iRhythm Technologies at Jefferies Conference: Expanding Markets and Innovation

On Thursday, 20 November 2025, iRhythm Technologies (NASDAQ:IRTC) presented at the Jefferies London Healthcare Conference 2025. The digital healthcare company outlined a strategic plan focusing on expansion and innovation, highlighting both its robust financial growth and the challenges of scaling operations internationally.

Key Takeaways

• iRhythm's Zio platform serves over 2 million patients annually, with a 30% market share in cardiac monitoring.
• Q3 2025 revenue reached $192.9 million, marking a 30.7% increase year-over-year.
• The company aims to expand its total addressable market to 27 million patients, including international markets.
• iRhythm expects to be free cash flow positive for the full year 2025, a first in its history.
• New product developments include a next-generation Zio MCT and a multivitals platform.

Financial Results

• Q3 2025 Revenue: $192.9 million, a 30.7% increase from the previous year.
• Gross Margin: 71.1% in Q3, with a target of 72-73% by 2027.
• Adjusted EBITDA Margin: 11.2% in Q3 2025.
• Full Year 2025 Revenue Guidance: $735 million to $740 million, representing 24-25% growth.
• Full Year 2025 Adjusted EBITDA Margin Guidance: 8.25% to 8.75%, a 400 basis point increase from last year.
• Free Cash Flow: Projected to be positive for the full year 2025.

Operational Updates

• Zio Platform: Combines hardware, software, and services, achieving significant scale in patient reach.
• Market Share: Over 30% in the core market and 70% in long-term continuous monitoring.
• International Expansion: Focused on the UK, Switzerland, Spain, Austria, Netherlands, and Japan.
• Primary Care Expansion: Targeting 15 million patients with cardiac palpitations and 16 million with risk factors.
• EHR Integration: Over 50% of volume runs through EHR systems, with partnerships like Epic Aura.

Future Outlook

• TAM Expansion: Targeting a market of 27 million patients, including primary care and international markets.
• Product Innovation: Launching Zio MCT and developing a multivitals platform, with potential sleep monitoring expansion.
• Growth Strategy: Focusing on core market penetration, adjacent market expansion, and operational efficiency.
• Financial Goals: Aiming for 24-25% revenue growth in 2025, with a 15% adjusted EBITDA margin by 2027.

The full transcript of iRhythm Technologies' presentation at the Jefferies London Healthcare Conference 2025 can be accessed below.

Full transcript - Jefferies London Healthcare Conference 2025:

Mike Sarcone, Analyst, Jefferies: Okay, good morning. My name's Mike Sarcone. I'm an analyst on the U.S. Medical Supplies and Devices team, and welcome to the Jefferies London Healthcare Conference. This is a session for iRhythm Technologies, which is a leading digital healthcare company currently focused on cardiac monitoring. With us from the company, we've got the CFO, Daniel Wilson, and we've also got Stephanie Zhadkevich, who heads the IR function, and Dan's going to be going through a presentation today. Dan, we'll kick it off.

Daniel Wilson, CFO, iRhythm Technologies: Great. Thank you, Mike, and thank you all for being here. It is our pleasure to participate in the Jefferies Conference and share the iRhythm story with you all. I hope the story that you hear is a story of high clinical value, a story of scale, and a story of sustainable, profitable growth. With that, I will be making forward-looking statements today. I refer you all to our SEC filings, our 10Q and 10K, for a full description of our risk factors and other disclosures. I will start here with an overview of the Zio platform, and you can think of our platform really as a very powerful combination of hardware, software, and services. On the hardware side, we have developed a patented wearable biosensor. Pictured there is our Zio Monitor device.

This is a patient-friendly device that patients can wear comfortably for up to 14 days, capturing on average a million and a half heartbeats over those 14 days. That's—patients can go about their normal day-to-day activities. They can shower, sleep, and exercise. Compare that to traditional Holter monitoring, which we have been disrupting over the last decade. It's capital equipment. It's bulky. It's not patient-friendly. Patients can only wear it for 24 or 48 hours and very disruptive to patient life. We developed this wearable biosensor to, again, be patient-friendly and to be worn up to 14 days. In those 14 days, we're capturing on average a million and a half heartbeats. To really draw the relevant insights out of that data, you need powerful AI on the back end, which is another thing we've invested in from the very beginning. We have our second-generation FDA-cleared deep-learned algorithm.

We're working on our third, and we'll have that to market soon. That's really critical to, again, sort through the million and a half heartbeats and draw out the relevant clinical insights. Lastly, on the services side, all of that's great, but unless you can deliver it to a clinician and really seamlessly integrate into their workflows, you're going to be challenged. This is another thing that we've invested in from the very beginning. We have our Zio Suite platform, which is pictured there, and make other investments in terms of being operationally complete. We've been on this journey for over a decade commercially, and I'll speak to some of the scale that we've accomplished in that time. In our most recent quarter, third quarter here, we reported revenue of $192.9 million.

That's year-over-year growth of 30.7%, and really have seen kind of an acceleration growth-wise through 2025. It's been a tremendous year for us. We're now serving over 2 million patients a year and growing, obviously. Within our core market, we have over a 30% share in our core market. I'll speak to some of the TAM expansion opportunities as I go through my presentation. In our history, we've served nearly 12 million patients. Again, speaks to the scale that we've been able to accomplish. As we think about TAM expansion, we see a real opportunity: 27 million patients who are candidates for Zio monitoring, and I'll peel back the onion on that number a little bit as I go through the presentation. Certainly, what we've done in the U.S. in terms of changing the standard of care, that is an opportunity outside the U.S. as well.

We see a market opportunity of 5 million tests in prioritized countries, a handful of countries that we're prioritizing. A number we're really proud of: 125 scientific manuscripts. We have really led with clinical evidence and more and more economic evidence that essentially demonstrates the superiority of our Zio platform. That is something we will continue to invest in. Then 2.5 billion hours of curated ECG data. I mentioned a million and a half heartbeats on average for every patient. The 12 million that we have serviced in our lifetime has generated a patient database of 2.5 billion hours. If you think about AI, AI is really only as good as the data that you are training it on. We have a patient database to really drive those powerful AI tools that I mentioned.

If you think about the problem that we are trying to solve, cardiac arrhythmias are obviously highly prevalent. Over 11 million folks in the U.S. with arrhythmias, we believe that is significantly undiagnosed, as I was mentioning earlier, and it comes with clinical and financially devastating impacts. Five times increased risk of stroke for patients with atrial fibrillation, which is the most common cardiac arrhythmia, and you have a lifetime risk of 40% of developing atrial fibrillation for individuals over 55. Obviously, clinically and economically devastating. With the aging population, this problem is growing by the day. There is now over 4 million individuals aging into Medicare every year, which is an acceleration from prior years, and this problem, or opportunity for us to go solve, continues to grow each year. Now, looking at our market opportunity, we segment it across three different segments.

Our core market today: 6.5 million ACM tests in the U.S. We operate in two segments of that: the long-term continuous monitoring market, which is about 3 million of the 6.5 million tests. That is the market segment that we pioneered with our Zio XT device initially, now Zio Monitor. We have over 70% share in that market and continue to actually grow that number over the last year or two. Below that is the MCT segment, mobile cardiac telemetry segment. We service that market with our Zio AT product. We introduced that just a few years ago, back in 2019, have been growing share steadily within that segment of the market. We're calling it about 15% share in that segment, an opportunity to continue to expand our share within that segment. We do have a next-generation product, Zio MCT, that we recently filed with the FDA.

We believe that's a meaningfully improved product profile relative to Zio AT and really a key to unlock a bigger market share opportunity for us within that segment. Internationally, I mentioned 5 million tests across our prioritized countries. Certainly, the opportunity to shift away from traditional Holter monitoring to long-term continuous monitoring is an opportunity in international markets that we continue to pursue. On top of that, again, I mentioned 27 million patients that we believe are candidates for ambulatory cardiac monitoring. A big part in opening up that opportunity is moving upstream into primary care, which we've been making significant inroads in, and I'll speak to that in a minute. Mentioned international. This is a list of our prioritized countries. We've been commercialized in the U.K. now for a few years. That's a market opportunity of, call it, 500,000 tests annually.

We're really focused today on the private market. We're seeing nice, healthy growth there within the private market. We are pursuing NHS-wide reimbursement and hopefully can secure that long-term reimbursement here in the coming years to really open up that full opportunity for us. We recently launched in four Western European countries a little more than a year ago: Switzerland, Spain, Austria, and the Netherlands. Certainly, Germany and France will be on our roadmap in time as well across those countries. 2.1 million tests per year across those countries and a big opportunity there for us as well. Japan, we commercially launched in Japan earlier this year. That was following a reimbursement decision. Unfortunately, we are currently operating under the existing Holter rate, traditional Holter rate there in Japan. We do believe that doesn't fully represent the value that we're delivering with Zio Monitor and long-term continuous monitoring.

We are running head-to-head studies there in market to compare Zio Monitor against traditional Japanese Holter monitors. With that data, we'll come back to MHLW and hopefully secure premium reimbursement. We'll think of that more as a 2027 event versus 2026. Seeing really good adoption there in Japan, the feedback has been fantastic. We're launching a number of accounts. From a volume standpoint, I'm seeing really nice, healthy growth there. I mentioned the 27 million patient opportunity. We really think about this as our bigger opportunity, and we're seeing early signs that this is an opportunity that is opening up for us. That 27 million is comprised of 15 million patients who are presenting at primary care with cardiac palpitations noted in their medical record. These are individuals that are already presenting at primary care with palpitations noted in their medical record.

Yet what I showed on a prior page, only 6.5 million tests being done per year across all modalities and all prescriber settings. A real opportunity to even just grow our core market for symptomatic patients. Adding to that is another 16 million patients we believe have risk factors according to clinical studies that we've ran that are suggestive of undiagnosed arrhythmias. These are oftentimes either asymptomatic or symptoms are confused with other diseases, and therefore they're not being monitored for cardiac arrhythmias. You've heard the risk of stroke and other cardiac events if they go unmonitored and undiagnosed, and we are seeing a shift in the market to more proactive monitoring and preventative care, which we believe we're really well positioned for. I mentioned primary care is a key piece of opening up that opportunity. We're approaching that really with a two-prong approach.

One, it's been part of our strategy for, call it, the last five years or so, the Land and Expand model. We often open an account, an IDN with a clinical champion, generally a cardiologist or electrophysiologist. Through partnership with that clinical champion, we move upstream in this Land and Expand model into primary care. We also move into other departments across the account. It could be emergency room, neurology, nephrology, other pockets of prescribers. A big part of unlocking that prescriber base is EHR integration. I'm going to speak to that in a minute. That being operationally complete, being able to seamlessly integrate into the prescriber's workflows, is critical to opening this up. We have seen cardiologists and electrophysiologists support this move upstream into primary care.

If you think about the tailwinds in our market, certainly consumer wearables alerting individuals of potential arrhythmias presenting in primary care, that has been a tailwind for our market in terms of the patient funnel. Pulse field ablation, a lot of excitement around that technology and looking for patients that are appropriate candidates for that technology. That has been a nice tailwind of our market and this move into primary care as well. The other part of our strategy is more aligned to that 27 million patient number and proactive monitoring. This is the innovative channel part of our business. There are a few logos noted here on the page. We have seen these partners really adopt Zio and do proactive monitoring based on risk factors within their patient population. This has been a really nice part of our business and emerging part of our business.

We recently commented that it's, call it, low single-digit % of revenue today. Rewind 12, 18 months ago, it was zero. This has started to open up in a meaningful way, and we're excited about the pipeline there and how that has the opportunity to expand. Related to that, identifying which patients are candidates for proactive monitoring and really looking at risk factors. We've been generating a lot of clinical evidence to show some of these adjacent diseases that if there's undiagnosed arrhythmias within a diabetic population or CAD, COPD, those patients have additional risk beyond just their underlying conditions. A lot of clinical evidence here that is demonstrating that that is a motivating factor for these innovative channel partners to proactively monitor.

We recently announced a partnership with Lusum Health, which is essentially AI for kind of population health management, where there's an algorithm that can look at a patient population across a customer base and identify the patients that have the highest risk of undiagnosed monitoring. These partners can then proactively monitor those patients based on those risk factors. It's a tunable algorithm where if a customer wants to monitor a patient group and have an 80% diagnostic yield, meaning for every 100 patients, they're going to find 80 with arrhythmias, we can tune the algorithm that way. If they want to open the aperture and monitor more broadly and they're accepting of a 40% diagnostic yield, we can tune the algorithm that way as well. That was a partnership we announced just a few months ago and are taking that to market today.

I'm excited about what that means for us. If you think about iRhythm's competitive advantage and why we're positioned to win on the opportunities that I just mentioned, I would segment this across hardware, software, and services and really being complete across all three. AI is absolutely critical to everything we do, not only delivering that clinical value, but allowing for scale and efficiency in serving large volume of patients. Provider preference. In our Zio report, we deliver an initial preliminary findings to the physician. Physician then populates the final findings. What we see in our data is 99% physician agreement with what we report, meaning there's high confidence in what we're calling in the report. Provider can look at our report, know what needs to happen with that patient, and quickly move into next steps. Workflows, mentioned how critical that is.

I'll speak to the EHR here in a minute. Again, ability to scale, ability to serve the large number of patients that we're seeing across our different partners. We are well positioned there. We have an IDTF that's part of our service, hundreds of cardiac technicians that combine with the AI to deliver that high clinical value at the end of the day. Ultimately, demonstrating that with robust clinical and economic evidence. EHR integration, mentioned it a few times now. We signed a partnership with Epic Aura a little more than a year ago. Now have, call it, 30 customers live under the Epic Aura platform. EHR integration broadly has been a strategy that we have been executing on for many years. In fact, now over 50% of our volume runs through an EHR integration. The benefits are twofold there.

One, I mentioned earlier, it opens up the entire prescriber base for an account. It embeds it into the workflows. They do not need to exit out of the EHR to go to a different platform or system to order Zio. It is embedded there in the EHR. It makes it extremely efficient. It also makes our business quite sticky. Accounts have made the investment in the integration for EHR, and we cannot think of an account that we have lost once we have EHR integrated. Very valuable for us, something we will continue to invest in, and this partnership with Epic Aura speaks to that. In terms of where we are going next, I mentioned our Zio MCT product recently submitted to the FDA. That is our next-generation product. We will be taking it to market.

If you think beyond that or the next generation beyond Zio MCT, we want to start building a multivitals platform. Today, we're really just taking the ECG from a patient and providing clinical insights based on that. We believe there's a real opportunity to start gathering more patient data, whether it be heart rate, heart rate variability, respiration rate, SpO2, and provide deeper insights and open up adjacent market opportunities. This is a platform that we're actively developing and investing in. We licensed some technology about a year and a half ago, giving us several of these components. I'm excited about what this can mean both for our core business in terms of deepening our competitive positioning, but then now starting to open up adjacent market opportunities. The one I will point you to there is sleep. Sleep is a big opportunity for us.

We believe it's a lot of the same thing that we've done in cardiac monitoring. There's significant overlap between sleep and cardiac arrhythmia patients. You often need to be managing both parts to really deliver good patient care. This is something we're testing in the market today while we're building our multivitals platform to ultimately open up that market in a bigger way. Shifting to the financials here before I close out, here's a snapshot of what we reported in the third quarter. Again, $192.9 million of revenue, 31% growth, and we've seen that growth accelerate nicely through 2025. A lot of momentum in the business. We're really excited about what we're seeing and how we'll close out 2025 and enter 2026. From a profitability standpoint, the teams are executing at a really high level there. We've seen nice gross margin expansion, 71.1% in the most recent quarter.

We have a long-range target out there in 2027 of 72-73%. Feel good about our trajectory towards that target. On the bottom line, 11.2% most recently in the most recent quarter in terms of adjusted EBITDA margin. Looking at guidance for full year, third time this year, we've updated guidance, speaking to that acceleration in our business. Now expecting revenue between $735 million and $740 million. That's 24-25% year-over-year growth and adjusted EBITDA margin between 8.25-8.75%. That adjusted EBITDA margin, that's about 400 basis points of expansion relative to last year. That is a cadence that we're comfortable with. We have a 2027 target out there for 15% adjusted EBITDA. We feel good about delivering that number. This is balanced with driving profitability, but also reinvesting back in the business to some of the aspects that I mentioned earlier.

I also want to highlight that we now believe or are guiding to being free cash flow positive for full year 2025. That's the first time in the company's history, a significant milestone and really speaks to the financial maturity of the company and something we're really excited about. I will wrap here with just kind of a conclusion of what our investment thesis is. We believe there's a lot of opportunities here to generate long-term shareholder value. You think about the market expansion opportunities, not only continuing to penetrate our core market and take advantage of the tailwinds that we're seeing within that market, but start to open up other market opportunities, adjacent market opportunities. There's a number of market expansion opportunities we're investing in.

We're investing in the innovation to serve those opportunities, whether it be on the hardware side or on the AI side, really continue to invest in both of those aspects. We want to be operationally efficient. We know that's critical to continue to win in the market. Operational efficiency, both internally as well as how we deliver the service to our customers and an improving financial profile. I mentioned the growth acceleration, profitability expansion, now free cash flow positive. Really excited about all of that coming together and want to thank you all for your time and your interest in iRhythm. Thank you. Great. Thanks a lot, Den.

This article was generated with the support of AI and reviewed by an editor. For more information see our T&C.