 2021 EUR (€)

Mar. 05, 2019 EUR (€)

Other Commitments [Line Items]

Reimbursed legal fees

$ 315,403

€ 292

Annual environmental maintenance | €

€ 1,000

Subsequent Event

Other Commitments [Line Items]

Number of claim | claim

65

Pending Litigation

Other Commitments [Line Items]

Estimate of possible loss

$ 618,000

Judicial Ruling

Other Commitments [Line Items]

Estimate of possible loss | €

€ 572,100

Saluggia, Italy

Other Commitments [Line Items]

Period to demonstrate financial capacity

5 years

Number of national repository sites | repository_site

67

Estimate of possible loss

€ 35,700

38,600

€ 35,800

$ 39,700

Saluggia, Italy | Minimum

Other Commitments [Line Items]

Estimated provision

35,700

38,600

Saluggia, Italy | Maximum

Other Commitments [Line Items]

Estimated provision

€ 45,500

49,200

Product Liability

Other Commitments [Line Items]

Bond required to be posted

157

Loss contingency accrual

20,015

13,860

Additional liability recorded

(6,400)

SNIA | Pending Litigation | SNIA s.p.a

Other Commitments [Line Items]

Compensation sought

3,700,000

Non-privileged creditor, amount | €

€ 454,000

SNIA | Judicial Ruling

Other Commitments [Line Items]

Estimate of possible loss

489,900

€ 453,600

Payment period

30 days

SNIA | Judicial Ruling | Surety Bond

Other Commitments [Line Items]

Bond required to be posted

€ 270,000

$ 291,600

Italian MedTech Payback | Pending Litigation

Other Commitments [Line Items]

Estimate of possible loss

$ 8,400

$ 8,200

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Product Liability (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2024 USD ($)
Loss Contingency Accrual [Roll Forward]
Less current portion of litigation liability at period end	$ 16,980
Litigation provision liability	3,035
Product Liability
Loss Contingency Accrual [Roll Forward]
Beginning liability	13,860
Payments	(157)
Adjustments	6,392
FX and other	(80)
Ending liability	$ 20,015

Stockholders' Equity - Statemen

Stockholders' Equity - Statement of Stockholders' Equity (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance (in shares)	53,942,151
Beginning balance	$ 1,277,628	$ 1,207,624
Issuance of shares	0
Stock-based compensation plans	3,175	5,260
Net (loss) income	(41,943)	7,370
Other comprehensive income (loss)	$ (17,323)	7,087
Ending balance (in shares)	54,295,837
Ending balance	$ 1,221,537	$ 1,227,341
Ordinary Shares
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance (in shares)	53,942,000	53,852,000
Beginning balance	$ 82,533	$ 82,424
Issuance of shares	$ 440
Stock-based compensation plans (in shares)	354,000	2,000
Stock-based compensation plans	$ 2	$ 0
Ending balance (in shares)	54,296,000	53,854,000
Ending balance	$ 82,975	$ 82,424
Additional Paid-In Capital
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	2,189,517	2,157,724
Stock-based compensation plans	3,159	5,204
Ending balance	2,192,676	2,162,928
Treasury Stock
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	(55)	(375)
Issuance of shares	(440)
Stock-based compensation plans	14	56
Ending balance	(481)	(319)
Accumulated Other Comprehensive Loss
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	(27,883)	(48,119)
Other comprehensive income (loss)	(17,323)	7,087
Ending balance	(45,206)	(41,032)
Accumulated Deficit
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	(966,484)	(984,030)
Net (loss) income	(41,943)	7,370
Ending balance	$ (1,008,427)	$ (976,660)

Stockholders' Equity - Comprehe

Stockholders' Equity - Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	$ 1,277,628	$ 1,207,624
Other comprehensive loss before reclassifications, before tax	(17,323)	7,620
Tax benefit	0	0
Other comprehensive loss before reclassifications, net of tax	(17,323)	7,620
Reclassification of gain from accumulated other comprehensive loss, before tax		(533)
Reclassification of tax benefit		0
Reclassification of gain from accumulated other comprehensive loss, after tax		(533)
Total other comprehensive (loss) income	(17,323)	7,087
Ending balance	1,221,537	1,227,341
Total
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(27,883)	(48,119)
Total other comprehensive (loss) income	(17,323)	7,087
Ending balance	(45,206)	(41,032)
Change in Unrealized Loss on Derivatives
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	0	966
Other comprehensive loss before reclassifications, before tax	0	(433)
Tax benefit	0	0
Other comprehensive loss before reclassifications, net of tax	0	(433)
Reclassification of gain from accumulated other comprehensive loss, before tax		(533)
Reclassification of tax benefit		0
Reclassification of gain from accumulated other comprehensive loss, after tax		(533)
Total other comprehensive (loss) income	0	(966)
Ending balance	0	0
Foreign Currency Translation Adjustments Gain (Loss)
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(27,883)	(49,085)
Other comprehensive loss before reclassifications, before tax	(17,323)	8,053
Tax benefit	0	0
Other comprehensive loss before reclassifications, net of tax	(17,323)	8,053
Reclassification of gain from accumulated other comprehensive loss, before tax		0
Reclassification of tax benefit		0
Reclassification of gain from accumulated other comprehensive loss, after tax		0
Total other comprehensive (loss) income	(17,323)	8,053
Ending balance	$ (45,206)	$ (41,032)

Stock-Based Incentive Plans - N

Stock-Based Incentive Plans - Narrative (Details) $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Income tax benefit	4 years
Total expense, net of income tax benefit	$ 0.1
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Income tax benefit	3 years

Stock-Based Incentive Plans - C

Stock-Based Incentive Plans - Compensation Expense (Details) - Continuing Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 10,226	$ 10,579
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	5,074	5,717
SARs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	3,283	3,121
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	1,059	881
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	448	570
Employee share purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 362	$ 290

Stock-Based Incentive Plans - E

Stock-Based Incentive Plans - Executed Agreements (Details) shares in Thousands	3 Months Ended
	Mar. 31, 2024 $ / shares shares
SARs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	697,124
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 26.38
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	336,423
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 55.94
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	60,104
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 75.13
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	60,098
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 55.94

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Effective tax rate (percent)	(22.60%)	24.30%

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Earnings Per Share, Basic and Diluted (Details) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Numerator
Net (loss) income	$ (41,943)	$ 7,370
Denominator
Basic weighted average shares outstanding (in shares)	54,008	53,617
Add: Dilutive effect of share-based compensation and convertible debt instruments (in shares)	0	283
Diluted weighted average shares outstanding (in shares)	54,008	53,900
Stock Compensation Plan
Denominator
Antidilutive securities excluded from computation of earnings per share amount (in shares)	4,600	3,200

Geographic and Segment Inform_3

Geographic and Segment Information - Narrative (Details)	3 Months Ended	12 Months Ended
	Mar. 31, 2024 geographic_region segment	Dec. 31, 2023 segment
Segment Reporting [Abstract]
Reportable segments | segment	2	3
Number of geographic regions in which entity operates | geographic_region	3

Geographic and Segment Inform_4

Geographic and Segment Information - Revenue by Operating Segment & Geographic Region (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting Information [Line Items]
Net revenue	$ 294,912	$ 263,418
Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	155,891	135,744
Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	133,872	120,723
Other Revenue
Segment Reporting Information [Line Items]
Net revenue	5,149	6,951
United States
Segment Reporting Information [Line Items]
Net revenue	160,620	140,267
United States | Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	50,577	39,609
United States | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	105,929	94,489
Europe
Segment Reporting Information [Line Items]
Net revenue	54,341	49,643
Europe | Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	40,926	36,385
Europe | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	13,407	13,280
Rest of World
Segment Reporting Information [Line Items]
Net revenue	79,951	73,508
Rest of World | Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Net revenue	64,388	59,750
Rest of World | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net revenue	$ 14,536	$ 12,954

Geographic and Segment Inform_5

Geographic and Segment Information - Reconciliation of Segment (Loss) Income (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting Information [Line Items]
Operating income (loss)	$ 16,246	$ (2,342)
Interest expense	(15,893)	(13,437)
Loss on debt extinguishment	(25,482)	0
Foreign exchange and other income/(expense)	(9,071)	25,547
(Loss) income before tax	(34,200)	9,768
Operating Segments
Segment Reporting Information [Line Items]
Segment income	61,389	36,180
Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Segment income	14,711	9,174
Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Segment income	46,678	27,006
Other
Segment Reporting Information [Line Items]
Other income and expense	$ (45,143)	$ (38,522)

Geographic and Segment Inform_6

Geographic and Segment Information - Assets & Expenditures by Segments (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Segment Reporting Information [Line Items]
Assets	$ 2,459,602		$ 2,429,563
Capital expenditures	6,447	$ 7,851
Operating Segments | Cardiopulmonary
Segment Reporting Information [Line Items]
Assets	943,405		964,735
Capital expenditures	3,748	4,798
Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Assets	651,863		647,391
Capital expenditures	276	359
Other
Segment Reporting Information [Line Items]
Assets	864,334		$ 817,437
Capital expenditures	$ 2,423	$ 2,694

Geographic and Segment Inform_7

Geographic and Segment Information - Changes in Carrying Amount of Goodwill (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2024 USD ($)
Goodwill
Goodwill, beginning	$ 782,941
Foreign currency adjustments	(11,124)
Goodwill, ending	771,817
Cardiopulmonary
Goodwill
Goodwill, beginning	384,187
Foreign currency adjustments	(11,124)
Goodwill, ending	373,063
Neuromodulation
Goodwill
Goodwill, beginning	398,754
Foreign currency adjustments	0
Goodwill, ending	$ 398,754

Geographic and Segment Inform_8

Geographic and Segment Information - Geographic Areas (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Segment Reporting Information [Line Items]
Property, plant and equipment, net	$ 152,237	$ 154,181
United States
Segment Reporting Information [Line Items]
Property, plant and equipment, net	63,846	62,701
Europe
Segment Reporting Information [Line Items]
Property, plant and equipment, net	82,833	85,606
Rest of World
Segment Reporting Information [Line Items]
Property, plant and equipment, net	$ 5,558	$ 5,874

Supplemental Financial Inform_3

Supplemental Financial Information - Inventory (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Raw materials	$ 76,782	$ 81,878
Work-in-process	15,964	12,901
Finished goods	60,430	53,108
Inventory, Net	$ 153,176	$ 147,887

Supplemental Financial Inform_4

Supplemental Financial Information - Narrative (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Provision for obsolescence	$ 25	$ 24.4
Contract liability	$ 14.1	$ 15.3

Supplemental Financial Inform_5

Supplemental Financial Information - Accrued Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Legal and professional costs	$ 19,961	$ 17,794
Operating lease liabilities	8,578	8,362
Italian medical device payback law	8,447	8,223
Contract liabilities	8,113	10,725
Interest payable	7,985	7,840
Provisions for agents, returns and other	6,705	4,464
Restructuring liability	4,601	911
Royalty accrual	4,146	4,441
Research and development costs	3,099	2,462
Contingent consideration	0	13,750
Current derivative liabilities	0	3,883
Other accrued expenses	22,394	24,446
Accrued liabilities and other	$ 94,029	$ 107,301

Supplemental Financial Inform_6

Supplemental Financial Information - Foreign Exchange (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Derivative Instruments, Gain (Loss) [Line Items]
Foreign exchange rate fluctuations	$ (922)	$ 222
Interest income	7,021	4,536
Other	(369)	(222)
Foreign exchange and other income/(expense)	(9,071)	25,547
2025 Notes
Derivative Instruments, Gain (Loss) [Line Items]
Changes in fair value	(1,978)	44,390
2029 Notes
Derivative Instruments, Gain (Loss) [Line Items]
Changes in fair value	(6,831)	0
Capped Call Derivative Assets (2025 Notes) | 2025 Notes
Derivative Instruments, Gain (Loss) [Line Items]
Changes in fair value	(7,962)	(23,379)
Capped Call Derivative Assets (2025 Notes) | 2029 Notes
Derivative Instruments, Gain (Loss) [Line Items]
Changes in fair value	$ 1,970	$ 0

Supplemental Financial Inform_7

Supplemental Financial Information - Cash, Cash Equivalents, Restricted Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023	Dec. 31, 2022	Mar. 18, 2022
Restricted Cash and Cash Equivalents Items [Line Items]
Cash and cash equivalents	$ 309,191	$ 266,504
Restricted cash	306,492	311,368
Cash, cash equivalents and restricted cash	$ 615,683	$ 577,872	$ 522,958	$ 515,618
Bridge Loan | Judicial Ruling | SNIA
Restricted Cash and Cash Equivalents Items [Line Items]
Percentage of cash collateral required as guarantee					105%