iRhythm Q1 2025 presentation: Revenue jumps 20%, guidance raised on market expansion

Introduction & Market Context

iRhythm Technologies (NASDAQ:IRTC) presented its first quarter 2025 financial results on May 1, showcasing strong revenue growth and an improved outlook for the full year. The cardiac monitoring technology company continues to capitalize on its leadership position in an underpenetrated market, with shares rising nearly 5% in after-hours trading following the presentation.

The company operates in the ambulatory cardiac monitoring (ACM) space, where it has established dominant market share with its Zio monitoring devices. iRhythm highlighted the substantial market opportunity, noting that over 27 million potential patients in the United States could benefit from its monitoring solutions, with only about 30% market penetration achieved to date in its core segment.

As shown in the following chart of key metrics, iRhythm has built a substantial data foundation with over 10 million patient reports since inception and more than 2.5 billion hours of curated ECG data:

Quarterly Performance Highlights

iRhythm reported first quarter 2025 revenue of $158.7 million, representing a 20.3% increase compared to the same period in 2024. This result exceeded analyst expectations of $153.49 million, contributing to the positive market reaction. The company posted an adjusted net loss of $0.95 per share, slightly better than the forecasted loss of $0.96 per share.

Gross profit margin for Q1 2025 was 68.8%, consistent with the third quarter of 2024 but slightly below the 70.0% achieved in Q4 2024. Adjusted EBITDA came in at -$2.6 million, or -1.7% of revenue, showing improvement from the -9.2% margin in the first quarter of 2024.

The following chart illustrates iRhythm’s quarterly financial performance trends, showing the revenue growth trajectory and profitability metrics over the past five quarters:

Despite the negative adjusted EBITDA for the quarter, iRhythm’s financial position remains strong, with the earnings report noting a current ratio of 5.82, indicating robust liquidity to support ongoing growth initiatives.

Strategic Initiatives

iRhythm’s presentation emphasized multiple growth levers across different market segments. The company maintains over 70% market share in the Long-Term Continuous Monitoring (LTCM) segment with its Zio monitor and over 10% share in Mobile Cardiac Telemetry (MCT) with Zio AT. Management highlighted plans to launch a new Zio MCT product in Q3 2025, following FDA submission.

The company’s growth strategy focuses on three key areas: expanding in the current U.S. market, developing international markets, and addressing the undiagnosed patient population. This multi-faceted approach is illustrated in the following diagram:

A significant focus for iRhythm is penetrating the primary care physician channel, which represents a substantial opportunity to diagnose arrhythmias earlier in the care pathway. The company noted that nearly half (46.3%) of all U.S. counties do not have any cardiologists, with the average wait time to see a cardiologist being around 26.6 days for non-urgent appointments.

The company’s approach to the primary care market employs a two-pronged strategy of "land-and-expand" within Integrated Delivery Networks and top-down integration at large national accounts, as shown here:

International expansion represents another significant growth opportunity, with iRhythm targeting a $1+ billion total addressable market across prioritized countries in Europe and Asia Pacific. The company is in various stages of commercialization across these markets, with early traction in the UK and ongoing reimbursement negotiations in Japan.

The international strategy is visualized in the following map:

iRhythm also emphasized its competitive advantages, particularly in artificial intelligence and clinical evidence. The company has FDA-cleared AI technology and an expansive dataset of over 2.5 billion hours of curated ECG data, which it leverages for both current products and future innovation.

Forward-Looking Statements

Based on strong Q1 performance, iRhythm raised its full-year 2025 guidance. The company now expects revenue between $690 million and $700 million, up from the previous range of $675 million to $685 million. Similarly, adjusted EBITDA margin guidance was increased to 7.5%-8.5% of revenue, compared to the prior range of 7.0%-8.0%.

The updated guidance is presented in the following graphic:

During the earnings call, CEO Quentin Blackford expressed confidence in the company’s growth potential, stating, "We believe the market is much larger than what it is today." CFO Dan Wilson emphasized that the company’s "highest priority is ensuring continued supply to meet the growing demand for our Zio services."

The company anticipates being slightly free cash flow negative in 2025 but aims to achieve positive cash flow in 2026. Management also highlighted potential risks, including supply chain disruptions, regulatory challenges with the FDA that could delay new product launches, and potential tariff impacts on international operations.

iRhythm’s long-term investment thesis centers on four key pillars: market expansion opportunities, innovation, operational efficiency, and an improving financial profile. With its strong market position, technological advantages, and expanding addressable market, the company appears well-positioned to maintain its growth trajectory through 2025 and beyond.

Full presentation:

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