0001628280-24-014036 | 10-K | XBRL Viewer

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Net Loss Per Common Share - Schedule of Antidilutive Securities (Details) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	14,467,240	14,698,227
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	6,665,841
Exercise of common stock warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	4,576,505	4,576,505
Exercise of stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	1,039,564	1,744,253
Vesting of RSUs and RSAs
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	2,185,330	1,659,898
Issuance of shares under 2020 ESPP
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	0	51,730

Operating Leases

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Operating Leases

The Company leases approximately 50,800 square feet of office space for its corporate headquarters and manufacturing facility in Carlsbad, California under a non-cancelable 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.

Additionally, the Company leases approximately 3,900 square feet of office space in Zaventem, Belgium under a non-cancelable operating lease that expires on December 31, 2024. The lease is subject to variable charges that are determined annually for common area maintenance and other costs based on actual costs, and base rent is subject to an annual increase each year based on an index rate.

The Carlsbad and Belgium leases were not impacted by the restructure. The Carlsbad office will continue as the corporate headquarters and the facility to manufacture the Products. The Belgium office will continue to facilitate the upkeep of the Company's CE Mark.

The following table summarizes quantitative information about the Company’s operating leases for the years ended December 31, 2023 and 2022 (dollars in thousands):


	Year Ended December 31,
	2023		2022

Operating cash flows from operating leases	$	756	$	898

Weighted average remaining lease term – operating leases (in years)	4.0		4.9
Weighted average discount rate – operating leases	7.0%		7.0%

The following table provides the components of the Company’s operating lease expense for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022

Operating leases
Operating lease cost	$	1,006	$	1,013
Variable lease cost	324		293
Total operating lease expense	$	1,330	$	1,306

As of December 31, 2023, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):



Year ending December 31, 2024	$	1,160
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Year ending December 31, 2027	1,221
Total	4,717
Less: present value discount	(756)
Operating lease liabilities	$	3,961

Intangible Assets - Summary of Finite and Indefinite Lived Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Intangible Assets	$ 2,000	$ 2,000
Accumulated Amortization	(582)	(417)
Transfer to Discontinued Operations	(1,416)	(1,583)
Balance	0	$ 0
Licensed intangibles
Finite-Lived Intangible Assets [Line Items]
Estimated Useful Life (in years)		10 years
Weighted Average Remaining Life (in years)		7 years 10 months 24 days
Intangible Assets	2,000	$ 2,000
Accumulated Amortization	(582)	(417)
Transfer to Discontinued Operations	(1,416)	(1,583)
Balance	$ 0	$ 0

Discontinued Operations, Assets Held for Sale and Restructuring (Tables)

12 Months Ended

Dec. 31, 2023

Discontinued Operations and Disposal Groups [Abstract]

Summary of Sale of Discontinued Operation

The major assets and liabilities (at carrying value) associated with discontinued operations included in the Company's consolidated balance sheets are as follows (in thousands):


	December 31, 2023			December 31, 2022
Carrying amounts of major classes of assets included as part of discontinued operations

Accounts receivable	$	510		$	3,166
Inventory	12,780		*	11,533
Prepaid expenses and other current assets	902		*	1,287
Property and equipment, net	4,871		*	7,552
Intangible assets, net	1,416		*	1,583
Other assets	—			803
Less: Loss recognized on classification as held for sale	(16,369)		*	—
Total assets of the disposal group classified as discontinued operations in the statement of financial position	$	4,110		$	25,924

* These comprise assets held for sale, at their carrying value of $3.6 million as of December 31, 2023. The Company recorded the loss on classification of held for sale as a valuation allowance on the group of assets held for sale, without allocation to the individual assets within the group.

Carrying amounts of major classes of liabilities included as part of discontinued operations

Accounts payable	1,892			2,248
Accrued restructure	5,649			—
Accrued liabilities	2,762			6,376
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$	10,303		$	8,624

The revenues and expenses associated with discontinued operations included in the Company's consolidated statements of operations and comprehensive loss were as follows (in thousands):


	December 31, 2023		December 31, 2022
Major line items constituting pretax loss of discontinued operations

Revenue	$	10,937	$	13,332

Cost of product sold	(19,002)		(26,969)
Research and development	(18,335)		(25,035)
Selling, general and administrative	(18,852)		(27,339)
Impairment of inventory	(384)		—
Impairment of prepaid assets and other current assets	(580)		—
Impairment of property and equipment	(621)		—
Restructuring	(6,324)		(2,371)
Impairment from held for sale classification	(16,369)		—

Loss from discontinued operations before income taxes	(69,530)		(68,382)
Income tax expense	212		67
Net loss from discontinued operations	$	(69,742)	$	(68,449)

The Company recorded the following amounts for the year ended December 31, 2023, resulting in a net gain of $9.1 million related to the sale of business to Medtronic, calculated as the difference between the non-contingent consideration earned, less direct transaction costs (in thousands):


	Year Ended December 31, 2023

Percentage of Product Net Sales Earnout accrued as of December 31, 2023	$	9,360
Transaction costs	(280)
Gain on sale of business, net	$	9,080

Schedule of Inventory Transferred to Held For Sale

Inventory in discontinued operations consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

Raw materials	$	8,020	$	8,301
Work in process	2,211		1,827
Finished goods	2,549		1,405
Total inventory transferred to held for sale	$	12,780	$	11,533

Summary of Property and Equipment, Net Transferred to Held For Sale

Property and equipment, net, in discontinued operations consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

Furniture and fixtures	$	20	$	20
Laboratory equipment and software	18,295		18,477
Construction in process	1,141		1,186
Total property and equipment	19,456		19,683
Less: accumulated depreciation	(14,585)		(12,131)
Total property and equipment, net, related to discontinued operations	$	4,871	$	7,552

Summary of Disaggregation of Revenue

The following table sets forth the Company’s continuing revenues (primarily sales to Medtronic) for disposables and service/other (transitional services for Medtronic) for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
Disposables	$	6,315	$	3,031
Service/Other	849		—
Total revenue	$	7,164	$	3,031

The following table sets forth the breakdown of Company’s discontinued operations revenue for disposables, systems and service/other for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
Disposables	$	8,082	$	9,891
Systems	1,254		1,750
Service/Other	1,601		1,691
Total revenue	$	10,937	$	13,332

Summary of Discontinued Operations Revenue from External Customers by Geographic Areas

The following table provides discontinued operations revenue by geographic location for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
United States	$	4,450	$	5,849
Outside the United States	6,487		7,483
Total revenue	$	10,937	$	13,332

Schedule of Restructuring Activities and Related Accruals

The following summarizes the restructuring activities and their related accruals as of December 31, 2023:


	Employee		Contract
	Termination Costs		Termination Costs		Other Costs		Total

Restructure Accrual Balance at 12/31/2022	$	—	$	—	$	—	$	—
Restructuring charges	4,164		2,156		4		6,324
Payments	(671)		—		(4)		(675)
Restructure Accrual Balance at 12/31/23	$	3,493	$	2,156	$	—	$	5,649

- 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.

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+ Details

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2023
Audit Information [Abstract]
Auditor Name	KPMG LLP
Auditor Location	San Diego, California
Auditor Firm ID	185

Consolidated Statements of Stockholders’ (Deficit) Equity - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Accumulated Other Comprehensive Income (Loss)
Preferred stock, beginning balance (in shares) at Dec. 31, 2021		6,666
Balance at beginning of period at Dec. 31, 2021	$ 105,726	$ 0	$ 28	$ 584,613	$ (478,698)	$ (217)
Common stock, beginning balance (in shares) at Dec. 31, 2021			27,957,223
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain on marketable securities	39					39
Foreign currency translation adjustment	(691)					(691)
Stock option exercises (in shares)			35,478
Stock option exercises	67		$ 1	66
Stock-based compensation (in shares)			412,628
Stock-based compensation	9,280			9,280
Employee stock purchase plan shares issued (in shares)			149,327
Employee stock purchase plan shares issued	214			214
Net income (loss)	$ (39,616)				(39,616)
Preferred stock, ending balance (in shares) at Dec. 31, 2022	6,666	6,666
Balance at end of period at Dec. 31, 2022	$ 75,019	$ 0	$ 29	594,173	(518,314)	(869)
Common stock, ending balance (in shares) at Dec. 31, 2022	28,554,656		28,554,656
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain on marketable securities	$ 7					7
Foreign currency translation adjustment	$ (4)					(4)
Stock option exercises (in shares)	3,218		3,218
Stock option exercises	$ 4			4
Stock-based compensation (in shares)			710,631
Stock-based compensation	5,733			5,733
Employee stock purchase plan shares issued (in shares)			45,162
Employee stock purchase plan shares issued	25			25
Net income (loss)	$ (81,663)				(81,663)
Preferred stock, ending balance (in shares) at Dec. 31, 2023	6,666	6,666
Balance at end of period at Dec. 31, 2023	$ (879)	$ 0	$ 29	$ 599,935	$ (599,977)	$ (866)
Common stock, ending balance (in shares) at Dec. 31, 2023	29,313,667		29,313,667

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Disaggregation of Revenue [Line Items]
Revenue	$ 7,164	$ 3,031
Disposables
Disaggregation of Revenue [Line Items]
Revenue	6,315	3,031
Service/Other
Disaggregation of Revenue [Line Items]
Revenue	$ 849	$ 0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount, excluding 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.

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+ Details

Income Taxes - Schedule of Reconciliation of Expected Tax Computed at U.S. Statutory Federal Income Tax Rate to Total Expense for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Income tax benefit at federal statutory rate	$ (2,490)	$ 6,058
Adjustments for tax effects of:
State taxes, net	(271)	872
Permanent adjustments	(750)	808
Goodwill impairment	0	2,525
Stock based compensation expense	2,616	2,525
Research and development credit	(1,720)	(2,099)
Unrecognized tax benefit	626	630
Return to provision	(1,959)	534
Valuation allowance	4,012	(11,839)
Income tax expense	$ 63	$ 15
Adjustments for tax effects of:
Income tax benefit at federal statutory rate	21.00%	21.00%
State taxes, net	2.30%	3.00%
Permanent adjustments	6.30%	2.80%
Goodwill impairment	0.00%	8.80%
Stock based compensation expense	(22.10%)	8.80%
Research and development credit	14.50%	(7.30%)
Unrecognized tax benefit	(5.30%)	2.20%
Return to provision	16.50%	1.90%
Valuation allowance	(33.80%)	(41.00%)
Income tax expense	(0.50%)	0.10%

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies The Company and certain of its current and former officers have been named as defendants in two putative securities class action lawsuits filed in the United States District Court for the Southern District of California on February 14, 2022 and March 23, 2022. On July 19, 2022, the court consolidated the two actions, appointed a lead plaintiff and appointed lead counsel for the proposed class. On September 16, 2022, the lead plaintiff filed a consolidated amended complaint. The defendants thereafter filed a motion to dismiss. On September 27, 2023, the court granted the defendant’s motion to dismiss in its entirety, but gave plaintiffs leave to file an amended complaint. On October 27, 2023, the plaintiffs filed a second amended complaint asserting similar claims. The defendants thereafter filed a motion to dismiss. We are defending the action. 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.

Stock-Based Compensation - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Stock Options
Outstanding at beginning of period (in shares)	2,898,821
Options granted (in shares)	755,580
Options exercised (in shares)	(3,218)
Options forfeited (in shares)	(1,746,460)
Outstanding at end of period (in shares)	1,904,723	2,898,821
Options vested and expected to vest at end of period (in shares)	1,904,723
Options exercisable at end of period (in shares)	1,039,564
Weighted Average Exercise Price
Outstanding at beginning of period (in dollars per share)	$ 6.83
Options granted (in dollars per share)	1.28
Options exercised (in dollars per share)	1.34
Options forfeited (in dollars per share)	9.74
Outstanding at end of period (in dollars per share)	1.98	$ 6.83
Options vested and expected to vest at end of period (in dollars per share)	1.98
Options exercisable at end of period (in dollars per share)	$ 2.50
Stock Options Activity, Additional Disclosures
Weighted average remaining contractual life, outstanding	7 years 9 months 18 days	6 years 10 months 24 days
Weighted average remaining contractual life, options vested and expected to vest at end of period	7 years 9 months 18 days
Weighted average remaining contractual life, options exercisable at end of period	6 years 9 months 18 days
Aggregate intrinsic value, outstanding balance at beginning of period	$ 79
Aggregate intrinsic value, options exercised	0
Aggregate intrinsic value, outstanding balance at end of period	0	$ 79
Aggregate intrinsic value, options vested and expected to vest at end of period	0
Aggregate intrinsic value, options exercisable at end of period	$ 0

Property and Equipment, Net - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 4,449	$ 5,025
Less: accumulated depreciation	(3,624)	(3,356)
Property and equipment, net	825	1,669
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Total property and equipment	432	431
Office equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	1,537	1,537
Laboratory equipment and software
Property, Plant and Equipment [Line Items]
Total property and equipment	1,494	1,497
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total property and equipment	979	580
Construction in process
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 7	$ 980

Income Taxes - Schedule of Components of Company's Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred tax assets:
Net operating losses	$ 96,679	$ 94,437
Stock-based compensation	1,031	1,678
Research and development credit	11,733	10,273
Capitalized research costs	12,679	9,471
Intangible assets	93	94
Accrued compensation	733	1,161
Debt	623	0
Lease liability	929	1,019
Inventory	6,811	655
Other	1,241	35
Total gross deferred tax assets	132,552	118,823
Valuation allowance	(131,395)	(110,907)
Net deferred tax asset	1,157	7,916
Deferred tax liabilities:
Deferred installment gain	0	(5,315)
Property and equipment	(249)	(1,105)
Right of use assets	(747)	(891)
Prepaid expenses	(47)	(105)
Other	(115)	(461)
Debt	0	(39)
Total deferred tax liabilities	(1,157)	(7,916)
Net deferred tax assets (liabilities)	$ 0	$ 0

Marketable Securities - Narrative (Details) - USD ($)	Dec. 31, 2023	Dec. 31, 2022
Investments, Debt and Equity Securities [Abstract]
Fair Value	$ 3,233,000	$ 44,863,000
Marketable securities, short-term, maturity	1 year	1 year
Marketable securities, long-term	$ 0	$ 0

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Basis of Presentation

The consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”).

Principles of Consolidation

The 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.

Discontinued Operations

In accordance with Accounting Standards Codification ("ASC") 205, Presentation of Financial Statements, under subtopic 205-20 Discontinued Operations, a disposal of a component of an entity or a group of components of an entity is required to be reported as discontinued operations if the disposal represents a strategic shift that has (or will have) a major effect on an entity’s operations and financial results when the components of an entity meets the criteria in paragraph 205-20-45-10. In the period in which the component meets held-for-sale or discontinued operations criteria the major current assets, non-current assets, current liabilities, and non-current liabilities are reported as components of total assets and liabilities separate from those balances of the continuing operations. At the same time, the results of all discontinued operations, less applicable income taxes, are reported as components of net loss separate from the net loss of continuing operations.

The strategic shift approved by the Company's Board of Directors (discussed in Note 1 – Organization and Description of Business above) met the definition of a discontinued operation as of December 31, 2023. Accordingly, the major current assets, non-current assets, current liabilities, and non-current liabilities are reported as components of total assets and liabilities separate from those balances of the continuing operations as of December 31, 2023 and 2022, and the operating results of the components disposed are reported as loss from discontinued operations in the accompanying consolidated statement of operations and comprehensive loss for the years ended December 31, 2023 and 2022. For additional information, see Note 3 - Discontinued Operations, Assets Held for Sale and Restructuring.

Use of Estimates and Assumptions

The preparation of the consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue, expenses and disclosures of contingent assets and liabilities. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of revenue and expenses that are not readily apparent from other sources. Actual results could differ from those estimates.

Segments

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

Cash and Cash Equivalents and Restricted Cash

The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of December 31, 2023 and December 31, 2022, exceeded federally insured limits.

Restricted cash consists of (i) deposited cash collateral for the Company’s corporate credit card program and (ii) cash received for the sale of business to Medtronic held in an indemnity escrow account until certain terms of sale are met.

The following table reconciles cash, cash equivalents and restricted cash in the consolidated balance sheets to the total balances as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023		December 31, 2022
Cash and cash equivalents	$	19,170	$	25,584
Restricted cash	7,030		5,764
Total cash, cash equivalents and restricted cash	$	26,200	$	31,348

Marketable Securities

The Company’s marketable securities portfolio consists of investments in money market funds, commercial paper, U.S. treasury securities, Yankee debt securities, and asset-backed 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 income (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 may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investee’s financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s consolidated statements of operations and comprehensive loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s consolidated statements of operations and comprehensive loss for the years ended December 31, 2023 and 2022.

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. 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.

Revenue from Contracts with Customers

The Company accounts for revenue earned from contracts with customers under 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 whether an agreement contains a lease. ASC 842 defines a lease as a contract, or part of a contract, that conveys the right to control the use of identified property, plant or equipment for a period of time in exchange for consideration.

The below description applies to products that will no longer be manufactured and sold by the Company upon completion of the Restructuring. See Note 1 – Organization and Description of Business – Liquidity and Capital Resources, above.

For new customers, the Company places its medical diagnostic equipment, the 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 United States, the Company also has the Qubic Force Device which generates revenue from the sale of the AcQBlate Force Ablation Catheters. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation.

Additionally, the Company sells the AcQMap System to customers along with software updates on a when-and-if-available basis, as well as the Qubic Force Device and a transseptal crossing line of products which can be used in a variety of heart 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 has determined that such deferred equipment agreements include an embedded sales-type lease. The Company allocates contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and 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 is 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 AcQMap System after an evaluation. These lease agreements impose no requirement on the customer to purchase the equipment, and the equipment is not transferred to the customer at the end of the lease term. The short-term nature of the lease agreements does not result in lease payments accumulating to an amount that equals the value of the equipment nor is the lease term reflective of the economic life of the equipment.

The Company’s contracts 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, at which point the customer obtains control and thus revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped 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 Systems 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

include, but are not limited to, sales transactions where the specific performance obligations are sold separately, Company list prices and specific 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 ("SG&A") expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of December 31, 2023 and December 31, 2022.

In May 2020, the Company entered into bi-lateral distribution agreements (the “Bi-Lateral Distribution Agreements”) with Biotronik. 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 a specified transfer price 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.

In 2022, the Company sold its left-heart access transseptal crossing business to Medtronic. In connection with the sale, the Company entered into a distribution agreement (the "Distribution Agreement") with Medtronic, pursuant to which the Company acts as the original equipment manufacturer ("OEM") supplier of these products. The Company will produce and sell the products to Medtronic for a period of up to four years. Revenue is recognized when the title to the products are transferred to Medtronic, which occurs when the products are shipped from our facility (or FOB shipping point). See Note 4 – Sale of Business, below, for further details. As part of the Restructuring, the Company will focus exclusively on the manufacturing and distribution of the left-heart access Products to Medtronic to continue to generate revenue from such sales and potentially earn the associated earnout payments.


	Year Ended December 31,
	2023		2022
Disposables	$	6,315	$	3,031
Service/Other	849		—
Total revenue	$	7,164	$	3,031

Revenue from continuing operations is primarily US-based.

Inventory

Inventory is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory of $3.2 million and $3.8 million for the years ended December 31, 2023 and 2022, respectively, based on management’s review of inventories on hand, comparisons to estimated future usage and sales, observed shelf-life and assumptions about the likelihood of obsolescence.

Accounts Receivable

Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates future credit losses 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 December 31, 2023 or December 31, 2022.

Accounts receivable recorded on the consolidated balance sheets as of December 31, 2023 and December 31, 2022 consists of the following (in thousands):


	December 31, 2023		December 31, 2022

Trade accounts receivable	$	1,993	$	919
Earnouts receivable from Medtronic	9,360		17,000
Total accounts receivable	$	11,353	$	17,919

Employee Retention Credit Receivable

The Employee Retention Credit is a refundable U.S. tax credit separate from tax based on income for businesses that continued to pay employees while shut down due to the COVID-19 pandemic or had significant declines in gross receipts from March 13, 2020 to December 31, 2021. The Company applied for the tax credit in 2022 and as of December 31, 2023, the entire $6.8 million claimed tax credit has been refunded to the Company, of which $4.7 million was received during the year ended December 31, 2023.

Property and Equipment, Net

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

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 year ended December 31, 2022, the Company fully impaired its goodwill balance of $12.0 million.

Impairment of Long-Lived Assets

The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the years ended December 31, 2023 and 2022, 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 consolidated balance sheets and foreign currency translation adjustment in the consolidated statements of operations and comprehensive loss.

Lease Property

The Company leases office space in Carlsbad, California as its corporate headquarters and for manufacturing operations. Additionally, it leases office space in Zaventem, Belgium for international operations. The Company accounts for its lease property 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 consolidated balance sheets 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, which is the rate for collateralized borrowings based on the current economic environment, credit history, credit rating, value of leases, currency in which the lease obligation is satisfied, rate sensitivity, lease term and materiality. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred.

In calculating the right-of-use asset and lease liability, the Company elected to combine lease and non-lease components. The Company adopted the policy election to exclude short-term leases having initial terms of twelve months from the initial recognition provisions of ASC 842. See Note 11 - Operating Leases for additional details.

Cost of Products Sold

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

Research and Development

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

Research and development expenses 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 expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in 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, insurance costs, and additionally, prior to the Restructuring, salaries and employee-related costs for personnel in sales, marketing, and other administrative functions.

Fair Value Measurements

Financial Instruments

Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy is used in determining the inputs for 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 consist of financial instruments valued 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 years ended December 31, 2023 and 2022.

As of December 31, 2023 and December 31, 2022, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of each instrument. The carrying amount of the Company’s long-term debt approximates fair value (using Level 2 assumptions) 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 December 31, 2023 and December 31, 2022 (in thousands):


	Fair Value Measurements as of December 31, 2023

	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets included in:
Cash and cash equivalents
Money market securities	$	16,911	$	—	$	—	$	16,911
Marketable securities at fair value
U.S. treasury securities	—		—		—		—
Commercial paper	—		1,978		—		1,978
Asset-backed securities	—		497		—		497
Yankee debt securities	—		758		—		758
Total fair value	$	16,911	$	3,233	$	—	$	20,144

Liabilities included in:
Warrant liability	—		—		409		409

Total fair value	$	—	$	—	$	409	$	409


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

Liabilities included in:
Warrant liability	—		—		3,346		3,346
Contingent consideration	—		—		1,800		1,800
Total fair value	$	—	$	—	$	5,146	$	5,146

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

The fair value for the available-for-sale marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs) such as quoted prices for similar assets, 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.

Financial Obligations

The following table presents changes in Level 3 liabilities measured at fair value for the year ended December 31, 2023 (in thousands):


	Contingent Consideration		Warrant Liability
Balance, December 31, 2022	$	1,800	$	3,346
Change in fair value	123		(2,937)
Final payment of contingent consideration	(1,923)		—
Balance, December 31, 2023	$	—	$	409

As of December 31, 2023, the fair value of the common stock warrants was estimated using the Black-Scholes option pricing model. The fair value was estimated to be $0.1083 per warrant as of December 31, 2023 and the significant inputs used in the estimation of the fair value were as follows:


	December 31, 2023

Risk-free interest rate	3.88	%
Expected term in years	6.5
Expected volatility	90.00	%

Stock-Based Compensation

The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock units ("RSUs"), and restricted stock awards ("RSAs"), to be recognized in the 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 RSUs and RSAs are valued based on the fair value of the Company’s common stock on the date of grant. The Company expenses stock-based compensation related to stock options, RSUs and RSAs over the requisite service period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the consolidated statements of operations and comprehensive loss based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See Note 15—Stock-Based Compensation for additional details.

Income Taxes

Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the 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.

Warrant Liability

The Company accounts for certain common stock warrants outstanding as a liability at fair value, determined using the Black-Scholes option pricing model, on the consolidated balance sheets in accordance with ASC 815, Derivatives and Hedging (“ASC 815”). The liability is subject to re-measurement at each reporting period and any change in fair value is recognized in the consolidated statements of operations and comprehensive loss. See Note 14—Warrants for additional details.

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 is calculated as the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired.

Recently Adopted Accounting Pronouncements

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

2016-13 is effective for smaller reporting companies in 2023. The Company adopted the guidance in the first quarter of 2023 with no material impact on the consolidated financial statements.

Recently Issued Accounting Pronouncements Not Yet Adopted

In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280) ("ASU 2023-07"), which improves reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. Additionally, the amendments enhance interim disclosure requirements, clarify circumstances in which an entity can disclose multiple segment measures of profit or loss, provide new segment disclosure requirements for entities with a single reportable segment, and contain other disclosure requirements. ASU 2023-07 is effective for public entities with annual periods beginning after December 15, 2023, with early adoption permitted. The Company is evaluating the impact of this guidance on its consolidated financial statements.

In December 2023, the FASB issued ASU No. 2023-09, Income Taxes: Improvements to Income Tax Disclosures (Topic 740) ("ASU 2023-09"), which requires disaggregated information about a reporting entity's effective tax rate reconciliation as well as information on income taxes paid. ASU 2023-09 is effective for public entities with annual periods beginning after December 15, 2024, with early adoption permitted. The Company is evaluating the impact of this guidance on its consolidated financial statements.

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Contingent Consideration
Change in fair value	$ 123	$ 1,053
Significant Unobservable Inputs (Level 3) \| Contingent consideration
Contingent Consideration
Balance at beginning of period	1,800
Change in fair value	123
Final payment of contingent consideration	(1,923)
Balance at end of period	0	1,800
Significant Unobservable Inputs (Level 3) \| Warrant liability
Contingent Consideration
Balance at beginning of period	3,346
Change in fair value	(2,937)
Final payment of contingent consideration	0
Balance at end of period	$ 409	$ 3,346

Discontinued Operations, Assets Held for Sale and Restructuring - Schedule of Property and Equipment, Net in Discontinued Operations (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	$ 4,449	$ 5,025
Less: accumulated depreciation	(3,624)	(3,356)
Property and equipment, net	825	1,669
Furniture and fixtures
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	432	431
Laboratory equipment and software
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	1,494	1,497
Construction in process
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	7	980
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	19,456	19,683
Less: accumulated depreciation	(14,585)	(12,131)
Property and equipment, net	4,871	7,552
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Furniture and fixtures
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	20	20
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Laboratory equipment and software
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	18,295	18,477
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Construction in process
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	$ 1,141	$ 1,186

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023		December 31, 2022

Furniture and fixtures	$	432	$	431
Office equipment	1,537		1,537
Laboratory equipment and software	1,494		1,497
Leasehold improvements	979		580
Construction in process	7		980
Total property and equipment	4,449		5,025
Less: accumulated depreciation	(3,624)		(3,356)
Property and equipment, net	$	825	$	1,669

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2023
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On February 16, 2024, the Biotronik Parties filed the Demand against Acutus with the American Arbitration Association (who notified us of the Demand on February 29, 2024), alleging that the Company breached its contractual obligations under five agreements relating to the licensing, manufacturing, distribution and development of medical devices as a result of the wind down of our businesses. As the arbitration process has effectively begun; and, as the parties will appoint an arbitral tribunal and set a procedural timetable, the Company has determined the Demand loss contingency to be "reasonably possible" as it is less than “probable”, but, more than “remote”. The Company has also determined that it cannot reasonably estimate the possible loss related to this contingency as the outcome is both unknown and not reasonably estimable.

Income Taxes - Schedule of NOLs and Tax Credit Carryforwards (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Domestic Tax Authority \| Net Operating Loss Carryforwards, Expire in 2031
Operating Loss Carryforwards [Line Items]
NOL carryforwards	$ 93,096
Domestic Tax Authority \| Net Operating Loss Carryforwards, Expire in 2031 \| Research Tax Credit Carryforward
Operating Loss Carryforwards [Line Items]
Tax credit carryforwards	11,087
Domestic Tax Authority \| Net Operating Loss Carryforwards, Indefinite Expiration
Operating Loss Carryforwards [Line Items]
NOL carryforwards	331,657
State and Local Jurisdiction \| Net Operating Loss Carryforwards, Expire in 2026
Operating Loss Carryforwards [Line Items]
NOL carryforwards	104,529
State and Local Jurisdiction \| Net Operating Loss Carryforwards, Indefinite Expiration
Operating Loss Carryforwards [Line Items]
NOL carryforwards	16,269
State and Local Jurisdiction \| Net Operating Loss Carryforwards, Indefinite Expiration \| Research Tax Credit Carryforward \| CALIFORNIA
Operating Loss Carryforwards [Line Items]
Tax credit carryforwards	$ 7,183

Net Loss Per Common Share (Tables)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Schedule of Antidilutive Securities

For the year ended December 31, 2023, the table below provides potentially dilutive securities not included in the calculation of diluted loss per common share for loss from continuing operations, loss from discontinued operations and net loss because to do so would be anti-dilutive:


												Year Ended December 31,
												2023

Shares issuable upon:
Conversion of Series A Common Equivalent Preferred Stock												6,665,841
Exercise of common stock warrants												4,576,505
Exercise of stock options												1,039,564
Vesting of RSUs and RSAs												2,185,330
Issuance of shares under 2020 ESPP												—
Total potentially dilutive securities												14,467,240

For the year ended December 31, 2022, the table below provides potentially dilutive securities not included in the calculation of diluted loss per common share for loss from discontinued operations and net loss because to do so would be anti-dilutive:


												December 31,
												2022

Shares issuable upon:
Conversion of Series A Common Equivalent Preferred Stock												6,665,841
Exercise of common stock warrants												4,576,505
Exercise of stock options												1,744,253
Vesting of RSUs and RSAs												1,659,898
Issuance of shares under 2020 ESPP												51,730
Total potentially dilutive securities												14,698,227

Schedule of Reconciliation of the Denominator of the Basic and Diluted Earnings Per Share

For the year ended December 31, 2022, the table below provides a reconciliation of the denominator of the basic and diluted earnings per share computation for continuing operations:


												Year Ended December 31,
												2022

Denominator for basic earnings per share:
Weighted average shares outstanding												28,471,389

Effect of dilutive securities:
Conversion of Series A Common Equivalent Preferred Stock												6,665,841
Exercise of common stock warrants												318,535
Exercise of stock options												34,312
Vesting of RSUs and RSAs												1,610,560
Issuance of shares under 2020 ESPP												51,730
Denominator for diluted earnings per share												37,152,367

Operating Leases - Summary of Quantitative Information About Operating Leases (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Operating cash flows from operating leases	$ 756	$ 898
Weighted average remaining lease term – operating leases	4 years	4 years 10 months 24 days
Weighted average discount rate – operating leases	7.00%	7.00%

Related Party Transactions (Details) - USD ($) $ / shares in Units, $ in Thousands		12 Months Ended
	Jun. 30, 2022	Dec. 31, 2023	Dec. 31, 2022	Aug. 04, 2023	May 20, 2019
Related Party Transaction [Line Items]
Interest expense		$ 5,655	$ 5,149
Common stock, shares issued (in shares)		29,313,667	28,554,656
Piggy-back registration rights, period	5 years
Warrant liability
Related Party Transaction [Line Items]
Class of warrants, exercise price (in dollars per share)	$ 1.1114
Warrant, term	8 years
2022 credit agreement \| Senior term loan
Related Party Transaction [Line Items]
Face amount				$ 35,000
Consulting agreement \| Board of directors chairman
Related Party Transaction [Line Items]
Consulting fees incurred for related party, less than		$ 100	$ 200
Credit agreements \| Related party \| 2019 credit agreement
Related Party Transaction [Line Items]
Loan balance, repaid in full	$ 40,000
Credit agreements \| Related party \| 2019 credit agreement \| Senior term loan
Related Party Transaction [Line Items]
Face amount					$ 70,000
Credit agreements \| Related party \| 2022 credit agreement
Related Party Transaction [Line Items]
Liability for loan balance		34,500	34,400
Interest expense		$ 5,700	$ 5,100
Credit agreements \| Related party \| 2022 credit agreement \| Senior term loan
Related Party Transaction [Line Items]
Face amount	$ 35,000
Long-term debt, term	5 years
Warrants \| Related party \| Warrant liability
Related Party Transaction [Line Items]
Common stock, shares issued (in shares)	3,779,018
Class of warrants, exercise price (in dollars per share)	$ 1.1114
Warrant, term	8 years

Net Loss Per Common Share - Schedule of Reconciliation of the Denominator of the Basic and Diluted Earnings Per Share (Details) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Denominator for basic earnings per share:
Basic weighted average number of shares outstanding (in shares)	29,095,294	28,471,389
Effect of dilutive securities:
Diluted weighted average number of shares outstanding (in shares)		37,152,367
Conversion of Series A Common Equivalent Preferred Stock
Effect of dilutive securities:
Dilutive effect of stock options (in shares)		6,665,841
Exercise of common stock warrants
Effect of dilutive securities:
Dilutive effect of stock options (in shares)		318,535
Stock Option
Effect of dilutive securities:
Dilutive effect of stock options (in shares)		34,312
Vesting of RSUs and RSAs
Effect of dilutive securities:
Dilutive effect of stock options (in shares)		1,610,560
Issuance of shares under 2020 ESPP
Effect of dilutive securities:
Dilutive effect of stock options (in shares)		51,730

401(k) Retirement Plan	12 Months Ended
401(k) Retirement Plan	Dec. 31, 2023
Retirement Benefits [Abstract]
401(k) Retirement Plan	401(k) Retirement Plan The Company has a 401(k) retirement savings plan that provides retirement benefits to substantially all full-time U.S. employees. Eligible employees may contribute a percentage of their annual compensation, subject to Internal Revenue Service limitations. The Company provided no contributions to the 401(k) retirement savings plan for the years ended December 31, 2023 and 2022.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 70
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480794/715-70-50-1

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 17
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480482/715-20-55-17

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(iv)(03)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (q)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (l)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

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

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(iii)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (o)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (p)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (r)(1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (r)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480126/715-20-S99-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 60
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480266/715-60-50-3

+ Details

Operating Leases - Summary of Future Minimum Payments Under the Non-Cancelable Operating Leases (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
Year ending December 31, 2024	$ 1,160
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Year ending December 31, 2027	1,221
Total	4,717
Less: present value discount	(756)
Operating lease liabilities	$ 3,961

Discontinued Operations, Assets Held for Sale and Restructuring

12 Months Ended

Dec. 31, 2023

Discontinued Operations and Disposal Groups [Abstract]

Discontinued Operations, Assets Held for Sale and Restructuring

In November 2023, with approval of the “Restructuring”, the Company began implementation of its business model shift to solely support the manufacturing and distribution of Medtronic’s left-heart access product portfolio. As part of the Restructuring, the Company is no longer manufacturing or distributing the AcQMap Mapping System, the AcQMap 3D Mapping Catheter, the AcQBlate Force-Sensing Ablation Catheter, the AcQGuide Max 2.0 Steerable Sheath, and associated accessories. Additionally, the Company has halted any further research and development related to this suite of products.

Discontinued operations comprise those activities that were disposed of during the period, abandoned or which were classified as held for sale at the end of the period and relate to the Company's mapping and ablation business, which it is winding down, and expects to substantially complete by the end of the first quarter of 2024.

Assets Held for Sale

The Company considers assets to be held for sale when management approves and commits to a plan to actively market the assets for sale at a reasonable price in relation to its fair value, the assets are available for immediate sale in their present condition, an active program to locate a buyer and other actions required to complete the sale have been initiated, the sale of the assets is expected to be completed within one year and it is unlikely that significant changes will be made to the plan. Upon designation as held for sale, the Company ceases to record depreciation and amortization expenses and measures the assets at the lower of their carrying value or estimated fair value less costs to sell. At December 31, 2023, assets held for sale are included as non-current assets in the Company’s consolidated balance sheet and the loss recognized on classification of assets held for sale is included in the Company’s restructure expenses. The assets held for sale were determined to be non-current assets as any proceeds from disposal will be used to pay down the Company's long-term debt.

The major assets and liabilities (at carrying value) associated with discontinued operations included in the Company's consolidated balance sheets are as follows (in thousands):


	December 31, 2023			December 31, 2022
Carrying amounts of major classes of assets included as part of discontinued operations

Accounts receivable	$	510		$	3,166
Inventory	12,780		*	11,533
Prepaid expenses and other current assets	902		*	1,287
Property and equipment, net	4,871		*	7,552
Intangible assets, net	1,416		*	1,583
Other assets	—			803
Less: Loss recognized on classification as held for sale	(16,369)		*	—
Total assets of the disposal group classified as discontinued operations in the statement of financial position	$	4,110		$	25,924

* These comprise assets held for sale, at their carrying value of $3.6 million as of December 31, 2023. The Company recorded the loss on classification of held for sale as a valuation allowance on the group of assets held for sale, without allocation to the individual assets within the group.

Carrying amounts of major classes of liabilities included as part of discontinued operations

Accounts payable	1,892			2,248
Accrued restructure	5,649			—
Accrued liabilities	2,762			6,376
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$	10,303		$	8,624

Inventory in discontinued operations consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

Raw materials	$	8,020	$	8,301
Work in process	2,211		1,827
Finished goods	2,549		1,405
Total inventory transferred to held for sale	$	12,780	$	11,533

Property and equipment, net, in discontinued operations consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

Furniture and fixtures	$	20	$	20
Laboratory equipment and software	18,295		18,477
Construction in process	1,141		1,186
Total property and equipment	19,456		19,683
Less: accumulated depreciation	(14,585)		(12,131)
Total property and equipment, net, related to discontinued operations	$	4,871	$	7,552

Depreciation expense was $3.6 million and $5.7 million for the years ended December 31, 2023 and 2022, respectively. Assets transferred to held for sale are no longer depreciated.

Intangibles, net, consists solely of licensed intangible assets acquired from Biotronik relating to the force sensing ablation catheter, which is part of the Company's operations that it intends to sell. The Company recorded amortization expense related to the above intangible assets of $0.17 million and $0.20 million for the years ended December 31, 2023 and 2022, respectively, which are reflected in the loss from discontinued operations in the consolidated statements of operations and comprehensive loss for the years ended December 31, 2023 and 2022, respectively. Intangible assets held for sale are no longer amortized.

The revenues and expenses associated with discontinued operations included in the Company's consolidated statements of operations and comprehensive loss were as follows (in thousands):


	December 31, 2023		December 31, 2022
Major line items constituting pretax loss of discontinued operations

Revenue	$	10,937	$	13,332

Cost of product sold	(19,002)		(26,969)
Research and development	(18,335)		(25,035)
Selling, general and administrative	(18,852)		(27,339)
Impairment of inventory	(384)		—
Impairment of prepaid assets and other current assets	(580)		—
Impairment of property and equipment	(621)		—
Restructuring	(6,324)		(2,371)
Impairment from held for sale classification	(16,369)		—

Loss from discontinued operations before income taxes	(69,530)		(68,382)
Income tax expense	212		67
Net loss from discontinued operations	$	(69,742)	$	(68,449)

The following table sets forth the breakdown of Company’s discontinued operations revenue for disposables, systems and service/other for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
Disposables	$	8,082	$	9,891
Systems	1,254		1,750
Service/Other	1,601		1,691
Total revenue	$	10,937	$	13,332

The following table provides discontinued operations revenue by geographic location for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
United States	$	4,450	$	5,849
Outside the United States	6,487		7,483
Total revenue	$	10,937	$	13,332

Prior to the Restructuring, revenue was subject to fluctuation based on the foreign currency in which our products were sold. For the years ended December 31, 2023 and 2022, approximately 59% and 56%, respectively, of discontinued operations sales were sold outside of the United States.

Impairment of Inventory

For the year ended December 31, 2023, certain inventory was impaired as a result of the strategic decision to wind down the mapping and ablation business. The Company determined that certain non-left-heart access inventories needed to be destroyed or that the net realizable value for certain inventories was lower than cost, resulting in an impairment expense recognition of approximately $0.4 million related to its inventory for the year ended December 31, 2023. The balance of remaining inventory in discontinued operations at December 31, 2023 and 2022 was $12.8 million and $11.5 million, respectively.

Impairment of Prepaid Assets and Other Current Assets

For the year ended December 31, 2023, certain prepaid assets and other current assets were impaired as a result of the strategic decision to wind down the mapping and ablation business. The Company determined that for these prepaid assets and other current assets it could not seek a refund, however, the service related to the respective asset was no longer required due to the business shift, resulting in an impairment expense recognition of approximately $0.6 million related to its prepaid assets and other current assets for the year ended December 31, 2023. The remaining balance of prepaid assets and other current assets in discontinued operations at December 31, 2023 and 2022 was $0.9 and $1.3 million, respectively.

Impairment of Property and Equipment

For the year ended December 31, 2023, certain property and equipment were impaired as a result of the strategic decision to wind down the mapping and ablation business. The Company determined that certain property and equipment that had been tailored or integrated in ways specific to the Company, had no salvage value or the efforts to separate and/or transfer/sell the property and equipment was cost prohibitive, resulting in an impairment expense recognition of approximately $0.6 million related to property and equipment for the year ended December 31, 2023. The remaining balance of property and equipment in discontinued operations at December 31, 2023 and 2022 was $4.9 and $7.6 million, respectively.

Impairment of Assets Classified as Held for Sale

For the year ended December 31, 2023, certain intangible assets, inventory and property and equipment were impaired as a result of meeting the criteria to be classified as held for sale. The Company engaged an independent third-party to determine the fair value of the assets held for sale (“disposal group”.) The Company determined that the carrying value of $3.6 million (fair value of $3.8 million less estimated costs to sell of $0.2 million) of the disposal group was less than the book values of the disposal group, thus, the Company recorded an impairment charge related to the held for sale classification of $16.4 million for

the year ended December 31, 2023. Due to the nature of estimates, the actual amounts realized upon sale may be more than or less than the estimated carrying value of the disposal group. Any difference will be recognized as a gain or loss in discontinued operations of future financial statements. The fair value measurements of the assets held for sale are based on significant inputs that are unobservable and thus represents Level 3 measurements.

Restructuring Activities

In connection with the strategic decision to wind down the ablation and mapping business, restructuring actions were taken related to this shift in business model, resulting in the realignment of resources, including an organizational workforce reduction and corporate restructure. Restructuring and exit-related charges consisting of severance expenses and related benefit costs for employees affected by the organizational workforce reduction, retention bonuses for certain employees that are assisting with the Restructuring, contract termination costs and other restructuring costs were recorded as restructuring expense, cost of product sold or selling, general administrative expense and is included in the loss from discontinued operations.

The Company identified three major types of restructuring activities related to the disposal of the mapping and ablation business, in addition to, the asset impairments detailed above. These three types of activities are employee termination costs, contract termination costs, and other costs. For the year ended December 31, 2023, the Company recorded $4.2 million for employee termination costs within restructure expenses of discontinued operations. Additionally, the Company estimated $2.2 million in contract termination costs, which were recorded in restructuring expense of discontinued operations, as these contract termination costs were deemed probable and estimable.

The following summarizes the restructuring activities and their related accruals as of December 31, 2023:


	Employee		Contract
	Termination Costs		Termination Costs		Other Costs		Total

Restructure Accrual Balance at 12/31/2022	$	—	$	—	$	—	$	—
Restructuring charges	4,164		2,156		4		6,324
Payments	(671)		—		(4)		(675)
Restructure Accrual Balance at 12/31/23	$	3,493	$	2,156	$	—	$	5,649

Sale of Business

On June 30, 2022, the Company completed the First Closing in accordance with the Asset Purchase Agreement with Medtronic, pursuant to which the Company agreed to sell to Medtronic certain transseptal access and sheath assets which make up the Company's left-heart access portfolio (and which comprised the Rhythm Xience, Inc. ("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 Asset Purchase Agreement, Medtronic paid $50.0 million at the First Closing, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure indemnification obligations of the Company under the Asset Purchase Agreement, which the Company has recorded as restricted cash on its condensed consolidated balance sheets.

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

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

(ii) $17.0 million upon the earlier of (A) the Second Closing (as defined below) or (B) the Company’s initial submission for CE Mark certification of the Products under the European Union Medical Devices Regulation, to the reasonable satisfaction of a third-party regulatory consultant, subject to certain other conditions as set forth in the Asset Purchase Agreement (the “Transfer Earnout”); and

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

The $20.0 million OEM Earnout was achieved in October 2022 and payment was received in November 2022, of which $1.6 million is held in escrow and recorded as restricted cash on the consolidated balance sheets. The $17.0 million Transfer Earnout was achieved in December 2022 and payment was received in January 2023, of which $1.4 million is held in escrow and recorded as restricted cash on the consolidated balance sheets. During the year ended December 31, 2023, $9.4 million was earned under item (iii) and recorded as a receivable on the consolidated balance sheet as of December 31, 2023.

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

The Company recorded a net gain of $79.5 million during the year ended December 31, 2022 related to the sale of business to Medtronic, calculated as the difference between the non-contingent consideration received, less direct transaction costs and the net carrying amount of the assets sold.


	Year Ended December 31, 2023

Percentage of Product Net Sales Earnout accrued as of December 31, 2023	$	9,360
Transaction costs	(280)
Gain on sale of business, net	$	9,080

The net gain on sale will be adjusted in future periods by the contingent consideration, based on the achievement of the predetermined milestones mentioned above. The sale was 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 loss from operations on the consolidated statements of operations and comprehensive loss. The sale did not represent a strategic shift having a major effect on the Company's operations and financial results and, consequently, did not qualify as a discontinued operation.

Operating Leases - Summary of Components of Lease Cost (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Operating leases
Operating lease cost	$ 1,006	$ 1,013
Variable lease cost	324	293
Total operating lease expense	$ 1,330	$ 1,306

Operating Leases (Tables)

12 Months Ended

Dec. 31, 2023

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 years ended December 31, 2023 and 2022 (dollars in thousands):


	Year Ended December 31,
	2023		2022

Operating cash flows from operating leases	$	756	$	898

Weighted average remaining lease term – operating leases (in years)	4.0		4.9
Weighted average discount rate – operating leases	7.0%		7.0%

The following table provides the components of the Company’s operating lease expense for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022

Operating leases
Operating lease cost	$	1,006	$	1,013
Variable lease cost	324		293
Total operating lease expense	$	1,330	$	1,306

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

As of December 31, 2023, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):



Year ending December 31, 2024	$	1,160
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Year ending December 31, 2027	1,221
Total	4,717
Less: present value discount	(756)
Operating lease liabilities	$	3,961

Income Taxes - Narrative (Details) - USD ($)	12 Months Ended
Income Taxes - Narrative (Details) - USD ($)	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Taxes [Line Items]
Provision for state and foreign income taxes	$ 100,000	$ 100,000
Valuation allowance	131,395,000	110,907,000
Unrecognized Tax Benefits	5,481,000	4,795,000	$ 4,128,000
Unrecognized tax benefits that, if recognized, would affect the effective tax rate	4,800,000
Interest and/or penalties recognized	0	0
Interest and penalties accrued	0	0
Capitalization of research and development expenses	$ 20,600,000	$ 28,800,000
Domestic Tax Authority
Income Taxes [Line Items]
Tax years remain open for examination, statute of limitation term	3 years

Discontinued Operations, Assets Held for Sale and Restructuring - Schedule of Inventories in Discontinued Operations (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Raw materials	$ 3,428	$ 878
Work in process	319	197
Finished goods	531	719
Total inventory	4,278	1,794
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Raw materials	8,020	8,301
Work in process	2,211	1,827
Finished goods	2,549	1,405
Total inventory	$ 12,780	$ 11,533

Summary of Significant Accounting Policies - Narrative (Details)	1 Months Ended	12 Months Ended
	May 31, 2020	Dec. 31, 2023 USD ($) segment reporting_unit	Dec. 31, 2022 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segment \| segment		1
Number of reportable segments \| segment		1
Distribution agreement, term	5 years
Inventory write-down		$ 3,200,000	$ 3,800,000
Allowance for uncollectible accounts		0	0
Employer retention credit receivable		$ 0	4,703,000
Number of reporting unit \| reporting_unit		1
Goodwill impairment		$ 0	12,026,000
Tangible asset impairment charges		0	0
Impairment of intangible assets		0	$ 0
CARES employee retention credit
Summary Of Significant Accounting Policies [Line Items]
Employer retention credit, amount refunded		6,800,000
Employer retention credit receivable		$ 4,700,000
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
Agreement to produce and sell products, term			4 years
Property and equipment, estimated useful lives		5 years
Deferred equipment agreements \| Minimum
Summary Of Significant Accounting Policies [Line Items]
Term of contract		2 years
Deferred equipment agreements \| Maximum
Summary Of Significant Accounting Policies [Line Items]
Term of contract		4 years

Discontinued Operations, Assets Held for Sale and Restructuring - Schedule of Assets and Liabilities Associated with Discontinued Operations (Details) - Discontinued Operations, Held-for-Sale or Disposed of by Sale - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Carrying amounts of major classes of assets included as part of discontinued operations
Accounts receivable	$ 510	$ 3,166
Inventory	12,780	11,533
Prepaid expenses and other current assets	902	1,287
Property and equipment, net	4,871	7,552
Intangible assets, net	1,416	1,583
Other assets	0	803
Less: Loss recognized on classification as held for sale	(16,369)	0
Total assets of the disposal group classified as discontinued operations in the statement of financial position	4,110	25,924
Assets held for sale, carrying value	3,600
Carrying amounts of major classes of liabilities included as part of discontinued operations
Accounts payable	1,892	2,248
Accrued restructure	5,649	0
Accrued liabilities	2,762	6,376
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$ 10,303	$ 8,624

Net Loss Per Common Share

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Net Loss Per Common Share

Basic net loss per common share is computed by dividing net loss attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. Diluted net loss per common share includes the potential impact of the Company’s convertible preferred stock, common stock options, RSUs, RSAs, intended ESPP purchases and warrants when such shares are not anti-dilutive. For the year ended December 31, 2023, the Company reported loss from continuing operations, discontinued operations and net loss per common share, and, therefore, basic and diluted net loss per common share are the same. For the year ended December 31, 2022, the Company reported income from continuing operations. When calculating diluted earnings per common share from continuing operations there were no adjustments to the numerator and the denominator was adjusted for dilutive securities (see the table for the reconciliation of the denominator.) For the years ended December 31, 2022, the Company reported loss from discontinued operations and net loss per common share, and, therefore, basic and diluted net loss per common share are the same.


												Year Ended December 31,
												2023

Shares issuable upon:
Conversion of Series A Common Equivalent Preferred Stock												6,665,841
Exercise of common stock warrants												4,576,505
Exercise of stock options												1,039,564
Vesting of RSUs and RSAs												2,185,330
Issuance of shares under 2020 ESPP												—
Total potentially dilutive securities												14,467,240

For the year ended December 31, 2022, the table below provides a reconciliation of the denominator of the basic and diluted earnings per share computation for continuing operations:


												Year Ended December 31,
												2022

Denominator for basic earnings per share:
Weighted average shares outstanding												28,471,389

Effect of dilutive securities:
Conversion of Series A Common Equivalent Preferred Stock												6,665,841
Exercise of common stock warrants												318,535
Exercise of stock options												34,312
Vesting of RSUs and RSAs												1,610,560
Issuance of shares under 2020 ESPP												51,730
Denominator for diluted earnings per share												37,152,367


												December 31,
												2022

Shares issuable upon:
Conversion of Series A Common Equivalent Preferred Stock												6,665,841
Exercise of common stock warrants												4,576,505
Exercise of stock options												1,744,253
Vesting of RSUs and RSAs												1,659,898
Issuance of shares under 2020 ESPP												51,730
Total potentially dilutive securities												14,698,227

Stock-Based Compensation - Schedule of Estimate of the Fair Value of Stock Option (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum	3.91%	1.76%
Risk-free interest rate, maximum	4.27%	3.39%
Expected dividend yield	0.00%	0.00%
Expected volatility, minimum	75.00%	75.00%
Expected volatility, maximum	85.00%	90.00%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	5 years 6 months	5 years 6 months
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	5 years 7 months 6 days	6 years

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 35
-Paragraph 1D
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480483/718-10-35-1D

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480483/718-10-35-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 2
-Subparagraph (a)(3)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iii)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iv)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iv)(01)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iv)(02)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iv)(03)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iv)(04)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(2)(i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(2)(ii)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(2)(iii)
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(2)(iii)(01)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Subparagraph (c)(2)(iii)(02)
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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Reference 20: http://www.xbrl.org/2003/role/disclosureRef
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Reference 21: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2003/role/disclosureRef
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Reference 23: http://www.xbrl.org/2003/role/disclosureRef
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Reference 24: http://www.xbrl.org/2003/role/disclosureRef
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Reference 25: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(ii)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 26: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
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Reference 27: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 28: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(v)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

+ Details

Marketable Securities - Summary of Marketable Securities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Available-for-sale securities - short-term:
Amortized Cost	$ 3,233	$ 44,870
Gross Unrealized Gains	0	5
Gross Unrealized Losses	0	(12)
Fair Value	3,233	44,863
Total available-for-sale securities
Amortized Cost	3,233	44,870
Gross Unrealized Gains	0	5
Gross Unrealized Losses	0	(12)
Fair Value	3,233	44,863
U.S. treasury securities
Available-for-sale securities - short-term:
Amortized Cost		26,906
Gross Unrealized Gains		3
Gross Unrealized Losses		(12)
Fair Value		26,897
Commercial paper
Available-for-sale securities - short-term:
Amortized Cost	1,978	3,200
Gross Unrealized Gains	0	2
Gross Unrealized Losses	0	0
Fair Value	1,978	3,202
Asset-backed securities
Available-for-sale securities - short-term:
Amortized Cost	497
Gross Unrealized Gains	0
Gross Unrealized Losses	0
Fair Value	497
Yankee debt securities
Available-for-sale securities - short-term:
Amortized Cost	758	14,764
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	$ 758	$ 14,764

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities
Net income (loss)	$ (81,663)	$ (39,616)
Less: Loss on discontinued operations	69,742	68,449
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense	191	339
AcQMap Systems converted to sales	0	0
Sales-type lease gain	0	0
Amortization of intangible assets	0	220
Non-cash stock-based compensation expense	3,032	3,400
Accretion of discounts on marketable securities, net	(1,428)	(24)
Amortization of debt issuance costs	571	850
Amortization of operating lease right-of-use assets	683	649
Loss on debt extinguishment	0	7,947
Goodwill impairment	0	12,026
Gain on sale of business, net	(9,080)	(79,465)
Direct costs paid related to sale of business	0	(4,027)
Change in fair value of warrant liability	(2,937)	(33)
Loss on disposal of property and equipment	0	0
Change in fair value of contingent consideration	123	1,053
Changes in operating assets and liabilities:
Accounts receivable	(1,074)	(464)
Inventory	(2,484)	(65)
Employer retention credit receivable	4,703	(4,703)
Prepaid expenses and other current assets	656	2,452
Other assets	0	0
Accounts payable	288	(204)
Accrued liabilities	(700)	1,434
Operating lease liabilities	(461)	(526)
Other long-term liabilities	(12)	(538)
Net cash used in operating activities - continuing operations	(19,850)	(30,846)
Net cash used in operating activities - discontinued operations	(43,268)	(58,071)
Net cash used in operating activities	(63,118)	(88,917)
Cash flows from investing activities
Proceeds from sale of business	17,000	70,000
Purchases of available-for-sale marketable securities	(39,765)	(54,508)
Sales of available-for-sale marketable securities	750	18,599
Maturities of available-for-sale marketable securities	82,000	74,642
Purchases of property and equipment	(219)	(228)
Net cash provided by investing activities - continuing operations	59,766	108,505
Net cash used in investing activities - discontinued operations	(1,211)	(3,754)
Net cash provided by investing activities	58,555	104,751
Cash flows from financing activities
Repayment of debt	0	(44,550)
Penalty fees paid for early prepayment of debt	0	(1,063)
Borrowing under new debt, net of fees	0	34,825
Payment of debt issuance costs	(490)	(626)
Proceeds from the exercise of stock options	4	67
Repurchase of common shares to pay employee withholding taxes	0	(111)
Proceeds from employee stock purchase plan	25	214
Payment of contingent consideration	(1,923)	(372)
Net cash used in financing activities - continuing operations	(2,384)	(11,616)
Net cash used in financing activities - discontinued operations	(280)	0
Net cash used in financing activities	(2,664)	(11,616)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	2,079	2,909
Net change in cash, cash equivalents and restricted cash	(5,148)	7,127
Cash, cash equivalents and restricted cash, at the beginning of the period	31,348	24,221
Cash, cash equivalents and restricted cash, at the end of the period	26,200	31,348
Supplemental disclosure of cash flow information:
Cash paid for interest	5,012	4,231
Supplemental disclosure of noncash investing and financing activities:
Changes between assets and liabilities in discontinued operations	5,445	(11,341)
Accounts receivable from sale of business	9,360	17,000
Change in unrealized (gain) loss on marketable securities	(7)	(39)
Change in unpaid purchases of property and equipment	0	54
Contingent consideration escrow release	0	381
Net book value on AcQMap system sales-type leases	0	244
Amount of debt proceeds allocated to warrant liability	$ 0	$ 3,379

Organization and Description of Business (Details) - USD ($) $ in Thousands			1 Months Ended		12 Months Ended
	Feb. 01, 2023	Jun. 30, 2022	Jan. 31, 2023	Nov. 30, 2022	Dec. 31, 2023	Dec. 31, 2022
Subsidiary, Sale of Stock [Line Items]
Cash, cash equivalents, restricted cash and marketable securities					$ 29,400	$ 76,200
Net income (loss) from continuing operations					(11,921)	28,833
Net loss from discontinued operations					69,742	68,449
Net cash used in operating activities - continuing operations					19,850	30,846
Net cash used in operating activities - discontinued operations					43,268	58,071
Accumulated deficit					599,977	518,314
Working capital					27,300	98,000
Proceeds from sale of business					17,000	70,000
Left-heart access portfolio
Subsidiary, Sale of Stock [Line Items]
Contingent consideration received from sales					9,400
Held-for-sale \| Left-heart access portfolio
Subsidiary, Sale of Stock [Line Items]
Proceeds from sale of business		$ 50,000	$ 17,000	$ 20,000
Indemnity escrow account, amount		$ 4,000	$ 1,400	$ 1,600
Indemnity escrow account, term		18 months
Milestone consideration, period	4 years	4 years
Held-for-sale \| Left-heart access portfolio \| Year one
Subsidiary, Sale of Stock [Line Items]
Milestone consideration, royalty percentage	100.00%	100.00%
Held-for-sale \| Left-heart access portfolio \| Year two
Subsidiary, Sale of Stock [Line Items]
Milestone consideration, royalty percentage	75.00%	75.00%
Held-for-sale \| Left-heart access portfolio \| Year three
Subsidiary, Sale of Stock [Line Items]
Milestone consideration, royalty percentage	50.00%	50.00%
Held-for-sale \| Left-heart access portfolio \| Year four
Subsidiary, Sale of Stock [Line Items]
Milestone consideration, royalty percentage	50.00%	50.00%
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Subsidiary, Sale of Stock [Line Items]
Net loss from discontinued operations					69,742	$ 68,449
Net cash used in operating activities - continuing operations					$ 19,900

Stockholders’ Equity (Details) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	Aug. 31, 2021 investor $ / shares shares	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2022 USD ($) $ / shares 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	0.049
Common stock conversion, notice for increase, period	61 days
Maximum percentage of outstanding common stock, notice for increase	0.099	0.099
Stock option exercises (in shares)		3,218
Proceeds from the exercise of stock options \| $		$ 4	$ 67
Employee stock purchase plan shares issued \| $		$ 25	$ 214
Common Stock
Class of Stock [Line Items]
Conversion of stock, shares converted (in shares)	6,665,841
Stock option exercises (in shares)		3,218	35,478
Proceeds from the exercise of stock options \| $			$ 100
Employee stock purchase plan shares issued (in shares)		45,162	149,327
Employee stock purchase plan shares issued \| $		$ 100	$ 200
Common Stock \| Restricted stock units (RSUs)
Class of Stock [Line Items]
Restricted share award shares issued (in shares)		710,631	412,628
Common Stock \| Maximum
Class of Stock [Line Items]
Proceeds from the exercise of stock options \| $		$ 100
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
Conversion of stock, option to convert to common stock (in shares)	1,000

Discontinued Operations, Assets Held for Sale and Restructuring - Schedule of Company’s Discontinued Operations Revenue (Details) - Discontinued Operations, Held-for-Sale or Disposed of by Sale - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	$ 10,937	$ 13,332
Disposables
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	8,082	9,891
Systems
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	1,254	1,750
Service/Other
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	$ 1,601	$ 1,691

Warrants - Schedule of Outstanding Warrants to Purchase the Company's Common Stock (Details) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Class of Warrant or Right [Line Items]
Warrants outstanding (in shares)	4,576,505	4,576,505
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	3,779,018

Discontinued Operations, Assets Held for Sale and Restructuring - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Depreciation expense	$ 191	$ 339
Amortization of intangible assets	0	220
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Depreciation expense	3,600	5,700
Amortization of intangible assets	170	200
Impairment of inventory	384	0
Inventory	12,780	11,533
Impairment of prepaid assets and other current assets	580	0
Prepaid expenses and other current assets	902	1,287
Impairment of property and equipment	621	0
Property and equipment, net	4,871	7,552
Assets held for sale, carrying value	3,600
Assets held for sale, fair value	3,800
Assets held for sale, estimated costs to sell	200
Impairment from held for sale classification	16,369	$ 0
Restructuring charges	6,324
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Employee Termination Costs
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Restructuring charges	4,164
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Contract Termination Costs
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Restructuring charges	$ 2,156
Outside the United States \| Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Revenue Benchmark \| Geographic Concentration Risk
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Discontinued operation sales (as a percent)	59.00%	56.00%

Sale of Business

12 Months Ended

Dec. 31, 2023

Discontinued Operations and Disposal Groups [Abstract]

Sale of Business

Discontinued Operations, Assets Held for Sale and Restructuring

Assets Held for Sale

The major assets and liabilities (at carrying value) associated with discontinued operations included in the Company's consolidated balance sheets are as follows (in thousands):


	December 31, 2023			December 31, 2022
Carrying amounts of major classes of assets included as part of discontinued operations

Accounts receivable	$	510		$	3,166
Inventory	12,780		*	11,533
Prepaid expenses and other current assets	902		*	1,287
Property and equipment, net	4,871		*	7,552
Intangible assets, net	1,416		*	1,583
Other assets	—			803
Less: Loss recognized on classification as held for sale	(16,369)		*	—
Total assets of the disposal group classified as discontinued operations in the statement of financial position	$	4,110		$	25,924

* These comprise assets held for sale, at their carrying value of $3.6 million as of December 31, 2023. The Company recorded the loss on classification of held for sale as a valuation allowance on the group of assets held for sale, without allocation to the individual assets within the group.

Carrying amounts of major classes of liabilities included as part of discontinued operations

Accounts payable	1,892			2,248
Accrued restructure	5,649			—
Accrued liabilities	2,762			6,376
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$	10,303		$	8,624

Inventory in discontinued operations consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

Raw materials	$	8,020	$	8,301
Work in process	2,211		1,827
Finished goods	2,549		1,405
Total inventory transferred to held for sale	$	12,780	$	11,533

Property and equipment, net, in discontinued operations consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

Furniture and fixtures	$	20	$	20
Laboratory equipment and software	18,295		18,477
Construction in process	1,141		1,186
Total property and equipment	19,456		19,683
Less: accumulated depreciation	(14,585)		(12,131)
Total property and equipment, net, related to discontinued operations	$	4,871	$	7,552

Depreciation expense was $3.6 million and $5.7 million for the years ended December 31, 2023 and 2022, respectively. Assets transferred to held for sale are no longer depreciated.

The revenues and expenses associated with discontinued operations included in the Company's consolidated statements of operations and comprehensive loss were as follows (in thousands):


	December 31, 2023		December 31, 2022
Major line items constituting pretax loss of discontinued operations

Revenue	$	10,937	$	13,332

Cost of product sold	(19,002)		(26,969)
Research and development	(18,335)		(25,035)
Selling, general and administrative	(18,852)		(27,339)
Impairment of inventory	(384)		—
Impairment of prepaid assets and other current assets	(580)		—
Impairment of property and equipment	(621)		—
Restructuring	(6,324)		(2,371)
Impairment from held for sale classification	(16,369)		—

Loss from discontinued operations before income taxes	(69,530)		(68,382)
Income tax expense	212		67
Net loss from discontinued operations	$	(69,742)	$	(68,449)

The following table sets forth the breakdown of Company’s discontinued operations revenue for disposables, systems and service/other for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
Disposables	$	8,082	$	9,891
Systems	1,254		1,750
Service/Other	1,601		1,691
Total revenue	$	10,937	$	13,332

The following table provides discontinued operations revenue by geographic location for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
United States	$	4,450	$	5,849
Outside the United States	6,487		7,483
Total revenue	$	10,937	$	13,332

Impairment of Inventory

Impairment of Prepaid Assets and Other Current Assets

Impairment of Property and Equipment

Impairment of Assets Classified as Held for Sale

Restructuring Activities

The following summarizes the restructuring activities and their related accruals as of December 31, 2023:


	Employee		Contract
	Termination Costs		Termination Costs		Other Costs		Total

Restructure Accrual Balance at 12/31/2022	$	—	$	—	$	—	$	—
Restructuring charges	4,164		2,156		4		6,324
Payments	(671)		—		(4)		(675)
Restructure Accrual Balance at 12/31/23	$	3,493	$	2,156	$	—	$	5,649

Sale of Business

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


	Year Ended December 31, 2023

Percentage of Product Net Sales Earnout accrued as of December 31, 2023	$	9,360
Transaction costs	(280)
Gain on sale of business, net	$	9,080

Marketable Securities (Tables)

12 Months Ended

Dec. 31, 2023

Investments, Debt and Equity Securities [Abstract]

Summary of Marketable Securities

Marketable securities consisted of the following as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
Commercial paper	$	1,978	$	—	$	—	$	1,978
Asset-backed securities	497		—		—		497
Yankee debt securities	758		—		—		758
Total available-for-sale securities - short-term	3,233		—		—		3,233
Total available-for-sale securities	$	3,233	$	—	$	—	$	3,233


	December 31, 2022
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
U.S. treasury securities	$	26,906	$	3	$	(12)	$	26,897
Commercial paper	3,200		2		—		3,202
Yankee debt securities	14,764		—		—		14,764
Total available-for-sale securities - short-term	44,870		5		(12)		44,863
Total available-for-sale securities	$	44,870	$	5	$	(12)	$	44,863

- Definition

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-9

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aa)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aaa)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

+ Details

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Summary of Cash and Cash Equivalents and Restricted Cash

The following table reconciles cash, cash equivalents and restricted cash in the consolidated balance sheets to the total balances as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023		December 31, 2022
Cash and cash equivalents	$	19,170	$	25,584
Restricted cash	7,030		5,764
Total cash, cash equivalents and restricted cash	$	26,200	$	31,348

Summary of Cash and Cash Equivalents and Restricted Cash

The following table reconciles cash, cash equivalents and restricted cash in the consolidated balance sheets to the total balances as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023		December 31, 2022
Cash and cash equivalents	$	19,170	$	25,584
Restricted cash	7,030		5,764
Total cash, cash equivalents and restricted cash	$	26,200	$	31,348

Summary of Disaggregation of Revenue


	Year Ended December 31,
	2023		2022
Disposables	$	6,315	$	3,031
Service/Other	849		—
Total revenue	$	7,164	$	3,031

The following table sets forth the breakdown of Company’s discontinued operations revenue for disposables, systems and service/other for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
Disposables	$	8,082	$	9,891
Systems	1,254		1,750
Service/Other	1,601		1,691
Total revenue	$	10,937	$	13,332

Schedule of Accounts, Notes, Loans and Financing Receivable

Accounts receivable recorded on the consolidated balance sheets as of December 31, 2023 and December 31, 2022 consists of the following (in thousands):


	December 31, 2023		December 31, 2022

Trade accounts receivable	$	1,993	$	919
Earnouts receivable from Medtronic	9,360		17,000
Total accounts receivable	$	11,353	$	17,919

Summary of Fair Value, Liabilities Measured on Recurring Basis


	Fair Value Measurements as of December 31, 2023

	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets included in:
Cash and cash equivalents
Money market securities	$	16,911	$	—	$	—	$	16,911
Marketable securities at fair value
U.S. treasury securities	—		—		—		—
Commercial paper	—		1,978		—		1,978
Asset-backed securities	—		497		—		497
Yankee debt securities	—		758		—		758
Total fair value	$	16,911	$	3,233	$	—	$	20,144

Liabilities included in:
Warrant liability	—		—		409		409

Total fair value	$	—	$	—	$	409	$	409


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

Liabilities included in:
Warrant liability	—		—		3,346		3,346
Contingent consideration	—		—		1,800		1,800
Total fair value	$	—	$	—	$	5,146	$	5,146

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 year ended December 31, 2023 (in thousands):


	Contingent Consideration		Warrant Liability
Balance, December 31, 2022	$	1,800	$	3,346
Change in fair value	123		(2,937)
Final payment of contingent consideration	(1,923)		—
Balance, December 31, 2023	$	—	$	409

Weighted-Average Unobservable Inputs to Measure Warranty Liability

The fair value was estimated to be $0.1083 per warrant as of December 31, 2023 and the significant inputs used in the estimation of the fair value were as follows:


	December 31, 2023

Risk-free interest rate	3.88	%
Expected term in years	6.5
Expected volatility	90.00	%

As of December 31, 2023 and December 31, 2022, the outstanding warrants to purchase the Company’s common stock consisted of the following:


	Exercise Price		Expiration Date	December 31, 2023	December 31, 2022

Warrants issued in 2015	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	$	1.11	6/30/30	3,779,018	3,779,018
Total Warrants				4,576,505	4,576,505

Summary of Significant Accounting Policies - Summary of Cash and Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Cash and cash equivalents	$ 19,170	$ 25,584
Restricted Cash	7,030	5,764
Total cash, cash equivalents and restricted cash	$ 26,200	$ 31,348	$ 24,221

Sale of Business (Tables)

12 Months Ended

Dec. 31, 2023

Discontinued Operations and Disposal Groups [Abstract]

Summary of Sale of Discontinued Operation

The major assets and liabilities (at carrying value) associated with discontinued operations included in the Company's consolidated balance sheets are as follows (in thousands):


	December 31, 2023			December 31, 2022
Carrying amounts of major classes of assets included as part of discontinued operations

Accounts receivable	$	510		$	3,166
Inventory	12,780		*	11,533
Prepaid expenses and other current assets	902		*	1,287
Property and equipment, net	4,871		*	7,552
Intangible assets, net	1,416		*	1,583
Other assets	—			803
Less: Loss recognized on classification as held for sale	(16,369)		*	—
Total assets of the disposal group classified as discontinued operations in the statement of financial position	$	4,110		$	25,924

* These comprise assets held for sale, at their carrying value of $3.6 million as of December 31, 2023. The Company recorded the loss on classification of held for sale as a valuation allowance on the group of assets held for sale, without allocation to the individual assets within the group.

Carrying amounts of major classes of liabilities included as part of discontinued operations

Accounts payable	1,892			2,248
Accrued restructure	5,649			—
Accrued liabilities	2,762			6,376
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$	10,303		$	8,624

The revenues and expenses associated with discontinued operations included in the Company's consolidated statements of operations and comprehensive loss were as follows (in thousands):


	December 31, 2023		December 31, 2022
Major line items constituting pretax loss of discontinued operations

Revenue	$	10,937	$	13,332

Cost of product sold	(19,002)		(26,969)
Research and development	(18,335)		(25,035)
Selling, general and administrative	(18,852)		(27,339)
Impairment of inventory	(384)		—
Impairment of prepaid assets and other current assets	(580)		—
Impairment of property and equipment	(621)		—
Restructuring	(6,324)		(2,371)
Impairment from held for sale classification	(16,369)		—

Loss from discontinued operations before income taxes	(69,530)		(68,382)
Income tax expense	212		67
Net loss from discontinued operations	$	(69,742)	$	(68,449)


	Year Ended December 31, 2023

Percentage of Product Net Sales Earnout accrued as of December 31, 2023	$	9,360
Transaction costs	(280)
Gain on sale of business, net	$	9,080

Summary of Disaggregation of Revenue


	Year Ended December 31,
	2023		2022
Disposables	$	6,315	$	3,031
Service/Other	849		—
Total revenue	$	7,164	$	3,031

The following table sets forth the breakdown of Company’s discontinued operations revenue for disposables, systems and service/other for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,
	2023		2022
Disposables	$	8,082	$	9,891
Systems	1,254		1,750
Service/Other	1,601		1,691
Total revenue	$	10,937	$	13,332

- Definition

+ References

+ Details

Debt

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Debt

Outstanding debt as of December 31, 2023 and December 31, 2022 consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

2022 Credit Agreement(1)	$	36,792	$	36,776
Total outstanding debt, gross	36,792		36,776
Less: Unamortized debt discount and fees	(2,274)		(2,342)
Total outstanding debt, long-term	$	34,518	$	34,434

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

2022 Amended and Restated Credit Agreement

On June 30, 2022, the Company amended and restated its prior debt facility. The amended and restated credit agreement is with related parties Deerfield Private Design Fund III, L.P. and Deerfield Partners, L.P. (collectively referred to as “Deerfield” or "Lenders") and is for an aggregate principal amount of $35.0 million and has a 5-year term. Proceeds from the 2022 Credit Agreement, along with cash on hand, were used to repay the prior debt facility and to pay related fees and expenses.

The 2022 Credit Agreement bears an annual interest of 9% plus the one-month adjusted term Secured Overnight Financing Rate (applying a 2.5% minimum rate). From date of closing, amortization payments are due as follows:

•$2,500,000 of the principal due at the end of month 24;

•$7,500,000 of the principal due at the end of month 36;

•$10,000,000 of the principal due at the end of month 48; and

•$15,000,000 due at the end of month 60.

The 2022 Credit Agreement is subject to prepayment penalties and provides for final payment fees of an additional $1.8 million due upon prepayment, on the maturity date or upon acceleration.

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

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.

On August 4, 2023, the Company and Deerfield entered into that certain Amendment No. 1, dated August 4, 2023 (“Amendment No.1”) to the 2022 Credit Agreement. Pursuant to Amendment No. 1, the 2022 Credit Agreement was amended to decrease the amount of cash the Company is required to maintain pursuant to the minimum liquidity covenant in the 2022 Credit Agreement to $5,000,000 for a period of 18 months, at which point the amount required under the minimum liquidity covenant shall increase to $20,000,000 (or, if certain conditions are met, $10,000,000), in exchange for a fee paid by the Company.

On November 8, 2023, the Company and Deerfield entered into that certain Amendment No. 2, dated November 8, 2023 (“Amendment No. 2”) to the 2022 Credit Agreement. Pursuant to Amendment No. 2, the 2022 Credit Agreement was amended to, among other things: (i) adjust and increase the amortization schedule such that payments commence on June 30, 2024 and are made 12, 24 and 36 months (i.e., the scheduled maturity date) following June 30, 2024; (ii) limit the business activities the Company may engage in; and (iii) require the Company to maintain a minimum liquidity of $10,000,000 at all times, in exchange for fees paid by the Company.

On March 4, 2024, the Company entered into Waiver and Amendment No. 3 ("Amendment No. 3") to the 2022 Credit Agreement. Previously, on February 16, 2024, the Biotronik Parties filed the Demand against Acutus with the American Arbitration Association (who notified the Company of the Demand on February 29, 2024), alleging that the Company breached its contractual obligations under five agreements relating to the licensing, manufacturing, distribution and development of medical devices as a result of the wind down of its businesses. Pursuant to Amendment No. 3, Deerfield has agreed to waive any Default or Event of Default (each defined in the 2022 Credit Agreement) that has arisen or may arise in connection with the Demand. In addition, pursuant to Amendment No. 3 among other things, (i) the 2022 Credit Agreement was amended such that (x) a Change in Control (as defined in the 2022 Credit Agreement) under the 2022 Credit Agreement would not be deemed to occur in the event the Company's common stock ceases to be listed on Nasdaq (without a comparable re-listing) (a "Delisting") and (y) exposure incurred in excess of $3.0 million in respect of proceedings in relation to the Demand and/or related proceedings and/or between such parties is deemed an Event of Default (as defined in the 2022 Credit Agreement) under the 2022 Credit Agreement.

In connection with entering into the 2022 Credit Agreement, the Company entered into a warrant purchase agreement (the "2022 Warrant Purchase Agreement") with Deerfield, pursuant to which the Company issued to Deerfield warrants to purchase up to an aggregate 3,779,018 shares of the Company's common stock at an exercise price of $1.1114 per warrant share for a period of eight years following issuance (the "2022 Warrants").

On March 4, 2024, the Company entered into an amendment (the “Warrant Amendment”) to the 2022 Warrants and 2022 Warrant Purchase Agreement with Deerfield. Pursuant to the Warrant Amendment, (i) the 2022 Warrants were amended to remove Deerfield’s option to require the Company to repurchase the 2022 Warrants from Deerfield upon a Delisting, and to modify the volatility rate that would be used to calculate the Black-Scholes value of the 2022 Warrants that would apply to certain other transactions involving the Company pursuant to the 2022 Warrants, and (ii) the Warrant Purchase Agreement was amended to remove the Company obligation to take all commercially reasonable actions necessary to cause the Company's common stock to remain listed on Nasdaq at all times during the term of 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 consolidated statements of operations and comprehensive loss. Refer to Fair Value Measurements in Note 2 - Summary of Significant Accounting Policies and Note 14 - Warrants for more information.

- 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://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//470/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
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-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

Discontinued Operations, Assets Held for Sale and Restructuring - Schedule of Restructuring Activities and Related Accruals (Details) - Discontinued Operations, Held-for-Sale or Disposed of by Sale $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Restructuring Reserve [Roll Forward]
Beginning balance	$ 0
Restructuring charges	6,324
Payments	(675)
Ending balance	5,649
Employee Termination Costs
Restructuring Reserve [Roll Forward]
Beginning balance	0
Restructuring charges	4,164
Payments	(671)
Ending balance	3,493
Contract Termination Costs
Restructuring Reserve [Roll Forward]
Beginning balance	0
Restructuring charges	2,156
Payments	0
Ending balance	2,156
Other Costs
Restructuring Reserve [Roll Forward]
Beginning balance	0
Restructuring charges	4
Payments	(4)
Ending balance	$ 0

Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Statement of Comprehensive Income [Abstract]
Revenue	$ 7,164	$ 3,031
Cost of products sold	10,301	4,941
Gross loss	(3,137)	(1,910)
Operating expenses (income):
Research and development	3,482	3,118
Selling, general and administrative	14,066	20,315
Goodwill impairment	0	12,026
Change in fair value of contingent consideration	123	1,053
Gain on sale of business	(9,080)	(79,465)
Total operating expenses (income)	8,591	(42,953)
(Loss) income from operations	(11,728)	41,043
Other income (expense):
Loss on debt extinguishment	0	(7,947)
Change in fair value of warrant liability	2,937	33
Interest income	2,588	868
Interest expense	(5,655)	(5,149)
Total other expense, net	(130)	(12,195)
(Loss) income from continuing operations before income taxes	(11,858)	28,848
Income tax expense	63	15
Net (loss) income from continuing operations	(11,921)	28,833
Discontinued operations:
Loss from discontinued operations before income taxes	(69,530)	(68,382)
Income tax expense - discontinued operations	212	67
Loss from discontinued operations	(69,742)	(68,449)
Net loss	(81,663)	(39,616)
Other comprehensive income (loss):
Unrealized gain on marketable securities	7	39
Foreign currency translation adjustment	(4)	(691)
Comprehensive loss	$ (81,660)	$ (40,268)
Net (loss) earnings per share, basic:
Income (loss) from continuing operations, basic (in dollars per share)	$ (0.41)	$ 1.02
Loss from discontinued operations , basic (in dollars per share)	(2.40)	(2.42)
Net loss per common share, basic (in dollars per share)	(2.81)	(1.40)
Net earnings (loss) per share, diluted:
Income (loss) from continuing operations , diluted (in dollars per share)	(0.41)	0.78
Loss from discontinued operations, diluted (in dollars per share)	(2.40)	(2.42)
Net Loss per common share, diluted (in dollars per share)	$ (2.81)	$ (1.40)
Weighted Average Number of Shares Outstanding [Abstract]
Weighted average number of common shares outstanding, basic (in shares)	29,095,294	28,471,389
Weighted average number of common shares outstanding, diluted- continuing operations (in shares)	29,095,294	37,152,367
Weighted average number of common shares outstanding, diluted- discontinued operations and net loss per common share (in shares)	29,095,294	28,471,389

Discontinued Operations, Assets Held for Sale and Restructuring - Schedule of Discontinued Operations Revenue by Geographic Location (Details) - Discontinued Operations, Held-for-Sale or Disposed of by Sale - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	$ 10,937	$ 13,332
United States
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	4,450	5,849
Outside the United States
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	$ 6,487	$ 7,483

Income Taxes - Schedule of Components of Pretax Loss From Continuing Operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
U.S.	$ (11,858)	$ 28,848
Foreign	0	0
(Loss) income from continuing operations before income taxes	$ (11,858)	$ 28,848

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(11))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483586/944-220-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Section 50
-Paragraph 30
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-30

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/exampleRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
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-Paragraph 1
-SubTopic 20
-Topic 940
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481913/940-20-25-1

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(10))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483621/220-10-S99-2

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 942
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-Name Accounting Standards Codification
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-Paragraph 1
-Subparagraph (SX 210.9-04(15))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483589/942-220-S99-1

+ Details

Stock-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2023

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 years ended December 31, 2023 and 2022:


	Year Ended December 31,
	2023	2022

Risk-free interest rate	3.91% - 4.27%	1.76% - 3.39%
Expected dividend yield	—	—
Expected term in years	5.5 - 5.6	5.5 - 6.0
Expected volatility	75% - 85%	75% - 90%

Summary of Stock Option Activity

The Company's stock option activity for the year ended December 31, 2023 was as follows:


	Stock Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2022	2,898,821	$	6.83	6.9	$	79
Options granted	755,580	1.28
Options exercised	(3,218)	1.34			$	—
Options forfeited	(1,746,460)	9.74
Outstanding as of December 31, 2023	1,904,723	$	1.98	7.8	$	—
Options vested and expected to vest December 31, 2023	1,904,723	$	1.98	7.8	$	—
Options exercisable December 31, 2023	1,039,564	$	2.50	6.8	$	—

Schedule of RSU Activity

The Company’s RSU activity for the year ended December 31, 2023 was as follows:


	Number of Shares	Weighted Average Grant Price
Unvested as of December 31, 2022	1,659,898	$	4.17
Granted	1,937,520	1.28
Forfeited	(500,521)	3.95
Vested	(911,567)	2.94
Unvested as of December 31, 2023	2,185,330	$	2.18

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 consolidated statements of operations and comprehensive loss for the years ended December 31, 2023 and 2022 (in thousands):


	Year Ended December 31,				Year Ended December 31, 2023				Year Ended December 31, 2022
	2023		2022		Continuing Operations		Discontinued Operations		Continuing Operations		Discontinued Operations

Cost of products sold	$	454	$	669	$	288	$	166	$	504	$	165
Research and development	1,167		1,736		46		1,121		65		1,671
Selling, general and administrative	4,112		6,986		2,698		1,414		2,831		4,155
Total stock-based compensation	$	5,733	$	9,391	$	3,032	$	2,701	$	3,400	$	5,991

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Basis of Presentation

The consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”).

Principles of Consolidation

The 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.

Discontinued Operations

Use of Estimates and Assumptions

Segments

Cash and Cash Equivalents and Restricted Cash

Marketable Securities

The Company’s marketable securities portfolio consists of investments in money market funds, commercial paper, U.S. treasury securities, Yankee debt securities, and asset-backed securities.

Concentrations of Credit Risk and Off-Balance Sheet Risk

Revenue from Contracts with Customers

•Step 1: Identify the contract with the customer.

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

•Step 3: Determine the transaction price.

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

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

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


	Year Ended December 31,
	2023		2022
Disposables	$	6,315	$	3,031
Service/Other	849		—
Total revenue	$	7,164	$	3,031

Revenue from continuing operations is primarily US-based.

Inventory

Accounts Receivable

Employee Retention Credit Receivable

Property and Equipment, Net

Goodwill

Impairment of Long-Lived Assets

Foreign Currency Translation and Transactions

Lease Property

Cost of Products Sold

Research and Development

Selling, General and Administrative

Fair Value Measurements

Financial Instruments

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.

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

Stock-Based Compensation

Income Taxes

Warrant Liability

Business Combinations

Recently Adopted Accounting Pronouncements and Recently Issued Accounting Pronouncements Not Yet Adopted

Recently Adopted Accounting Pronouncements

2016-13 is effective for smaller reporting companies in 2023. The Company adopted the guidance in the first quarter of 2023 with no material impact on the consolidated financial statements.

Recently Issued Accounting Pronouncements Not Yet Adopted

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net income (loss)	$ (81,663)	$ (39,616)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147483443/250-10-50-3

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-Topic 944
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Organization and Description of Business	12 Months Ended
Organization and Description of Business	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	Organization and Description of Business Acutus Medical, Inc. (the “Company”) historically designed, manufactured and marketed a range of tools for catheter-based ablation procedures to treat various arrhythmias. Prior to November 2023, the Company’s product portfolio included novel access sheaths, diagnostic and mapping catheters, ablation catheters, mapping and imaging consoles and accessories, as well as supporting algorithms and software programs. In November 2023, the Company’s Board of Directors approved a strategic realignment of resources and corporate restructuring (the “Restructuring”). The Company began implementation of a shift in its business model to solely support the manufacturing and distribution of Medtronic Inc.’s (“Medtronic”) left-heart access product portfolio, including to potentially earn earnout payments from Medtronic pursuant to its manufacturing and distribution arrangements with Medtronic. As part of the Restructuring, the Company wound down its mapping and ablation businesses and no longer manufactures or distributes the AcQMap Mapping System, the AcQMap 3D Mapping Catheter, the AcQBlate Force-Sensing Ablation Catheter, the AcQGuide Max 2.0 Steerable Sheath or associated accessories, and are exploring strategic alternatives for these businesses (specifically a potential sale of related assets). The Company expects that the Restructuring will be substantially complete in the first quarter of 2024. The Company was incorporated in the state of Delaware on March 25, 2011, and is located in Carlsbad, California. Liquidity and Capital Resources The Company has limited revenue, and has incurred significant operating losses and negative cash flows from operations since its inception, and if it is unable to realize the expected benefits of the Restructuring, anticipates that it could incur significant losses for at least the next several years. As of December 31, 2023 and December 31, 2022, the Company had cash, cash equivalents, restricted cash and marketable securities of $29.4 million and $76.2 million, respectively. For the year ended December 31, 2023, net loss was $11.9 million from continuing operations and net loss was $69.7 million from discontinued operations. For the year ended December 31, 2022, net income was $28.8 million from continuing operations and net loss was $68.4 million from discontinued operations. Net cash used in operating activities for continuing operations was $19.9 million and $30.8 million for continuing operations , and for discontinued operations was $43.3 million and $58.1 million, for the years ended December 31, 2023 and 2022, respectively. As of December 31, 2023 and December 31, 2022, the Company had an accumulated deficit of $600.0 million and $518.3 million, respectively, and working capital of $27.3 million and $98.0 million, respectively. The Restructuring is intended to reduce the Company’s operating expenses and optimize its cash resources by focusing exclusively on the manufacturing and distribution of the Products (as defined in Note 4 – Sale of Business, below) to Medtronic to continue to generate revenue from such sales in addition to the associated earnout payments discussed further below. Following the Restructuring, the Company expects its primary uses of capital to be investments in manufacturing and distributing the Products to Medtronic and related expenses, raw materials and supplies, legal and other regulatory expenses, general administrative costs and working capital. On June 30, 2022, Medtronic paid the Company $50.0 million at the first closing (the "First Closing") of the sale of the Company's left-heart access portfolio to Medtronic, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure the Company's indemnification obligations under the asset purchase agreement ("Asset Purchase Agreement") entered into with Medtronic on April 26, 2022. The OEM Earnout (as defined in Note 4 - Sale of Business, below) under the Asset Purchase Agreement with Medtronic was achieved on October 31, 2022, with $20.0 million paid by Medtronic to the Company in November 2022. Additionally, the Transfer Earnout (as defined in Note 4 - Sale of Business, below) under the Asset Purchase Agreement with Medtronic was achieved on December 21, 2022, with $17.0 million paid by Medtronic to the Company in January 2023. Beginning in February 2023, following Medtronic's first commercial sale of the Products after the Company's achievement of the OEM Earnout (as defined in Note 4 - Sale of Business, below), the Company became eligible to earn amounts equal to 100%, 75%, 50% and 50%, respectively, of quarterly Net Sales (as defined in the Asset Purchase Agreement) of the Products achieved by Medtronic each year over four years. During the year ended December 31, 2023, the Company earned $9.4 million (before transaction costs) based on Medtronic's Products sales to be paid in fiscal 2024 and is recorded in accounts receivable as of December 31, 2023. Management believes the Company’s current cash, cash equivalents and marketable securities are sufficient to fund operations for at least the next 12 months from the date of this filing.

Sale of Business - Narrative (Details) - USD ($) $ in Thousands			1 Months Ended		12 Months Ended
	Feb. 01, 2023	Jun. 30, 2022	Jan. 31, 2023	Nov. 30, 2022	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of business					$ 17,000	$ 70,000
Gain on sale of business, net					9,080	79,465
Held-for-sale \| Left-heart access portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of business		$ 50,000	$ 17,000	$ 20,000
Indemnity escrow account, amount		$ 4,000	$ 1,400	$ 1,600
Indemnity escrow account, term		18 months
Milestone consideration, period	4 years	4 years
Held-for-sale \| Left-heart access portfolio \| OEM earnout
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of business		$ 20,000
Held-for-sale \| Left-heart access portfolio \| Transfer earnout
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of business		$ 17,000
Held-for-sale \| Left-heart access portfolio \| Medtronic
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Earnout accrued					9,360
Gain on sale of business, net					$ 9,080	$ 79,500
Held-for-sale \| 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%	100.00%
Held-for-sale \| 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%	75.00%
Held-for-sale \| 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%	50.00%
Held-for-sale \| 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%	50.00%

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

401(k) Retirement Plan (Details) - USD ($)	12 Months Ended
401(k) Retirement Plan (Details) - USD ($)	Dec. 31, 2023	Dec. 31, 2022
401(k) retirement plan
Defined Contribution Plan Disclosure [Line Items]
Employer contribution to defined benefit plan	$ 0	$ 0

Stockholders’ Equity	12 Months Ended
Stockholders’ Equity	Dec. 31, 2023
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 (the "Preferred Stock"). In connection with the issuance of the 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 of the Company with the Secretary of State of the State of Delaware. The 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 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 Preferred Stock is non-voting. Upon election, each holder may convert each share of Preferred Stock into 1,000 shares of common stock, except to 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 Exchange Act including shares held by any “group” (as defined in Section 13(d) of the Securities Exchange Act of 1934, as amended (the "Exchange Act") and applicable regulations of the Securities and Exchange Commission ("SEC")) of which such holder is a member, but excluding shares beneficially owned by virtue of the ownership of securities or rights to acquire securities that have limitations on the right to convert, exercise or purchase similar to the limitation set forth in the Series A Certificate of Designation, exceeds 4.9% (or, at the election of the holders, OrbiMed Private Investments IV, LP or OrbiMed Royalty Opportunities II, LP, made by delivering at least 61 days advance written notice to the Company of its intention to increase the beneficial ownership cap applicable to such holder, 9.9%) of the total number of shares of common stock then issued and outstanding. Common Stock During the years ended December 31, 2023 and 2022, stock options to acquire 3,218 shares and 35,478 shares, respectively, were exercised for shares of the Company's common stock with proceeds of less than $0.1 million and $0.1 million, respectively. Additionally in conjunction with the 2020 Employee Stock Purchase Plan (the "2020 ESPP"), during the years ended December 31, 2023 and 2022, 45,162 shares and 149,327 shares, respectively, of common stock were issued for consideration of less than $0.1 million and $0.2 million, respectively. During the years ended December 31, 2023 and 2022, the Company issued 710,631 shares and 412,628 shares, respectively, of common stock upon vesting of RSUs.

- Definition

The entire disclosure for equity.

+ References

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+ Details

Warrants

12 Months Ended

Dec. 31, 2023

Warrants and Rights Note Disclosure [Abstract]

Warrants

As of December 31, 2023 and December 31, 2022, the outstanding warrants to purchase the Company’s common stock consisted of the following:


	Exercise Price		Expiration Date	December 31, 2023	December 31, 2022

Warrants issued in 2015	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	$	1.11	6/30/30	3,779,018	3,779,018
Total Warrants				4,576,505	4,576,505

There was no warrant activity during the year ended December 31, 2023 .

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

In accordance with ASC 480, the 2022 Warrants are recorded at fair value on the consolidated balance sheets as a warrant liability. Changes in fair value are recognized as a change in fair value of warrant liability in the consolidated statements of operations and comprehensive loss. For the year ended December 31, 2023, a favorable fair value change of $2.9 million was recognized.

In connection with the Series A Common Equivalent Preferred Stock Exchange Agreements (as defined below), four warrant holders are limited to exercising their warrants such that following any such exercise, the 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.

Income Taxes - Schedule of Components of Income Tax Expense for Continuing Operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Federal	$ 0	$ 0
State	63	15
Foreign	0	0
Total provision for income taxes	$ 63	$ 15

Debt - Narrative (Details)	Aug. 04, 2023 USD ($)	Jun. 30, 2022 $ / shares shares	Mar. 04, 2024 USD ($)	Feb. 16, 2024 agreement	Dec. 31, 2023 USD ($)	Nov. 08, 2023 USD ($)
Exercise of common stock warrants
Debt Instrument [Line Items]
Class of warrants number of securities called by the warrants or rights (in shares) \| shares		3,779,018
Class of warrants, exercise price (in dollars per share) \| $ / shares		$ 1.1114
Warrant, term		8 years
Deerfield Credit Agreement, Amendment 1
Debt Instrument [Line Items]
Minimum liquidity covenant						$ 10,000,000
Deerfield Credit Agreement, Amendment 3 \| Subsequent Event
Debt Instrument [Line Items]
Number of agreements alleged to be breached \| agreement				5
Maximum exposure incurred in proceedings before Event of Default			$ 3,000,000
Term 1 \| Deerfield Credit Agreement, Amendment 1
Debt Instrument [Line Items]
Minimum liquidity covenant	$ 5,000,000
Minimum liquidity covenant, term	18 months
Term 2 \| Deerfield Credit Agreement, Amendment 1
Debt Instrument [Line Items]
Minimum liquidity covenant	$ 20,000,000
Term 3 \| Deerfield Credit Agreement, Amendment 1
Debt Instrument [Line Items]
Minimum liquidity covenant	10,000,000
2022 credit agreement \| Senior term loan
Debt Instrument [Line Items]
Face amount	$ 35,000,000.0
Debt instrument, term	5 years
Fee amount	$ 1,800,000				$ 1,800,000
2022 credit agreement \| Senior term loan \| End of month 24
Debt Instrument [Line Items]
Periodic payment principal due					2,500,000
2022 credit agreement \| Senior term loan \| End of month 36
Debt Instrument [Line Items]
Periodic payment principal due					7,500,000
2022 credit agreement \| Senior term loan \| End of month 48
Debt Instrument [Line Items]
Periodic payment principal due					10,000,000
2022 credit agreement \| Senior term loan \| End of month 60
Debt Instrument [Line Items]
Periodic payment principal due					$ 15,000,000
2022 credit agreement \| Senior term loan \| Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate
Debt Instrument [Line Items]
Variable rate		9.00%
Variable rate, floor		2.50%

Accrued Liabilities - Schedule of Accrued Liabilities from Continuing Operations (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total accrued liabilities	$ 2,887	$ 3,310
Continuing Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Compensation and related expenses	2,225	2,433
Professional fees	378	186
Sales and use tax	0	181
Other	274	510
Total accrued liabilities	$ 2,877	$ 3,310

Commitments and Contingencies (Details) - lawsuit	Jul. 19, 2022	Feb. 14, 2022
Commitments and Contingencies Disclosure [Abstract]
Number of class action lawsuits		2
Number of class action lawsuits consolidated	2

Property and Equipment, Net - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 191	$ 339
Property, Plant and Equipment [Line Items]
Depreciation expense	191	339
Continuing Operations
Property, Plant and Equipment [Abstract]
Depreciation expense	200	300
Property, Plant and Equipment [Line Items]
Depreciation expense	$ 200	$ 300

Income Taxes - Schedule of Changes to Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized Tax Benefits	$ 5,481	$ 4,795	$ 4,128
Gross increases – tax positions in current period	556	683
Gross increases – tax positions in prior period	130	0
Gross decreases – tax positions in prior period	$ 0	$ (16)

Cover Page - USD ($) $ in Millions	12 Months Ended
Cover Page - USD ($) $ in Millions	Dec. 31, 2023	Mar. 25, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
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 Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
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
ICFR Auditor Attestation Flag	false
Document Financial Statement Error Correction	false
Entity Shell Company	false
Entity Public Float			$ 26.0
Entity Common Stock, Shares Outstanding		29,715,962
Documents Incorporated by Reference	Part III of this Annual Report on Form 10-K incorporates certain information by reference from the definitive proxy statement for the Registrant’s 2024 Annual Meeting of Stockholders to be filed within 120 days of the Registrant’s fiscal year ended December 31, 2023 (the “Proxy Statement”). Except with respect to information specifically incorporated by reference in this Form 10-K, the Proxy Statement is not deemed to be filed as part of this Form 10-K.
Amendment Flag	false
Document Fiscal Period Focus	FY
Entity Central Index Key	0001522860
Document Fiscal Year Focus	2023

Debt (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Summary of Outstanding Debt

Outstanding debt as of December 31, 2023 and December 31, 2022 consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

2022 Credit Agreement(1)	$	36,792	$	36,776
Total outstanding debt, gross	36,792		36,776
Less: Unamortized debt discount and fees	(2,274)		(2,342)
Total outstanding debt, long-term	$	34,518	$	34,434

(1)The 2022 Credit Agreement includes final payment fees of $1.8 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://www.xbrl.org/2003/role/exampleRef
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+ Details

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 19,170	$ 25,584
Marketable securities, short-term	3,233	44,863
Restricted cash, short-term	7,030	5,764
Accounts receivable	11,353	17,919
Inventory	4,278	1,794
Employer retention credit receivable	0	4,703
Prepaid expenses and other current assets	678	1,254
Current assets of discontinued operations (Note 3)	510	15,986
Total current assets	46,252	117,867
Noncurrent assets
Property and equipment, net	825	1,669
Right-of-use assets, net	3,189	3,872
Other assets	94	94
Non-current assets of discontinued operations (Note 3)	3,600	9,938
Total assets	53,960	133,440
Current liabilities:
Accounts payable	2,761	2,473
Accrued liabilities	2,887	3,310
Contingent consideration, short-term	0	1,800
Operating lease liabilities, short-term	718	319
Long-term debt, current portion	1,864	0
Warrant liability	409	3,346
Current liabilities of discontinued operations (Note 3)	10,303	8,624
Total current liabilities	18,942	19,872
Operating lease liabilities, long-term	3,243	4,103
Long-term debt	32,654	34,434
Other long-term liabilities	0	12
Total liabilities	54,839	58,421
Commitments and contingencies (Note 12)
Stockholders' (deficit) equity
Preferred stock, $0.001 par value; 5,000,000 shares authorized as of December 31, 2023 and December 31, 2022; 6,666 shares of the preferred stock, designated as Series A Common Equivalent Preferred Stock, are issued and outstanding as of December 31, 2023 and December 31, 2022, respectively	0	0
Common stock, $0.001 par value; 260,000,000 shares authorized as of December 31, 2023 and December 31, 2022; 29,313,667 and 28,554,656 shares issued and outstanding as of December 31, 2023 and December 31, 2022, respectively	29	29
Additional paid-in capital	599,935	594,173
Accumulated deficit	(599,977)	(518,314)
Accumulated other comprehensive loss	(866)	(869)
Total stockholders' equity	(879)	75,019
Total liabilities and stockholders' equity	$ 53,960	$ 133,440

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule of Income before Income Tax, Domestic and Foreign

The components of pretax loss from continuing operations for the years ended December 31, 2023 and 2022 are as follows (in thousands):


	December 31,
	2023		2022

U.S.	$	(11,858)	$	28,848
Foreign	—		—
Pretax loss from continuing operations	$	(11,858)	$	28,848

Schedule of Components of Income Tax Expense (Benefit)

The components of income tax expense for continuing operations are as follows (in thousands):


	December 31,
	2023		2022









Federal	$	—	$	—
State	63		15
Foreign	0		0
Total provision for income taxes	$	63	$	15

Schedule of Effective Income Tax Rate Reconciliation

The following table presents a reconciliation of income tax computed at the U.S. federal statutory tax rate to the total income tax expense for the years ended December 31, 2023 and 2022 (dollars in thousands):


	Year Ended December 31,
	2023				2022
	Amount		Tax Rate		Amount		Tax Rate
















Income tax benefit at federal statutory rate	$	(2,490)	21.0	%	$	6,058	21.0	%
Adjustments for tax effects of:
State taxes, net	(271)		2.3	%	872		3.0	%
Permanent adjustments	(750)		6.3	%	808		2.8	%
Goodwill impairment	—		—	%	2,525		8.8	%
Stock based compensation expense	2,616		(22.1)	%	2,525		8.8	%

Research and development credit	(1,720)		14.5	%	(2,099)		(7.3)	%
Unrecognized tax benefit	626		(5.3)	%	630		2.2	%
Return to provision	(1,959)		16.5	%	534		1.9	%
Valuation allowance	4,012		(33.8)	%	(11,839)		(41.0)	%
Income tax expense	$	63	(0.5)	%	$	15	0.1	%

Schedule of Deferred Tax Assets and Liabilities

Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2023 and 2022 are as follows (in thousands):


	December 31,
	2023		2022


































Deferred tax assets:
Net operating losses	$	96,679	$	94,437
Stock-based compensation	1,031		1,678
Research and development credit	11,733		10,273
Capitalized research costs	12,679		9,471
Intangible assets	93		94
Accrued compensation	733		1,161
Debt	623		—
Lease liability	929		1,019
Inventory	6,811		655
Other	1,241		35
Total gross deferred tax assets	132,552		118,823
Valuation allowance	(131,395)		(110,907)
Net deferred tax asset	$	1,157	$	7,916

Deferred tax liabilities:
Deferred installment gain	$	—	$	(5,315)
Property and equipment	(249)		(1,105)
Right of use assets	(747)		(891)
Prepaid expenses	(47)		(105)

Other	(115)		(461)
Debt	—		(39)
Total deferred tax liabilities	(1,157)		(7,916)
Net deferred tax assets (liabilities)	$	—	$	—

Summary of Operating Loss Carryforwards

The following table presents NOLs and tax credit carryforwards as of December 31, 2023 (in thousands):


	Amount		Expiration Years
NOLs, federal (post-December 31, 2017)	$	331,657	Indefinite (1)
NOLs, federal (pre-January 1, 2018)	$	93,096	2031	-	2037
NOLs, state	$	104,529	2026	-	2043
NOLs, state (post-December 31, 2017)	$	16,269	Indefinite (1)
Research and development tax credits, federal	$	11,087	2031	-	2043
Research and development tax credits, California	$	7,183	Indefinite
____________________
(1) NOL carryforwards generated after 2017 can be carried forward indefinitely and can generally be used to offset up to 80%of future taxable income.

Schedule of Unrecognized Tax Benefits Roll Forward

The following table summarizes the changes to unrecognized tax benefits as of December 31, 2023 and 2022 (in thousands):


	December 31,
	2023		2022
Balance at beginning of year	$	4,795	$	4,128
Gross increases – tax positions in current period	556		683
Gross increases – tax positions in prior period	130		—
Gross decreases – tax positions in prior period	—		(16)


Balance at end of year	$	5,481	$	4,795

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
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)	29,313,667	28,554,656
Common stock, shares outstanding (in shares)	29,313,667	28,554,656

Operating Leases - Narrative (Details)	Dec. 31, 2023 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

Stock-Based Compensation - Schedule of RSU Activity (Details) - Restricted stock units (RSUs)	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Number of Shares
Unvested balance at beginning of period (in shares) \| shares	1,659,898
Granted (in shares) \| shares	1,937,520
Forfeited (in shares) \| shares	(500,521)
Vested (in shares) \| shares	(911,567)
Unvested balance at end of period (in shares) \| shares	2,185,330
Weighted Average Grant Price
Unvested balance at beginning of period (in dollars per share) \| $ / shares	$ 4.17
Granted (in dollars per share) \| $ / shares	1.28
Forfeited (in dollars per share) \| $ / shares	3.95
Vested (in dollars per share) \| $ / shares	2.94
Unvested balance at end of period (in dollars per share) \| $ / shares	$ 2.18

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Assets included in:
Available-for-sale securities	$ 3,233	$ 44,863
Total fair value	20,144	67,563
Liabilities included in:
Total fair value	409	5,146
Warrant liability
Liabilities included in:
Total fair value	409	3,346
Contingent consideration
Liabilities included in:
Total fair value		1,800
Money market securities
Assets included in:
Money market securities	16,911	22,700
U.S. treasury securities
Assets included in:
Available-for-sale securities	0	26,897
Commercial paper
Assets included in:
Available-for-sale securities	1,978	14,764
Asset-backed securities
Assets included in:
Available-for-sale securities	497
Yankee debt securities
Assets included in:
Available-for-sale securities	758
Total fair value		3,202
Quoted Prices in Active Markets for Identical Assets (Level 1)
Assets included in:
Total fair value	16,911	22,700
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	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Contingent consideration
Liabilities included in:
Total fair value		0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Money market securities
Assets included in:
Money market securities	16,911	22,700
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) \| Asset-backed securities
Assets included in:
Available-for-sale securities	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Yankee debt securities
Assets included in:
Available-for-sale securities	0
Total fair value		0
Significant Other Observable Inputs (Level 2)
Assets included in:
Total fair value	3,233	44,863
Liabilities included in:
Total fair value	0	0
Significant Other Observable Inputs (Level 2) \| Warrant liability
Liabilities included in:
Total fair value	0	0
Significant Other Observable Inputs (Level 2) \| Contingent consideration
Liabilities included in:
Total fair value		0
Significant Other Observable Inputs (Level 2) \| Money market securities
Assets included in:
Money market securities	0	0
Significant Other Observable Inputs (Level 2) \| U.S. treasury securities
Assets included in:
Available-for-sale securities	0	26,897
Significant Other Observable Inputs (Level 2) \| Commercial paper
Assets included in:
Available-for-sale securities	1,978	14,764
Significant Other Observable Inputs (Level 2) \| Asset-backed securities
Assets included in:
Available-for-sale securities	497
Significant Other Observable Inputs (Level 2) \| Yankee debt securities
Assets included in:
Available-for-sale securities	758
Total fair value		3,202
Significant Unobservable Inputs (Level 3)
Assets included in:
Total fair value	0	0
Liabilities included in:
Total fair value	409	5,146
Significant Unobservable Inputs (Level 3) \| Warrant liability
Liabilities included in:
Total fair value	409	3,346
Significant Unobservable Inputs (Level 3) \| Contingent consideration
Liabilities included in:
Total fair value		1,800
Significant Unobservable Inputs (Level 3) \| Money market securities
Assets included in:
Money market securities	0	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) \| Asset-backed securities
Assets included in:
Available-for-sale securities	0
Significant Unobservable Inputs (Level 3) \| Yankee debt securities
Assets included in:
Available-for-sale securities	$ 0
Total fair value		$ 0

Debt - Summary of Outstanding Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Aug. 04, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Long-term debt, gross	$ 36,792		$ 36,776
Less: Unamortized debt discount and fees	(2,274)		(2,342)
Total outstanding debt, long-term	34,518		34,434
2022 credit agreement
Debt Instrument [Line Items]
Long-term debt, gross	36,792		$ 36,776
2022 credit agreement \| Senior term loan
Debt Instrument [Line Items]
Fee amount	$ 1,800	$ 1,800

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
-Paragraph 1D
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1D

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1D
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1D

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1F
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1F

Reference 22: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1F
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1F

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1F
-Subparagraph (b)(1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1F

Reference 24: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1F
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1F

Reference 25: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Marketable Securities

12 Months Ended

Dec. 31, 2023

Investments, Debt and Equity Securities [Abstract]

Marketable Securities

Marketable securities consisted of the following as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
Commercial paper	$	1,978	$	—	$	—	$	1,978
Asset-backed securities	497		—		—		497
Yankee debt securities	758		—		—		758
Total available-for-sale securities - short-term	3,233		—		—		3,233
Total available-for-sale securities	$	3,233	$	—	$	—	$	3,233


	December 31, 2022
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
U.S. treasury securities	$	26,906	$	3	$	(12)	$	26,897
Commercial paper	3,200		2		—		3,202
Yankee debt securities	14,764		—		—		14,764
Total available-for-sale securities - short-term	44,870		5		(12)		44,863
Total available-for-sale securities	$	44,870	$	5	$	(12)	$	44,863

As of December 31, 2023, the Company’s available-for-sale securities classified as short-term of $3.2 million mature in one year or less and there were none held long-term. As of December 31, 2022, the Company’s available-for-sale securities classified as short-term of $44.9 million mature in one year or less and there were none held long-term.

Summary of Significant Accounting Policies - Weighted-Average Unobservable Inputs to Measure Warranty Liability (Details) - Significant Unobservable Inputs (Level 3) - Exercise of common stock warrants	Dec. 31, 2023 year $ / shares
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Share price (in usd per share) \| $ / shares	$ 0.1083
Risk-free interest rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input	0.0388
Expected term in years
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input \| year	6.5
Expected volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input	0.9000

Inventory - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
Inventory - Narrative (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Inventory write-down	$ 3.2	$ 3.8

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	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 5,733	$ 9,391
Continuing Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	3,032	3,400
Discontinued Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	2,701	5,991
Cost of products sold
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	454	669
Cost of products sold \| Continuing Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	288	504
Cost of products sold \| Discontinued Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	166	165
Research and development
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	1,167	1,736
Research and development \| Continuing Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	46	65
Research and development \| Discontinued Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	1,121	1,671
Selling, general and administrative
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	4,112	6,986
Selling, general and administrative \| Continuing Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	2,698	2,831
Selling, general and administrative \| Discontinued Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 1,414	$ 4,155

Accrued Liabilities

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Accrued Liabilities

Accrued liabilities related to continuing operations consisted of the following as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023		December 31, 2022

Compensation and related expenses	$	2,225	$	2,433
Professional fees	378		186
Sales and use tax	—		181
Other*	274		510
Total accrued liabilities	$	2,877	$	3,310

*Other is principally comprised of earnout transaction cost accruals.

Discontinued Operations, Assets Held for Sale and Restructuring - Schedule of Revenues and Expenses Associated with Discontinued Operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss from discontinued operations before income taxes	$ (69,530)	$ (68,382)
Income tax expense	212	67
Loss from discontinued operations	(69,742)	(68,449)
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	10,937	13,332
Cost of product sold	(19,002)	(26,969)
Research and development	(18,335)	(25,035)
Selling, general and administrative	(18,852)	(27,339)
Impairment of inventory	(384)	0
Impairment of prepaid assets and other current assets	(580)	0
Impairment of property and equipment	(621)	0
Restructuring	(6,324)	(2,371)
Impairment from held for sale classification	(16,369)	0
Loss from discontinued operations before income taxes	(69,530)	(68,382)
Income tax expense	212	67
Loss from discontinued operations	$ (69,742)	$ (68,449)

Sale of Business - Summary of Sale of Discontinued Operation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on sale of business, net	$ 9,080	$ 79,465
Held-for-sale \| Left-heart access portfolio \| Medtronic
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Percentage of Product Net Sales Earnout accrued as of December 31, 2023	9,360
Transaction costs	(280)
Gain on sale of business, net	$ 9,080	$ 79,500

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2023
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions Consulting Agreement The Company has a consulting agreement with the chairman of the Company’s Board of Directors. The Company recorded less than approximately $0.1 million and less than approximately $0.2 million for the years ended December 31, 2023 and 2022, respectively. Credit Agreements The Company's prior credit agreement (the "2019 Credit Agreement") was between the Company and related parties OrbiMed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P., and provided for a loan of up to $70.0 million with a maturity date of May 20, 2024. On June 30, 2022, the loan balance of $40.0 million was repaid in full out of the proceeds of the 2022 Credit Agreement. The 2022 Credit Agreement with related parties Deerfield Private Design Fund III, L.P. and Deerfield Partners, L.P. replaced the 2019 Credit Agreement and provides for an aggregate principal amount of $35.0 million and a maturity date five years from the closing of the loan. Refer to Note 9 - Debt for additional details. The liability for the loan balance related to the 2022 Credit Agreement recorded on the Company's consolidated balance sheets was $34.5 million and $34.4 million as of December 31, 2023 and 2022, respectively. The Company recorded interest expense related to the debt on the consolidated statements of operations and comprehensive loss of $5.7 million and $5.1 million for the years ended December 31, 2023 and 2022, respectively. Warrants In connection with the 2022 Credit Agreement, the Company entered into the 2022 Warrant Purchase Agreement with Deerfield, pursuant to which the Company issued warrants for the purchase up to an aggregate 3,779,018 shares of the Company’s common stock at an exercise price of $1.1114 per share for a period of eight years following issuance. Refer to Note 13 - Warrants for additional details. Registration Rights Agreement On June 30, 2022, in connection with the issuance of the 2022 Warrants, the Company also entered into a registration rights agreement (the “Registration Rights Agreement”) with Deerfield, pursuant to which the Company filed a shelf registration statement on Form S-3 with the SEC to register the resale of certain securities held by Deerfield and their affiliates (the “Registrable Securities”). In addition, for a period of five years following the execution of the Registration Rights Agreement, or until all Registrable Securities are registered or no longer subject to restrictions on transfer (whichever is earlier), Deerfield will hold certain “piggy-back” registration rights with respect to registration statements filed during such period. The Company will generally pay all reasonable expenses incidental to its obligations and performance under the Registration Rights Agreement, other than underwriting discounts and commissions and such other charges.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

+ Details

Stock-Based Compensation - Narrative (Details) - USD ($) $ / shares in Units, $ in Millions		12 Months Ended
	Jan. 01, 2023	Dec. 31, 2023	Dec. 31, 2022	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)		$ 0.20	$ 1.15
Share based compensation by share based payment arrangement weighted-average grant date fair value per share of stock option grants (in dollars per share)		$ 1.17
Unrecognized compensation related to stock options not vested		$ 1.7
Share based compensation non vested award period for recognition		1 year 10 days
Restricted stock units (RSUs)
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based compensation non vested award period for recognition		1 year 6 months
Unrecognized compensation related to restricted stock not vested		$ 2.8
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)		5,669,799
2020 plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)		5,573,491
Share based payment arrangement number of shares available for issuance (in shares)		3,191,792
Share based compensation by share based payments arrangement, number of additional shares authorized (in shares)	1,142,186
2011 plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)		195,537
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)		252,042		645,105
Number of shares available for purchase (in shares)		669,017
2020 ESPP \| Maximum
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Participants purchase price of common stock (as a percent)		85.00%

Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Summary of Finite Lived Intangible Assets

The tables below present the details of intangible assets as of December 31, 2023 and December 31, 2022 (dollars in thousands):


December 31, 2023	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization		Transfer to Discontinued Operations		Balance



Licensed intangibles	—	—	$	2,000	$	(582)	$	(1,416)	$	—
Total intangible assets			$	2,000	$	(582)	$	(1,416)	$	—


December 31, 2022	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization		Transfer to Discontinued Operations		Balance
Licensed intangibles	10.0	7.9	$	2,000	$	(417)	$	(1,583)	$	—
Total intangible assets			$	2,000	$	(417)	$	(1,583)	$	—

Warrants - Narrative (Details) $ in Thousands	1 Months Ended	12 Months Ended
Warrants - Narrative (Details) $ in Thousands	Aug. 31, 2021	Dec. 31, 2023 USD ($) holder	Dec. 31, 2022 USD ($)
Warrants and Rights Note Disclosure [Abstract]
Change in fair value of warrant liability \| $		$ 2,937	$ 33
Number of warrant holders		4
Maximum percentage of outstanding common stock	0.049	0.049
Number of warrant holders with ability to increase stock ownership percentage after written notice election		2
Maximum percentage of outstanding common stock, notice for increase	0.099	0.099

Inventory

12 Months Ended

Dec. 31, 2023

Inventory Disclosure [Abstract]

Inventory

Inventory as of December 31, 2023 and December 31, 2022 consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

Raw materials	$	3,428	$	878
Work in process	319		197
Finished goods	531		719
Total inventory	$	4,278	$	1,794

Inventory is recorded net of write-downs and manufacturing scrap of $3.2 million and $3.8 million for the years ended December 31, 2023 and 2022, respectively.

Property and Equipment, Net

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023		December 31, 2022

Furniture and fixtures	$	432	$	431
Office equipment	1,537		1,537
Laboratory equipment and software	1,494		1,497
Leasehold improvements	979		580
Construction in process	7		980
Total property and equipment	4,449		5,025
Less: accumulated depreciation	(3,624)		(3,356)
Property and equipment, net	$	825	$	1,669

Depreciation expense was $0.2 million and $0.3 million for the years ended December 31, 2023 and 2022, respectively.

Stock-Based Compensation

12 Months Ended

Dec. 31, 2023

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, RSUs, RSAs, stock appreciation rights, performance share units ("PSUs"), performance shares and other equity-based awards to employees, directors and consultants, became effective on March 30, 2022. As of December 31, 2023, 6,000,000 shares of common stock were authorized for issuance under the 2022 Plan, of which 5,669,799 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 December 31, 2023, 5,573,491 shares of common stock were authorized for issuance under the 2020 Plan, including 1,142,186 additional shares that were authorized on January 1, 2023. As of December 31, 2023, 3,191,792 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 December 31, 2023, 195,537 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 from 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 years ended December 31, 2023 and 2022:


	Year Ended December 31,
	2023	2022

Risk-free interest rate	3.91% - 4.27%	1.76% - 3.39%
Expected dividend yield	—	—
Expected term in years	5.5 - 5.6	5.5 - 6.0
Expected volatility	75% - 85%	75% - 90%

The Company's stock option activity for the year ended December 31, 2023 was as follows:


	Stock Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2022	2,898,821	$	6.83	6.9	$	79
Options granted	755,580	1.28
Options exercised	(3,218)	1.34			$	—
Options forfeited	(1,746,460)	9.74
Outstanding as of December 31, 2023	1,904,723	$	1.98	7.8	$	—
Options vested and expected to vest December 31, 2023	1,904,723	$	1.98	7.8	$	—
Options exercisable December 31, 2023	1,039,564	$	2.50	6.8	$	—

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 $0.20 and $1.15 as of December 31, 2023 and December 31, 2022, 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 year ended December 31, 2023 was $1.17. As of December 31, 2023, the total unrecognized compensation related to unvested stock option awards granted was $1.7 million, which the Company expects to recognize over a weighted-average period of approximately 1.03 years.

Restricted Stock Units (RSUs)

The Company’s RSU activity for the year ended December 31, 2023 was as follows:


	Number of Shares	Weighted Average Grant Price
Unvested as of December 31, 2022	1,659,898	$	4.17
Granted	1,937,520	1.28
Forfeited	(500,521)	3.95
Vested	(911,567)	2.94
Unvested as of December 31, 2023	2,185,330	$	2.18

As of December 31, 2023, there was $2.8 million of unrecognized compensation related to unvested RSUs, which the Company expects to recognize over a weighted-average period of approximately 1.5 years.

Employee Stock Purchase Plan

The 2020 ESPP permitted individual employees to purchase shares of the Company’s common stock from amounts accumulated under payroll deductions. The 2020 ESPP became effective on August 5, 2020, wherein 645,105 shares of common stock were authorized. Additional shares of common stock were historically allocated to the 2020 ESPP by the determination of the Compensation Committee of the Company’s Board of Directors, in its sole discretion, and by evergreen provisions in the plan authorization. Automatically authorized in 2023 were 252,042 shares under the plan's evergreen provision. As of December 31, 2023, 669,017 shares were available for purchase under the Company's 2020 ESPP.

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

As part of the Restructuring, the Company’s Board of Directors resolved to terminate the 2020 ESPP effective November 8, 2023, and return to the respective contributors all contributions made under the 2020 ESPP during the purchase period ending November 14, 2023.

The fair value of the 2020 ESPP shares used in determining compensation expense is estimated using the Black-Scholes option pricing model.

Total Stock-Based Compensation


	Year Ended December 31,				Year Ended December 31, 2023				Year Ended December 31, 2022
	2023		2022		Continuing Operations		Discontinued Operations		Continuing Operations		Discontinued Operations

Cost of products sold	$	454	$	669	$	288	$	166	$	504	$	165
Research and development	1,167		1,736		46		1,121		65		1,671
Selling, general and administrative	4,112		6,986		2,698		1,414		2,831		4,155
Total stock-based compensation	$	5,733	$	9,391	$	3,032	$	2,701	$	3,400	$	5,991

Summary of Significant Accounting Policies - Summary of Accounts Receivable (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	$ 11,353	$ 17,919
Trade accounts receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	1,993	919
Earnouts receivable from Medtronic
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	$ 9,360	$ 17,000

Subsequent Events (Details)	Feb. 16, 2024 agreement
Subsequent Event \| Deerfield Credit Agreement, Amendment 3
Subsequent Event [Line Items]
Number of agreements alleged to be breached	5

Inventory - Schedule of Inventories (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw materials	$ 3,428	$ 878
Work in process	319	197
Finished goods	531	719
Total inventory	$ 4,278	$ 1,794

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

Note 18—Income Taxes

The components of pretax loss from continuing operations for the years ended December 31, 2023 and 2022 are as follows (in thousands):


	December 31,
	2023		2022

U.S.	$	(11,858)	$	28,848
Foreign	—		—
Pretax loss from continuing operations	$	(11,858)	$	28,848

The components of income tax expense for continuing operations are as follows (in thousands):


	December 31,
	2023		2022









Federal	$	—	$	—
State	63		15
Foreign	0		0
Total provision for income taxes	$	63	$	15

A provision for state and foreign income taxes was less than $0.1 and $0.1 million for the years ended December 31, 2023 and 2022, respectively. Current income taxes are based upon the year’s income taxable for federal, state and foreign tax reporting purposes. Deferred income taxes are provided for certain income and expenses which are recognized in different periods for tax and financial reporting purposes. Deferred tax assets and liabilities are computed for differences between the consolidated financial statements and tax bases of assets and liabilities that will result in taxable or deductible amounts in the future based on enacted tax laws and rates applicable to the period in which the differences are expected to affect taxable income, and NOL carryforwards and R&D tax credit carryforwards. The Company adopted ASU 2019-12 in the first quarter of 2021 and has recorded franchise taxes not based on income outside of income tax expense.


	Year Ended December 31,
	2023				2022
	Amount		Tax Rate		Amount		Tax Rate
















Income tax benefit at federal statutory rate	$	(2,490)	21.0	%	$	6,058	21.0	%
Adjustments for tax effects of:
State taxes, net	(271)		2.3	%	872		3.0	%
Permanent adjustments	(750)		6.3	%	808		2.8	%
Goodwill impairment	—		—	%	2,525		8.8	%
Stock based compensation expense	2,616		(22.1)	%	2,525		8.8	%

Research and development credit	(1,720)		14.5	%	(2,099)		(7.3)	%
Unrecognized tax benefit	626		(5.3)	%	630		2.2	%
Return to provision	(1,959)		16.5	%	534		1.9	%
Valuation allowance	4,012		(33.8)	%	(11,839)		(41.0)	%
Income tax expense	$	63	(0.5)	%	$	15	0.1	%

Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2023 and 2022 are as follows (in thousands):


	December 31,
	2023		2022


































Deferred tax assets:
Net operating losses	$	96,679	$	94,437
Stock-based compensation	1,031		1,678
Research and development credit	11,733		10,273
Capitalized research costs	12,679		9,471
Intangible assets	93		94
Accrued compensation	733		1,161
Debt	623		—
Lease liability	929		1,019
Inventory	6,811		655
Other	1,241		35
Total gross deferred tax assets	132,552		118,823
Valuation allowance	(131,395)		(110,907)
Net deferred tax asset	$	1,157	$	7,916

Deferred tax liabilities:
Deferred installment gain	$	—	$	(5,315)
Property and equipment	(249)		(1,105)
Right of use assets	(747)		(891)
Prepaid expenses	(47)		(105)

Other	(115)		(461)
Debt	—		(39)
Total deferred tax liabilities	(1,157)		(7,916)
Net deferred tax assets (liabilities)	$	—	$	—

In assessing the realizability of deferred tax assets as of December 31, 2023 and 2022, management considered whether it is more likely than not that some portion or all of the deferred tax assets will be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible or the NOL carryforwards and R&D credit carryforwards will be used. The Company determined it is more

likely than not that its net deferred tax assets will not be realized. Accordingly, a valuation allowance was recorded as of December 31, 2023 and 2022 to fully offset the net deferred tax assets of $131.4 million and $110.9 million, respectively.

The following table presents NOLs and tax credit carryforwards as of December 31, 2023 (in thousands):


	Amount		Expiration Years
NOLs, federal (post-December 31, 2017)	$	331,657	Indefinite (1)
NOLs, federal (pre-January 1, 2018)	$	93,096	2031	-	2037
NOLs, state	$	104,529	2026	-	2043
NOLs, state (post-December 31, 2017)	$	16,269	Indefinite (1)
Research and development tax credits, federal	$	11,087	2031	-	2043
Research and development tax credits, California	$	7,183	Indefinite
____________________
(1) NOL carryforwards generated after 2017 can be carried forward indefinitely and can generally be used to offset up to 80%of future taxable income.

NOL carryforwards may be subject to a substantial annual limitation due to ownership change limitations that may have occurred or that could occur in the future, as required by Section 382 of the Internal Revenue Code of 1986, as amended (the “Code”), as well as similar state and foreign provisions. These ownership changes may limit the amount of NOL and R&D credit carryforwards that can be used annually to offset future taxable income and tax, respectively. In general, an “ownership change” as defined by Section 382 of the Code results from a transaction or series of transactions over a three-year period resulting in an ownership change of more than 50% of the outstanding stock of a company by certain stockholders. The Company believes it has experienced certain ownership changes in the past and has recorded the deferred tax assets related to NOL and R&D credit carryforwards net of any previous limitations due to sections 382 and 383.

The Company had conducted intensive research and experimentation activities, generating R&D tax credits for federal and state purposes under Section 41 of the Code. The Company has not performed a formal study validating these credits claimed in the tax returns. Once a study is prepared, the amount of R&D tax credits available could vary from what was originally claimed on the tax returns.

The following table summarizes the changes to unrecognized tax benefits as of December 31, 2023 and 2022 (in thousands):


	December 31,
	2023		2022
Balance at beginning of year	$	4,795	$	4,128
Gross increases – tax positions in current period	556		683
Gross increases – tax positions in prior period	130		—
Gross decreases – tax positions in prior period	—		(16)


Balance at end of year	$	5,481	$	4,795

As of December 31, 2023, the Company has unrecognized tax benefits of $5.5 million of which $4.8 million will affect the effective tax rate if recognized when the Company no longer has a valuation allowance offsetting its deferred tax assets.

The Company does not anticipate that there will be a significant change in unrecognized tax benefits over the next 12 months.

The Company is subject to U.S. federal and various state tax as well as Belgium, and the UK tax jurisdictions. Since the Company formed in 2011, all filed tax returns are subject to examination. Generally, the tax years remain open for examination by the federal statute under a three-year statute of limitation; however, states generally keep their statutes open between three and four years. However, the Company’s tax years from inception are subject to examination by the United States and various state taxing authorities due to the carry forward of unused NOLs and R&D credits.

The Company’s practice is to recognize interest and/or penalties related to income tax matters in income tax expense. The Company had no accrual for interest and penalties on its consolidated balance sheets and has not recognized interest and/or penalties in the consolidated statements of operations and comprehensive loss for the years ended December 31, 2023 and 2022.

The Tax Cuts and Jobs Act enacted in 2017 requires taxpayers to capitalize and amortize R&D expenditures for tax purposes incurred in tax years beginning after December 31, 2021. The rule resulted in the Company's capitalization of R&D expenditures of approximately $20.6 million and $28.8 million incurred during 2023 and 2022, respectively. For R&D

performed in the U.S., the Company will amortize costs capitalized for tax purposes over 5 years and for R&D performed outside the U.S, the Company will amortize costs capitalized for tax purposes over 15 years.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Warrants (Tables)

12 Months Ended

Dec. 31, 2023

Warrants and Rights Note Disclosure [Abstract]

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

The fair value was estimated to be $0.1083 per warrant as of December 31, 2023 and the significant inputs used in the estimation of the fair value were as follows:


	December 31, 2023

Risk-free interest rate	3.88	%
Expected term in years	6.5
Expected volatility	90.00	%

As of December 31, 2023 and December 31, 2022, the outstanding warrants to purchase the Company’s common stock consisted of the following:


	Exercise Price		Expiration Date	December 31, 2023	December 31, 2022

Warrants issued in 2015	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	$	1.11	6/30/30	3,779,018	3,779,018
Total Warrants				4,576,505	4,576,505

Inventory (Tables)

12 Months Ended

Dec. 31, 2023

Inventory Disclosure [Abstract]

Summary of Inventory

Inventory as of December 31, 2023 and December 31, 2022 consisted of the following (in thousands):


	December 31, 2023		December 31, 2022

Raw materials	$	3,428	$	878
Work in process	319		197
Finished goods	531		719
Total inventory	$	4,278	$	1,794

Accrued Liabilities (Tables)

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Summary of Accrued Liabilities

Accrued liabilities related to continuing operations consisted of the following as of December 31, 2023 and December 31, 2022 (in thousands):


	December 31, 2023		December 31, 2022

Compensation and related expenses	$	2,225	$	2,433
Professional fees	378		186
Sales and use tax	—		181
Other*	274		510
Total accrued liabilities	$	2,877	$	3,310

*Other is principally comprised of earnout transaction cost accruals.

Intangible Assets

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Intangible Assets

Licensed intangible assets relate to the Force Sensing Ablation Catheter licensed intangible acquired from Biotronik which is part of the ablation business which the Company intends to sell due to the strategic shift and, therefore, were transferred to assets held for sale and are part of discontinued operations.

The tables below present the details of intangible assets as of December 31, 2023 and December 31, 2022 (dollars in thousands):


December 31, 2023	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization		Transfer to Discontinued Operations		Balance



Licensed intangibles	—	—	$	2,000	$	(582)	$	(1,416)	$	—
Total intangible assets			$	2,000	$	(582)	$	(1,416)	$	—


December 31, 2022	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization		Transfer to Discontinued Operations		Balance
Licensed intangibles	10.0	7.9	$	2,000	$	(417)	$	(1,583)	$	—
Total intangible assets			$	2,000	$	(417)	$	(1,583)	$	—