0001628280-22-022514 | 10-Q | XBRL Viewer

Print Document View Excel Document

Asset Acquisition and Business Combination	6 Months Ended
Asset Acquisition and Business Combination	Jun. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Asset Acquisition and Business Combination	Asset Acquisition and Business Combination Biotronik Asset Acquisition In July 2019, the Company entered into a License and Distribution Agreement with Biotronik and VascoMed GmbH (the “Biotronik Parties”) to obtain certain licenses to the Biotronik Parties’ patents, whereby the Company acquired certain manufacturing equipment and obtained from the Biotronik Parties a license under certain patents and technology to develop, commercialize, distribute and manufacture the AcQBlate Force ablation catheters and Qubic Force Device (the “Biotronik Asset Acquisition"). In exchange for the rights granted to the Company, the Company made cash payments totaling $10.0 million during the year ended December 31, 2020 and issued 273,070 shares of Series D convertible preferred stock valued at $5.0 million during the three months ended March 31, 2020. The implied value of $5.0 million was recorded as an accrued liability as of December 31, 2019. In accordance with ASC 805, the Biotronik Asset Acquisition was accounted for as an asset acquisition as substantially all of the $15.0 million value transferred to Biotronik was allocated to intellectual property. On the acquisition date, the products licensed had not yet received regulatory approval and the intellectual property did not have an alternative use. Accordingly, the $15.0 million paid to Biotronik was immediately charged to research and development expense—license acquired in the condensed consolidated statement of operations and comprehensive loss in July 2019. Additional contingent milestone payments of up to $10.0 million, of which $2.0 million has been paid as of June 30, 2022, are to be made to the Biotronik Parties contingent upon certain regulatory approvals and first commercial sale. In further consideration of the rights granted, beginning with the Company’s first commercial sale of the first Force sensing ablation catheter within the licensed product line, the Company also makes per unit royalty payments. As of June 30, 2022, less than $0.1 million has been included within accrued liabilities for these royalties. The Company determined that the remaining $8.0 million contingent milestones are not probable and estimable and therefore have not been recorded as a liability as of June 30, 2022 and December 31, 2021. Upon regulatory approval in December 2020 of the Company’s Force sensing ablation catheter in Europe, the $2.0 million milestone was capitalized and is being amortized, and the royalty payments are recorded as cost of products sold as sales of catheters are recognized. Rhythm Xience Business Combination On June 18, 2019 (the “Acquisition Date”), the Company acquired an integrated family of transseptal crossing and steerable introducer systems through its acquisition of Rhythm Xience for $3.0 million in cash in exchange for all of the stock of Rhythm Xience (the “Rhythm Xience Acquisition”). The cash payment did not include the potential $17.0 million in earn out consideration, of which $2.2 million was paid with the issuance of Series D convertible preferred stock in February 2020 and the remainder is to be paid based on the achievement of certain regulatory milestones and revenue milestones. In accordance with ASC 805, the Rhythm Xience Acquisition was accounted for as a business combination. As part of the Rhythm Xience Acquisition, the Company recorded a contingent consideration liability for potential additional payments due to the sellers of Rhythm Xience if certain regulatory approval milestones and revenue milestones are achieved. The initial contingent consideration liability of $13.4 million was based on the fair value of the contingent consideration liability at the Acquisition Date. During the year ended December 31, 2020, the Company issued 119,993 shares of Series D convertible preferred stock and paid $2.5 million of the contingent consideration for the achievement of certain regulatory and revenue milestones. During the year ended December 31, 2021, the Company paid an additional $3.4 million of the contingent consideration for the achievement of certain regulatory and revenue milestones. During the six months ended June 30, 2022, the Company paid an additional $0.6 million of the contingent consideration for the achievement of certain revenue milestones. Additionally, the Company recorded a $0.9 million increase and a $0.3 million decrease for the three months ended June 30, 2022 and 2021, respectively, and a $1.0 million increase and a $1.4 million decrease to the fair value of the contingent consideration liability for the six months ended June 30, 2022 and 2021, respectively, which is included in change in fair value of contingent consideration in the condensed consolidated statements of operations and comprehensive income (loss). As of June 30, 2022, the contingent consideration liability of $2.2 million is the fair value of the remaining payments due to the sellers of Rhythm Xience if certain revenue milestones are achieved. On June 30, 2022, the Company sold its Rhythm Xience product line acquired as part of the Rhythm Xience Acquisition to Medtronic, Refer to Note 4 - Sale of Business for further detail.

Lessor Sales-Type Leases - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Lessor, Lease, Description [Line Items]
Lease revenue	$ 0.2	$ 0.3	$ 0.2	$ 1.2
Prepaid Expenses and Other Current Assets
Lessor, Lease, Description [Line Items]
Lease receivable	0.7		0.7		$ 0.9
Other Assets
Lessor, Lease, Description [Line Items]
Lease receivable	$ 0.5		$ 0.5		$ 0.7

Debt

6 Months Ended

Jun. 30, 2022

Debt Disclosure [Abstract]

Debt

Outstanding debt as of June 30, 2022 and December 31, 2021 consisted of the following (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
2022 Amended Credit Agreement(1)	$	36,750	$	—
2019 Credit Agreement(2)	—		44,550
Total debt, gross	36,750		44,550
Less: Unamortized debt discount and fees	(2,551)		(4,135)
Total long-term debt	$	34,199	$	40,415

(1)The 2022 Amended Credit Agreement includes final payment fees of $1.8 million.

(2)The 2019 Credit Agreement included final payment fees of $4.6 million.

2019 Credit Agreement

On May 20, 2019, the Company entered into a credit agreement (the “2019 Credit Agreement”). The 2019 Credit Agreement provided the Company with a senior term loan facility in aggregate principal amount of $70.0 million, of which the Company borrowed $40.0 million upon closing. Of the remaining $30.0 million, none is available for borrowing. The 2019 Credit Agreement bore interest per annum at 7.75% plus LIBOR for such interest period and the principal amount of term loans outstanding under the 2019 Credit Agreement was due on May 20, 2024. The 2019 Credit Agreement provided for final payment fees of an additional $4.6 million that were due upon prepayment or on the maturity date or upon acceleration.

Upon the occurrence and during an event of default, which included but was not limited to payment default, covenant default or the occurrence of a material adverse change, the lenders could have declared all outstanding principal and accrued and unpaid interest immediately due and payable, all unfunded commitments would be terminated, there would be an increase in the applicable interest rate by 10% per annum, and the lenders would be entitled to exercise their other rights and remedies provided for under the 2019 Credit Agreement. Additionally, the lenders could have requested repayment of a portion of obligations outstanding under the 2019 Credit Agreement to the extent of the Company’s receipt of any (i) net casualty proceeds or (ii) net asset sales proceeds, as defined. These acceleration and early payment features were an embedded derivative that was separately measured from the loan host instrument and classified with the loan host instrument.

In connection with the issuance of the 2019 Credit Agreement, the Company issued liability-classified warrants with a fair value of $0.9 million to purchase 419,992 shares of Series C convertible preferred stock at $16.67 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at $16.67 per share and then were automatically converted into warrants to purchase an equal

number of shares of common stock at $16.67 per share. The initial recognition of the warrant liability and direct fees of $1.2 million and final payment fees of $4.6 million for the 2019 Credit Agreement resulted in a discount of $6.7 million, which was being amortized to interest expense over the term of the 2019 Credit Agreement using the effective interest method.

The Company’s obligations under the 2019 Credit Agreement were secured by substantially all of its assets, including its intellectual property, and is guaranteed by Acutus NV. The 2019 Credit Agreement contained customary affirmative and negative covenants, including with respect to the Company’s ability to enter into fundamental transactions, incur additional indebtedness, grant liens, pay any dividend or make any distributions to its holders, make investments and merge or consolidate with any other person or engage in transactions with its affiliates, but did not include any financial covenants, other than a minimum liquidity requirement.

On June 30, 2022, the 2019 Credit Agreement was modified and resulted in an extinguishment of the debt. This transaction resulted in a loss on extinguishment of debt of $7.9 million. See 2022 Amended and Restated Credit Agreement section below for more details.

2022 Amended and Restated Credit Agreement

On June 30, 2022, the Company amended and restated its prior debt facility, which had a maturity date of May 20, 2024, with certain affiliates of Deerfield Management Company (collectively referred to as “Deerfield“) as lenders. The amended and restated credit agreement (the “2022 Credit Agreement“) is for an aggregate principal amount of $35.0 million and a has a five-year term. Proceeds from the 2022 Credit Agreement, along with cash on hand, were used to repay the then existing 2019 Credit Agreement and to pay related fees and expenses.

The 2022 Credit Agreement has amortization payments becoming due as follows: 15% of the principal due at the end of month 36, 15% of the principal due at the end of month 48 and the remaining 70% due at the end of month 60 following the closing of the loan. The new debt facility will bear interest at the one-month adjusted term Secured Overnight Financing Rate, with a floor of 2.50% per annum, plus 9.00% per annum.

The 2022 Credit Agreement is secured by a first-priority perfected lien on and security interest in substantially all of the Company’s existing and after-acquired tangible and intangible assets, subject to certain exceptions noted in the 2022 Credit Agreement.

The 2022 Credit Agreement is subject to certain customary affirmative covenants, representations and warranties and other terms and conditions. It also contains certain customary negative covenants, including, but not limited to, restrictions on the Company’s ability and that of its subsidiaries to merge and consolidate with other companies, incur indebtedness, grant liens or security interests on assets, pay dividends or make other restricted payments, sell or otherwise transfer assets or enter into transactions with affiliates.

In addition, the 2022 Credit Agreement includes customary events of default and other provisions that could require all amounts due thereunder to become immediately due and payable, either automatically or at the option of the lenders, if the Company fails to comply with the terms.

The Company also issued warrants to purchase its common stock to Deerfield in connection with the 2022 Credit Agreement. The Company issued warrants to purchase up to an aggregate 3,779,018 shares of the Company’s common stock, par value $0.001 per share common stock, at an exercise price of $1.1114 per warrant share for a period of eight years (the “2022 Warrants“).

The 2022 Warrants represent a freestanding financial instrument and are conditionally puttable at the holder’s option upon an event that is outside of the Company’s control. Therefore, the 2022 Warrants are classified as liability pursuant to ASC 480, Distinguishing Liabilities from Equity, initially and subsequently recognized at fair value, with changes in fair value recognized in the statement of operations and comprehensive income (loss).

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-URI https://asc.fasb.org/topic&trid=2208564

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (h)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (c)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (d)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (g)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1E
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495348-112611

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (i)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

+ Details

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Assets included in:
Available-for-sale securities	$ 42,400	$ 83,822
Total fair value	55,727	105,715
Liabilities included in:
Total fair value	5,579	2,000
Warrant liability
Liabilities included in:
Total fair value	3,379
Contingent consideration
Liabilities included in:
Total fair value	2,200	2,000
Money market securities
Assets included in:
Money market securities	13,327	21,893
Corporate debt securities
Assets included in:
Available-for-sale securities		18,860
U.S. treasury securities
Assets included in:
Available-for-sale securities	4,998	5,064
Commercial paper
Assets included in:
Available-for-sale securities	24,992	36,759
Yankee debt securities
Assets included in:
Available-for-sale securities	3,879	3,932
Supranational
Assets included in:
Available-for-sale securities	3,025	3,051
Asset-backed securities
Assets included in:
Available-for-sale securities	5,506	16,156
Quoted Prices in Active Markets for Identical Assets (Level 1)
Assets included in:
Total fair value	13,327	21,893
Liabilities included in:
Total fair value	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Warrant liability
Liabilities included in:
Total fair value	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Contingent consideration
Liabilities included in:
Total fair value	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Money market securities
Assets included in:
Money market securities	13,327	21,893
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Corporate debt securities
Assets included in:
Available-for-sale securities		0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| U.S. treasury securities
Assets included in:
Available-for-sale securities	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Commercial paper
Assets included in:
Available-for-sale securities	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Yankee debt securities
Assets included in:
Available-for-sale securities	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Supranational
Assets included in:
Available-for-sale securities	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Asset-backed securities
Assets included in:
Available-for-sale securities	0	0
Significant Other Observable Inputs (Level 2)
Assets included in:
Total fair value	42,400	83,822
Liabilities included in:
Total fair value	0	0
Significant Other Observable Inputs (Level 2) \| Warrant liability
Liabilities included in:
Total fair value	0
Significant Other Observable Inputs (Level 2) \| Contingent consideration
Liabilities included in:
Total fair value	0	0
Significant Other Observable Inputs (Level 2) \| Money market securities
Assets included in:
Money market securities	0	0
Significant Other Observable Inputs (Level 2) \| Corporate debt securities
Assets included in:
Available-for-sale securities		18,860
Significant Other Observable Inputs (Level 2) \| U.S. treasury securities
Assets included in:
Available-for-sale securities	4,998	5,064
Significant Other Observable Inputs (Level 2) \| Commercial paper
Assets included in:
Available-for-sale securities	24,992	36,759
Significant Other Observable Inputs (Level 2) \| Yankee debt securities
Assets included in:
Available-for-sale securities	3,879	3,932
Significant Other Observable Inputs (Level 2) \| Supranational
Assets included in:
Available-for-sale securities	3,025	3,051
Significant Other Observable Inputs (Level 2) \| Asset-backed securities
Assets included in:
Available-for-sale securities	5,506	16,156
Significant Unobservable Inputs (Level 3)
Assets included in:
Total fair value	0	0
Liabilities included in:
Total fair value	5,579	2,000
Significant Unobservable Inputs (Level 3) \| Warrant liability
Liabilities included in:
Total fair value	3,379
Significant Unobservable Inputs (Level 3) \| Contingent consideration
Liabilities included in:
Total fair value	2,200	2,000
Significant Unobservable Inputs (Level 3) \| Money market securities
Assets included in:
Money market securities	0	0
Significant Unobservable Inputs (Level 3) \| Corporate debt securities
Assets included in:
Available-for-sale securities		0
Significant Unobservable Inputs (Level 3) \| U.S. treasury securities
Assets included in:
Available-for-sale securities	0	0
Significant Unobservable Inputs (Level 3) \| Commercial paper
Assets included in:
Available-for-sale securities	0	0
Significant Unobservable Inputs (Level 3) \| Yankee debt securities
Assets included in:
Available-for-sale securities	0	0
Significant Unobservable Inputs (Level 3) \| Supranational
Assets included in:
Available-for-sale securities	0	0
Significant Unobservable Inputs (Level 3) \| Asset-backed securities
Assets included in:
Available-for-sale securities	$ 0	$ 0

Debt - Summary of Outstanding Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021	May 20, 2019
Debt Instrument [Line Items]
Long-term debt, gross	$ 36,750	$ 44,550
Less: Unamortized debt discount and fees	(2,551)	(4,135)
Total long-term debt	34,199	40,415
2022 Amended Credit Agreement
Debt Instrument [Line Items]
Long-term debt, gross	36,750	0
Fee amount	1,800
2019 Credit Agreement
Debt Instrument [Line Items]
Long-term debt, gross	$ 0	44,550
Fee amount		$ 4,600	$ 4,600

Subsequent Events (Details)	Jul. 15, 2022 $ / shares
Subsequent Event
Subsequent Event [Line Items]
Option, exercise price range (in dollars per share)	$ 1.34

Operating Leases - Narrative (Details)	Jun. 30, 2022 ft²
Corporate Office Space and Manufacturing Facility
Lessee, Lease, Description [Line Items]
Office space	50,800
Operating lease, renewal term	5 years
Office Space Zaventem Belgium
Lessee, Lease, Description [Line Items]
Office space	3,900
Operating lease, renewal term	2 years

Debt - Narrative (Details) - USD ($)			3 Months Ended		6 Months Ended
Debt - Narrative (Details) - USD ($)	Jun. 30, 2022	May 20, 2019	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Debt Instrument [Line Items]
Class of warrants, exercise price (in dollars per share)	$ 2.56		$ 2.56		$ 2.56		$ 9.41
Loss on debt extinguishment			$ 7,947,000	$ 0	$ 7,947,000	$ 0
Common stock, shares issued (in shares)	28,349,200		28,349,200		28,349,200		27,957,223
Common stock, par value (in dollars per share)	$ 0.001		$ 0.001		$ 0.001		$ 0.001
Exercise of common stock warrants
Debt Instrument [Line Items]
Class of warrants, exercise price (in dollars per share)	$ 1.1114		$ 1.1114		$ 1.1114
Common stock, shares issued (in shares)	3,779,018		3,779,018		3,779,018
Common stock, par value (in dollars per share)	$ 0.001		$ 0.001		$ 0.001
Warrant, term	8 years
2019 Credit Agreement
Debt Instrument [Line Items]
Interest rate		7.75%
Fee amount		$ 4,600,000					$ 4,600,000
Warrants liability fair value		900,000
Direct fees		$ 1,200,000
2019 Credit Agreement \| Series C Convertible Preferred Stock
Debt Instrument [Line Items]
Class of warrants number of securities called by the warrants or rights (in shares)		419,992
Class of warrants, exercise price (in dollars per share)		$ 16.67
2019 Credit Agreement \| Series D Convertible Preferred Stock
Debt Instrument [Line Items]
Class of warrants, exercise price (in dollars per share)		$ 16.67
2019 Credit Agreement \| Senior Term Loan
Debt Instrument [Line Items]
Face amount		$ 70,000,000
Proceeds from senior term loan		40,000,000
Remaining amount		30,000,000
Unused borrowing capacity		0
Fee amount		4,600,000
Initial debt discount before inception		$ 6,700,000
Default Event \| Senior Term Loan
Debt Instrument [Line Items]
Interest rate, increase (decrease)		10.00%
2022 Amended Credit Agreement
Debt Instrument [Line Items]
Fee amount	$ 1,800,000		$ 1,800,000		$ 1,800,000
2022 Amended Credit Agreement \| Senior Term Loan
Debt Instrument [Line Items]
Face amount	$ 35,000,000.0		$ 35,000,000.0		$ 35,000,000.0
Debt instrument, term	5 years
2022 Amended Credit Agreement \| Senior Term Loan \| Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate
Debt Instrument [Line Items]
Variable rate, floor	2.50%
Variable rate	9.00%
2022 Amended Credit Agreement \| Senior Term Loan \| End of Month 36
Debt Instrument [Line Items]
Periodic payment, percentage of principal	15.00%
2022 Amended Credit Agreement \| Senior Term Loan \| End of Month 48
Debt Instrument [Line Items]
Periodic payment, percentage of principal	15.00%
2022 Amended Credit Agreement \| Senior Term Loan \| End of Month 60
Debt Instrument [Line Items]
Periodic payment, percentage of principal	70.00%

401(k) Retirement Plan	6 Months Ended
401(k) Retirement Plan	Jun. 30, 2022
Retirement Benefits [Abstract]
401(k) Retirement Plan	401(k) Retirement PlanThe Company has a 401(k) retirement savings plan that provides retirement benefits to substantially all full-time U.S. employees. Eligible employees may contribute a percentage of their annual compensation, subject to Internal Revenue Service limitations. The Company was not required to contribute and did not provide any contributions to the 401(k) retirement savings plan for the three and six months ended June 30, 2022 and 2021.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 55
-Paragraph 17
-URI https://asc.fasb.org/extlink&oid=123450688&loc=d3e4179-114921

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section S99
-Paragraph 2
-URI https://asc.fasb.org/extlink&oid=21916913&loc=d3e273930-122802

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (d)(i)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (o)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (p)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 70
-Section 50
-Paragraph 1
-URI https://asc.fasb.org/extlink&oid=49170846&loc=d3e28014-114942

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-URI https://asc.fasb.org/topic&trid=2235017

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 60
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI https://asc.fasb.org/extlink&oid=6414203&loc=d3e39689-114964

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (d)(iv)(03)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (q)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (r)(1)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (d)(iii)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (l)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (r)(2)
-URI https://asc.fasb.org/extlink&oid=123447040&loc=d3e1928-114920

+ Details

Operating Leases - Summary of Components of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Operating leases
Operating lease cost	$ 246	$ 237	$ 493	$ 454
Variable lease cost	63	77	140	160
Total rent expense	$ 309	$ 314	$ 633	$ 614

Sale of Business (Tables)

6 Months Ended

Jun. 30, 2022

Discontinued Operations and Disposal Groups [Abstract]

Summary of Sale of Discontinued Operation

The following sets forth the calculation for the gain on sale as of the First Closing (in thousands):


Non-contingent cash consideration received	$	50,000
Property and equipment sold	(498)
Intangible assets sold	(3,010)
Direct transaction costs	(2,917)
Gain on sale of business, net	$	43,575

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 50
-Paragraph 3A
-URI https://asc.fasb.org/extlink&oid=109226691&loc=SL51724579-110230

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 3
-URI https://asc.fasb.org/extlink&oid=109222650&loc=d3e1474-107760

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5D
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721677-107760

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
-Paragraph 11
-URI https://asc.fasb.org/extlink&oid=109222160&loc=SL51721533-107759

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 3A
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721659-107760

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 4B
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721665-107760

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 50
-Paragraph 3
-URI https://asc.fasb.org/extlink&oid=109226691&loc=d3e2941-110230

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5C
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721675-107760

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 7
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721683-107760

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 1
-URI https://asc.fasb.org/extlink&oid=109222650&loc=d3e1361-107760

Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5A
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721671-107760

Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5B
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721673-107760

Reference 13: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 4A
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721663-107760

+ Details

Warrants - Schedule of Outstanding Warrants to Purchase the Company's Common Stock (Details) - $ / shares	Jun. 30, 2022	Dec. 31, 2021
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 2.56	$ 9.41
Warrants outstanding (in shares)	4,576,505	797,487
Common Stock \| Warrants issued in 2015
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 5.25
Warrants outstanding (in shares)	3,808	3,808
Common Stock \| Warrants issued with 2018 Convertible Notes
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 0.10
Warrants outstanding (in shares)	346,689	346,689
Common Stock \| Warrants issued with 2018 Term Loan
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 16.67
Warrants outstanding (in shares)	26,998	26,998
Common Stock \| Warrants issued with 2019 Credit Agreement
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 16.67
Warrants outstanding (in shares)	419,992	419,992
Common Stock \| Warrants issued with 2022 Credit Agreement
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 1.11
Warrants outstanding (in shares)	3,779,018	0

Related Party Transactions (Details) - USD ($)		1 Months Ended	3 Months Ended		6 Months Ended
Related Party Transactions (Details) - USD ($)	Jun. 30, 2022	Aug. 31, 2021	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021	Aug. 23, 2021	Dec. 31, 2019
Related Party Transaction [Line Items]
Preferred stock, par value (in dollars per share)	$ 0.001		$ 0.001		$ 0.001		$ 0.001
Common stock, shares issued (in shares)	28,349,200		28,349,200		28,349,200		27,957,223
Common stock, par value (in dollars per share)	$ 0.001		$ 0.001		$ 0.001		$ 0.001
Class of warrants, exercise price (in dollars per share)	$ 2.56		$ 2.56		$ 2.56		$ 9.41
Exercise of common stock warrants
Related Party Transaction [Line Items]
Common stock, shares issued (in shares)	3,779,018		3,779,018		3,779,018
Common stock, par value (in dollars per share)	$ 0.001		$ 0.001		$ 0.001
Class of warrants, exercise price (in dollars per share)	$ 1.1114		$ 1.1114		$ 1.1114
Warrant, term	8 years
2019 Credit Agreement
Related Party Transaction [Line Items]
Line of credit cumulative drawdowns till date	$ 40,000,000		$ 40,000,000		$ 40,000,000		$ 40,000,000
2022 Amended Credit Agreement \| Senior Term Loan
Related Party Transaction [Line Items]
Face amount	$ 35,000,000.0		35,000,000.0		35,000,000.0
Debt instrument, term	5 years
Orbimed Royalty Oppurtunities Two LP and Deerfield Private Design Fund LP \| 2019 Credit Agreement
Related Party Transaction [Line Items]
Line of credit maximum borrowing capacity									$ 70,000,000
Interest expenses related party			1,300,000	$ 1,400,000	2,700,000	$ 2,700,000
Maximum \| Selling, general and administrative \| Consulting Agreement \| Director and the Chairman
Related Party Transaction [Line Items]
Consulting fees incurred for related party			$ 100,000	$ 100,000	$ 100,000	$ 100,000
Common Stock
Related Party Transaction [Line Items]
Conversion of stock, shares converted (in shares)		6,665,841
Series A Preferred Stock
Related Party Transaction [Line Items]
Conversion of stock, shares issued (in shares)		6,666
Preferred stock, par value (in dollars per share)		$ 0.001						$ 0.001

Stockholders’ Equity (Details) $ / shares in Units, $ in Thousands		1 Months Ended		3 Months Ended	6 Months Ended
	Aug. 10, 2020 shares	Aug. 31, 2021 investor $ / shares shares	Jul. 31, 2021 USD ($) $ / shares shares	Jun. 30, 2021 shares	Jun. 30, 2022 USD ($) $ / shares shares	Jun. 30, 2021 USD ($) shares	Dec. 31, 2021 $ / shares	Aug. 23, 2021 $ / shares
Class of Stock [Line Items]
Number of investors \| investor		4
Preferred stock, par value (in dollars per share) \| $ / shares					$ 0.001		$ 0.001
Maximum percentage of outstanding common stock					0.049
Common stock conversion, notice for increase, period					61 days
Maximum percentage of outstanding common stock, notice for increase					0.099
Stock issued during period (in shares)			6,325,000	26,958		26,958
Proceeds from the issuance of common stock, net of issuance costs \| $			$ 82,700
Stock option exercises (in shares)					35,478
Proceeds from stock options exercises \| $					$ 66	$ 619
Restricted Stock Units (RSUs)
Class of Stock [Line Items]
Restricted share award shares issued (in shares)					262,273	94,088
Restricted Stock
Class of Stock [Line Items]
Restricted share award shares issued (in shares)					0	186
Common Stock
Class of Stock [Line Items]
Stock option exercises (in shares)				71,460	35,478	98,969
Employee stock purchase plan shares issued (in shares)					94,226	0
Common Stock
Class of Stock [Line Items]
Conversion of stock, shares converted (in shares)		6,665,841
Series A Preferred Stock
Class of Stock [Line Items]
Conversion of stock, shares issued (in shares)		6,666
Preferred stock, par value (in dollars per share) \| $ / shares		$ 0.001						$ 0.001
Preferred stock, liquidation preference (in dollars per share) \| $ / shares								$ 0.001
Conversion of stock, option to convert to common stock (in shares)					1,000
Over-Allotment Option
Class of Stock [Line Items]
Stock issued during period (in shares)	1,323,529		825,000
Price per share (in dollars per share) \| $ / shares			$ 14.00
Public Stock Offering
Class of Stock [Line Items]
Consideration received on transaction \| $			$ 88,600

Summary of Significant Accounting Policies - Summary of Cash and Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021	Jun. 30, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Cash and cash equivalents	$ 46,567	$ 24,071
Restricted cash, short-term	150	150
Restricted cash, long-term	4,000	0
Total cash, cash equivalents and restricted cash	$ 50,717	$ 24,221	$ 7,277	$ 25,384

Summary of Significant Accounting Policies

6 Months Ended

Jun. 30, 2022

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Basis of Presentation

The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.

Principles of Consolidation

The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

Use of Estimates and Assumptions

The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, expenses and disclosures of contingent assets and liabilities. The most significant estimates and assumptions in the Company’s condensed consolidated financial statements include, but are not limited to, revenue recognition, useful lives of intangible assets, assessment of impairment of goodwill, measurement of operating lease liabilities, and the fair value of common stock, stock options, warrants, intangible assets and contingent consideration. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are not readily apparent from other sources. Actual results could differ from those estimates.

Segments

Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business as one operating segment.

Cash and Cash Equivalents and Restricted Cash

The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of June 30, 2022 and December 31, 2021, exceeded federally insured limits.

Historically, restricted cash has served as collateral for the Company’s corporate credit card program; however, $4.0 million of the proceeds received on June 30, 2022 from the sale of the left-heart access portfolio assets to Medtronic are being held in an indemnity escrow account for a period of 18 months following the first closing as further discussed in Note 4 - Sale of Business, and was recorded in “Restricted cash, long-term” on the condensed consolidated balance sheet. The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total balances as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Cash and cash equivalents	$	46,567	$	24,071
Restricted cash, short-term	150		150
Restricted cash, long-term	4,000		—
Total cash, cash equivalents and restricted cash	$	50,717	$	24,221

Marketable Securities

The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets.

Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ equity until their disposition or maturity. See “Fair Value Measurements” below. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method.

Marketable securities are subject to a periodic impairment review. The Company recognizes an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive income (loss). The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive income (loss) for the three and six months ended June 30, 2022 and 2021.

Concentrations of Credit Risk and Off-Balance Sheet Risk

Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions which, at times, may exceed the Federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant. The Company’s marketable securities portfolio primarily consists of investments in commercial paper, Yankee debt securities, supranational, U.S. treasury securities, asset-backed securities and short-term high credit quality corporate debt securities.

Revenue from Contracts with Customers

The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification ("ASC") 606, Revenue from Contracts with Customers (“ASC 606”), and ASC 842, Leases ("ASC 842"). The core principle of ASC 606 is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle:

•Step 1: Identify the contract with the customer.

•Step 2: Identify the performance obligations in the contract.

•Step 3: Determine the transaction price.

•Step 4: Allocate the transaction price to the performance obligations in the contract.

•Step 5: Recognize revenue when, or as, the company satisfies a performance obligation.

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

For new customers, the Company places its medical diagnostic equipment, AcQMap System, at customer sites under evaluation agreements and generates revenue from the sale of disposable products used with the AcQMap System. Disposable products primarily include AcQMap catheters and AcQGuide steerable sheaths. Outside of the U.S., the Company also has a Qubic Force Device which generates revenue from the sale of the AcQBlate Force ablation catheters. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation.

The Company sells the AcQMap System to customers along with software updates on a when-and-if-available basis, as well as the Qubic Force Device and a transseptal crossing line of products which can be used in a variety of heart procedures and does not need to be accompanied with an AcQMap System or Qubic Force Device. Included in the transseptal crossing line of products are primarily the AcQRef introducer sheath, the AcQGuide sheaths and the AcQCross Transseptal Dilator/Needle.

The Company also enters into deferred equipment agreements that are generally structured such that the Company agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two to four years. The Company determined that the deferred equipment agreements include embedded sales-type leases. The Company allocates contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and non-lease components at contract inception. The Company expenses the cost of the device at the inception of the agreement and records a financial lease asset equal to the gross consideration allocated to the lease. The lease asset will be reduced by payments for minimum disposable purchases that are allocated to the lease.

Lastly, the Company enters into short-term operating leases, for the rental of the system after an evaluation. These lease agreements impose no requirement on the customer to purchase the equipment and the equipment is not transferred to the customer at the end of the lease term. The short-term nature of the lease agreements does not result in lease payments accumulating to an amount that equals the value of the equipment nor is the lease term reflective of the economic life of the equipment.

The Company’s contracts primarily include fixed consideration. Generally, there are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days.

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

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

The Company allocates the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company determines SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which

includes, but is not limited to, transactions where the specific performance obligations are sold separately, list prices and offers to customers.

Except for the deferred equipment agreements noted above, the Company’s contracts with customers generally have an expected duration of one year or less, and therefore the Company has elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts are recorded as selling, general and administrative expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of June 30, 2022 and December 31, 2021.

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

The following table sets forth the Company’s revenue for disposables, systems and service/other for the three and six months ended June 30, 2022 and 2021 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
Disposables	$	3,334	$	3,509	$	6,545	$	5,852
Systems	346		799		346		1,768
Service/Other	396		401		866		680
Total revenue	$	4,076	$	4,709	$	7,757	$	8,300

The following table provides revenue by geographic location for the three and six months ended June 30, 2022 and 2021 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
United States	$	2,037	$	2,486	$	4,060	$	4,068
Outside the United States	2,039		2,223		3,697		4,232
Total revenue	$	4,076	$	4,709	$	7,757	$	8,300

Inventory

Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for manufacturing scrap and excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $1.4 million and $0.1 million for the three months ended June 30, 2022 and 2021, respectively, and $2.4 million and $0.9 million for the six months ended June 30, 2022 and 2021, respectively.

Accounts Receivable

The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of June 30, 2022 and December 31, 2021.

Property and Equipment, Net

Property and equipment are recorded at cost. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the related assets, generally three to five years, or, in the case of leasehold improvements, over the lesser of the useful life of the related asset or the lease term.

Intangible Assets

At December 31, 2021, intangible assets consisted of acquired developed technology, acquired in-process technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019, as well as a license agreement with Biotronik. The Rhythm Xience intangible assets were included in the assets sold to Medtronic, leaving only the license agreement with Biotronik in intangible assets on the condensed consolidated balance sheet as of June 30, 2022. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired in-process technology was classified as an indefinite-lived intangible asset, until the receipt of Food and Drug Administration (the “FDA”) approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was classified as a finite-lived intangible and amortization for in-process technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite-lived intangible assets are impaired if their estimated fair values are less than their carrying value.

Goodwill

Goodwill represents the excess of the purchase price of an entity over the estimated fair value of the assets acquired and liabilities assumed, and it is presented as goodwill in the accompanying condensed consolidated balance sheets. Under ASC 350, Intangibles – Goodwill and Other (“ASC 350”), goodwill is not amortized but is subject to periodic impairment testing. ASC 350 requires that an entity assign its goodwill to reporting units and test each reporting unit’s goodwill for impairment at least on an annual basis and between annual tests if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. In the evaluation of goodwill for impairment, which is performed annually during the fourth quarter, the Company first assesses qualitative factors to determine whether the existence of events or circumstances led to a determination that it was more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events or circumstances, it is determined that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, the Company is required to perform the quantitative goodwill impairment test. The Company has one reporting unit. During the six months ended June 30, 2022, the Company fully impaired its goodwill balance of $12.0 million. Refer to Note 9 - Goodwill and Intangible Assets for further details.

Impairment of Long-Lived Assets

The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three and six months ended June 30, 2022 and 2021, the Company determined that there was no impairment of property and equipment or intangible assets.

Foreign Currency Translation and Transactions

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

Lessee Leases

The Company accounts for its lessee leases under ASC 842. Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases, and are recorded on the condensed consolidated balance sheet as both a right-of-use asset and a lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred.

In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the guidance as an accounting policy election.

Cost of Products Sold

Cost of products sold includes raw materials, direct labor, manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products.

Research and Development

The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation.

In April 2021, the Company and Biotronik entered into a Feasibility and Development Agreement to pursue the development of hardware, software and IT infrastructure to implement the Qubic Connect System ("QBS"). The QBS will allow data transfer from multiple diagnostic and therapeutic medical products during an electrophysiology procedure to be aggregated and analyzed for the purposes of designing improved treatment protocols.

Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials.

Selling, General and Administrative

Selling, general and administrative (“SG&A”) expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs. The Company expenses all SG&A costs as incurred.

Restructuring

Restructuring expense consists of severance expenses and benefits related to employees affected by the organizational RIF. The RIF was made to align resources with the Company's current strategic direction.

Employee Retention Credit

The Coronavirus Aid, Relief and Economic Security (“CARES”) Act provides an employee retention credit (“CARES Employee Retention Credit”), which is a refundable tax credit against certain employment taxes of up to $5 thousand per employee for eligible employers. The tax credit is equal to 50% of qualified wages paid to employees during a quarter, capped at $10 thousand of qualified wages per employee per calendar year through December 31, 2020. Additional relief provisions were passed by the United States government, which extended and expanded the qualified wage caps on these credits through September 30, 2021. Based on these additional provisions, the tax credit is now equal to 70% of qualified wages paid to employees during a quarter beginning with the first quarter of 2021, and the limit on qualified wages per employee has been increased to $10 thousand of qualified wages per quarter instead of per calendar year.

The Company qualifies for the tax credit under the CARES Act. The Company filed 2021 Form 941-X Adjusted Employer’s Quarterly Federal Tax Return or Claim for Refund for the quarters ended March 31, 2021 and June 30, 2021 on March 24, 2022. The refunds due are an aggregate of $4.0 million for the quarters ended March 31, 2021 and June 30, 2021. The Company filed its 2020 Form 941-X Adjusted Employer’s Quarterly Federal Tax Return or Claim for Refund for the period March 12, 2020 through December 31, 2020 on March 31, 2022. The refunds due for that period are an aggregate of $0.6 million.

The Company elected to classify the ERC amounts as a reduction to payroll tax expense. During the six months ended June 30, 2022, the Company recorded $1.5 million, $1.4 million and $1.7 million related to the CARES Employee Retention Credit within cost of products sold, research and development expense and SG&A expense, respectively, on the Company’s condensed consolidated statement of operations and comprehensive income (loss). As of June 30, 2022, the Company has a $4.6 million receivable balance from the United States government related to the CARES Act, which is recorded in “Prepaid expenses and other current assets” on the Company’s condensed consolidated balance sheet.

Fair Value Measurements

Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy has been used in determining the inputs used in measuring fair value:

Level 1—Quoted prices in active markets for identical assets or liabilities.

Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace.

Level 3—Unobservable inputs which are supported by little or no market activity and that are financial instruments whose values are determined using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation.

Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for the three and six months ended June 30, 2022 and 2021.

As of June 30, 2022 and December 31, 2021, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of the instruments.

The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt.

The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of June 30, 2022 and December 31, 2021 (in thousands):


	Fair Value Measurements as of June 30, 2022
	(unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at June 30, 2022
Assets included in:
Cash and cash equivalents
Money market securities	$	13,327	$	—	$	—	$	13,327
Marketable securities at fair value

U.S. treasury securities	—		4,998		—		4,998
Commercial paper	—		24,992		—		24,992
Yankee debt securities	—		3,879		—		3,879
Supranational	—		3,025		—		3,025
Asset-backed securities	—		5,506		—		5,506
Total fair value	$	13,327	$	42,400	$	—	$	55,727

Liabilities included in:
Warrant liability	$	—	$	—	$	3,379	$	3,379
Contingent consideration	—		—		2,200		2,200
Total fair value	$	—	$	—	$	5,579	$	5,579


	Fair Value Measurements as of December 31, 2021
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at December 31, 2021
Assets included in:
Cash and cash equivalents
Money market securities	$	21,893	$	—	$	—	$	21,893
Marketable securities at fair value
Corporate debt securities	—		18,860		—		18,860
U.S. treasury securities	—		5,064		—		5,064
Commercial paper	—		36,759		—		36,759
Yankee debt securities	—		3,932		—		3,932
Supranational	—		3,051		—		3,051
Asset-backed securities	—		16,156		—		16,156
Total fair value	$	21,893	$	83,822	$	—	$	105,715

Liabilities included in:
Contingent consideration	$	—	$	—	$	2,000	$	2,000
Total fair value	$	—	$	—	$	2,000	$	2,000

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

The Company’s portfolio of marketable securities is comprised of commercial paper, asset-backed securities, U.S. treasury securities, Yankee debt securities, supranational and short-term highly liquid, high credit quality corporate debt securities. The fair value for the available-for-sale marketable securities is determined based on trade prices in active markets for identical assets (Level 1 inputs) or valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments, broker and dealer quotes, as well as other relevant economic measures.

The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2022 (in thousands):


	Contingent Consideration		Warrant Liability
Balance, December 31, 2021	$	2,000	$	—
Payment of contingent consideration	(598)		—
Escrow release(1)	(157)		—
Issuance of warrants(2)	—		3,379
Change in fair value	955		—
Balance, June 30, 2022 (unaudited)	$	2,200	$	3,379

(1) As part of the Rhythm Xience acquisition (see Note 3), the first $0.5 million earned related to revenue success payments was paid at the end of the first month following the end of the quarter in which the revenue success payments were earned, into an escrow account until the expiration of an additional 18 month hold-back period commencing with the end of the quarter during which such revenue success payment amounts were earned. Amounts noted above were released from the escrow account.

(2) Common stock warrants issued to lenders under the 2022 Amended Credit Agreement (see Notes 11 and 14).

Unrealized gains and losses associated with liabilities within the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long-dated volatilities) inputs.

The fair value of the contingent consideration from the acquisition of Rhythm Xience (see Note 3) represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective earn-out period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales; (iii) risk-free interest rate and (iv) expected volatility of net sales. Estimated payments, as determined through the respective model, were further discounted by a credit spread assumption to account for credit risk. The fair value of the milestones-based contingent consideration was determined by probability weighting and discounting to the respective valuation date at the Company’s cost of debt. The Company’s cost of debt was determined by performing a synthetic credit rating for the Company and selecting yields based on companies with a similar credit rating. The contingent consideration is revalued to fair value each period, and any increase or decrease is recorded in operating income (loss). The fair value of the contingent consideration may be impacted by certain unobservable inputs, most significantly with regard to projected performance, expected term, discount rates, expected volatility and historical performance. Significant changes to these inputs in isolation, including how these inputs are weighted, could result in a significantly different fair value measurement. The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of June 30, 2022 and December 31, 2021 were as follows:


	June 30, 2022	December 31, 2021
	(unaudited)
Risk-free interest rate	2.80%	0.60%
Expected term in years	0.0 - 1.0	1.0 - 2.0
Expected volatility	30.5%	28.8%

The common stock warrants issued by the Company on June 30, 2022 in connection with the 2022 Amended Credit Agreement met the definition of a freestanding financial instrument, as they are legally detachable and separately exercisable from the debt. The fair value of the common stock warrants was estimated using the Black-Scholes option pricing model. The fair value was

impacted by the model selected, as well as assumptions surrounding inputs including the risk-free interest rate, expected term and expected volatility. The fair value was estimated to be $0.89 per share as of June 30, 2022 and the significant inputs used in the estimation of the fair value were as follows:


			June 30, 2022
			(unaudited)
Risk-free interest rate			3.04%
Expected term in years			8.0
Expected volatility			85.0%

Stock-Based Compensation

The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock awards (“RSAs”), restricted stock units (“RSUs”) and restricted stock units with non-market performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs, RSUs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSAs and RSUs over the requisite service period. As the PSUs have a performance condition, compensation expense was recognized for each vesting tranche over the respective requisite service period of each tranche upon the registration statement becoming effective on August 5, 2020, when the Company’s management deemed it probable that the performance conditions were satisfied. The Company recognized a cumulative true-up adjustment related to PSUs once the conditions became probable of being satisfied as the related service period had been completed in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive income (loss) based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See also Note 15 - Stock-Based Compensation below.

Income Taxes

Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse, and net operating loss (“NOL”) carryforwards and research and development tax credit carryforwards. Valuation allowances are provided if, based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized.

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

Business Combinations

The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805, Business Combinations (“ASC 805”), which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in the acquisition. Goodwill represents the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Subsequent adjustments to fair value of any contingent consideration are recorded to the Company’s condensed consolidated statements of operations and comprehensive income (loss).

The determination of estimated fair value requires the Company to make significant estimates and assumptions. These fair value determinations require judgment and involve the use of significant estimates and assumptions, including assumptions with respect to future cash inflows and outflows, discount rates, and asset lives, among other items. As a result, we may record

adjustments to the fair values of assets acquired and liabilities assumed within the measurement period (up to one year from the acquisition date) with the corresponding offset to goodwill.

Recently Adopted Accounting Pronouncements

In May 2021, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") No. 2021-05, Leases (Topic 842), Lessors – Certain Leases with Variable Lease Payments, which clarifies that lessors should classify and account for a lease with variable lease payments that do not depend on a reference index or a rate as an operating lease. This ASU is effective for smaller reporting companies in 2022. The Company adopted this guidance in the first quarter of 2022, which did not have a material impact on its condensed consolidated financial statements.

In April 2021, the FASB issued ASU No. 2021-04, Earnings Per Share (Topic 260), Debt Modifications and Extinguishments (Subtopic 470-50), Compensation Stock Compensation (Topic 718), and Derivatives and Hedging Contracts in Entity’s Own Equity (Subtopic 815-40), which provides clarification on how to account for a modification or exchange of free-standing equity-classified written call options that remain equity classified after the modification or exchange. This ASU is effective for smaller reporting companies in 2022. The Company adopted this guidance in the first quarter of 2022, which did not have a material impact on its condensed consolidated financial statements.

Accounting Pronouncements to Be Adopted

In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326). The ASU sets forth a “current expected credit loss” model which requires the Company to measure all expected credit losses for financial instruments held at the reporting date based on historical experience, current conditions and reasonable supportable forecasts. This replaces the existing incurred loss model and is applicable to the measurement of credit losses on financial assets measured at amortized cost, available-for-sale debt securities and applies to certain off-balance sheet credit exposures. This ASU is effective for smaller reporting companies in 2023. The Company is currently assessing the impact of the adoption of this ASU on its condensed consolidated financial statements.

In March 2020, the FASB issued ASU No. 2020-4, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides temporary optional guidance to ease the potential burden in accounting for reference rate reform. The new guidance provides optional expedients and exceptions for applying U.S. GAAP to transactions affected by reference rate reform if certain criteria are met. These transactions include contract modifications, hedging relationships and sale or transfer of debt securities classified as held-to-maturity. Entities may apply the provisions of the new standard as of the beginning of the reporting period when the election is made (i.e., as early as the first quarter of 2020). Unlike other topics, the provisions of this update are only available until December 31, 2022, when the reference rate replacement activity is expected to have been completed. The Company is currently evaluating the impact of this standard on its condensed consolidated financial statements and has yet to elect an adoption date.

Related Party Transactions	6 Months Ended
Related Party Transactions	Jun. 30, 2022
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions In August 2021, the Company entered into the Exchange Agreements with Deerfield Private Design Fund III, L.P., Deerfield Partners, L.P., OrbiMed Private Investments IV, LP and OrbiMed Royalty Opportunities II, LP pursuant to which the investors exchanged 6,665,841 shares of the Company’s common stock for 6,666 shares of Series A Common Equivalent Preferred Stock, par value $0.001 per share (see Note 15). The Company has a consulting agreement with a director and chairman of the Company’s Board of Directors. The Company recorded less than $0.1 million for both the three months ended June 30, 2022 and 2021, and approximately $0.1 million for both the six months ended June 30, 2022 and 2021 in SG&A expense in the condensed consolidated statements of operations and comprehensive income (loss) for the consulting services. Multiple preferred stock shareholders entered into the 2018 and 2019 Convertible Notes that also contained detached warrants. Additionally, OrbiMed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P. entered into the 2019 Credit Agreement with the Company in 2019 for a total of $70.0 million, with $40.0 million being drawn as of December 31, 2021 until the 2019 Credit Agreement was repaid in full on June 30, 2022, and replaced by the 2022 Amended Credit Agreement, which the Company entered into with Deerfield Private Design Fund III, L.P. and Deerfield Partners, L.P. The Company recorded $1.3 million and $1.4 million for the three months ended June 30, 2022 and 2021, respectively, and $2.7 million for both the six months ended June 30, 2022 and 2021, in interest expense related to these debt agreements. On June 30, 2022, the Company amended and restated its existing debt facility, which had a maturity date of May 20, 2024, with Deerfield with an aggregate principal amount of $35.0 million with a maturity date five years from the closing of the loan. In addition, the Company issued warrants to purchase its common stock to Deerfield in connection with the 2022 Amended Credit Agreement. The Company issued warrants to purchase up to an aggregate 3,779,018 shares of the Company’s common stock, par value $0.001 per share common stock, at an exercise price of $1.1114 per warrant share for a period of eight years. Refer to Note 11 - Debt for further detail.

Marketable Securities (Tables)

6 Months Ended

Jun. 30, 2022

Investments, Debt and Equity Securities [Abstract]

Summary of Marketable Securities

Marketable securities consisted of the following as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022 (unaudited)
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:

U.S. treasury securities	$	5,037	$	—	$	(39)	$	4,998
Commercial paper	24,992		—		—		24,992
Yankee debt securities	3,899		—		(20)		3,879
Supranational	3,028		—		(3)		3,025
Asset-backed securities	5,528		—		(22)		5,506
Total available-for-sale securities - short-term	42,484		—		(84)		42,400


Total available-for-sale securities	$	42,484	$	—	$	(84)	$	42,400


	December 31, 2021
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
Corporate debt securities, short-term	$	15,786	$	—	$	(6)	$	15,780
U.S. treasury securities	5,073		—		(9)		5,064
Commercial paper	36,759		$	—	—		36,759
Yankee debt securities	3,941		—		(9)		3,932
Supranational	3,054		—		(3)		3,051
Asset-backed securities, short-term	12,128		—		(12)		12,116
Total available-for-sale securities - short-term	76,741		—		(39)		76,702

Available-for-sale securities - long-term:
Corporate debt securities, long-term	$	3,082	$	—	$	(2)	$	3,080
Asset-backed securities, long-term	4,044		—		(4)		4,040
Total available-for-sale securities - long-term	7,126		—		(6)		7,120
Total available-for-sale securities	$	83,867	$	—	$	(45)	$	83,822

Goodwill and Intangible Assets (Tables)

6 Months Ended

Jun. 30, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Summary of Goodwill and Intangible Assets Activities

The table below summarizes goodwill and intangible assets activities as of June 30, 2022 and December 31, 2021 (in thousands):


	Goodwill		Intangible Assets
Balance, December 31, 2021	$	12,026	$	5,013
Amortization expense	—		(320)
Goodwill impairment	(12,026)		—
Intangible assets disposed in sale(1)	—		(3,010)
Balance, June 30, 2022 (unaudited)	$	—	$	1,683

(1) Intangible assets were reduced by $3.0M related to intangible assets sold to Medtronic. See Note 4 - Sale of Business for further information about the intangible assets disposed of in the sale.

Summary of Finite Lived Intangible Assets


	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization		June 30, 2022
							(unaudited)


Licensed intangibles	10.0	8.4	$	2,000	$	(317)	$	1,683
Total			$	2,000	$	(317)	$	1,683


	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization		December 31, 2021
Developed technology	10.0	7.6	$	4,200	$	(1,020)	$	3,180
Customer-related intangible	5.0	2.5	100		(50)		50
Licensed intangibles	10.0	8.9	2,000		(217)		1,783
Total			$	6,300	$	(1,287)	$	5,013

Summary of Remaining Amortization Expense

The following table shows the remaining amortization expense associated with the Company's licensed intangibles as of June 30, 2022 (in thousands):


	Total Amortization
Six months ending December 31, 2022	$	100
Year ending December 31, 2023	200
Year ending December 31, 2024	200
Year ending December 31, 2025	200
Year ending December 31, 2026	200
Thereafter	783
Total	$	1,683

Operating Leases (Tables)

6 Months Ended

Jun. 30, 2022

Leases [Abstract]

Summary of Quantitative Information About Operating Leases and Components of Lease Cost

The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 2022 and 2021 (dollars in thousands):


	Six Months Ended June 30,
	2022			2021
	(unaudited)
Operating cash flows from operating leases	$	365		$	439

Weighted average remaining lease term – operating leases (in years)	3.3			3.9
Weighted average discount rate – operating leases	7.0		%	7.0		%

The following table provides the components of the Company’s lease cost (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	246	$	237	$	493	$	454
Variable lease cost	63		77		140		160
Total rent expense	$	309	$	314	$	633	$	614

Summary of Future Minimum Payments Under the Non-cancelable Operating Leases

As of June 30, 2022, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):


Six months ending December 31, 2022	$	535
Year ending December 31, 2023	1,132
Year ending December 31, 2024	1,165
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Thereafter	1,221
Total	6,389
Less: present value discount	(1,606)
Operating lease liabilities	$	4,783

Subsequent Events	6 Months Ended
Subsequent Events	Jun. 30, 2022
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events Repricing On July 15, 2022, and in accordance with the terms of the Company’s 2011 and 2020 Plans, the Company’s Board of Directors approved a stock option repricing (the “2022 Repricing”) where the exercise price of each designated option was reduced to $1.34 per share, the closing stock price of the Company’s common stock as of the market close on July 25, 2022. “Designated options” are all outstanding stock options to acquire shares of the Company’s common stock that were issued to active employees (not a non-employee member of the Board or a consultant) of the Company as of July 25, 2022. All outstanding options will continue to remain outstanding in accordance with their current terms and conditions. The Company is in the process of determining the incremental compensation cost associated with the 2022 Repricing.

Net Income (Loss) Per Common Share - Schedule of Earnings Per Share, Basic and Diluted (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Earnings Per Share [Abstract]
Net income (loss)	$ 5,718	$ (28,727)	$ (34,299)	$ (57,908)
Net income allocated to participating securities, basic	(1,197)	0	0	0
Net income allocated to participating securities, diluted	(1,197)	0	0	0
Net income (loss) available to common stockholders, basic	4,521	(28,727)	(34,299)	(57,908)
Net income (loss) available to common stockholders, diluted	$ 4,521	$ (28,727)	$ (34,299)	$ (57,908)
Basic weighted average shares outstanding (in shares)	28,339,362	28,152,305	28,229,338	28,092,329
Dilutive effect of stock options (in shares)	10,067	0	0	0
Diluted weighted average shares outstanding (in shares)	28,349,429	28,152,305	28,229,338	28,092,329
Basic net income (loss) per common share (in dollars per share)	$ 0.16	$ (1.02)	$ (1.22)	$ (2.06)
Diluted net income (loss) per common share (in dollars per share)	$ 0.16	$ (1.02)	$ (1.22)	$ (2.06)

Commitments and Contingencies (Details)	Jun. 30, 2022 lawsuit
Commitments and Contingencies Disclosure [Abstract]
Number of class action lawsuits	2

Net Income (Loss) Per Common Share

6 Months Ended

Jun. 30, 2022

Earnings Per Share [Abstract]

Net Income (Loss) Per Common Share

Net Income (Loss) Per Common ShareThe Company calculates basic and diluted net income (loss) per share attributable to common stockholders in conformity with the two-class method required for participating securities as the application of the if-converted method is not more dilutive. The two-class method requires income available to common stockholders for the period to be allocated between common stock and

participating securities based upon their respective rights to receive dividends as if all income for the period had been distributed.

The Company considers its convertible preferred stock and its warrants to be participating securities. In accordance with the two-class method, net income (loss) is adjusted for earnings allocated to these participating securities and the related number of outstanding shares of the participating securities have been excluded from the computation of basic and diluted net loss per share attributable to common stockholders. The convertible preferred stock does not contractually require the holders of such shares to participate in the Company’s losses. As such, where applicable, net losses were not allocated to these securities.

Basic net income (loss) per share attributable to common stockholders is computed using net income (loss) attributable to common stockholders divided by the weighted average number of common shares outstanding during the period. Diluted net income (loss) per share attributable to common stockholders represents net income (loss) attributable to common stockholders divided by the weighted average number of common shares outstanding during the period, including the effects of any dilutive securities outstanding. Basic and diluted net loss per common share attributable to common stockholders are the same for the three months ended June 30, 2021 and the six months ended June 30, 2022 and 2021, since the inclusion of all potential shares of common stock outstanding would have been anti-dilutive due to the Company's net loss.

The following table presents the calculation of basic and diluted net income (loss) per share attributable to common stockholders, as well as the calculation of basic and diluted weighted average number of common shares used to compute net income (loss) per share attributable to common stockholders (in thousands except share and per share amounts):


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
Net income (loss)	$	5,718	$	(28,727)	$	(34,299)	$	(57,908)
Net income allocated to participating securities	(1,197)		—		—		—
Net income (loss) available to common stockholders	$	4,521	$	(28,727)	$	(34,299)	$	(57,908)
					—		—
Basic weighted average number of shares outstanding	28,339,362		28,152,305		28,229,338		28,092,329
Dilutive effect of stock options	10,067		—		—		—
Diluted weighted average number of shares outstanding	28,349,429		28,152,305		28,229,338		28,092,329
					—		—
Basic net income (loss) per common share	$	0.16	$	(1.02)	$	(1.22)	$	(2.06)
Diluted net income (loss) per common share	$	0.16	$	(1.02)	$	(1.22)	$	(2.06)

The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:


	Three Months Ended June 30,		Six Months Ended June 30,
	2022	2021	2022	2021
	(unaudited)		(unaudited)




Conversion of Series A Common Equivalent Preferred Stock	6,665,841	—	6,665,841	—
Exercise of stock options	3,915,381	4,192,572	3,925,448	4,192,572
Exercise of common stock warrants	4,576,505	797,487	4,576,505	797,487

Vesting of PSUs and RSUs	1,767,655	907,320	1,767,655	907,320
Total	16,925,382	5,897,379	16,935,449	5,897,379

Organization and Description of Business (Details) $ / shares in Units, $ in Thousands				1 Months Ended	3 Months Ended		6 Months Ended
	Jun. 30, 2022 USD ($)	Aug. 10, 2020 USD ($) $ / shares shares	Jul. 28, 2020	Jul. 31, 2021 USD ($) $ / shares shares	Jun. 30, 2022 USD ($)	Jun. 30, 2021 USD ($) shares	Jun. 30, 2022 USD ($)	Jun. 30, 2021 USD ($) shares	Dec. 31, 2021 USD ($)
Subsidiary, Sale of Stock [Line Items]
Cash, cash equivalents, restricted cash and marketable securities	$ 93,100				$ 93,100		$ 93,100		$ 108,000
Net loss					(5,718)	$ 28,727	34,299	$ 57,908
Net cash used in operating activities							48,218	$ 49,915
Accumulated deficit	512,997				512,997		512,997		478,698
Working capital	93,300				$ 93,300		93,300		$ 107,800
Proceeds from sale of convertible preferred stock and convertible debt		$ 253,900
Reverse stock split conversion ratio			0.102838
Stock issued during period (in shares) \| shares				6,325,000		26,958		26,958
Proceeds from the issuance of common stock, net of issuance costs				$ 82,700
Proceeds from divestiture of businesses							50,000	$ 0
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Subsidiary, Sale of Stock [Line Items]
Proceeds from divestiture of businesses	$ 50,000						$ 50,000
IPO
Subsidiary, Sale of Stock [Line Items]
Stock issued during period (in shares) \| shares		10,147,058
Price per share (in dollars per share) \| $ / shares		$ 18.00
Proceeds from issuance, initial public offering		$ 166,300
Over-Allotment Option
Subsidiary, Sale of Stock [Line Items]
Stock issued during period (in shares) \| shares		1,323,529		825,000
Price per share (in dollars per share) \| $ / shares				$ 14.00
Public Stock Offering
Subsidiary, Sale of Stock [Line Items]
Consideration received on transaction				$ 88,600

Stock-Based Compensation (Tables)

6 Months Ended

Jun. 30, 2022

Share-Based Payment Arrangement [Abstract]

Schedule of Estimate of the Fair Value of Stock Option

The following assumptions were used to estimate the fair value of stock options for the six months ended June 30, 2022 and 2021:


	Six Months Ended June 30,
	2022	2021
	(unaudited)
Risk-free interest rate	1.76% - 3.35%	0.76% - 1.39%
Expected dividend yield	—	—
Expected term in years	5.5 - 6.0	7.0
Expected volatility	75% - 90%	60% - 84%

Summary of Stock Option Activity

The following table summarizes stock option activity during the six months ended June 30, 2022:


	Stock Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2021	3,781,636	$	13.12	7.6	$	93
Options granted	724,050	1.99
Options exercised	(35,478)	1.85			33
Options forfeited	(544,760)	9.77
Outstanding as of June 30, 2022 (unaudited)	3,925,448	$	11.64	5.9	$	97
Options vested and exercisable as of June 30, 2022 (unaudited)	2,006,949	$	12.99	5.0	$	—

Schedule of RSU Activity

The Company’s RSU activity for the six months ended June 30, 2022 was as follows:


	Number of Shares	Weighted Average Grant Price
Unvested as of December 31, 2021	995,091	$	13.47
Granted	1,367,786	1.99
Forfeited	(299,407)	7.66
Vested	(295,815)	13.78
Unvested as of June 30, 2022 (unaudited)	1,767,655	$	5.52

Summary of the Total Stock-Based Compensation Expense for the Stock Options, PSUs and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss

The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs, RSAs and ESPP expense recorded in the condensed consolidated statements of operations and comprehensive income (loss) for the three and six months ended June 30, 2022 and 2021 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
Cost of products sold	$	225	$	223	$	451	$	380
Research and development	554		629		1,068		1,071
Selling, general and administrative	1,802		2,924		4,094		5,235
Total stock-based compensation	$	2,581	$	3,776	$	5,613	$	6,686

Summary of Significant Accounting Policies - Summary of Weighted-Average Fair Value Assumptions on Contingent Consideration (Details) - Significant Unobservable Inputs (Level 3) - Rhythm Xience	Jun. 30, 2022	Dec. 31, 2021
Risk-free interest rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, fair value inputs	0.0280	0.0060
Expected term in years \| Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, fair value inputs	0.0	1.0
Expected term in years \| Maximum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, fair value inputs	1.0	2.0
Expected volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, fair value inputs	0.305	0.288

Property and Equipment, Net (Tables)

6 Months Ended

Jun. 30, 2022

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Medical diagnostic equipment	$	17,165	$	16,759
Furniture and fixtures	431		433
Office equipment	1,571		1,538
Laboratory equipment and software	4,840		5,302
Leasehold improvements	571		582
Construction in process	1,348		958
Total property and equipment	25,926		25,572
Less: accumulated depreciation	(14,560)		(11,902)
Property and equipment, net	$	11,366	$	13,670

Summary of Significant Accounting Policies - Summary of Revenue from External Customers by Geographic Areas (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Disaggregation of Revenue [Line Items]
Total revenue	$ 4,076	$ 4,709	$ 7,757	$ 8,300
United States
Disaggregation of Revenue [Line Items]
Total revenue	2,037	2,486	4,060	4,068
Outside the United States
Disaggregation of Revenue [Line Items]
Total revenue	$ 2,039	$ 2,223	$ 3,697	$ 4,232

- Definition

Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9038-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI https://asc.fasb.org/extlink&oid=126920106&loc=SL49130545-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8906-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126920106&loc=SL49130543-203045

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9054-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9031-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 924
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-URI https://asc.fasb.org/extlink&oid=6472922&loc=d3e499488-122856

+ Details

Property and Equipment, Net - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 25,926	$ 25,572
Less: accumulated depreciation	(14,560)	(11,902)
Property and equipment, net	11,366	13,670
Medical diagnostic equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	17,165	16,759
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Total property and equipment	431	433
Office equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	1,571	1,538
Laboratory equipment and software
Property, Plant and Equipment [Line Items]
Total property and equipment	4,840	5,302
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total property and equipment	571	582
Construction in process
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 1,348	$ 958

Net Income (Loss) Per Common Share - Summary of Calculation of the Diluted Net Loss per Common Share (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	16,925,382	5,897,379	16,935,449	5,897,379
Conversion of Series A Common Equivalent Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	6,665,841	0	6,665,841	0
Exercise of stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	3,915,381	4,192,572	3,925,448	4,192,572
Exercise of common stock warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	4,576,505	797,487	4,576,505	797,487
Vesting of PSUs and RSUs
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	1,767,655	907,320	1,767,655	907,320

Stock-Based Compensation - Schedule of Estimate of the Fair Value of Stock Option (Details)	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum	1.76%	0.76%
Risk-free interest rate, maximum	3.35%	1.39%
Expected dividend yield	0.00%	0.00%
Expected term		7 years
Expected volatility, minimum	75.00%	60.00%
Expected volatility, maximum	90.00%	84.00%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	5 years 6 months
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	6 years

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Cash flows from operating activities
Net loss	$ (34,299)	$ (57,908)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense	3,145	2,747
AcQMap Systems converted to sales	110	0
Sales-type lease gain	(57)	0
Amortization of intangible assets	320	320
Stock-based compensation expense	5,613	6,686
Amortization of premiums and accretion of discounts on marketable securities, net	264	797
Amortization of debt issuance costs	641	672
Amortization of right-of-use assets	321	343
Goodwill impairment	12,026	0
Loss on debt extinguishment	7,947	0
Gain on sale of business	(43,575)	0
Change in fair value of contingent consideration	955	(1,411)
Changes in operating assets and liabilities:
Accounts receivable	1,037	(1,199)
Inventory	1,101	(1,705)
Prepaid expenses and other current assets	(3,592)	2,501
Other assets	223	(289)
Accounts payable	236	(2,727)
Accrued liabilities	(386)	1,600
Operating lease liabilities	(203)	(342)
Other long-term liabilities	(45)	0
Net cash used in operating activities	(48,218)	(49,915)
Cash flows from investing activities
Proceeds from sale of business	50,000	0
Direct costs paid related to sale of business	(2,488)	0
Purchases of available-for-sale marketable securities	0	(9,134)
Sales of available-for-sale marketable securities	13,099	4,590
Maturities of available-for-sale marketable securities	27,787	44,407
Purchases of property and equipment	(1,718)	(5,841)
Net cash provided by investing activities	86,680	34,022
Cash flows from financing activities
Repayment of debt	(44,550)	0
Penalty fees paid for early prepayment of debt	(1,074)	0
Borrowing under new debt	35,000	0
Payment of debt issuance costs	(624)	0
Payment of deferred offering costs	0	(10)
Payment of contingent consideration	(598)	(2,758)
Repurchase of common shares to pay employee withholding taxes	(45)	0
Proceeds from stock options exercises	66	619
Proceeds from employee stock purchase plan	182	0
Net cash used in financing activities	(11,643)	(2,149)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(323)	(65)
Net change in cash, cash equivalents and restricted cash	26,496	(18,107)
Cash, cash equivalents and restricted cash, at the beginning of the period	24,221	25,384
Cash, cash equivalents and restricted cash, at the end of the period	50,717	7,277
Supplemental disclosure of cash flow information:
Cash paid for income taxes	0	38
Cash paid for interest	2,073	2,263
Supplemental disclosure of noncash investing and financing activities:
Amount of debt proceeds allocated to warrant liability	3,379	0
Change in unrealized (gain) loss on marketable securities	39	(10)
Change in unpaid purchases of property and equipment	42	58
Escrow release	157	0
Unpaid transaction costs from sale of business	429	0
Unpaid debt issuance costs	177	0
Right-of-use assets exchanged for operating lease liabilities	0	3,527
Net book value on AcQMap system sales-type leases	110	0
Unpaid deferred offering costs	$ 0	$ 313

Sale of Business - Summary of Sale of Discontinued Operation (Details) - USD ($) $ in Thousands		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2022	Jun. 30, 2021
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestiture of businesses		$ 50,000	$ 0
Property and equipment sold	$ (500)	(500)
Intangible assets sold	(3,000)	(3,000)
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestiture of businesses	50,000	50,000
Property and equipment sold	(498)	(498)
Intangible assets sold	(3,010)	(3,010)
Direct transaction costs	(2,917)	$ (2,917)
Gain on sale of business, net	$ 43,575

Stockholders’ Equity	6 Months Ended
Stockholders’ Equity	Jun. 30, 2022
Equity [Abstract]
Stockholders Equity	Stockholders’ Equity Series A Common Equivalent Preferred Stock In August 2021, the Company entered into exchange agreements (the “Exchange Agreements”) with four investors pursuant to which the investors exchanged 6,665,841 shares of the Company’s common stock for 6,666 shares of a new series of non-voting convertible preferred stock of the Company designated as “Series A Common Equivalent Preferred Stock,” par value $0.001 per share. In connection with the issuance of Series A Common Equivalent Preferred Stock pursuant to the Exchange Agreements, on August 23, 2021, the Company filed a Certificate of Designation of Preferences, Rights and Limitations of the Series A Common Equivalent Preferred Stock, par value $0.001 per share, of the Company (the “Series A Certificate of Designation”) with the Secretary of State of the State of Delaware. The Series A Common Equivalent Preferred Stock ranks senior to the common stock with respect to rights on the distribution of assets on any voluntary or involuntary liquidation, dissolution or winding up of the affairs of the Company, having a liquidation preference equal to its par value of $0.001 per share. The Series A Common Equivalent Preferred Stock will participate equally and ratably on an as-converted basis with the holders of common stock in all cash dividends paid on the common stock. The Series A Common Equivalent Preferred Stock is non-voting. The holder thereof may convert each share of Series A Common Equivalent Preferred Stock into 1,000 shares of common stock at its election, except to the extent that, following such conversion, the number of shares of common stock held by such holder, its affiliates and any other persons whose beneficial ownership of common stock would be aggregated with such holder’s for purposes of Section 13(d) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), including shares held by any “group” (as defined in Section 13(d) of the Exchange Act and applicable regulations of the Securities and Exchange Commission) of which such holder is a member, but excluding shares beneficially owned by virtue of the ownership of securities or rights to acquire securities that have limitations on the right to convert, exercise or purchase similar to the limitation set forth in the Series A Certificate of Designation, exceeds 4.9% (or, at the election of the holders, OrbiMed Private Investments IV, LP or OrbiMed Royalty Opportunities II, LP, made by delivering at least 61 days advance written notice to the Company of its intention to increase the beneficial ownership cap applicable to such holder, to 9.9%) of the total number of shares of common stock then issued and outstanding. Common Stock In July 2021, the Company issued 6,325,000 shares of common stock in a public offering, which included 825,000 shares of common stock issued upon the underwriter's exercise in full of an option to purchase additional shares of common stock. The price to the public for each share was $14.00. The Company received gross proceeds of $88.6 million from the offering. Net of underwriting discounts and commission and other offering expenses, the Company received proceeds of $82.7 million from the offering. During the six months ended June 30, 2022 and 2021, stock options to acquire 35,478 shares and 98,969 shares were exercised for shares of common stock, respectively. The Company received $0.1 million and $0.6 million for the exercise price of the stock options for the six months ended June 30, 2022 and 2021, respectively. 94,226 shares were issued related to the 2020 Employee Stock Purchase Plan (the “2020 ESPP”) for the six months ended June 30, 2022. No shares were issued related to the 2020 ESPP for the six months ended June 30, 2021. Additionally, during the six months ended June 30, 2022 and 2021, the Company issued 262,273 and 94,088 shares of common stock upon vesting of RSUs, respectively. Finally, the Company issued 186 shares of common stock for RSAs during the six months ended June 30, 2021. There were no issuances of RSAs during the six months ended June 30, 2022.

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-URI https://asc.fasb.org/topic&trid=2208762

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496158-112644

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496158-112644

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 14
-Subparagraph (c)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496171-112644

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 14
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496171-112644

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-URI https://asc.fasb.org/extlink&oid=120397183&loc=d3e187085-122770

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 18
-Subparagraph (d)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496189-112644

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (g)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496158-112644

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 18
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496189-112644

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (h)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496158-112644

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 14
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496171-112644

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 18
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496189-112644

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 16
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496180-112644

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (i)
-URI https://asc.fasb.org/extlink&oid=126973232&loc=SL123496158-112644

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 50
-Paragraph 6
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126731327&loc=SL126733271-114008

+ Details

Commitments and Contingencies	6 Months Ended
Commitments and Contingencies	Jun. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and ContingenciesAs of June 30, 2022, the Company and certain of its current and former officers have been named as defendants in two putative securities class action lawsuits filed in the United States District Court for the Southern District of California. On July 19, 2022, the court consolidated the two actions, appointed a lead plaintiff and appointed lead counsel for the proposed class. Due to the complex nature of the legal and factual issues involved in these class action matters, the outcome is not presently determinable and any loss is neither probable nor reasonably estimable.

Asset Acquisition and Business Combination (Details) - USD ($) $ in Thousands		1 Months Ended		3 Months Ended			6 Months Ended		12 Months Ended
	Jun. 18, 2019	Feb. 29, 2020	Jul. 31, 2019	Jun. 30, 2022	Jun. 30, 2021	Mar. 31, 2020	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2021
Business Acquisition [Line Items]
Research and development				$ 7,935	$ 9,174		$ 15,938	$ 18,544
Payments for contingent consideration							598	2,758
Biotronik Asset Acquisition
Business Acquisition [Line Items]
Consideration paid in cash									$ 10,000
Equity interests issued and issuable										$ 5,000
Consideration transferred			$ 15,000
Payments for contingent consideration							2,000
Accrued liabilities (less than)				100			100
Contingent milestone and royalty payments				8,000			8,000				$ 8,000
Potential milestone payments capitalized									2,000
Biotronik Asset Acquisition \| Maximum
Business Acquisition [Line Items]
Potential milestone payments payable				10,000			10,000
Biotronik Asset Acquisition \| Intellectual Property
Business Acquisition [Line Items]
Research and development			$ 15,000
Rhythm Xience
Business Acquisition [Line Items]
Consideration paid in cash	$ 3,000
Payments for contingent consideration							600		$ 2,500
Contingent consideration liability	13,400			2,200			2,200				$ 3,400
Contingent consideration liability increase (decrease)				$ 900	$ (300)		$ 1,000	$ (1,400)
Rhythm Xience \| Earnout Consideration
Business Acquisition [Line Items]
Potential milestone payments payable	$ 17,000
Series D Convertible Preferred Stock \| Biotronik Asset Acquisition
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable (in shares)						273,070
Equity interests issued and issuable						$ 5,000
Series D Convertible Preferred Stock \| Rhythm Xience
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable (in shares)									119,993
Series D Convertible Preferred Stock \| Rhythm Xience \| Earnout Consideration
Business Acquisition [Line Items]
Equity interests issued and issuable		$ 2,200

Sale of Business - Narrative (Details) - USD ($) $ in Thousands		6 Months Ended		12 Months Ended
	Jun. 30, 2022	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2023	Dec. 31, 2021
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestiture of businesses		$ 50,000	$ 0
Restricted cash, long-term	$ 4,000	$ 4,000			$ 0
Indemnity escrow account, period		18 months
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestiture of businesses	50,000	$ 50,000
Gain on sale of business, net	(43,600)
Regulatory Milestones \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Compliance consideration period		15 months
Forecast \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, period				4 years
Forecast \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year one
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, royalty percentage				100.00%
Forecast \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year two
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, royalty percentage				75.00%
Forecast \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year three
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, royalty percentage				50.00%
Forecast \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year four
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, royalty percentage				50.00%
Forecast \| Manufacturing Qualification Requirements \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Compliance consideration amount				$ 20,000
Forecast \| Regulatory Milestones \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Maximum
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Compliance consideration amount				17,000
Forecast \| Regulatory Milestones \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Minimum
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Compliance consideration amount				$ 13,000
Medtronic \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestiture of businesses	$ 50,000

Marketable Securities - Narrative (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Debt Securities, Available-for-Sale, Fair Value to Amortized Cost, after Allowance for Credit Loss [Abstract]
Marketable securities, short-term	$ 42,400	$ 76,702
Marketable securities, short-term, maturity	1 year	1 year
Marketable securities, long-term	$ 0	$ 7,120
Marketable securities, long-term, maturity		2 years

Warrants - Narrative (Details) $ in Millions	6 Months Ended
Warrants - Narrative (Details) $ in Millions	Jun. 30, 2022 holder	Aug. 10, 2020 USD ($)
Warrants and Rights Note Disclosure [Abstract]
Common and preferred stock warrant liability \| $		$ 14.5
Number of warrant holders \| holder	4
Maximum percentage of outstanding common stock	0.049
Maximum percentage of outstanding common stock, notice for increase	0.099

Organization and Description of Business	6 Months Ended
Organization and Description of Business	Jun. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	Organization and Description of Business Acutus Medical, Inc. (the “Company”) is an arrhythmia management company focused on improving the way cardiac arrhythmias are diagnosed and treated. The Company designs, manufactures and markets a range of tools for catheter-based ablation procedures to treat various arrhythmias. The Company’s product portfolio includes novel access sheaths, transseptal crossing tools, diagnostic and mapping catheters, ablation catheters, mapping and imaging consoles and accessories, as well as supporting algorithms and software programs. The Company was incorporated in the state of Delaware on March 25, 2011, and is located in Carlsbad, California. Liquidity, Capital Resources and Going Concern The Company has limited revenue, has incurred significant operating losses and negative cash flows from operations since its inception, and anticipates that it will incur significant losses for at least the next several years. As of June 30, 2022 and December 31, 2021, the Company had cash, cash equivalents, restricted cash and marketable securities of $93.1 million and $108.0 million, respectively. For the six months ended June 30, 2022 and 2021, net losses were $34.3 million and $57.9 million, respectively, and net cash used in operating activities was $48.2 million and $49.9 million, respectively. As of June 30, 2022 and December 31, 2021, the Company had an accumulated deficit of $513.0 million and $478.7 million, respectively, and working capital of $93.3 million and $107.8 million, respectively. Prior to the Company’s initial public offering (“IPO”) in August 2020, operations had been financed primarily by aggregate net proceeds from the sale of convertible preferred stock and principal of converted debt of $253.9 million, as well as other indebtedness. On August 10, 2020, the Company issued 10,147,058 shares of common stock in its IPO, which included 1,323,529 shares of common stock issued upon the exercise in full by the underwriters of an option to purchase additional shares of common stock, at the public offering price less underwriting discounts and commissions. The price to the public was $18.00 per share, for net proceeds of $166.3 million. In July 2021, the Company issued 6,325,000 shares of common stock in a public offering, which included 825,000 shares of common stock issued upon the underwriter’s exercise in full of an option to purchase additional shares of common stock. The price to the public for each share was $14.00. The Company received gross proceeds of $88.6 million from the offering. Net of underwriting discounts and commission and other offering expenses, the Company received proceeds of $82.7 million from the offering. With the closing of the Company’s IPO in August 2020, the follow on offering in July 2021, the reduction in force (“RIF”) announced in January 2022, $50.0 million of proceeds received from the June 30, 2022 first closing in the sale of certain transseptal access and sheath assets to Medtronic, Inc. (“Medtronic”), as further discussed in Note 4 - Sale of Business, and further cost reduction actions taken in July 2022, management believes the Company’s current cash, cash equivalents and marketable securities are sufficient to fund operations for at least the next 12 months. To ensure that the Company has sufficient resources to fund operations, management continues to review cost improvement opportunities and pathways to reduce expenses and cash burn, while preserving the resources to invest in future growth. In the future, the Company may need to raise additional funds through one or more of the following: the issuance of debt and/or equity securities or otherwise. Until such time, if ever, that the Company can generate revenue sufficient to achieve profitability, the Company expects to finance its operations through equity or debt financings, which may not be available to the Company on the timing needed or on terms that the Company deems to be favorable. To the extent that the Company raises additional capital through the sale of equity or convertible debt securities, the ownership interest of its stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect the rights of common stockholders. Debt financing and preferred equity financing, if available, may involve agreements that include covenants limiting or restricting the Company’s ability to take specific actions, such as incurring additional debt, making acquisitions or capital expenditures or declaring dividends. If the Company is unable to maintain sufficient financial resources, its business, financial condition, and results of operations will be materially and adversely affected. The Company may be required to delay, limit, reduce or terminate its product discovery and development activities or future commercialization efforts. There can be no assurance that the Company will be able to obtain the needed financing on acceptable terms or at all. Impact of COVID-19 COVID-19 has restricted the Company's access to hospital and other customer sites, which negatively impacted the Company's ability to install its AcQMap consoles and workstations in new accounts and for sales representatives and mappers to promote the use of the Company's products with physicians. Furthermore, the impact of COVID-19 has varied by region and by healthcare facility, which has hampered the Company’s ability to forecast the sustained impact on its business from COVID-19. The Company expects medical procedure rates to continue to vary by therapy and country, and could be impacted by regional COVID-19 case volumes, healthcare system staffing shortages, patient's willingness to schedule deferrable procedures, travel restrictions, transportation limitations, quarantine restriction, vaccine and booster immunizations rates, and new COVID-19 variants. While COVID-19 case volumes appear to be decreasing in the U.S. and certain other countries as a result of higher vaccination rates, the global COVID-19 outlook remains uncertain as new variants emerge. The magnitude of the impact of the COVID-19 pandemic on productivity, results of operations and financial position, and its disruption to the Company’s business and clinical programs and timelines, will depend, in part, on the length and severity of the pandemic, associated restrictions and other measures designed to prevent the spread of COVID-19 and on the Company’s ability to conduct business in the ordinary course. The markets the Company serves could see continued impacts from COVID-19 for the foreseeable future, and the emergence of new variants of COVID-19 creates significant uncertainty as to how long COVID-19 will continue to impact the Company’s business.

Inventory

6 Months Ended

Jun. 30, 2022

Inventory Disclosure [Abstract]

Inventory

Inventory as of June 30, 2022 and December 31, 2021 consisted of the following (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Raw materials	$	7,723	$	6,779
Work in process	2,184		1,772
Finished goods	5,400		7,857
Total inventory	$	15,307	$	16,408

Sale of Business

6 Months Ended

Jun. 30, 2022

Discontinued Operations and Disposal Groups [Abstract]

Sale of Business

On June 30, 2022, the Company completed the first closing (the “First Closing”) with Medtronic, in accordance with the Asset Purchase Agreement (the “Agreement”) executed on April 26, 2022, pursuant to which the Company agreed to sell to Medtronic certain transseptal access and sheath assets which make up the Company's left-heart access portfolio (and which comprised the Rhythm Xience product line acquired as part of the Rhythm Xience Acquisition). The assets transferred to Medtronic upon the First Closing (the “Assets”) include patents, trademarks, patent and trademark applications, know-how, copyrights, prototypes and other intellectual property owned or licensed by the Company, business records and documents (including regulatory and clinical materials) and manufacturing equipment related to the AcQCross® line of sheath-compatible septal crossing devices, AcQGuide® MINI integrated crossing device and sheath, AcQGuide® FLEX Steerable Introducer with integrated transseptal dilator and needle, and AcQGuide® VUE steerable sheaths (the “Products”).

Pursuant to the Agreement, Medtronic paid $50.0 million at the First Closing, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure indemnification obligations of the Company under the Agreement, which the Company has recorded as restricted cash, long-term on its condensed consolidated balance sheet as of June 30, 2022.

The Company is also eligible to receive the following contingent cash consideration pursuant to the Agreement:

(i) $20.0 million upon the Company’s completion, to the reasonable satisfaction of Medtronic, of certain conditions set forth in the Agreement relating to the Company becoming a qualified supplier of Medtronic for the Products, including demonstration of ISO 14971:2019 compliance, completion of certain test method validations and compliance with certain other reporting requirements (the “OEM Earnout”);

(ii) $17.0 million upon the earlier of (A) the Second Closing (as defined below) or (B) the Company’s initial submission for CE Mark certification of the Products under the European Union Medical Devices Regulation, to the reasonable

satisfaction of a third-party regulatory consultant, subject to certain other conditions as set forth in the Agreement (the “Transfer Earnout”). The Transfer Earnout will be reduced to $13.0 million if the Second Closing does not occur, or the Transfer Earnout is not achieved, within 15 months of the First Closing; and

(iii) amounts equal to 100%, 75%, 50% and 50%, respectively, of quarterly Net Sales (as defined in the Agreement) from sales of the Products achieved by Medtronic over each year of a four-year period beginning on the first full quarter after Medtronic’s first commercial sale of a Product and achievement of the OEM Earnout.

None of the above milestones were achieved as of June 30, 2022.

A second closing would occur on a date determined by Medtronic, but no later than the fourth anniversary of the First Closing, subject to the satisfaction of customary closing conditions (the “Second Closing”). At the Second Closing, Medtronic would acquire certain additional assets relating to the Products, primarily supplier agreements and permits and design and specification files required for Medtronic to become the manufacturer of record of the Products. The Agreement provides that the Company may continue to sell the Products to third parties prior to achievement of the OEM Earnout. Following achievement of the OEM Earnout, the Company would manufacture the Products exclusively for Medtronic pursuant to a distribution agreement executed between the parties.

The Company recorded the following amounts on June 30, 2022, resulting in a net gain of $43.6 million on the sale, calculated as the difference between the non-contingent cash consideration received, direct transaction costs and the net carrying amount of the assets sold. The following sets forth the calculation for the gain on sale as of the First Closing (in thousands):


Non-contingent cash consideration received	$	50,000
Property and equipment sold	(498)
Intangible assets sold	(3,010)
Direct transaction costs	(2,917)
Gain on sale of business, net	$	43,575

The net gain on the sale may be adjusted in future periods by the contingent consideration, based upon the achievement of the pre-determined milestones mentioned above. The sale has been accounted for as a derecognition of a group of assets that is a business pursuant to ASC 810, Consolidation, with the resulting gain classified as operating income within income (loss) from operations on the condensed consolidated statement of operations and comprehensive income (loss). The sale does not qualify as a discontinued operation because it does not represent a strategic shift that will have a major effect on the Company's operations and financial results.

Inventory (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Inventory Disclosure [Abstract]
Raw materials	$ 7,723	$ 6,779
Work in process	2,184	1,772
Finished goods	5,400	7,857
Total inventory	$ 15,307	$ 16,408

Operating Leases

6 Months Ended

Jun. 30, 2022

Leases [Abstract]

Operating Leases

Operating LeasesThe Company leases approximately 50,800 square feet of office space for its corporate headquarters and manufacturing facility in Carlsbad, California under a noncancelable operating lease that expires on December 31, 2027. The lease is subject to

variable charges for common area maintenance and other costs that are determined annually based on actual costs. The base rent is subject to an annual increase each year. The Company has a renewal option for an additional five-year term upon the expiration date of the lease, which has been excluded from the calculation of the right-of-use asset as it is not reasonably certain to be exercised.

The Company also leases approximately 3,900 square feet of office space in Zaventem, Belgium under a noncancelable operating lease that expires on December 31, 2022. The lease is subject to variable charges that are determined annually for common area maintenance and other costs based on actual costs, and base rent is subject to an annual increase each year based on an index rate. The Company has a renewal option for an additional two-year term upon the expiration date of the lease, which has been included in the calculation of the right-of-use asset as it is reasonably certain to be exercised.

The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 2022 and 2021 (dollars in thousands):


	Six Months Ended June 30,
	2022			2021
	(unaudited)
Operating cash flows from operating leases	$	365		$	439

Weighted average remaining lease term – operating leases (in years)	3.3			3.9
Weighted average discount rate – operating leases	7.0		%	7.0		%

The following table provides the components of the Company’s lease cost (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	246	$	237	$	493	$	454
Variable lease cost	63		77		140		160
Total rent expense	$	309	$	314	$	633	$	614

As of June 30, 2022, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):


Six months ending December 31, 2022	$	535
Year ending December 31, 2023	1,132
Year ending December 31, 2024	1,165
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Thereafter	1,221
Total	6,389
Less: present value discount	(1,606)
Operating lease liabilities	$	4,783

Goodwill and Intangible Assets - Summary of Remaining Amortization Expense (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2022	$ 100
Year ending December 31, 2023	200
Year ending December 31, 2024	200
Year ending December 31, 2025	200
Year ending December 31, 2026	200
Thereafter	783
Finite-lived intangible assets, net	1,683	$ 5,013
Developed technology
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, net		3,180
Customer-related intangible
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, net		50
Licensed intangibles
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets, net	$ 1,683	$ 1,783

Lessor Sales-Type Leases (Tables)

6 Months Ended

Jun. 30, 2022

Leases [Abstract]

Estimated Future Maturities of Sales-Type Lease Receivables

As of June 30, 2022, estimated future maturities of sales-type lease receivables for each of the following years are as follows (in thousands):


Six months ending December 31, 2022	$	437
Year ending December 31, 2023	501
Year ending December 31, 2024	279
Year ending December 31, 2025	17
Lease receivable	$	1,234

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Contingent Consideration
Change in fair value	$ 948	$ (258)	$ 955	$ (1,411)
Contingent consideration
Contingent Consideration
Issuance of warrants			$ 0
Additional holdback period			18 months
Warrant liability
Contingent Consideration
Issuance of warrants			$ 3,379
Significant Unobservable Inputs (Level 3) \| Contingent consideration
Contingent Consideration
Balance at beginning of period			2,000
Payment of contingent consideration			(598)
Escrow release			(157)
Change in fair value			955
Balance at end of period (unaudited)	2,200		2,200
Revenue success payments			500
Significant Unobservable Inputs (Level 3) \| Warrant liability
Contingent Consideration
Balance at beginning of period			0
Payment of contingent consideration			0
Escrow release			0
Change in fair value			0
Balance at end of period (unaudited)	$ 3,379		$ 3,379

Inventory (Tables)

6 Months Ended

Jun. 30, 2022

Inventory Disclosure [Abstract]

Summary of Inventory

Inventory as of June 30, 2022 and December 31, 2021 consisted of the following (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Raw materials	$	7,723	$	6,779
Work in process	2,184		1,772
Finished goods	5,400		7,857
Total inventory	$	15,307	$	16,408

Stock-Based Compensation - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2022	Dec. 31, 2021
Stock Options
Outstanding at beginning of period (in shares)	3,781,636
Options granted (in shares)	724,050
Options exercised (in shares)	(35,478)
Options forfeited (in shares)	(544,760)
Outstanding at end of period (unaudited) (in shares)	3,925,448	3,781,636
Options vested and exercisable at end of period (unaudited) (in shares)	2,006,949
Weighted Average Exercise Price
Outstanding at beginning of period (in dollars per share)	$ 13.12
Options granted (in dollars per share)	1.99
Options exercised (in dollars per share)	1.85
Options forfeited (in dollars per share)	9.77
Outstanding at end of period (unaudited)(in dollars per share)	11.64	$ 13.12
Options vested and exercisable at end of period (unaudited) (in dollars per share)	$ 12.99
Stock Options Activity, Additional Disclosures
Weighted average remaining contractual life, Outstanding	5 years 10 months 24 days	7 years 7 months 6 days
Weighted average remaining contractual life, Options vested and exercisable at end of period (unaudited)	5 years
Aggregate intrinsic value, Outstanding balance at beginning of period	$ 93
Aggregate intrinsic value, Options exercised	33
Aggregate intrinsic value, Outstanding balance at end of period (unaudited)	97	$ 93
Aggregate intrinsic value, Options vested and exercisable at end of period (unaudited)	$ 0

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Disaggregation of Revenue [Line Items]
Total revenue	$ 4,076	$ 4,709	$ 7,757	$ 8,300
Disposables
Disaggregation of Revenue [Line Items]
Total revenue	3,334	3,509	6,545	5,852
Systems
Disaggregation of Revenue [Line Items]
Total revenue	346	799	346	1,768
Service/Other
Disaggregation of Revenue [Line Items]
Total revenue	$ 396	$ 401	$ 866	$ 680

- Definition

+ References

+ Details

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Statement of Comprehensive Income [Abstract]
Revenue	$ 4,076	$ 4,709	$ 7,757	$ 8,300
Costs and operating (income) expenses:
Cost of products sold	9,697	7,492	16,638	14,447
Research and development	7,935	9,174	15,938	18,544
Selling, general and administrative	14,143	15,601	28,528	31,853
Goodwill impairment	0	0	12,026	0
Restructuring	0	0	949	0
Change in fair value of contingent consideration	948	(258)	955	(1,411)
Gain on sale of business	(43,575)	0	(43,575)	0
Total costs and operating (income) expenses	(10,852)	32,009	31,459	63,433
Income (loss) from operations	14,928	(27,300)	(23,702)	(55,133)
Other income (expense):
Loss on debt extinguishment	(7,947)	0	(7,947)	0
Interest income	27	29	51	69
Interest expense	(1,290)	(1,456)	(2,701)	(2,844)
Total other expense, net	(9,210)	(1,427)	(10,597)	(2,775)
Income (loss) before income taxes	5,718	(28,727)	(34,299)	(57,908)
Income tax benefit	0	0	0	0
Net income (loss)	5,718	(28,727)	(34,299)	(57,908)
Other comprehensive income (loss)
Unrealized gain (loss) on marketable securities	18	4	(39)	10
Foreign currency translation adjustment	(387)	92	(553)	(134)
Comprehensive income (loss)	$ 5,349	$ (28,631)	$ (34,891)	$ (58,032)
Basic net income (loss) per common share (in dollars per share)	$ 0.16	$ (1.02)	$ (1.22)	$ (2.06)
Diluted net income (loss) per common share (in dollars per share)	$ 0.16	$ (1.02)	$ (1.22)	$ (2.06)
Basic weighted average shares outstanding (in shares)	28,339,362	28,152,305	28,229,338	28,092,329
Diluted weighted average shares outstanding (in shares)	28,349,429	28,152,305	28,229,338	28,092,329

Summary of Significant Accounting Policies (Tables)

6 Months Ended

Jun. 30, 2022

Accounting Policies [Abstract]

Summary of Cash and Cash Equivalents and Restricted Cash

The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total balances as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Cash and cash equivalents	$	46,567	$	24,071
Restricted cash, short-term	150		150
Restricted cash, long-term	4,000		—
Total cash, cash equivalents and restricted cash	$	50,717	$	24,221

Summary of Cash and Cash Equivalents and Restricted Cash

The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total balances as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Cash and cash equivalents	$	46,567	$	24,071
Restricted cash, short-term	150		150
Restricted cash, long-term	4,000		—
Total cash, cash equivalents and restricted cash	$	50,717	$	24,221

Summary of Disaggregation of Revenue

The following table sets forth the Company’s revenue for disposables, systems and service/other for the three and six months ended June 30, 2022 and 2021 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
Disposables	$	3,334	$	3,509	$	6,545	$	5,852
Systems	346		799		346		1,768
Service/Other	396		401		866		680
Total revenue	$	4,076	$	4,709	$	7,757	$	8,300

Summary of Revenue from External Customers by Geographic Areas

The following table provides revenue by geographic location for the three and six months ended June 30, 2022 and 2021 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
United States	$	2,037	$	2,486	$	4,060	$	4,068
Outside the United States	2,039		2,223		3,697		4,232
Total revenue	$	4,076	$	4,709	$	7,757	$	8,300

Summary of Fair Value, Liabilities Measured on Recurring Basis


	Fair Value Measurements as of June 30, 2022
	(unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at June 30, 2022
Assets included in:
Cash and cash equivalents
Money market securities	$	13,327	$	—	$	—	$	13,327
Marketable securities at fair value

U.S. treasury securities	—		4,998		—		4,998
Commercial paper	—		24,992		—		24,992
Yankee debt securities	—		3,879		—		3,879
Supranational	—		3,025		—		3,025
Asset-backed securities	—		5,506		—		5,506
Total fair value	$	13,327	$	42,400	$	—	$	55,727

Liabilities included in:
Warrant liability	$	—	$	—	$	3,379	$	3,379
Contingent consideration	—		—		2,200		2,200
Total fair value	$	—	$	—	$	5,579	$	5,579


	Fair Value Measurements as of December 31, 2021
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at December 31, 2021
Assets included in:
Cash and cash equivalents
Money market securities	$	21,893	$	—	$	—	$	21,893
Marketable securities at fair value
Corporate debt securities	—		18,860		—		18,860
U.S. treasury securities	—		5,064		—		5,064
Commercial paper	—		36,759		—		36,759
Yankee debt securities	—		3,932		—		3,932
Supranational	—		3,051		—		3,051
Asset-backed securities	—		16,156		—		16,156
Total fair value	$	21,893	$	83,822	$	—	$	105,715

Liabilities included in:
Contingent consideration	$	—	$	—	$	2,000	$	2,000
Total fair value	$	—	$	—	$	2,000	$	2,000

Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation

The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2022 (in thousands):


	Contingent Consideration		Warrant Liability
Balance, December 31, 2021	$	2,000	$	—
Payment of contingent consideration	(598)		—
Escrow release(1)	(157)		—
Issuance of warrants(2)	—		3,379
Change in fair value	955		—
Balance, June 30, 2022 (unaudited)	$	2,200	$	3,379

(2) Common stock warrants issued to lenders under the 2022 Amended Credit Agreement (see Notes 11 and 14).

Weighted-Average Unobservable Inputs to Measure Contingent Consideration

The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of June 30, 2022 and December 31, 2021 were as follows:


	June 30, 2022	December 31, 2021
	(unaudited)
Risk-free interest rate	2.80%	0.60%
Expected term in years	0.0 - 1.0	1.0 - 2.0
Expected volatility	30.5%	28.8%

Weighted-Average Unobservable Inputs to Measure Warranty Liability

The fair value was estimated to be $0.89 per share as of June 30, 2022 and the significant inputs used in the estimation of the fair value were as follows:


			June 30, 2022
			(unaudited)
Risk-free interest rate			3.04%
Expected term in years			8.0
Expected volatility			85.0%

As of June 30, 2022 and December 31, 2021, the outstanding warrants to purchase the Company’s common stock were comprised of the following:


	Equity Upon Exercise (After Conversion)	Exercise Price		Expiration Date	June 30, 2022	December 31, 2021
					(unaudited)
Warrants issued in 2015	Common stock	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	Common stock	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	Common stock	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	Common stock	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	Common stock	$	1.11	6/30/30	3,779,018	—
Total Warrants					4,576,505	797,487

The Company's warrant activity for the six months ended June 30, 2022 is as follows:


	Warrants	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)
Balance - December 31, 2021	797,487	$	9.41	6.9
Granted	3,779,018	1.11		8.0

Balance - June 30, 2022	4,576,505	$	2.56	7.7

Summary of Significant Accounting Policies (Policies)	6 Months Ended
Summary of Significant Accounting Policies (Policies)	Jun. 30, 2022
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates and Assumptions	Use of Estimates and Assumptions The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, expenses and disclosures of contingent assets and liabilities. The most significant estimates and assumptions in the Company’s condensed consolidated financial statements include, but are not limited to, revenue recognition, useful lives of intangible assets, assessment of impairment of goodwill, measurement of operating lease liabilities, and the fair value of common stock, stock options, warrants, intangible assets and contingent consideration. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are not readily apparent from other sources. Actual results could differ from those estimates.
Segments	Segments Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business as one operating segment.
Cash and Cash Equivalents and Restricted Cash	Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of June 30, 2022 and December 31, 2021, exceeded federally insured limits. Historically, restricted cash has served as collateral for the Company’s corporate credit card program; however, $4.0 million of the proceeds received on June 30, 2022 from the sale of the left-heart access portfolio assets to Medtronic are being held in an indemnity escrow account for a period of 18 months following the first closing as further discussed in Note 4 - Sale of Business, and was recorded in “Restricted cash, long-term” on the condensed consolidated balance sheet.
Marketable Securities	Marketable Securities The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets. Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ equity until their disposition or maturity. See “Fair Value Measurements” below. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method. Marketable securities are subject to a periodic impairment review. The Company recognizes an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive income (loss). The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive income (loss) for the three and six months ended June 30, 2022 and 2021.
Concentrations of Credit Risk and Off-Balance Sheet Risk	Concentrations of Credit Risk and Off-Balance Sheet Risk Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions which, at times, may exceed the Federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant. The Company’s marketable securities portfolio primarily consists of investments in commercial paper, Yankee debt securities, supranational, U.S. treasury securities, asset-backed securities and short-term high credit quality corporate debt securities.
Revenue from Contracts with Customers	Revenue from Contracts with Customers The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification ("ASC") 606, Revenue from Contracts with Customers (“ASC 606”), and ASC 842, Leases ("ASC 842"). The core principle of ASC 606 is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle: •Step 1: Identify the contract with the customer. •Step 2: Identify the performance obligations in the contract. •Step 3: Determine the transaction price. •Step 4: Allocate the transaction price to the performance obligations in the contract. •Step 5: Recognize revenue when, or as, the company satisfies a performance obligation. ASC 842 provides guidance on determining if an agreement contains a lease. ASC 842 defines a lease as a contract, or part of a contract, that conveys the right to control the use of identified property, plant or equipment for a period of time in exchange for consideration. For new customers, the Company places its medical diagnostic equipment, AcQMap System, at customer sites under evaluation agreements and generates revenue from the sale of disposable products used with the AcQMap System. Disposable products primarily include AcQMap catheters and AcQGuide steerable sheaths. Outside of the U.S., the Company also has a Qubic Force Device which generates revenue from the sale of the AcQBlate Force ablation catheters. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation. The Company sells the AcQMap System to customers along with software updates on a when-and-if-available basis, as well as the Qubic Force Device and a transseptal crossing line of products which can be used in a variety of heart procedures and does not need to be accompanied with an AcQMap System or Qubic Force Device. Included in the transseptal crossing line of products are primarily the AcQRef introducer sheath, the AcQGuide sheaths and the AcQCross Transseptal Dilator/Needle. The Company also enters into deferred equipment agreements that are generally structured such that the Company agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two to four years. The Company determined that the deferred equipment agreements include embedded sales-type leases. The Company allocates contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and non-lease components at contract inception. The Company expenses the cost of the device at the inception of the agreement and records a financial lease asset equal to the gross consideration allocated to the lease. The lease asset will be reduced by payments for minimum disposable purchases that are allocated to the lease. Lastly, the Company enters into short-term operating leases, for the rental of the system after an evaluation. These lease agreements impose no requirement on the customer to purchase the equipment and the equipment is not transferred to the customer at the end of the lease term. The short-term nature of the lease agreements does not result in lease payments accumulating to an amount that equals the value of the equipment nor is the lease term reflective of the economic life of the equipment. The Company’s contracts primarily include fixed consideration. Generally, there are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days. The delivery of disposable products are performance obligations satisfied at a point in time. The disposable products are shipped Free on Board (“FOB”) shipping point or FOB destination. For disposable products that are shipped FOB shipping point, the customer has the significant risks and rewards of ownership and legal title to the assets when the disposable products leave the Company’s shipping facilities, thus the customer obtains control and revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination. For direct customers, the installation and delivery of the AcQMap System is satisfied at a point in time when the installation is complete, which is when the customer can benefit and has control of the system. For AcQMap System sales sold to Biotronik SE & Co. KG (“Biotronik”), the installation is not a performance obligation as it is performed by Biotronik, and therefore the AcQMap System is satisfied at a point in time when they have control of the system. The Company’s software updates and equipment service performance obligations are satisfied evenly over time as the customer simultaneously receives and consumes the benefits of the Company’s performance for these services throughout the service period. The Company allocates the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company determines SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which includes, but is not limited to, transactions where the specific performance obligations are sold separately, list prices and offers to customers. Except for the deferred equipment agreements noted above, the Company’s contracts with customers generally have an expected duration of one year or less, and therefore the Company has elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts are recorded as selling, general and administrative expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of June 30, 2022 and December 31, 2021. In May 2020, the Company entered into bi-lateral distribution agreements with Biotronik (the “Bi-Lateral Distribution Agreements”). Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non-exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a co-exclusive right to distribute these products in Hong Kong. Each party will pay to the other party specified transfer prices on the sale of the other party’s products and, accordingly, will earn a distribution margin on the sale of the other party’s products.
Inventory	Inventory Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for manufacturing scrap and excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $1.4 million and $0.1 million for the three months ended June 30, 2022 and 2021, respectively, and $2.4 million and $0.9 million for the six months ended June 30, 2022 and 2021, respectively.
Accounts Receivable	Accounts Receivable The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of June 30, 2022 and December 31, 2021.
Property and Equipment, Net	Property and Equipment, Net Property and equipment are recorded at cost. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the related assets, generally three to five years, or, in the case of leasehold improvements, over the lesser of the useful life of the related asset or the lease term.
Intangible Assets	Intangible Assets At December 31, 2021, intangible assets consisted of acquired developed technology, acquired in-process technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019, as well as a license agreement with Biotronik. The Rhythm Xience intangible assets were included in the assets sold to Medtronic, leaving only the license agreement with Biotronik in intangible assets on the condensed consolidated balance sheet as of June 30, 2022. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired in-process technology was classified as an indefinite-lived intangible asset, until the receipt of Food and Drug Administration (the “FDA”) approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was classified as a finite-lived intangible and amortization for in-process technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite-lived intangible assets are impaired if their estimated fair values are less than their carrying value.
Goodwill	GoodwillGoodwill represents the excess of the purchase price of an entity over the estimated fair value of the assets acquired and liabilities assumed, and it is presented as goodwill in the accompanying condensed consolidated balance sheets. Under ASC 350, Intangibles – Goodwill and Other (“ASC 350”), goodwill is not amortized but is subject to periodic impairment testing. ASC 350 requires that an entity assign its goodwill to reporting units and test each reporting unit’s goodwill for impairment at least on an annual basis and between annual tests if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. In the evaluation of goodwill for impairment, which is performed annually during the fourth quarter, the Company first assesses qualitative factors to determine whether the existence of events or circumstances led to a determination that it was more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events or circumstances, it is determined that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, the Company is required to perform the quantitative goodwill impairment test. The Company has one reporting unit. During the six months ended June 30, 2022, the Company fully impaired its goodwill balance of $12.0 million. Refer to Note 9 - Goodwill and Intangible Assets for further details.
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three and six months ended June 30, 2022 and 2021, the Company determined that there was no impairment of property and equipment or intangible assets.
Foreign Currency Translation and Transactions	Foreign Currency Translation and Transactions The assets, liabilities and results of operations of Acutus Medical N.V. and Acutus Medical UK Limited are measured using their functional currency, the Euro and British Pound Sterling, respectively, which is the currency of the primary foreign economic environment in which the subsidiaries operate. Upon consolidating these entities with the Company, their assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and their revenues and expenses are translated at the weighted average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating the entities’ financial statements are reported in accumulated other comprehensive loss in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive income (loss).
Lessee Leases	Lessee Leases The Company accounts for its lessee leases under ASC 842. Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases, and are recorded on the condensed consolidated balance sheet as both a right-of-use asset and a lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred. In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the guidance as an accounting policy election.
Cost of Products Sold	Cost of Products Sold Cost of products sold includes raw materials, direct labor, manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products.
Research and Development	Research and Development The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. In April 2021, the Company and Biotronik entered into a Feasibility and Development Agreement to pursue the development of hardware, software and IT infrastructure to implement the Qubic Connect System ("QBS"). The QBS will allow data transfer from multiple diagnostic and therapeutic medical products during an electrophysiology procedure to be aggregated and analyzed for the purposes of designing improved treatment protocols. Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials.
Selling, General and Administrative	Selling, General and Administrative Selling, general and administrative (“SG&A”) expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs. The Company expenses all SG&A costs as incurred.
Restructure	Restructuring Restructuring expense consists of severance expenses and benefits related to employees affected by the organizational RIF. The RIF was made to align resources with the Company's current strategic direction.
Employer Retention Credit	Employee Retention Credit The Coronavirus Aid, Relief and Economic Security (“CARES”) Act provides an employee retention credit (“CARES Employee Retention Credit”), which is a refundable tax credit against certain employment taxes of up to $5 thousand per employee for eligible employers. The tax credit is equal to 50% of qualified wages paid to employees during a quarter, capped at $10 thousand of qualified wages per employee per calendar year through December 31, 2020. Additional relief provisions were passed by the United States government, which extended and expanded the qualified wage caps on these credits through September 30, 2021. Based on these additional provisions, the tax credit is now equal to 70% of qualified wages paid to employees during a quarter beginning with the first quarter of 2021, and the limit on qualified wages per employee has been increased to $10 thousand of qualified wages per quarter instead of per calendar year. The Company qualifies for the tax credit under the CARES Act. The Company filed 2021 Form 941-X Adjusted Employer’s Quarterly Federal Tax Return or Claim for Refund for the quarters ended March 31, 2021 and June 30, 2021 on March 24, 2022. The refunds due are an aggregate of $4.0 million for the quarters ended March 31, 2021 and June 30, 2021. The Company filed its 2020 Form 941-X Adjusted Employer’s Quarterly Federal Tax Return or Claim for Refund for the period March 12, 2020 through December 31, 2020 on March 31, 2022. The refunds due for that period are an aggregate of $0.6 million. The Company elected to classify the ERC amounts as a reduction to payroll tax expense. During the six months ended June 30, 2022, the Company recorded $1.5 million, $1.4 million and $1.7 million related to the CARES Employee Retention Credit within cost of products sold, research and development expense and SG&A expense, respectively, on the Company’s condensed consolidated statement of operations and comprehensive income (loss). As of June 30, 2022, the Company has a $4.6 million receivable balance from the United States government related to the CARES Act, which is recorded in “Prepaid expenses and other current assets” on the Company’s condensed consolidated balance sheet.
Fair Value Measurements	Fair Value Measurements Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy has been used in determining the inputs used in measuring fair value: Level 1—Quoted prices in active markets for identical assets or liabilities. Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace. Level 3—Unobservable inputs which are supported by little or no market activity and that are financial instruments whose values are determined using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation. Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for the three and six months ended June 30, 2022 and 2021. As of June 30, 2022 and December 31, 2021, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of the instruments. The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt. The fair value of the Company’s money market securities is determined using quoted market prices in active markets for identical assets. The Company’s portfolio of marketable securities is comprised of commercial paper, asset-backed securities, U.S. treasury securities, Yankee debt securities, supranational and short-term highly liquid, high credit quality corporate debt securities. The fair value for the available-for-sale marketable securities is determined based on trade prices in active markets for identical assets (Level 1 inputs) or valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments, broker and dealer quotes, as well as other relevant economic measures. Unrealized gains and losses associated with liabilities within the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long-dated volatilities) inputs.The fair value of the contingent consideration from the acquisition of Rhythm Xience (see Note 3) represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective earn-out period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales; (iii) risk-free interest rate and (iv) expected volatility of net sales. Estimated payments, as determined through the respective model, were further discounted by a credit spread assumption to account for credit risk. The fair value of the milestones-based contingent consideration was determined by probability weighting and discounting to the respective valuation date at the Company’s cost of debt. The Company’s cost of debt was determined by performing a synthetic credit rating for the Company and selecting yields based on companies with a similar credit rating. The contingent consideration is revalued to fair value each period, and any increase or decrease is recorded in operating income (loss). The fair value of the contingent consideration may be impacted by certain unobservable inputs, most significantly with regard to projected performance, expected term, discount rates, expected volatility and historical performance. Significant changes to these inputs in isolation, including how these inputs are weighted, could result in a significantly different fair value measurement.
Stock-Based Compensation	Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock awards (“RSAs”), restricted stock units (“RSUs”) and restricted stock units with non-market performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs, RSUs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSAs and RSUs over the requisite service period. As the PSUs have a performance condition, compensation expense was recognized for each vesting tranche over the respective requisite service period of each tranche upon the registration statement becoming effective on August 5, 2020, when the Company’s management deemed it probable that the performance conditions were satisfied. The Company recognized a cumulative true-up adjustment related to PSUs once the conditions became probable of being satisfied as the related service period had been completed in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive income (loss) based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See also Note 15 - Stock-Based Compensation below.
Income Taxes	Income Taxes Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse, and net operating loss (“NOL”) carryforwards and research and development tax credit carryforwards. Valuation allowances are provided if, based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. To date, there have been no interest or penalties charged in relation to the unrecognized tax benefits.
Business Combinations	Business Combinations The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805, Business Combinations (“ASC 805”), which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in the acquisition. Goodwill represents the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Subsequent adjustments to fair value of any contingent consideration are recorded to the Company’s condensed consolidated statements of operations and comprehensive income (loss). The determination of estimated fair value requires the Company to make significant estimates and assumptions. These fair value determinations require judgment and involve the use of significant estimates and assumptions, including assumptions with respect to future cash inflows and outflows, discount rates, and asset lives, among other items. As a result, we may record adjustments to the fair values of assets acquired and liabilities assumed within the measurement period (up to one year from the acquisition date) with the corresponding offset to goodwill.
Recently Adopted Accounting Pronouncements and Accounting Pronouncements to Be Adopted	Recently Adopted Accounting Pronouncements In May 2021, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") No. 2021-05, Leases (Topic 842), Lessors – Certain Leases with Variable Lease Payments, which clarifies that lessors should classify and account for a lease with variable lease payments that do not depend on a reference index or a rate as an operating lease. This ASU is effective for smaller reporting companies in 2022. The Company adopted this guidance in the first quarter of 2022, which did not have a material impact on its condensed consolidated financial statements. In April 2021, the FASB issued ASU No. 2021-04, Earnings Per Share (Topic 260), Debt Modifications and Extinguishments (Subtopic 470-50), Compensation Stock Compensation (Topic 718), and Derivatives and Hedging Contracts in Entity’s Own Equity (Subtopic 815-40), which provides clarification on how to account for a modification or exchange of free-standing equity-classified written call options that remain equity classified after the modification or exchange. This ASU is effective for smaller reporting companies in 2022. The Company adopted this guidance in the first quarter of 2022, which did not have a material impact on its condensed consolidated financial statements. Accounting Pronouncements to Be Adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326). The ASU sets forth a “current expected credit loss” model which requires the Company to measure all expected credit losses for financial instruments held at the reporting date based on historical experience, current conditions and reasonable supportable forecasts. This replaces the existing incurred loss model and is applicable to the measurement of credit losses on financial assets measured at amortized cost, available-for-sale debt securities and applies to certain off-balance sheet credit exposures. This ASU is effective for smaller reporting companies in 2023. The Company is currently assessing the impact of the adoption of this ASU on its condensed consolidated financial statements. In March 2020, the FASB issued ASU No. 2020-4, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides temporary optional guidance to ease the potential burden in accounting for reference rate reform. The new guidance provides optional expedients and exceptions for applying U.S. GAAP to transactions affected by reference rate reform if certain criteria are met. These transactions include contract modifications, hedging relationships and sale or transfer of debt securities classified as held-to-maturity. Entities may apply the provisions of the new standard as of the beginning of the reporting period when the election is made (i.e., as early as the first quarter of 2020). Unlike other topics, the provisions of this update are only available until December 31, 2022, when the reference rate replacement activity is expected to have been completed. The Company is currently evaluating the impact of this standard on its condensed consolidated financial statements and has yet to elect an adoption date.

Operating Leases - Summary of Future Minimum Payments Under the Non-Cancelable Operating Leases (Details) $ in Thousands	Jun. 30, 2022 USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
Six months ending December 31, 2022	$ 535
Year ending December 31, 2023	1,132
Year ending December 31, 2024	1,165
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Thereafter	1,221
Total	6,389
Less: present value discount	(1,606)
Operating lease liabilities	$ 4,783

Stock-Based Compensation

6 Months Ended

Jun. 30, 2022

Share-Based Payment Arrangement [Abstract]

Stock-Based Compensation

2022 Inducement Equity Incentive Plan

The 2022 Inducement Equity Incentive Plan (the “2022 Plan”), which permits the granting of nonstatutory stock options, RSAs, RSUs, stock appreciation rights, PSUs, performance shares and other equity-based awards to employees, directors and consultants, became effective on March 30, 2022. As of June 30, 2022, 6,000,000 shares of common stock were authorized for issuance under the 2022 Plan, of which 5,990,000 remain available for issuance under the 2022 Plan.

2020 Equity Incentive Plan

The 2020 Equity Incentive Plan (the “2020 Plan”), which permits the granting of nonstatutory stock options, RSAs, RSUs, stock appreciation rights, PSUs, performance shares and other equity-based awards to employees, directors and consultants became effective on August 5, 2020. As of June 30, 2022, 4,431,305 shares of common stock were authorized for issuance under the 2020 Plan and include 1,118,288 additional shares that were authorized on January 3, 2022. As of June 30, 2022, 992,139 shares remain available for issuance under the 2020 Plan.

2011 Equity Incentive Plan

The Company’s 2011 Equity Incentive Plan (the “2011 Plan”) permits the granting of incentive stock options, non-statutory stock options, RSAs, RSUs and other stock-based awards to employees, directors, officers and consultants. As of June 30, 2022, 1,766,648 shares of common stock were authorized for issuance under the 2011 Plan and no shares remain available for issuance under the 2011 Plan. No additional awards will be granted under the 2011 Plan. Shares that become available for issuance from the outstanding awards under the 2011 Plan due to forfeiture, or otherwise, will become available for issuance of future awards under the 2020 Plan.

Stock Options

Stock options granted generally vest over four years and have a ten-year contractual term. The fair value of each employee and non-employee stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The Company's common stock became publicly traded in August 2020 and lacks company-specific historical and implied volatility information. Therefore, the Company estimates its expected stock volatility based on the historical volatility of a set of publicly traded peer companies. Due to the lack of historical exercise history, the expected term of the Company’s stock options has been determined using the “simplified” method for awards. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is zero based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future.

The following assumptions were used to estimate the fair value of stock options for the six months ended June 30, 2022 and 2021:


	Six Months Ended June 30,
	2022	2021
	(unaudited)
Risk-free interest rate	1.76% - 3.35%	0.76% - 1.39%
Expected dividend yield	—	—
Expected term in years	5.5 - 6.0	7.0
Expected volatility	75% - 90%	60% - 84%

The following table summarizes stock option activity during the six months ended June 30, 2022:


	Stock Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2021	3,781,636	$	13.12	7.6	$	93
Options granted	724,050	1.99
Options exercised	(35,478)	1.85			33
Options forfeited	(544,760)	9.77
Outstanding as of June 30, 2022 (unaudited)	3,925,448	$	11.64	5.9	$	97
Options vested and exercisable as of June 30, 2022 (unaudited)	2,006,949	$	12.99	5.0	$	—

For options in the money, the aggregate intrinsic value for options outstanding in the above table represents the product of the number of options outstanding multiplied by the difference between the per share fair value of the Company’s common stock on the last day of the fiscal period, which was $1.12 and $3.41 as of June 30, 2022 and December 31, 2021, respectively, and the exercise price. The aggregate intrinsic value for options exercised in the above table represents the product of the number of options exercised multiplied by the difference between the per share fair value of the Company’s stock on the date of exercise and the exercise price. The weighted average grant date fair value per share for the stock option awards granted during the six months ended June 30, 2022 was $1.32. As of June 30, 2022, the total unrecognized compensation related to unvested stock option awards granted was $12.4 million, which the Company expects to recognize over a weighted-average period of approximately 1.9 years.

Restricted Stock Units (RSUs)

The Company’s RSU activity for the six months ended June 30, 2022 was as follows:


	Number of Shares	Weighted Average Grant Price
Unvested as of December 31, 2021	995,091	$	13.47
Granted	1,367,786	1.99
Forfeited	(299,407)	7.66
Vested	(295,815)	13.78
Unvested as of June 30, 2022 (unaudited)	1,767,655	$	5.52

As of June 30, 2022, there was $8.1 million of unrecognized compensation related to unvested RSUs, which the Company expects to recognize over a weighted-average period of approximately 2.0 years.

Restricted Stock Awards (RSA)

The Company had no RSA activity for the six months ended June 30, 2022.

Employee Stock Purchase Plan

The 2020 ESPP, which permits employees to purchase shares of the Company’s common stock, became effective on August 5, 2020 and 645,105 shares of common stock were authorized for sale under the 2020 ESPP.

The 2020 ESPP was implemented by consecutive offering periods with a new offering period commencing on the first trading day on or after February 1 and August 1 of each year and terminating on the last trading day on or before July 31 and January 31, respectively. The first offering period began on February 1, 2021. In November 2021, the Company amended its ESPP offering periods beginning in 2022 after the January 31 purchase, to commence on the first trading day on or after May 15 and November 15 of each year and terminating on the last trading day on or before November 14 and May 14, respectively. On each purchase date, which falls on the last date of each offering period, 2020 ESPP participants will purchase shares of common stock at a price per share equal to 85% of the lesser of (1) the fair market value per share of the common stock on the offering date or (2) the fair market value of the common stock on the purchase date. The occurrence and duration of offering periods under the 2020 ESPP are subject to the determinations of the Compensation Committee of the Company’s Board of Directors, in its sole discretion.

The fair value of the 2020 ESPP shares is estimated using the Black-Scholes option pricing model.


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
Cost of products sold	$	225	$	223	$	451	$	380
Research and development	554		629		1,068		1,071
Selling, general and administrative	1,802		2,924		4,094		5,235
Total stock-based compensation	$	2,581	$	3,776	$	5,613	$	6,686

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, shares issued (in shares)	6,666	6,666
Preferred stock, shares outstanding (in shares)	6,666	6,666
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	260,000,000	260,000,000
Common stock, shares issued (in shares)	28,349,200	27,957,223
Common stock, shares outstanding (in shares)	28,349,200	27,957,223

Net Income (Loss) Per Common Share (Tables)

6 Months Ended

Jun. 30, 2022

Earnings Per Share [Abstract]

Schedule of Earnings Per Share, Basic and Diluted


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
	(unaudited)				(unaudited)
Net income (loss)	$	5,718	$	(28,727)	$	(34,299)	$	(57,908)
Net income allocated to participating securities	(1,197)		—		—		—
Net income (loss) available to common stockholders	$	4,521	$	(28,727)	$	(34,299)	$	(57,908)
					—		—
Basic weighted average number of shares outstanding	28,339,362		28,152,305		28,229,338		28,092,329
Dilutive effect of stock options	10,067		—		—		—
Diluted weighted average number of shares outstanding	28,349,429		28,152,305		28,229,338		28,092,329
					—		—
Basic net income (loss) per common share	$	0.16	$	(1.02)	$	(1.22)	$	(2.06)
Diluted net income (loss) per common share	$	0.16	$	(1.02)	$	(1.22)	$	(2.06)

Summary of Calculation of the Diluted Net Loss per Common Share

The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:


	Three Months Ended June 30,		Six Months Ended June 30,
	2022	2021	2022	2021
	(unaudited)		(unaudited)




Conversion of Series A Common Equivalent Preferred Stock	6,665,841	—	6,665,841	—
Exercise of stock options	3,915,381	4,192,572	3,925,448	4,192,572
Exercise of common stock warrants	4,576,505	797,487	4,576,505	797,487

Vesting of PSUs and RSUs	1,767,655	907,320	1,767,655	907,320
Total	16,925,382	5,897,379	16,935,449	5,897,379

Accrued Liabilities

6 Months Ended

Jun. 30, 2022

Payables and Accruals [Abstract]

Accrued Liabilities

Accrued liabilities consisted of the following as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Compensation and related expenses	$	6,601	$	7,088
Professional fees	703		158
Deferred revenue	278		401
Sales and use tax	205		71
Clinical studies	418		541
Clinician Council payable	393		358
Accrued royalties	92		129
Accrued restructuring	110		—
Other	338		350
Total accrued liabilities	$	9,138	$	9,096

Goodwill and Intangible Assets - Summary of Goodwill and Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Goodwill
Balance at beginning of period			$ 12,026
Goodwill impairment	$ 0	$ 0	(12,026)	$ 0
Balance at end of period (unaudited)	0		0
Intangible Assets
Balance at beginning of period			5,013
Amortization expense	(200)	$ (200)	(320)	$ (320)
Intangible assets disposed in sale			(3,010)
Balance at end of period (unaudited)	1,683		1,683
Intangible assets sold	$ 3,000		$ 3,000

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Lessor Sales-Type Leases

6 Months Ended

Jun. 30, 2022

Leases [Abstract]

Lessor Sales-Type Leases

The Company recognizes revenue and costs, as well as a lease receivable, at the time embedded sales-type leases within its deferred equipment agreements commence. Lease revenue related to sales-type leases was $0.2 million and $0.3 million for the three months ended June 30, 2022 and 2021, respectively, and for the six months ended June 30, 2022 and 2021, it was $0.2 million and $1.2 million, respectively. Lease income is included within revenue in the accompanying condensed consolidated statements of operations and comprehensive income (loss). Costs related to embedded leases within the Company’s deferred equipment agreements are included in cost of products sold in the accompanying condensed consolidated statements of operations and comprehensive income (loss).

The Company has a short-term lease receivable of $0.7 million and $0.9 million included in prepaid expenses and other current assets as of June 30, 2022 and December 31, 2021, respectively. The Company has a long-term lease receivable of $0.5 million and $0.7 million included in other assets as of June 30, 2022 and December 31, 2021, respectively.

As of June 30, 2022, estimated future maturities of sales-type lease receivables for each of the following years are as follows (in thousands):


Six months ending December 31, 2022	$	437
Year ending December 31, 2023	501
Year ending December 31, 2024	279
Year ending December 31, 2025	17
Lease receivable	$	1,234

Cover Page - shares	6 Months Ended
Cover Page - shares	Jun. 30, 2022	Aug. 08, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2022
Document Transition Report	false
Entity File Number	001-39430
Entity Registrant Name	ACUTUS MEDICAL, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-1306615
Entity Address, Address Line One	2210 Faraday Ave.
Entity Address, Address Line Two	Suite 100,
Entity Address, City or Town	Carlsbad
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92008
City Area Code	442
Local Phone Number	232-6080
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	AFIB
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		28,370,346
Amendment Flag	false
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001522860
Document Fiscal Year Focus	2022
Current Fiscal Year End Date	--12-31

Summary of Significant Accounting Policies - Weighted-Average Unobservable Inputs to Measure Warranty Liability (Details) - Significant Unobservable Inputs (Level 3) - Exercise of common stock warrants	Jun. 30, 2022 $ / shares
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Share price	$ 0.89
Risk-free interest rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input	0.0304
Expected term in years
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input	8.0
Expected volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input	0.850

Marketable Securities - Summary of Marketable Securities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Available-for-sale securities - short-term:
Amortized Cost	$ 42,484	$ 76,741
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(84)	(39)
Fair Value	42,400	76,702
Available-for-sale securities - long-term:
Amortized Cost		7,126
Gross Unrealized Gains		0
Gross Unrealized Losses		(6)
Fair Value	0	7,120
Total available-for-sale securities
Amortized Cost	42,484	83,867
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(84)	(45)
Fair Value	42,400	83,822
Corporate debt securities
Available-for-sale securities - short-term:
Amortized Cost		15,786
Gross Unrealized Gains		0
Gross Unrealized Losses		(6)
Fair Value		15,780
Available-for-sale securities - long-term:
Amortized Cost		3,082
Gross Unrealized Gains		0
Gross Unrealized Losses		(2)
Fair Value		3,080
U.S. treasury securities
Available-for-sale securities - short-term:
Amortized Cost	5,037	5,073
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(39)	(9)
Fair Value	4,998	5,064
Commercial paper
Available-for-sale securities - short-term:
Amortized Cost	24,992	36,759
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	24,992	36,759
Yankee debt securities
Available-for-sale securities - short-term:
Amortized Cost	3,899	3,941
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(20)	(9)
Fair Value	3,879	3,932
Supranational
Available-for-sale securities - short-term:
Amortized Cost	3,028	3,054
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(3)	(3)
Fair Value	3,025	3,051
Asset-backed securities
Available-for-sale securities - short-term:
Amortized Cost	5,528	12,128
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(22)	(12)
Fair Value	$ 5,506	12,116
Available-for-sale securities - long-term:
Amortized Cost		4,044
Gross Unrealized Gains		0
Gross Unrealized Losses		(4)
Fair Value		$ 4,040

Summary of Significant Accounting Policies - Narrative (Details)	3 Months Ended		6 Months Ended
	Jun. 30, 2022 USD ($)	Jun. 30, 2021 USD ($)	Jun. 30, 2022 USD ($) segment reportingUnit	Jun. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segment \| segment			1
Restricted cash, long-term	$ 4,000,000		$ 4,000,000		$ 0
Indemnity escrow account, period			18 months
Other-than-temporary impairments related to marketable securities			$ 0	$ 0
Cash, FDIC insured amount	250,000		250,000
Inventory write-down	1,400,000	$ 100,000	2,400,000	900,000
Allowance for uncollectible accounts	0		$ 0		0
Number of reporting unit \| reportingUnit			1
Goodwill impairment	0	0	$ 12,026,000	0
Impairment of property and equipment or intangible assets	0	0	0	0
Selling, general and administrative	14,143,000	15,601,000	28,528,000	31,853,000
Research and development	7,935,000	$ 9,174,000	15,938,000	$ 18,544,000
Prepaid expenses and other current assets	9,030,000		9,030,000		$ 5,326,000
Interest or penalties charged in relation to the unrecognized tax benefits	0		0
CARES Employee Retention Credit
Summary Of Significant Accounting Policies [Line Items]
Cost of products sold			1,500,000
Selling, general and administrative			1,400,000
Research and development			1,700,000
Prepaid expenses and other current assets	4,600,000		4,600,000
Tax Year 2021
Summary Of Significant Accounting Policies [Line Items]
Income taxes receivable	4,000,000		4,000,000
Tax Year 2020
Summary Of Significant Accounting Policies [Line Items]
Income taxes receivable	$ 600,000		$ 600,000
Minimum
Summary Of Significant Accounting Policies [Line Items]
Customers payment period			30 days
Property and equipment, estimated useful lives			3 years
Maximum
Summary Of Significant Accounting Policies [Line Items]
Customers payment period			60 days
Contracts with customers, expected duration	1 year		1 year
Property and equipment, estimated useful lives			5 years
Deferred Equipment Agreements
Summary Of Significant Accounting Policies [Line Items]
Up-front charge			$ 0
Deferred Equipment Agreements \| Minimum
Summary Of Significant Accounting Policies [Line Items]
Contract term			2 years
Deferred Equipment Agreements \| Maximum
Summary Of Significant Accounting Policies [Line Items]
Contract term			4 years

Accrued Liabilities (Tables)

6 Months Ended

Jun. 30, 2022

Payables and Accruals [Abstract]

Summary of Accrued Liabilities

Accrued liabilities consisted of the following as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Compensation and related expenses	$	6,601	$	7,088
Professional fees	703		158
Deferred revenue	278		401
Sales and use tax	205		71
Clinical studies	418		541
Clinician Council payable	393		358
Accrued royalties	92		129
Accrued restructuring	110		—
Other	338		350
Total accrued liabilities	$	9,138	$	9,096

Condensed Consolidated Statements of Stockholders’ Equity - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Accumulated Other Comprehensive Income (Loss)
Balance at beginning of period (in shares) at Dec. 31, 2020			27,991,425
Balance at beginning of period at Dec. 31, 2020	$ 126,583		$ 28	$ 487,290	$ (361,015)	$ 280
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain on marketable securities	10					10
Foreign currency translation adjustment	(134)					(134)
Stock option exercises (in shares)			98,969
Stock option exercises	619			619
Stock-based compensation (in shares)			94,274
Stock-based compensation	$ 6,686			6,686
Stock issued during period (in shares)	26,958
Employee stock purchase plan shares issued (in shares)			0
Net income	$ (57,908)				(57,908)
Balance at end of period (in shares) at Jun. 30, 2021			28,211,626
Balance at end of period at Jun. 30, 2021	75,856		$ 28	494,595	(418,923)	156
Balance at beginning of period (in shares) at Mar. 31, 2021			28,113,165
Balance at beginning of period at Mar. 31, 2021	100,261		$ 28	490,369	(390,196)	60
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain on marketable securities	4					4
Foreign currency translation adjustment	92					92
Stock option exercises (in shares)			71,460
Stock option exercises	450			450
Stock-based compensation (in shares)			43
Stock-based compensation	$ 3,776			3,776
Stock issued during period (in shares)	26,958
Net income	$ (28,727)				(28,727)
Balance at end of period (in shares) at Jun. 30, 2021			28,211,626
Balance at end of period at Jun. 30, 2021	75,856		$ 28	494,595	(418,923)	156
Balance at beginning of period (in shares) at Dec. 31, 2021		6,666	27,957,223
Balance at beginning of period at Dec. 31, 2021	105,726	$ 0	$ 28	584,613	(478,698)	(217)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain on marketable securities	(39)					(39)
Foreign currency translation adjustment	$ (553)					(553)
Stock option exercises (in shares)	35,478		35,478
Stock option exercises	$ 66			66
Stock-based compensation (in shares)			262,273
Stock-based compensation	5,568			5,568
Employee stock purchase plan shares issued (in shares)			94,226
Employee stock purchase plan shares issued	182			182
Net income	(34,299)				(34,299)
Balance at end of period (in shares) at Jun. 30, 2022		6,666	28,349,200
Balance at end of period at Jun. 30, 2022	76,651	$ 0	$ 28	590,429	(512,997)	(809)
Balance at beginning of period (in shares) at Mar. 31, 2022		6,666	28,279,065
Balance at beginning of period at Mar. 31, 2022	68,762	$ 0	$ 28	587,889	(518,715)	(440)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain on marketable securities	18					18
Foreign currency translation adjustment	(387)					(387)
Stock-based compensation (in shares)			70,135
Stock-based compensation	2,540			2,540
Net income	5,718				5,718
Balance at end of period (in shares) at Jun. 30, 2022		6,666	28,349,200
Balance at end of period at Jun. 30, 2022	$ 76,651	$ 0	$ 28	$ 590,429	$ (512,997)	$ (809)

Lessor Sales-Type Leases - Estimated Future Maturities of Sales-Type Lease Receivables (Details) $ in Thousands	Jun. 30, 2022 USD ($)
Leases [Abstract]
Six months ending December 31, 2022	$ 437
Year ending December 31, 2023	501
Year ending December 31, 2024	279
Year ending December 31, 2025	17
Lease receivable	$ 1,234

Property and Equipment, Net - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Property, Plant and Equipment [Abstract]
Property and equipment sold	$ 500,000		$ 500,000
Depreciation expense	1,600,000	$ 1,500,000	3,145,000	$ 2,747,000
Impairment of property and equipment or intangible assets	$ 0	$ 0	$ 0	$ 0

Marketable Securities

6 Months Ended

Jun. 30, 2022

Investments, Debt and Equity Securities [Abstract]

Marketable Securities

Marketable securities consisted of the following as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022 (unaudited)
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:

U.S. treasury securities	$	5,037	$	—	$	(39)	$	4,998
Commercial paper	24,992		—		—		24,992
Yankee debt securities	3,899		—		(20)		3,879
Supranational	3,028		—		(3)		3,025
Asset-backed securities	5,528		—		(22)		5,506
Total available-for-sale securities - short-term	42,484		—		(84)		42,400


Total available-for-sale securities	$	42,484	$	—	$	(84)	$	42,400


	December 31, 2021
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
Corporate debt securities, short-term	$	15,786	$	—	$	(6)	$	15,780
U.S. treasury securities	5,073		—		(9)		5,064
Commercial paper	36,759		$	—	—		36,759
Yankee debt securities	3,941		—		(9)		3,932
Supranational	3,054		—		(3)		3,051
Asset-backed securities, short-term	12,128		—		(12)		12,116
Total available-for-sale securities - short-term	76,741		—		(39)		76,702

Available-for-sale securities - long-term:
Corporate debt securities, long-term	$	3,082	$	—	$	(2)	$	3,080
Asset-backed securities, long-term	4,044		—		(4)		4,040
Total available-for-sale securities - long-term	7,126		—		(6)		7,120
Total available-for-sale securities	$	83,867	$	—	$	(45)	$	83,822

As of June 30, 2022, the Company’s available-for-sale securities classified as short-term of $42.4 million mature in one year or less. As of December 31, 2021, the Company’s available-for-sale securities classified as short-term of $76.7 million mature in one year or less and the available-for-sale securities classified as long-term of $7.1 million mature within two years.

Property and Equipment, Net

6 Months Ended

Jun. 30, 2022

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of June 30, 2022 and December 31, 2021 (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
Medical diagnostic equipment	$	17,165	$	16,759
Furniture and fixtures	431		433
Office equipment	1,571		1,538
Laboratory equipment and software	4,840		5,302
Leasehold improvements	571		582
Construction in process	1,348		958
Total property and equipment	25,926		25,572
Less: accumulated depreciation	(14,560)		(11,902)
Property and equipment, net	$	11,366	$	13,670

Property and equipment includes certain medical diagnostic equipment, AcQMap Systems, located at customer premises. The Company retains ownership of the equipment and has the right to remove the equipment if it is not being used according to expectations. The Company expenses the cost of the equipment when it is subsequently sold or enters into a sales-type lease agreement. See also Note 7—Lessor Sales-Type Leases above. Additionally, property and equipment disclosed above as of June 30, 2022 has been reduced by $0.5 million for the carrying amount of certain assets sold to Medtronic. See Note 4 - Sale of Business for further information about the property and equipment disposed of in the sale.

Depreciation expense was $1.6 million and $1.5 million for the three months ended June 30, 2022 and 2021, respectively and $3.1 million and $2.7 million for the six months ended June 30, 2022 and 2021, respectively. For the three and six months ended June 30, 2022 and 2021, the Company determined that there was no impairment of property and equipment.

Goodwill and Intangible Assets

6 Months Ended

Jun. 30, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

The table below summarizes goodwill and intangible assets activities as of June 30, 2022 and December 31, 2021 (in thousands):


	Goodwill		Intangible Assets
Balance, December 31, 2021	$	12,026	$	5,013
Amortization expense	—		(320)
Goodwill impairment	(12,026)		—
Intangible assets disposed in sale(1)	—		(3,010)
Balance, June 30, 2022 (unaudited)	$	—	$	1,683

(1) Intangible assets were reduced by $3.0M related to intangible assets sold to Medtronic. See Note 4 - Sale of Business for further information about the intangible assets disposed of in the sale.

During the first quarter of 2022, the Company experienced a significant decline in stock price which reduced the market capitalization below the carrying value of the Company. The Company performed a quantitative assessment of the fair value of

its reporting unit. The assessment used a combination of quoted market prices as well as present value calculations which included both the income and market approach. Based on the assessment, the Company concluded that the fair value of the reporting unit was less than its carrying amount in an amount that resulted in the Company fully impairing its goodwill balance of $12.0 million during the six months ended June 30, 2022.


	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization		June 30, 2022
							(unaudited)


Licensed intangibles	10.0	8.4	$	2,000	$	(317)	$	1,683
Total			$	2,000	$	(317)	$	1,683


	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization		December 31, 2021
Developed technology	10.0	7.6	$	4,200	$	(1,020)	$	3,180
Customer-related intangible	5.0	2.5	100		(50)		50
Licensed intangibles	10.0	8.9	2,000		(217)		1,783
Total			$	6,300	$	(1,287)	$	5,013

Acquired in-process technology was classified as an indefinite-lived intangible asset until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was reclassified as developed technology and amortization began. The Company recorded amortization expense related to the above intangible assets of $0.2 million for both the three months ended June 30, 2022 and 2021, and $0.3 million for both the six months ended June 30, 2022 and 2021. For the three and six months ended June 30, 2022 and 2021, the Company determined that there was no impairment of intangible assets.

The following table shows the remaining amortization expense associated with the Company's licensed intangibles as of June 30, 2022 (in thousands):


	Total Amortization
Six months ending December 31, 2022	$	100
Year ending December 31, 2023	200
Year ending December 31, 2024	200
Year ending December 31, 2025	200
Year ending December 31, 2026	200
Thereafter	783
Total	$	1,683

401(k) Retirement Plan (Details) - USD ($)	3 Months Ended		6 Months Ended
401(k) Retirement Plan (Details) - USD ($)	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
401(k) Retirement Plan
Defined Contribution Plan Disclosure [Line Items]
Employer contribution to defined benefit plan	$ 0	$ 0	$ 0	$ 0

Stock-Based Compensation - Schedule of RSU Activity (Details) - Restricted Stock Units (RSUs)	6 Months Ended
	Jun. 30, 2022 $ / shares shares
Number of Shares
Unvested balance at beginning of period (in shares) \| shares	995,091
Granted (in shares) \| shares	1,367,786
Forfeited (in shares) \| shares	(299,407)
Vested (in shares) \| shares	(295,815)
Unvested balance at end of period (unaudited) (in shares) \| shares	1,767,655
Weighted Average Grant Price
Unvested balance at beginning of period (in dollars per share) \| $ / shares	$ 13.47
Granted (in dollars per share) \| $ / shares	1.99
Forfeited (in dollars per share) \| $ / shares	7.66
Vested (in dollars per share) \| $ / shares	13.78
Unvested balance at end of period (unaudited) (in dollars per share) \| $ / shares	$ 5.52

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 46,567	$ 24,071
Marketable securities, short-term	42,400	76,702
Restricted cash, short-term	150	150
Accounts receivable	2,596	3,633
Inventory	15,307	16,408
Prepaid expenses and other current assets	9,030	5,326
Total current assets	116,050	126,290
Marketable securities, long-term	0	7,120
Restricted cash, long-term	4,000	0
Property and equipment, net	11,366	13,670
Right-of-use assets, net	4,191	4,521
Intangible assets, net	1,683	5,013
Goodwill	0	12,026
Other assets	1,040	1,152
Total assets	138,330	169,792
Current liabilities:
Accounts payable	7,975	7,519
Accrued liabilities	9,138	9,096
Contingent consideration, short-term	1,800	1,500
Operating lease liabilities, short-term	437	395
Warrant liability	3,379	0
Total current liabilities	22,729	18,510
Operating lease liabilities, long-term	4,346	4,591
Long-term debt	34,199	40,415
Contingent consideration, long-term	400	500
Other long-term liabilities	5	50
Total liabilities	61,679	64,066
Commitments and contingencies (Note 13)
Stockholders' equity
Preferred stock, $0.001 par value; 5,000,000 shares authorized as of June 30, 2022 and December 31, 2021; 6,666 shares of the preferred stock, designated as Series A Common Equivalent Preferred Stock, are issued and outstanding as of June 30, 2022 and December 31, 2021	0	0
Common stock, $0.001 par value; 260,000,000 shares authorized as of June 30, 2022 and December 31, 2021; 28,349,200 and 27,957,223 shares issued and outstanding as of June 30, 2022 and December 31, 2021, respectively	28	28
Additional paid-in capital	590,429	584,613
Accumulated deficit	(512,997)	(478,698)
Accumulated other comprehensive loss	(809)	(217)
Total stockholders' equity	76,651	105,726
Total liabilities and stockholders' equity	$ 138,330	$ 169,792

Warrants (Tables)

6 Months Ended

Jun. 30, 2022

Warrants and Rights Note Disclosure [Abstract]

Schedule of Outstanding Warrants to Purchase the Company's Common Stock

The fair value was estimated to be $0.89 per share as of June 30, 2022 and the significant inputs used in the estimation of the fair value were as follows:


			June 30, 2022
			(unaudited)
Risk-free interest rate			3.04%
Expected term in years			8.0
Expected volatility			85.0%

As of June 30, 2022 and December 31, 2021, the outstanding warrants to purchase the Company’s common stock were comprised of the following:


	Equity Upon Exercise (After Conversion)	Exercise Price		Expiration Date	June 30, 2022	December 31, 2021
					(unaudited)
Warrants issued in 2015	Common stock	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	Common stock	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	Common stock	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	Common stock	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	Common stock	$	1.11	6/30/30	3,779,018	—
Total Warrants					4,576,505	797,487

The Company's warrant activity for the six months ended June 30, 2022 is as follows:


	Warrants	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)
Balance - December 31, 2021	797,487	$	9.41	6.9
Granted	3,779,018	1.11		8.0

Balance - June 30, 2022	4,576,505	$	2.56	7.7

Goodwill and Intangible Assets - Summary of Finite and Indefinite Lived Intangible Assets (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Intangible Assets	$ 2,000	$ 6,300
Accumulated Amortization	(317)	(1,287)
Finite-lived intangible assets, net	$ 1,683	$ 5,013
Developed technology
Finite-Lived Intangible Assets [Line Items]
Estimated Useful Life		10 years
Weighted Average Remaining Life		7 years 7 months 6 days
Intangible Assets		$ 4,200
Accumulated Amortization		(1,020)
Finite-lived intangible assets, net		$ 3,180
Customer-related intangible
Finite-Lived Intangible Assets [Line Items]
Estimated Useful Life		5 years
Weighted Average Remaining Life		2 years 6 months
Intangible Assets		$ 100
Accumulated Amortization		(50)
Finite-lived intangible assets, net		$ 50
Licensed intangibles
Finite-Lived Intangible Assets [Line Items]
Estimated Useful Life	10 years	10 years
Weighted Average Remaining Life	8 years 4 months 24 days	8 years 10 months 24 days
Intangible Assets	$ 2,000	$ 2,000
Accumulated Amortization	(317)	(217)
Finite-lived intangible assets, net	$ 1,683	$ 1,783

Warrants - Warrant Activity (Details) - $ / shares	6 Months Ended
Warrants - Warrant Activity (Details) - $ / shares	Jun. 30, 2022	Dec. 31, 2021
Warrants
Balance at beginning of period (in shares)	797,487
Granted (in shares)	3,779,018
Balance at end of period (in shares)	4,576,505
Weighted Average Exercise Price
Balance at beginning of period (in dollars per share)	$ 9.41
Granted (in dollars per share)	1.11
Balance at end of period (in dollars per share)	$ 2.56
Weighted Average Remaining Contractual Life (in years)
Weighted average remaining contractual life	7 years 8 months 12 days	6 years 10 months 24 days
Weighted average remaining contractual life, granted	8 years

Goodwill and Intangible Assets - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill impairment	$ 0	$ 0	$ 12,026,000	$ 0
Amortization of intangible assets	200,000	200,000	320,000	320,000
Impairment of intangible assets	$ 0	$ 0	$ 0	$ 0

Warrants

6 Months Ended

Jun. 30, 2022

Warrants and Rights Note Disclosure [Abstract]

Warrants

As of June 30, 2022 and December 31, 2021, the outstanding warrants to purchase the Company’s common stock were comprised of the following:


	Equity Upon Exercise (After Conversion)	Exercise Price		Expiration Date	June 30, 2022	December 31, 2021
					(unaudited)
Warrants issued in 2015	Common stock	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	Common stock	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	Common stock	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	Common stock	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	Common stock	$	1.11	6/30/30	3,779,018	—
Total Warrants					4,576,505	797,487

The Company's warrant activity for the six months ended June 30, 2022 is as follows:


	Warrants	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)
Balance - December 31, 2021	797,487	$	9.41	6.9
Granted	3,779,018	1.11		8.0

Balance - June 30, 2022	4,576,505	$	2.56	7.7

The Company’s warrants provide the holder the option to purchase a specified number of shares for a specified price. The holder may exercise the warrant in cash or exercise pursuant to a cashless exercise whereby a calculated number of shares are withheld upon exercise to satisfy the exercise price. The warrants do not provide the holder any voting rights until the warrants are exercised.

In accordance with ASC 480, the 2022 Credit Agreement warrants issued on June 30, 2022 were recorded as liabilities at fair value at the issuance date. Changes in the fair value will be recognized in change in fair value of warrant liability in the condensed consolidated statements of operations and comprehensive income (loss) at the end of each subsequent reporting period.

Prior to the IPO, in accordance with ASC 815, the warrants issued in 2019 and prior, other than the ones issued in 2015, were also recorded as liabilities at fair value at the issuance date (the 2015 warrants have been equity classified since their issuance). Changes in the fair value were recognized in change in fair value of warrant liability in the condensed consolidated statements of operations and comprehensive loss at the end of each reporting period. On August 10. 2020, in connection with the closing of the IPO, the warrants recorded as liabilities no longer met the definition of a derivative. Accordingly, the fair value of the common and preferred stock warrant liability of $14.5 million was reclassified to stockholders’ equity in the condensed consolidated balance sheet.

In connection with the Exchange Agreements (see Note 15), four warrant holders are limited to exercising their warrants such that, following any such exercise, the number of shares of common stock beneficially owned by such holder cannot exceed 4.9% of the outstanding common stock of the Company (two of the holders may, at their option and upon sufficient prior written notice to the Company, increase such percentage to 9.9%). In the event the common share limit has been met and the holder chooses to exercise their warrants, the holder can sell any common stock they hold. Therefore, the amendment to the warrant agreements does not restrict the holder from fully exercising the warrants under the original terms of the warrant agreements.

Stock-Based Compensation - Summary of the Total Stock-Based Compensation Expense for the Stock Options, PSUs and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 2,581	$ 3,776	$ 5,613	$ 6,686
Cost of products sold
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	225	223	451	380
Research and development
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	554	629	1,068	1,071
Selling, general and administrative
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 1,802	$ 2,924	$ 4,094	$ 5,235

Stock-Based Compensation - Narrative (Details) - USD ($) $ / shares in Units, $ in Millions		3 Months Ended	6 Months Ended
	Jan. 03, 2022	Mar. 31, 2022	Jun. 30, 2022	Jun. 30, 2021	Aug. 05, 2020
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Expected dividend yield			0.00%	0.00%
Fair value exercise price to calculate aggregate intrinsic value of options (in dollars per share)		$ 3.41	$ 1.12
Share based compensation by share based payment arrangement weighted-average grant date fair value per share of stock option grants (in dollars per share)			$ 1.32
Unrecognized compensation related to stock options not vested			$ 12.4
Share based compensation non vested award period for recognition			1 year 10 months 24 days
Restricted Stock Units (RSUs)
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based compensation non vested award period for recognition			2 years
Unrecognized compensation related to restricted stock not vested			$ 8.1
2022 Plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)			6,000,000
Share based payment arrangement number of shares available for issuance (in shares)			5,990,000
2020 Plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)			4,431,305
Share based payment arrangement number of shares available for issuance (in shares)			992,139
Share based compensation by share based payments arrangement, number of additional shares authorized (in shares)	1,118,288
2011 Plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)			1,766,648
Share based payment arrangement number of shares available for issuance (in shares)			0
Share based compensation by share based payments arrangement, remain available for issuance (in shares)			0
Share based compensation by share based payment arrangement stock options vesting term			4 years
Share based compensation by share based payment arrangement stock options contractual term			10 years
2020 ESPP
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)					645,105
2020 ESPP \| Maximum
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Participants purchase price of common stock			85.00%

Operating Leases - Summary of Quantitative Information About Operating Leases (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Lessee Disclosure [Abstract]
Operating cash flows from operating leases	$ 365	$ 439
Weighted average remaining lease term – operating leases	3 years 3 months 18 days	3 years 10 months 24 days
Weighted average discount rate – operating leases	7.00%	7.00%

Debt (Tables)

6 Months Ended

Jun. 30, 2022

Debt Disclosure [Abstract]

Summary of Outstanding Debt

Outstanding debt as of June 30, 2022 and December 31, 2021 consisted of the following (in thousands):


	June 30, 2022		December 31, 2021
	(unaudited)
2022 Amended Credit Agreement(1)	$	36,750	$	—
2019 Credit Agreement(2)	—		44,550
Total debt, gross	36,750		44,550
Less: Unamortized debt discount and fees	(2,551)		(4,135)
Total long-term debt	$	34,199	$	40,415

(1)The 2022 Amended Credit Agreement includes final payment fees of $1.8 million.

(2)The 2019 Credit Agreement included final payment fees of $4.6 million.

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI https://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 3
-Subparagraph (SX 210.12-04(a))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e24072-122690

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 1A
-URI https://asc.fasb.org/extlink&oid=124435984&loc=d3e28541-108399

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 6
-URI https://asc.fasb.org/extlink&oid=126973232&loc=d3e21506-112644

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 55
-Paragraph 69B
-URI https://asc.fasb.org/extlink&oid=123466577&loc=SL123495735-112612

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 2
-URI https://asc.fasb.org/extlink&oid=124435984&loc=d3e28551-108399

Reference 7: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 55
-Paragraph 69E
-URI https://asc.fasb.org/extlink&oid=123466577&loc=SL123495743-112612

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 7
-URI https://asc.fasb.org/extlink&oid=126973232&loc=d3e21521-112644

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 8
-URI https://asc.fasb.org/extlink&oid=126973232&loc=d3e21538-112644

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 470
-Section 50
-Paragraph 3
-URI https://asc.fasb.org/extlink&oid=123599511&loc=d3e64711-112823

Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 55
-Paragraph 8
-URI https://asc.fasb.org/extlink&oid=114775985&loc=d3e28878-108400

Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-URI https://asc.fasb.org/extlink&oid=126973232&loc=d3e21475-112644

+ Details

Accrued Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Payables and Accruals [Abstract]
Compensation and related expenses	$ 6,601	$ 7,088
Professional fees	703	158
Deferred revenue	278	401
Sales and use tax	205	71
Clinical studies	418	541
Clinician Council payable	393	358
Accrued royalties	92	129
Accrued restructuring	110	0
Other	338	350
Total accrued liabilities	$ 9,138	$ 9,096