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AFIB Acutus Medical

Cover Page

Cover Page - shares3 Months Ended
Mar. 31, 2021May 10, 2021
Cover [Abstract]
Document Type10-Q
Entity Registrant NameACUTUS MEDICAL, INC.
Amendment Flagfalse
Document Period End DateMar. 31,
2021
Document Fiscal Period FocusQ1
Entity Central Index Key0001522860
Document Quarterly Reporttrue
Document Transition Reportfalse
Document Fiscal Year Focus2021
Current Fiscal Year End Date--12-31
Entity Filer CategoryNon-accelerated Filer
Entity Current Reporting StatusYes
Entity Interactive Data CurrentYes
Entity Shell Companyfalse
Entity Small Businesstrue
Entity Emerging Growth Companytrue
Entity Ex Transition Periodfalse
Entity Incorporation, State or Country CodeDE
Entity Address, Address Line One2210 Faraday Ave.
Entity Address, Address Line TwoSuite 100,
Entity File Number001-39430
Entity Tax Identification Number45-1306615
Entity Address, City or TownCarlsbad
Entity Address, State or ProvinceCA
Entity Address, Postal Zip Code92008
City Area Code442
Local Phone Number232-6080
Title of 12(b) SecurityCommon Stock, par value $0.001 per share
Trading SymbolAFIB
Security Exchange NameNASDAQ
Entity Common Stock, Shares Outstanding28,124,057

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Current assets:
Cash and cash equivalents $ 8,631 $ 25,234
Marketable securities, short-term86,888 105,839
Restricted cash150 150
Accounts receivable2,477 2,160
Inventory13,837 12,958
Prepaid expenses and other current assets4,124 5,047
Total current assets116,107 151,388
Marketable securities, long-term11,225 8,726
Property and equipment, net14,648 12,356
Right-of-use assets, net1,480 1,669
Intangible assets, net5,493 5,653
Goodwill12,026 12,026
Other assets967 717
Total assets161,946 192,535
Current liabilities:
Accounts payable6,108 8,266
Accrued liabilities8,808 7,308
Contingent consideration, short-term2,600 5,400
Operating lease liabilities, short-term955 933
Total current liabilities18,471 21,907
Operating lease liabilities, long-term875 1,134
Long-term debt39,339 39,011
Contingent consideration, long-term3,000 3,900
Total liabilities61,685 65,952
Commitments and contingencies (Note 12)
Stockholders' equity
Preferred stock, $0.001 par value; 5,000,000 shares authorized as of March 31, 2021 and December 31, 2020; no shares issued and outstanding as of March 31, 2021 and December 31, 2020
Common stock, $0.001 par value; 260,000,000 shares authorized as of March 31, 2021 and December 31, 2020; 28,113,165 and 27,991,425 shares issued and outstanding as of March 31, 2021 and December 31, 2020, respectively28 28
Additional paid-in capital490,369 487,290
Accumulated deficit(390,196)(361,015)
Accumulated other comprehensive income60 280
Total stockholders' equity100,261 126,583
Total liabilities and stockholders' equity $ 161,946 $ 192,535

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / sharesMar. 31, 2021Dec. 31, 2020
Statement Of Financial Position [Abstract]
Preferred Stock, Par or Stated Value Per Share $ 0.001 $ 0.001
Preferred Stock, Shares Authorized5,000,000 5,000,000
Preferred Stock, Shares Issued0 0
Preferred Stock, Shares Outstanding0 0
Common Stock, Par or Stated Value Per Share $ 0.001 $ 0.001
Common Stock, Shares Authorized260,000,000 260,000,000
Common Stock, Shares, Issued28,113,165 27,991,425
Common Stock, Shares, Outstanding28,113,165 27,991,425

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Statement Of Income And Comprehensive Income [Abstract]
Revenue $ 3,591 $ 1,583
Costs and operating expenses:
Cost of products sold6,955 3,194
Research and development9,370 7,973
Selling, general and administrative16,252 10,235
Change in fair value of contingent consideration(1,153)(2,219)
Total costs and operating expenses31,424 19,183
Loss from operations(27,833)(17,600)
Other income (expense):
Change in fair value of warrant liability581
Interest income40 275
Interest expense(1,388)(1,354)
Total other expense, net(1,348)(498)
Loss before income taxes(29,181)(18,098)
Net loss(29,181)(18,098)
Other comprehensive income (loss)
Unrealized gain (loss) on marketable securities6 (27)
Foreign currency translation adjustment(226)(27)
Comprehensive loss $ (29,401) $ (18,152)
Net loss per common share, basic and diluted $ (1.04) $ (25.84)
Weighted average shares outstanding, basic and diluted28,031,686 700,505

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Convertible Preferred Stock and Stockholders' Equity (Deficit) - USD ($) $ in ThousandsTotalCommon Stock [Member]Additional Paid-in Capital [Member]Accumulated Deficit [Member]Accumulated Other Comprehensive Income (Loss) [Member]Series A Convertible Preferred Stock [Member]Series B Convertible Preferred Stock [Member]Series C Convertible Preferred Stock [Member]Series D Convertible Preferred Stock [Member]
Beginning balances at Dec. 31, 2019 $ 3,059 $ 40,685 $ 74,575 $ 135,039
Beginning balances, Shares at Dec. 31, 2019391,210 3,088,444 4,499,921 8,200,297
Beginning balances at Dec. 31, 2019 $ (225,811) $ 1 $ 33,252 $ (259,034) $ (30)
Beginning balances, Shares at Dec. 31, 2019695,902
Unrealized gain (loss) on marketable securities(27)(27)
Foreign currency translation adjustment(27)(27)
Stock option exercises, shares0
Issuance of Series D convertible preferred stock for the Biotronik Asset Purchase $ 5,000
Issuance of Series D convertible preferred stock for the Biotronik Asset Purchase, Shares273,070
Issuance of Series D convertible preferred stock for the contingent consideration related to the Rhythm Xience Acquisition $ 2,197
Issuance of Series D convertible preferred stock for the contingent consideration related to the Rhythm Xience Acquisition, Shares119,993
Stock-based compensation1,741 1,741
Stock-based compensation, shares14,962
Net loss(18,098)(18,098)
Ending balances at Mar. 31, 2020 $ 3,059 $ 40,685 $ 74,575 $ 142,236
Ending balances, shares at Mar. 31, 2020391,210 3,088,444 4,499,921 8,593,360
Ending balances at Mar. 31, 2020(242,222) $ 1 34,993 (277,132)(84)
Ending balances, shares at Mar. 31, 2020710,864
Beginning balances at Dec. 31, 2020126,583 $ 28 487,290 (361,015)280
Beginning balances, Shares at Dec. 31, 202027,991,425
Unrealized gain (loss) on marketable securities6 6
Foreign currency translation adjustment(226)(226)
Stock option exercises169 169
Stock option exercises, shares27,509
Stock-based compensation2,910 2,910
Stock-based compensation, shares94,231
Net loss(29,181)(29,181)
Ending balances at Mar. 31, 2021 $ 100,261 $ 28 $ 490,369 $ (390,196) $ 60
Ending balances, shares at Mar. 31, 202128,113,165

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Cash flows from operating activities
Net loss $ (29,181) $ (18,098)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense1,241 429
Amortization of intangible assets160 110
Stock-based compensation expense2,910 1,741
Amortization of premiums/(accretion of discounts) on marketable securities, net412 (5)
Amortization of debt issuance costs328 154
Amortization of right-of-use assets180 169
Change in fair value of warrant liability(581)
Change in fair value of contingent consideration(1,153)(2,219)
Changes in operating assets and liabilities:
Accounts receivable(317)(708)
Inventory(879)(1,809)
Prepaid expenses and other current assets1,104 214
Other assets(250)(267)
Accounts payable(2,091)3,602
Accrued liabilities1,500 (83)
Operating lease liabilities(237)(207)
Net cash used in operating activities(26,273)(17,558)
Cash flows from investing activities
Purchases of available-for-sale marketable securities(9,135)
Sales of available-for-sale marketable securities8,100
Maturities of available-for-sale marketable securities25,000 25,300
Purchases of property and equipment(3,693)(1,683)
Net cash provided by investing activities12,172 31,717
Cash flows from financing activities
Payment of contingent consideration(2,547)(2,584)
Proceeds from stock options exercises169
Net cash used in financing activities(2,378)(2,584)
Effect of exchange rate changes on cash, cash equivalents and restricted cash(124)(27)
Net change in cash, cash equivalents and restricted cash(16,603)11,548
Cash, cash equivalents and restricted cash, at the beginning of the period25,384 9,602
Cash, cash equivalents and restricted cash, at the end of the period8,781 21,150
Supplemental disclosure of cash flow information:
Cash paid for income taxes35
Cash paid for interest1,125 1,188
Supplemental disclosure of noncash investing and financing activities:
Issuance of Series D convertible preferred stock for Biotronik asset purchase5,000
Issuance of Series D convertible preferred stock for Rhythm Xience Acquisition2,197
Change in unrealized (gain) loss on marketable securities(6)27
Unpaid purchases of property and equipment $ (67) $ 119

Organization and Description of

Organization and Description of Business3 Months Ended
Mar. 31, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Organization and Description of BusinessNote 1—Organization and Description of Business Acutus Medical, Inc. (the “Company”) is an arrhythmia management company focused on improving the way cardiac arrhythmias are diagnosed and treated. The Company designs, manufactures and markets a range of tools for catheter-based ablation procedures to treat various arrhythmias. The Company’s product portfolio includes novel access sheaths, transseptal crossing tools, diagnostic and mapping catheters, ablation catheters, mapping and imaging consoles and accessories, as well as supporting algorithms and software programs. The Company was incorporated in the state of Delaware on March 25, 2011, and is located in Carlsbad, California. Liquidity and Capital Resources The Company has limited revenue, has incurred operating losses since inception and expects to continue to incur significant operating losses for at least the next several years and may never become profitable. As of March 31, 2021 and December 31, 2020, the Company had an accumulated deficit of $390.2 million and $361.0 million, respectively, and working capital of $97.6 million and $129.5 million, respectively. The Company has historically funded its operations primarily through the sale of debt and equity securities, as well as other indebtedness. With the closing of the Company’s initial public offering (“IPO”) in August 2020, the Company’s current cash, cash equivalents and marketable securities are sufficient to fund operations for at least the next 12 months. However, the Company may need to raise additional funds through the issuance of additional debt, equity or both. Until such time, if ever, the Company can generate revenue sufficient to achieve profitability, the Company expects to finance its operations through equity or debt financings, which may not be available to the Company on the timing needed or on terms that the Company deems to be favorable. To the extent that the Company raises additional capital through the sale of equity or convertible debt securities, the ownership interest of its stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect the rights of common stockholders. Debt financing and preferred equity financing, if available, may involve agreements that include covenants limiting or restricting the Company’s ability to take specific actions, such as incurring additional debt, making acquisitions or capital expenditures or declaring dividends. If the Company is unable to maintain sufficient financial resources, its business, financial condition and results of operations will be materially and adversely affected. The Company may be required to delay, limit, reduce or terminate its product discovery and development activities or future commercialization efforts. There can be no assurance that the Company will be able to obtain the needed financing on acceptable terms or at all. Impact of COVID-19 Beginning in early March 2020, the COVID-19 pandemic and the measures imposed to contain this pandemic disrupted and are expected to continue to impact our business. For example, on March 19, 2020, the Executive Department of the State of California issued Executive Order N-33-20, ordering all individuals in the State of California to stay home or at their place of residence except as needed to maintain continuity of operations of the federal critical infrastructure sectors. Our primary operations are located in Carlsbad, California. As a result of such order, the majority of our employees have telecommuted, which may impact certain of our operations over the near term and long term. Moreover, beginning in March 2020, access to hospitals and other customer sites was restricted to essential personnel, which negatively impacted our ability to install our AcQMap consoles and workstations in new accounts and for our sales representatives and mappers to promote the use of our products with physicians. Moreover, hospitals and other therapeutic centers suspended many elective procedures, resulting in a significantly reduced volume of procedures using our products. In addition, all clinical trials in Europe were suspended with follow-ups for clinical trials done via telecom, and we believe enrollment timing in our planned clinical trials will be slowed due to COVID-19 driven delayed access to enrollment sites. As a result of the interruptions to our business due to COVID-19, we enacted a cash conservation program, which included delaying certain non-critical capital expenditures and other projects and implementing a hiring freeze, headcount reductions and temporary compensation reductions (through August 2020). The effects of the pandemic began to decrease in late April 2020 as electrophysiology labs began reopening and procedure volumes began increasing as compared to COVID-19 related low points in March 2020. Our IPO in August 2020 provided resources sufficient to restore compensation reductions to pre-COVID levels, as well as to restart hiring and capital expenditures in support of our growth. The second wave of the COVID-19 pandemic was initially observed negatively impacting electrophysiology procedural activity early during the fourth quarter of 2020 and we are continuing to see hospitals focusing on these patients and slowing elective procedures. During the first quarter of 2021, we saw the suspension of many elective procedures in many hospitals, resulting in reduced volume of procedures using our products. Access restrictions in certain hospitals have slowed our ability to install our AcQMap consoles and workstations in new accounts and for our sales representatives and mappers to promote the use of our products with physicians. The magnitude of the impact of the COVID-19 pandemic on our productivity, results of operations and financial position, and its disruption to our business and our clinical programs and timelines, will depend, in part, on the length and severity of the pandemic, associated restrictions and other measures designed to prevent the spread of COVID-19 and on our ability to conduct business in the ordinary course. Quarantines, shelter-in-place and similar government orders have also impacted, and may continue to impact, our third-party manufacturers and suppliers, and could in turn adversely impact the availability or cost of materials, which could disrupt our supply chain.

Summary of Significant Accounti

Summary of Significant Accounting Policies3 Months Ended
Mar. 31, 2021
Accounting Policies [Abstract]
Summary of Significant Accounting PoliciesNote 2—Summary of Significant Accounting Policies Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period. Principles of Consolidation The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiary Acutus Medical NV (“Acutus NV”), which was incorporated under the laws of Belgium in August 2013. All intercompany balances and transactions have been eliminated in consolidation. Use of Estimates and Assumptions The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, expenses and disclosures of contingent assets and liabilities. The most significant estimates and assumptions in the Company’s condensed consolidated financial statements include, but are not limited to, revenue recognition, useful lives of intangible assets, assessment of impairment of goodwill, provisions for income taxes, measurement of operating lease liabilities, and the fair value of common stock, stock options, warrants, intangible assets, contingent consideration and goodwill. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are not readily apparent from other sources. Actual results could differ from those estimates. Segments Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business in one operating segment. Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of March 31, 2021 and December 31, 2020, exceeded federally insured limits. Restricted cash serves as collateral for the Company’s corporate credit card program. The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total shown on the condensed consolidated statement of cash flows (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Cash and cash equivalents
$
8,631
$
25,234
Restricted cash
150
150
Total cash, cash equivalents and restricted cash
$
8,781
$
25,384
Marketable Securities The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets. Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ equity (deficit) 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 investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2021 and 2020. Concentrations of Credit Risk and Off-Balance Sheet Risk Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions, which, at times may exceed the Federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant. The Company’s marketable securities portfolio consists of investments in commercial paper, U.S. treasury securities, asset-backed securities and short-term high credit quality corporate debt securities. Revenue from Contracts with Customers The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers • 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. The Company usually places its medical diagnostic equipment, AcQMap System, at customer sites under loan agreements and generates revenue from the sale of disposable products used with the AcQMap System. Disposable products include AcQMap Catheters and AcQGuide Steerable Sheaths. 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 also sells the AcQMap System to customers along with software updates on a when-and-if-available basis and equipment service. 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. During the three months ended March 31, 2021, the Company entered into deferred equipment agreements that are generally structured such that the Company agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two to four years. The Company determined that the deferred equipment agreements include embedded sales-type leases. The Company allocates contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and non-lease components at contract inception. The Company expenses the cost of the device at the inception of the agreement and records a financial lease asset equal to the gross consideration allocated to the lease. The lease asset will be reduced by payments for minimum disposable purchases that are allocated to the lease. The Company’s contracts only include fixed consideration. There are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days. The delivery of disposable products are performance obligations satisfied at a point in time. The disposable products are shipped Free on Board (“FOB”) shipping point or FOB destination. For disposable products that are shipped FOB shipping point, the customer has the significant risks and rewards of ownership and legal title to the assets when the disposable products leave the Company’s shipping facilities, thus the customer obtains control and revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination. 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. The Company’s software updates and equipment service performance obligations are satisfied evenly over time as the customer simultaneously receives and consumes the benefits of the Company’s performance for these services throughout the service period. The Company allocates the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company determines SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which includes, but is not limited to, transactions where the specific performance obligations are sold separately, list prices, and offers to customers. The Company’s contracts with customers generally have an expected duration of one year or less, and therefore the Company has elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts are recorded as selling, general and administrative expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of March 31, 2021 and December 31, 2020. In May 2020, the Company entered into bi-lateral distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the “Bi-Lateral Distribution Agreements”). Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non-exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a co-exclusive right to distribute these products in Hong Kong. Each party will pay to the other party specified transfer prices on the sale of the other party’s products and, accordingly, will earn a distribution margin on the sale of the other party’s products. The following table sets forth the Company’s revenue for disposables, systems, and service/other for the three months ended March 31, 2021 and 2020 (in thousands):
Three Month Ended March 31,
2021
2020
(unaudited)
Acutus Direct
Disposables
$
1,783
$
1,017
Systems
613
520
Service/Other
35
10
Total Acutus direct revenue
2,431
1,547
Distribution agreements
1,160
36
Total revenue
$
3,591
$
1,583
The following table provides revenue by geographic location for the three months ended March 31, 2021 and 2020 (in thousands):
Year Ended December 31,
2021
2020
(unaudited)
Acutus Direct
United States
$
1,468
$
770
Europe
963
777
Total Acutus direct revenue
2,431
1,547
Distribution Agreements
United States
113

Europe
1,047
36
Total revenue through distribution
1,160
36
Total revenue
$
3,591
$
1,583
Inventory Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $0.1 million for each of the three months ended March 31, 2021 and 2020. Accounts Receivable Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of March 31, 2021 and December 31, 2020. 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 Intangible Assets Intangible assets consist of acquired developed technology, acquired in-process technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired in-process technology was classified as an indefinite-lived intangible asset, until the receipt of Food and Drug Administration (the “FDA”) approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was classified as a finite-lived intangible and amortization for in-process technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite - 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 amount, the Company is required to perform the quantitative goodwill impairment test. The Company has one reporting unit. For the three months ended March 31, 2021 , the qualitative testing did not indicate any impairment for the carrying amount of goodwill. Impairment of Long-Lived Assets The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three months ended March 31, 2021 and 2020, 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 NV are measured using their functional currency, the Euro, which is the currency of the primary foreign economic environment in which this subsidiary operates. Upon consolidating this entity with the Company, its assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and its 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 this entity’s financial statements are reported in accumulated other comprehensive income (loss) in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive loss. Lessee Leases The Company accounts for its lessee leases under ASC 842, Leases In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election. Cost of Products Sold Cost of products sold includes raw materials, direct labor, manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products. Research and Development The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials. Selling, General and Administrative Selling, general and administrative (“SG&A”) expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs. The Company expenses all SG&A costs as incurred. Fair Value Measurements Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy has been used in determining the inputs used in measuring fair value: Level 1—Quoted prices in active markets for identical assets or liabilities. Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace. Level 3—Unobservable inputs which are supported by little or no market activity and that are financial instruments whose values are determined using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation. Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for three months ended March 31, 2021 and 2020. As of March 31, 2021 and December 31, 2020, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of the instruments. The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt. The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of March 31, 2021 and December 31, 2020 (in thousands):
Fair Value Measured as of March 31, 2021
(unaudited)
Quoted Prices in Active Markets for Identical Assets (Level 1)
Significant Other Observable Inputs (Level 2)
Significant Unobservable Inputs (Level 3)
Fair Value at March 31, 2021
Assets included in:
Cash and cash equivalents
Money market securities
$
7,569
$

$

$
7,569
Marketable securities at fair value
Corporate debt securities

34,359

34,359
U.S. treasury securities

20,354

20,354
Commercial paper

32,175

32,175
Asset-backed securities

11,225

11,225
Total fair value
$
7,569
$
98,113
$

$
105,682
Liabilities included in:
Contingent consideration
$

$

$
5,600
$
5,600
Total fair value
$

$

$
5,600
$
5,600
Fair Value Measured as of December 31, 2020
Quoted Prices in Active Markets for Identical Assets (Level 1)
Significant Other Observable Inputs (Level 2)
Significant Unobservable Inputs (Level 3)
Fair Value at December 31, 2020
Assets included in:
Cash and cash equivalents
Money market securities
$
19,070
$

$

$
19,070
Marketable securities at fair value
Corporate debt securities

31,353

31,353
Asset-backed securities

8,726

8,726
U.S. treasury securities

20,531

20,531
Commercial paper

53,955

53,955
Total fair value
$
19,070
$
114,565
$

$
133,635
Liabilities included in:
Contingent consideration
$

$

$
9,300
$
9,300
Total fair value
$

$

$
9,300
$
9,300
The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets. The Company’s portfolio of marketable securities is comprised of commercial paper, asset-backed securities, U.S. treasury securities and short-term highly liquid, high credit quality corporate debt securities. The fair value for the available-for-sale marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets or liabilities, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments or debt, broker and dealer quotes, as well as other relevant economic measures. The following table presents changes in Level 3 liabilities measured at fair value for the three months ended March 31, 2021 (in thousands):
Contingent Consideration
Balance, December 31, 2020
$
9,300
Payment of contingent consideration
(2,547
)
Change in fair value
(1,153
)
Balance, March 31, 2021 (unaudited)
$
5,600
Unrealized gains and losses associated with liabilities within the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long-dated volatilities) inputs. The fair value of the contingent consideration from the acquisition of Rhythm Xience represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective earn-out period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales or earnings; (iii) risk-free interest rate and (iv) expected volatility of earnings. Estimated payments, as determined through the respective model, were further discounted by a credit spread assumption to account for credit risk. The fair value of the milestones-based contingent consideration was determined by probability weighting and discounting to the respective valuation date at the Company’s cost of debt. The Company’s cost of debt was determined by performing a synthetic credit rating for the Company and selecting yields based on companies with a similar credit rating. The contingent consideration is revalued to fair value each period, and any increase or decrease is recorded in operating loss. The fair value of the contingent consideration may be impacted by certain unobservable inputs, most significantly with regard to discount rates, expected volatility and historical and projected performance. Significant changes to these inputs in isolation could result in a significantly different fair value measurement. The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of March 31, 2021 and December 31, 2020 were as follows:
March 31, 2021
December 31, 2020
(unaudited)
Risk-free interest rate
0.30%
0.20%
Expected term in years
1.0 - 2.0
1.0 - 2.0
Expected volatility
20.6%
17.2%
Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock awards (“RSAs”), restricted stock units (“RSUs”) and restricted stock units with non-market performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs, RSUs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSAs and RSUs over the requisite service period. As the PSUs have a performance condition, compensation expense was recognized for each vesting tranche over the respective requisite service period of each tranche upon the registration statement used in connection with the Company’s IPO being declared effective on August 5, 2020, when the Company’s management deemed it probable that the performance conditions were satisfied. The Company recognized a cumulative true-up adjustment related to PSUs once the conditions became probable of being satisfied as the related service period had been completed in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive loss based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See “Note 16—Stock-Based Compensation” below. Income Taxes Income taxes are recorded in accordance with ASC 740, Income Taxes 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 will 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 accounted for certain common stock warrants and convertible preferred stock warrants outstanding as a liability, in accordance with ASC 815, Derivatives and Hedging Business Combinations The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805, which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in the acquisition. Goodwill represents the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Subsequent adjustments to fair value of any contingent consideration are recorded to the Company’s condensed consolidated statements of operations and comprehensive loss. Recently Adopted Accounting Pronouncements In December 2019, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes The Company adopted this guidance in the first quarter of 2021, which did not have a material impact on its condensed consolidated financial statements. Accounting Pronouncements to Be Adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326) In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting

Asset Acquisition and Business

Asset Acquisition and Business Combination3 Months Ended
Mar. 31, 2021
Business Combination Recognized Identifiable Assets Acquired Goodwill And Liabilities Assumed Net [Abstract]
Asset Acquisition and Business CombinationNote 3—Asset Acquisition and Business Combination Biotronik Asset Acquisition In July 2019, the Company entered into a License and Distribution Agreement with the Biotronik and VascoMed GmbH (the “Biotronik Parties”) to obtain certain licenses to the Biotronik Parties’ patents, whereby the Company acquired certain manufacturing equipment and obtained from the Biotronik Parties a license under certain patents and technology to develop, commercialize, distribute and manufacture the AcQBlate Force ablation catheters and Qubic Force device. In exchange for the rights granted to the Company, the Company made cash payments totaling $10.0 million during the year ended December 31, 2019, and issued 273,070 shares of Series D convertible preferred stock for $5.0 million during the three months ended March 31, 2020. The implied value of $5.0 million was recorded as an accrued liability as of December 31, 2019. In accordance with ASC 805, the Biotronik Asset Acquisition was accounted for as an asset acquisition as substantially all of the $15.0 million value transferred to Biotronik was allocated to intellectual property. On the acquisition date, the products licensed had not yet received regulatory approval and the intellectual property did not have an alternative use. Accordingly, the $15.0 million paid to Biotronik was immediately charged to research and development expense—licensed acquired in the condensed consolidated statement of operations and comprehensive loss in July 2019. Additional contingent milestone payments of up to $10.0 million, of which $2.0 million has been paid as of March 31, 2021, are to be made to the Biotronik Parties contingent upon certain regulatory approvals and first commercial sale. In further consideration of the rights granted, beginning with the Company’s first commercial sale of the first force sensing ablation catheter within the licensed product line, the Company will also make per unit royalty payments. The Company determined that the remaining $8.0 million contingent milestone and royalty payments are not probable and estimable and therefore have not been recorded as a liability as of March 31, 2021 and December 31, 2020. Upon regulatory approval in December 2020 of the Company’s force sensing ablation catheter in Europe, the $2.0 million milestone was capitalized and is being amortized, and the royalty payments are recorded as cost of products sold as sales of catheters are recognized. Rhythm Xience Business Combination On June 18, 2019 (the “Acquisition Date”), the Company acquired an integrated family of transseptal crossing and steerable introducer systems through its acquisition of Rhythm Xience for $3.0 million in cash in exchange for all of the stock of Rhythm Xience (the “Rhythm Xience Acquisition”). The cash payment did not include the potential $17.0 million in earn out consideration, of which $2.2 million was paid with the issuance of Series D convertible preferred stock in February 2020 and the remainder is to be paid based on the achievement of certain regulatory milestones and revenue milestones. In accordance with ASC 805, the Rhythm Xience Acquisition was accounted for as a business combination. As part of the Rhythm Xience Acquisition, the Company recorded a contingent consideration liability for potential additional payments due to the sellers of Rhythm Xience if certain regulatory approval milestones and revenue milestones are achieved. The initial contingent consideration liability of $13.4 million was based on the fair value of the contingent consideration liability at the acquisition date. During the year ended December 31, 2020, the Company issued 119,993 shares of Series D convertible preferred stock and paid $2.5 million of the contingent consideration for the achievement of certain regulatory and revenue milestones. During the three months ended March 31, 2021, the Company paid an additional $2.5 million of the contingent consideration for the achievement of certain regulatory and revenue milestones. Additionally, the Company recorded a $1.2 million decrease and a $2.2 million decrease to the fair value of the contingent consideration liability for the three months ended March 31, 2021 and 2020, respectively, which is included in change in fair value of contingent consideration in the condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2021 and 2020, respectively. As of March 31, 2021, the contingent consideration liability of $5.6 million is the fair value of the remaining payments due to the sellers of Rhythm Xience if certain additional regulatory approval milestones and revenue milestones are achieved. For the three months ended March 31, 2021 and 2020, no acquisition costs were incurred or recorded.

Marketable Securities

Marketable Securities3 Months Ended
Mar. 31, 2021
Investments Debt And Equity Securities [Abstract]
Marketable SecuritiesNote 4—Marketable Securities Marketable securities consisted of the following as of March 31, 2021 and December 31, 2020 (in thousands):
March 31, 2021 (unaudited)
Amortized Cost
Gross Unrealized Gains
Gross Unrealized Losses
Fair Value
Available-for-sale securities - short-term:
Corporate debt securities
$
34,366
$

$
(7
)
$
34,359
U.S. treasury securities
20,350
4

20,354
Commercial paper
32,175


32,175
Total available-for-sale securities - short-term
86,891
4
(7
)
86,888
Asset-backed securities, long-term
11,224
1

11,225
Total available-for-sale securities
$
98,115
$
5
$
(7
)
$
98,113
December 31, 2020
Amortized Cost
Gross Unrealized Gains
Gross Unrealized Losses
Fair Value
Available-for-sale securities - short-term:
Corporate debt securities
$
31,359
$

$
(6
)
$
31,353
U.S. treasury securities
20,533

(2
)
20,531
Commercial paper
53,955


53,955
Total available-for-sale securities - short-term
105,847

(8
)
105,839
Asset-backed securities, long-term
8,726


8,726
Total available-for-sale securities
$
114,573
$

$
(8
)
$
114,565
As of March 31, 2021, the Company’s available-for-sale securities classified as short-term of $86.9 million mature in one year or less and the available-for-sale securities classified as long-term of $11.2 million mature within two years. As of December 31, 2020, the Company’s available-for-sale securities classified as short-term of $105.8 million mature in one year or less and the available-for-sale securities classified as long-term of $8.7 million mature within two years.

Inventory

Inventory3 Months Ended
Mar. 31, 2021
Inventory Disclosure [Abstract]
InventoryNote 5—Inventory Inventory as of March 31, 2021 and December 31, 2020 consisted of the following (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Raw materials
$
7,114
$
7,960
Work in process
2,362
1,267
Finished goods
4,361
3,731
Total inventory
$
13,837
$
12,958

Lessor Sales-Type Leases

Lessor Sales-Type Leases3 Months Ended
Mar. 31, 2021
Leases [Abstract]
Lessor Sales-Type LeasesNote 6—Lessor Sales-Type Leases The Company recognizes revenue and costs, as well as a lease receivable, at the time embedded sales-type leases within its deferred equipment agreements commence. Lease revenue related to sales-type leases for the three months ended March 31, 2021 was $0.9 million and is included within revenue in the accompanying condensed consolidated statements of operations and comprehensive loss. There was no lease revenue for the three months ended March 31, 2020. Costs related to embedded leases within the Company’s deferred equipment agreements are included in cost of products sold in the accompanying condensed consolidated statements of operations and comprehensive loss. The Company has a short-term lease receivable of $0.4 million included in prepaid expenses and other current assets as of each of March 31, 2021 and December 31, 2020. The Company has a long-term lease receivable of $0.5 million and $0.4 million included in other assets, as of March 31, 2021 and December 31, 2020, respectively. As of March 31, 2021, estimated future maturities of sales-type lease receivables for each of the following years are as follows (in thousands):
Nine months ending December 31, 2021
$
304
Year ending December 31, 2022
378
Year ending December 31, 2023
149
Year ending December 31, 2024
72
Year ending December 31, 2025
22
Lease receivable
$
925

Property and Equipment, Net

Property and Equipment, Net3 Months Ended
Mar. 31, 2021
Property Plant And Equipment [Abstract]
Property and Equipment, NetNote 7—Property and Equipment, Net The Company’s property and equipment, net, consisted of the following as of March 31, 2021 and December 31, 2020 (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Medical diagnostic equipment
$
15,360
$
13,242
Furniture and fixtures
426
388
Office equipment
1,494
1,392
Laboratory equipment and software
3,699
3,491
Leasehold improvements
661
608
Construction in process
1,468
468
Total property and equipment
23,108
19,589
Less: accumulated depreciation
(8,460
)
(7,233
)
Property and equipment, net
$
14,648
$
12,356
Property and equipment includes certain medical diagnostic equipment, including AcQMap Systems, located at customer premises. The Company retains the ownership of the equipment and has the right to remove the equipment if it is not being used according to expectations. Depreciation expense was $1.2 million and $0.4 million for the three months ended March 31, 2021 and 2020, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets3 Months Ended
Mar. 31, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible AssetsNote 8—Goodwill and Intangible Assets The table below summarizes goodwill and intangible assets activities as of March 31, 2021 and December 31, 2020 (in thousands):
Goodwill
Intangible Assets
Balance, December 31, 2020
$
12,026
$
5,653
Amortization expense

(160
)
Balance, March 31, 2021 (unaudited)
$
12,026
$
5,493
Estimated Useful
Weighted Average Remaining
Life (in years)
Life (in years)
Intangible Assets
Accumulated Amortization
March 31, 2021
(unaudited)
Developed technology
10
8.3
$
4,200
$
(705
)
$
3,495
Customer-related intangible
5
3.3
100
(35
)
65
Licensed intangibles
10
9.7
2,000
(67
)
1,933
Total
$
6,300
$
(807
)
$
5,493
Estimated Useful
Weighted Average Remaining
Life (in years)
Life (in years)
Intangible Assets
Accumulated Amortization
December 31, 2020
Developed technology
10
8.6
$
4,200
$
(600
)
$
3,600
Customer-related intangible
5
3.5
100
(30
)
70
Licensed intangibles
10
9.9
2,000
(17
)
1,983
Total
$
6,300
$
(647
)
$
5,653
Acquired in-process technology was classified as an indefinite-lived intangible asset until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was reclassified as developed technology and amortization began. The Company recorded amortization expense related to the above intangible assets of $0.2 million and $0.1 million for the three months ended March 31, 2021 and 2020, respectively. The following table shows the remaining amortization expense associated with amortizable intangible assets as of March 31, 2021 (in thousands):
Developed Technology
Customer- Related Intangible
Licensed Intangibles
Total Amortization
Nine months ending December 31, 2021
$
315
$
15
$
150
$
480
Year ending December 31, 2022
420
20
200
640
Year ending December 31, 2023
420
20
200
640
Year ending December 31, 2024
420
10
200
630
Year ending December 31, 2025
420

200
620
Thereafter
1,500

983
2,483
Total
$
3,495
$
65
$
1,933
$
5,493

Accrued Liabilities

Accrued Liabilities3 Months Ended
Mar. 31, 2021
Payables And Accruals [Abstract]
Accrued LiabilitiesNote 9—Accrued Liabilities Accrued liabilities consisted of the following as of March 31, 2021 and December 31, 2020 (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Compensation and related expenses
$
6,957
$
6,250
Professional fees
304
120
Deferred revenue
479
301
Sales and use tax
206
169
Other
862
468
Total accrued liabilities
$
8,808
$
7,308

Debt

Debt3 Months Ended
Mar. 31, 2021
Debt Disclosure [Abstract]
DebtNote 10—Debt Outstanding debt as of March 31, 2021 and December 31, 2020 consisted of the following (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
2019 Credit Agreement (1)
$
44,550
$
44,550
Total debt, gross
44,550
44,550
Less: Unamortized debt discount and fees
(5,211
)
(5,539
)
Total long-term debt
$
39,339
$
39,011
(1) 2019 Credit Agreement On May 20, 2019, the Company entered into a Credit Agreement (the “2019 Credit Agreement”). The 2019 Credit Agreement provided the Company with a senior term loan facility in aggregate principal amount of $70.0 million, of which the Company borrowed $40.0 million upon closing. Of the remaining $30.0 million, none is available for borrowing. The 2019 Credit Agreement bears interest per annum at 7.75% plus LIBOR for such interest period and the principal amount of term loans outstanding under the 2019 Credit Agreement is due on May 20, 2024. The 2019 Credit Agreement provides for final payment fees of an additional $4.6 million that are due upon prepayment or on the maturity date or upon acceleration. Upon the occurrence and during an event of default, which includes but is not limited to payment default, covenant default or the occurrence of a material adverse change, the lenders may declare all outstanding principal and accrued and unpaid interest immediately due and payable, all unfunded commitments would be terminated, there would be an increase in the applicable interest rate by 10% per annum, and the lenders would be entitled to exercise their other rights and remedies provided for under the 2019 Credit Agreement. Additionally, the lenders may request repayment of a portion of obligations outstanding under the 2019 Credit Agreement to the extent of the Company’s receipt of any (i) net casualty proceeds or (ii) net asset sales proceeds, as defined. These acceleration and early payment features are an embedded derivative that is separately measured from the loan host instrument and classified with the loan host instrument. In connection with the issuance of the 2019 Credit Agreement, the Company issued liability-classified warrants with a fair value of $0.9 million to purchase 419,992 shares of Series C convertible preferred stock at $16.67 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at $16.67 per share and then were automatically converted into warrants to purchase an equal number of shares of common stock at $16.67 per share. The initial recognition of the warrant liability and direct fees of $1.2 million and final payment fees of $4.6 million for the 2019 Credit Agreement resulted in a discount of $6.7 million, which is being amortized to interest expense over the term of the 2019 Credit Agreement using the effective interest method. The Company’s obligations under the 2019 Credit Agreement are secured by substantially all of its assets, including its intellectual property, and is guaranteed by Acutus NV. The 2019 Credit Agreement contains customary affirmative and negative covenants, including with respect to the Company’s ability to enter into fundamental transactions, incur additional indebtedness, grant liens, pay any dividend or make any distributions to its holders, make investments and merge or consolidate with any other person or engage in transactions with its affiliates, but does not include any financial covenants, other than a minimum liquidity requirement. As of and for the three months ended March 31, 2021 and the year ended December 31, 2020, the Company was in compliance with all such covenants.

Operating Leases

Operating Leases3 Months Ended
Mar. 31, 2021
Leases [Abstract]
Operating LeasesNote 11—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 noncancelable operating lease that expires on December 31, 2022. The lease is subject to variable charges for common area maintenance and other costs that are determined annually based on actual costs. The base rent is subject to an annual increase each year. The Company has a renewal option for an additional five-year term upon the expiration date of the lease, which has been excluded from the calculation of the right-of-use asset as it is not reasonably certain to be exercised. The Company also leases approximately 3,900 square feet of office space in Zaventem, Belgium under a noncancelable operating lease that expires on December 31, 2021. The lease is subject to variable charges that are determined annually for common area maintenance and other costs based on actual costs, and base rent is subject to an annual increase each year based on an index rate. The Company has a renewal option for an additional three-year term upon the expiration date of the lease, which has been included in the calculation of the right-of-use asset as it is reasonably certain to be exercised. The following table summarizes quantitative information about the Company’s operating leases for the three months ended March 31, 2021 and 2020 (dollars in thousands):
Three Months Ended March 31,
Three Months Ended March 31,
2021
2020
(unaudited)
Operating cash flows from operating leases
$
261
$
253
Right-of-use assets exchanged for operating lease liabilities
$
-
$
-
Weighted average remaining lease term – operating leases (in years)
1.4
1.9
Weighted average discount rate – operating leases
7.0
%
7.0
%
Three Months Ended March 31,
Three Months Ended March 31,
2021
2020
(unaudited)
Operating leases
Operating lease cost
$
216
$
216
Variable lease cost
83
73
Total rent expense
$
299
$
289
As of March 31, 2021, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):
Nine months ending December 31, 2021
$
791
Year ending December 31, 2022
1,074
Year ending December 31, 2023
51
Year ending December 31, 2024
51
Year ending December 31, 2025

Total
1,967
Less: present value discount
(136
)
Operating lease liabilities
$
1,831

Commitments and Contingencies

Commitments and Contingencies3 Months Ended
Mar. 31, 2021
Commitments And Contingencies Disclosure [Abstract]
Commitments and ContingenciesNote 12—Commitments and Contingencies The Company is not a party to any material legal proceedings and is not aware of any pending or threatened claims. From time to time however, the Company may be subject to various legal proceedings and claims that arise in the ordinary course of its business activities.

Warrants

Warrants3 Months Ended
Mar. 31, 2021
Warrants And Rights Note Disclosure [Abstract]
WarrantsNote 13—Warrants As of March 31, 2021 and December 31, 2020, the outstanding warrants to purchase the Company’s common stock were comprised of the following:
Equity Upon
Exercise
March 31,
December 31,
(After Conversion)
Exercise Price
Expiration Date
2021
2020
(unaudited)
Warrants issued in 2015
Common stock
$
5.25
1/30/25
3,808
3,808
Warrants issued with 2018 Convertible Notes
Common stock
$
0.10
6/7/28
373,810
373,810
Warrants issued with 2018 Term Loan
Common stock
$
16.67
7/31/28
26,998
26,998
Warrants issued with 2019 Credit Agreement
Common stock
$
16.67
5/20/29
419,992
419,992
Total Warrants
824,608
824,608
The Company had no warrant activity for the three months ended March 31, 2021. The remaining weighted average contractual life is 7.2 years as of March 31, 2021. Warrants Classified as Liabilities The Company’s warrants provide the holder the option to purchase a specified number of shares for a specified price. The holder may exercise the warrant in cash or exercise pursuant to a cashless exercise whereby a calculated number of shares are withheld upon exercise to satisfy the exercise price. The warrants do not provide the holder any voting rights until the warrants are exercised. Prior to the IPO, in accordance with ASC 815, other than the warrants issued in 2015, the warrants were recorded as liabilities at fair value at the issuance date. Changes in the fair value were recognized in change in fair value of warrant liability in the condensed consolidated statements of operations and comprehensive loss at the end of each reporting period. On August 10, 2020, in connection with the closing of the IPO, the warrants recorded as liabilities no longer met the definition of a derivative. Accordingly, the fair value of the common and preferred stock warrant liability of $14.5 million was reclassified to stockholders’ equity (deficit) in the condensed consolidated balance sheet. Warrants Classified as Equity In accordance with ASC 815, the warrants issued in 2015 do not meet the definition of a derivative and are classified in stockholders’ equity (deficit) in the condensed consolidated balance sheets.

Convertible Preferred Stock

Convertible Preferred Stock3 Months Ended
Mar. 31, 2021
Temporary Equity [Abstract]
Convertible Preferred StockNote 14—Convertible Preferred Stock In February 2020, the Company issued 119,993 shares of its Series D convertible preferred stock with an implied value of $2.2 million in connection with a contingent consideration payment related to the Rhythm Xience Acquisition. In February 2020, the Company issued 273,070 shares of its Series D convertible preferred stock with an implied value of $5.0 million for the stock issuance portion of the purchase consideration of the Biotronik Asset Acquisition. On August 10, 2020, in connection with the closing of the IPO, all of the 391,210 shares of Series A, 3,088,444 shares of Series B, 4,499,921 shares of Series C and 8,593,360 shares of Series D convertible preferred stock, respectively, automatically converted into an equal number of shares of common stock. Redemption The convertible preferred stock was not unconditionally redeemable at the option of the holder thereof. However, the convertible preferred stock was contingently redeemable upon certain liquidation events. As redemption by the holders was not solely within the control of the Company, all of the outstanding convertible preferred stock was classified as temporary equity in the condensed consolidated balance sheets, prior to the conversion to common stock on August 10, 2020. Dividends The holders of shares of convertible preferred stock were entitled to receive dividends, out of any assets legally available therefore, prior and in preference to any declaration or payment of any dividend on the common stock of the Company, at the applicable dividend rate, payable on a pro rata pari passu Liquidation The holders of the Series D convertible preferred stock were entitled to receive a liquidation preference prior to any distribution to the holders of Series A convertible preferred stock, Series B convertible preferred stock and Series C convertible preferred stock (collectively the “Junior Preferred Stock”) and the holders of common stock, in the amount of the original issue price plus declared but unpaid dividends on such shares (the “Series D Liquidation Preference”). The holders of the Junior Preferred Stock were entitled to receive a liquidation preference prior to any distribution to the holders of common stock, after payment of the Series D Liquidation Preference, in the amount of the applicable original issue price plus declared but unpaid dividends on such shares. Voting Rights Holders of convertible preferred stock had the right to one vote for each share of common stock into which such preferred stock could then be converted, and with respect to such vote, such holder had full voting rights and powers equal to the voting rights and powers of the holders of common stock. As long as any shares of Series D convertible preferred stock were outstanding, the holders of such shares of Series D convertible preferred stock (voting exclusively as a separate series) were entitled to elect one director. As long as any shares of Series C convertible preferred stock were outstanding, the holders of such shares of Series C convertible preferred stock (voting exclusively as a separate series) were entitled to elect three directors. As long as any shares of Series A convertible preferred stock or Series B convertible preferred stock were outstanding, the holders of such shares (voting together as a single class and not as separate series, and on an as converted basis) were entitled to elect four directors. The holders of outstanding common stock were entitled to elect one director. The holders of convertible preferred stock and common stock (voting together as a single class and not as separate series, and on an as-converted basis) were entitled to elect any remaining directors. Conversion Each share of preferred stock was convertible, at the option of the holder thereof, at any time after the date of issuance of such share, into such number of fully paid and nonassessable shares of the Company’s common stock as was determined by dividing the original issue price, as adjusted, for such series by the applicable conversion price for such series in effect on the date the certificate is surrendered for conversion. The initial conversion price per share for each series of convertible preferred stock was the original issue price applicable to such series as follows:
Series
Conversion Price
Series A convertible preferred stock
$
8.295
Series B convertible preferred stock
$
13.370
Series C convertible preferred stock
$
16.667
Series D convertible preferred stock
$
16.667
Each share of convertible preferred stock was automatically convertible into fully-paid, non-assessable shares of common stock at the conversion rate at the time in effect for such series of preferred stock immediately upon: (i) the date, or the occurrence of an event, specified by vote or written consent or agreement of the requisite investors; or (ii) the closing of the sale of shares of common stock to the public, at a price of at least $50.00 per share, as adjusted, in a firm-commitment underwritten public offering pursuant to an effective registration statement under the Securities Act of 1933, as amended, resulting in at least $50.0 million of net proceeds to the Company. As noted above, on August 10, 2020, all shares of Series A, Series B, Series C and Series D convertible preferred stock were converted into common stock.

Stockholders Equity

Stockholders Equity3 Months Ended
Mar. 31, 2021
Equity [Abstract]
Stockholders EquityNote 15—Stockholders’ Equity On August 10, 2020, the Company issued 10,147,058 shares of common stock in its IPO, which included 1,323,529 shares of common stock issued upon the underwriters’ exercise in full of an option to purchase, at the public offering price less underwriting discounts and commissions, up to an additional 1,323,529 shares. The price to the public for each share was $18.00. The Company received gross proceeds of $182.6 million from the IPO. Net of underwriting discounts and commission and other offering expenses, the Company received net proceeds of $166.3 million from the IPO. On August 10, 2020, in connection with the closing of the IPO, the Company filed an amended and restated certificate of incorporation (the “A&R Certificate”) with the Secretary of State of the State of Delaware. The A&R Certificate amended and restated the Company’s authorized shares of common stock to 260,000,000 and authorized shares of undesignated preferred stock to 5,000,000. During the three months ended March 31, 2021, stock options to acquire 27,509 shares were exercised for shares of common stock. The Company received $0.2 million for the exercise price of the stock options for the three months ended March 31, 2021. No stock options were exercised for shares of common stock during the three months ended March 31, 2020.

Stock-Based Compensation

Stock-Based Compensation3 Months Ended
Mar. 31, 2021
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based CompensationNote 16—Stock-Based Compensation 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 March 31, 2021, 3,313,017 shares of common stock were authorized for issuance under the 2020 Plan and 2,132,646 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 March 31, 2021, 2,636,188 shares of common stock were authorized for issuance under the 2011 Plan and no shares remain available for issuance under the 2011 Plan. No additional awards will be granted under the 2011 Plan. Shares that become available for issuance from the outstanding awards under the 2011 Plan due to forfeiture, or otherwise, will become available for issuance of future awards under the 2020 Plan. Stock Options The stock options generally vest over four years and have a ten-year The following assumptions were used to estimate the fair value of stock option for the three months ended March 31, 2021 and 2020:
Three Months Ended March 31,
2021
2020
(unaudited)
Risk-free interest rate
0.76% - 1.28%
0.90%
Expected dividend yield


Expected term in years
7.0
7.0
Expected volatility
60% - 75%
70%
The following table summarizes stock option activity during the three months ended March 31, 2021:
Stock Options
Weighted Average Exercise Price
Weighted Average Remaining Contractual Life (in years)
Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2020
3,403,607
$
13.32
8.1
$
52,866
Options granted
32,749
23.02
Options exercised
(27,509
)
6.15
$
323
Options forfeited
(29,272
)
17.03
Outstanding as of March 31, 2021
3,379,575
$
13.45
7.9
$
6,252
Options vested and exercisable as of March 31, 2021 (unaudited)
1,564,993
$
10.19
6.6
$
5,672
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 stock on the last day of the fiscal period, which was $13.37 and $28.81 as of March 31, 2021 and December 31, 2020, 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 three months ended March 31, 2021 was $13.89. Performance-Based Restricted Stock Units and Restricted Stock Units In June 2019, the Company granted 567,509 PSUs, with a grant date fair value of $13.37. Vesting of the PSUs was dependent upon the satisfaction of both a service condition and a performance condition, which is an IPO or a change of control. The Company began recording compensation expense related to the PSUs upon the registration statement used in connection with the Company’s IPO being declared effective on August 5, 2020, as the performance conditions were satisfied. The compensation expense was determined using the original grant date fair value and is being recognized over the remaining service period. The Company’s PSU and RSU activity for the three months ended March 31, 2021 was as follows:
Number of Shares
Weighted Average Grant Price
Unvested as of December 31, 2020
545,466
$
16.53
Granted
23,375
23.88
Forfeited
(8,011
)
18.39
Vested
(94,045
)
13.37
Unvested as of March 31, 2021 (unaudited)
466,785
$
17.50
Restricted Stock The Company’s RSA activity for the three months ended March 31, 2021 was as follows:
Number of Shares
Weighted Average Grant Price
Unvested as of December 31, 2020
-
$
-
Granted
186
14.75
Vested
(186
)
14.75
Unvested as of March 31, 2021 (unaudited)
-
$
-
The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2021 and 2020 (in thousands):
Three Months Ended March 31,
2021
2020
(unaudited)
Cost of products sold
$
144
$
108
Research and development
417
211
Selling, general and administrative
2,268
1,422
Total stock-based compensation
$
2,829
$
1,741
Employee Stock Purchase Plan The 2020 Employee Stock Purchase Plan (the “2020 ESPP”), which permits employees to purchase shares of the Company’s common stock, became effective on August 10, 2020 and 387,063 shares of common stock were authorized for sale under the 2020 ESPP. The 2020 ESPP will be implemented by consecutive offering periods with a new offering period commencing on the first trading day on or after February 1 and August 1 of each year and terminating on the last trading day on or before July 31 and January 31 respectively. The first offering period began on February 1, 2021. On each purchase date, which falls on the last date of each offering period, 2020 ESPP participants will purchase shares of common stock at a price per share equal to 85% of the lesser of (1) the fair market value per share of the common stock on the offering date or (2) the fair market value of the common stock on the purchase date. The occurrence and duration of offering periods under the 2020 ESPP are subject to the determinations of the Compensation Committee of the Company’s Board of Directors, in its sole discretion. The fair value of the 2020 ESPP shares is estimated using the Black-Scholes option pricing model. The Company recorded $0.1 million of stock-based compensation expense related to the 2020 ESPP for the three months ended March 31, 2021. No expense was recorded for the three months ended March 31, 2020.

Net Loss Per Common Share

Net Loss Per Common Share3 Months Ended
Mar. 31, 2021
Earnings Per Share [Abstract]
Net Loss Per Common ShareNote 17—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 excludes the potential impact of the Company’s convertible preferred stock, common stock options and warrants because their effect would be anti-dilutive due to the Company’s net loss. Since the Company had a net loss in the periods presented, basic and diluted net loss per common share are the same. The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:
Three Months Ended March 31,
Shares issuable upon:
2021
2020
(unaudited)
Conversion of Series A preferred stock

391,210
Conversion of Series B preferred stock

3,088,444
Conversion of Series C preferred stock

4,499,921
Conversion of Series D preferred stock

8,593,360
Exercise of stock options
3,379,575
2,746,088
Exercise of common stock warrants
824,608
509,562
Exercise of preferred stock warrants

446,990
Vesting of PSUs and RSUs
466,785

Total
4,670,968
20,275,575

401(k) Retirement Plan

401(k) Retirement Plan3 Months Ended
Mar. 31, 2021
Compensation And Retirement Disclosure [Abstract]
401(k) Retirement PlanNote 18—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 did not provide any contributions to the 401(k) retirement savings plan for the three months ended March 31, 2021 and 2020.

Related Party Transactions

Related Party Transactions3 Months Ended
Mar. 31, 2021
Related Party Transactions [Abstract]
Related Party TransactionsNote 19—Related Party Transactions The Company licenses certain patent rights from a former director and shareholder. The license agreement provides for royalty payments to the shareholder of 3% of net product sales, as defined in the agreement. Royalties earned prior to the director’s resignation were less than $0.1 million for the three months ended March 31, 2020. Additionally, the former director and shareholder also works for one of the Company’s customers and can significantly influence the customer to purchase the Company’s product. Prior to the director’s resignation, the Company recorded sales to this customer of $0.3 million for the three months ended March 31 , The Company has a consulting agreement with a director and chairman of the Company’s board of directors. The Company recorded less than $0.1 million in SG&A expense in the condensed consolidated statements of operations and comprehensive loss for the consulting services for each of the three months ended March 31, 2021 and 2020. Multiple preferred stock shareholders entered into the 2018 and 2019 Convertible Notes that also contained detached warrants. Additionally, Orbimed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P. entered into the 2019 Credit Agreement with the Company in 2019 for a total of $70.0 million, with $40.0 million being drawn as of March 31, 2021 and December 31, 2020. The Company recorded $1.4 million and $1.3 million for the three months ended March 31, 2021 and 2020, respectively, in interest expense related to these debt agreements.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)3 Months Ended
Mar. 31, 2021
Accounting Policies [Abstract]
Basis of PresentationBasis of Presentation The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.
Principles of ConsolidationPrinciples of Consolidation The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiary Acutus Medical NV (“Acutus NV”), which was incorporated under the laws of Belgium in August 2013. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates and AssumptionsUse of Estimates and Assumptions The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, expenses and disclosures of contingent assets and liabilities. The most significant estimates and assumptions in the Company’s condensed consolidated financial statements include, but are not limited to, revenue recognition, useful lives of intangible assets, assessment of impairment of goodwill, provisions for income taxes, measurement of operating lease liabilities, and the fair value of common stock, stock options, warrants, intangible assets, contingent consideration and goodwill. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are not readily apparent from other sources. Actual results could differ from those estimates.
SegmentsSegments 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 in one operating segment.
Cash and Cash Equivalents and Restricted CashCash 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 March 31, 2021 and December 31, 2020, exceeded federally insured limits. Restricted cash serves as collateral for the Company’s corporate credit card program. The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total shown on the condensed consolidated statement of cash flows (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Cash and cash equivalents
$
8,631
$
25,234
Restricted cash
150
150
Total cash, cash equivalents and restricted cash
$
8,781
$
25,384
Marketable SecuritiesMarketable Securities The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets. Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ equity (deficit) 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 investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2021 and 2020.
Concentrations of Credit Risk and Off-Balance Sheet RiskConcentrations of Credit Risk and Off-Balance Sheet Risk Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions, which, at times may exceed the Federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant. The Company’s marketable securities portfolio consists of investments in commercial paper, U.S. treasury securities, asset-backed securities and short-term high credit quality corporate debt securities.
Revenue from Contracts with CustomersRevenue from Contracts with Customers The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers • 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. The Company usually places its medical diagnostic equipment, AcQMap System, at customer sites under loan agreements and generates revenue from the sale of disposable products used with the AcQMap System. Disposable products include AcQMap Catheters and AcQGuide Steerable Sheaths. 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 also sells the AcQMap System to customers along with software updates on a when-and-if-available basis and equipment service. 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. During the three months ended March 31, 2021, the Company entered into deferred equipment agreements that are generally structured such that the Company agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two to four years. The Company determined that the deferred equipment agreements include embedded sales-type leases. The Company allocates contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and non-lease components at contract inception. The Company expenses the cost of the device at the inception of the agreement and records a financial lease asset equal to the gross consideration allocated to the lease. The lease asset will be reduced by payments for minimum disposable purchases that are allocated to the lease. The Company’s contracts only include fixed consideration. There are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days. The delivery of disposable products are performance obligations satisfied at a point in time. The disposable products are shipped Free on Board (“FOB”) shipping point or FOB destination. For disposable products that are shipped FOB shipping point, the customer has the significant risks and rewards of ownership and legal title to the assets when the disposable products leave the Company’s shipping facilities, thus the customer obtains control and revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination. 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. The Company’s software updates and equipment service performance obligations are satisfied evenly over time as the customer simultaneously receives and consumes the benefits of the Company’s performance for these services throughout the service period. The Company allocates the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company determines SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which includes, but is not limited to, transactions where the specific performance obligations are sold separately, list prices, and offers to customers. The Company’s contracts with customers generally have an expected duration of one year or less, and therefore the Company has elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts are recorded as selling, general and administrative expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of March 31, 2021 and December 31, 2020. In May 2020, the Company entered into bi-lateral distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the “Bi-Lateral Distribution Agreements”). Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non-exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a co-exclusive right to distribute these products in Hong Kong. Each party will pay to the other party specified transfer prices on the sale of the other party’s products and, accordingly, will earn a distribution margin on the sale of the other party’s products. The following table sets forth the Company’s revenue for disposables, systems, and service/other for the three months ended March 31, 2021 and 2020 (in thousands):
Three Month Ended March 31,
2021
2020
(unaudited)
Acutus Direct
Disposables
$
1,783
$
1,017
Systems
613
520
Service/Other
35
10
Total Acutus direct revenue
2,431
1,547
Distribution agreements
1,160
36
Total revenue
$
3,591
$
1,583
The following table provides revenue by geographic location for the three months ended March 31, 2021 and 2020 (in thousands):
Year Ended December 31,
2021
2020
(unaudited)
Acutus Direct
United States
$
1,468
$
770
Europe
963
777
Total Acutus direct revenue
2,431
1,547
Distribution Agreements
United States
113

Europe
1,047
36
Total revenue through distribution
1,160
36
Total revenue
$
3,591
$
1,583
InventoryInventory Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $0.1 million for each of the three months ended March 31, 2021 and 2020.
Accounts ReceivableAccounts Receivable Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of March 31, 2021 and December 31, 2020.
Property and Equipment, NetProperty 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
Intangible AssetsIntangible Assets Intangible assets consist of acquired developed technology, acquired in-process technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired in-process technology was classified as an indefinite-lived intangible asset, until the receipt of Food and Drug Administration (the “FDA”) approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was classified as a finite-lived intangible and amortization for in-process technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite -
GoodwillGoodwill 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 amount, the Company is required to perform the quantitative goodwill impairment test. The Company has one reporting unit. For the three months ended March 31, 2021 , the qualitative testing did not indicate any impairment for the carrying amount of goodwill.
Impairment of Long-Lived AssetsImpairment of Long-Lived Assets The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three months ended March 31, 2021 and 2020, the Company determined that there was no impairment of property and equipment or intangible assets.
Foreign Currency Translation and TransactionsForeign Currency Translation and Transactions The assets, liabilities and results of operations of Acutus NV are measured using their functional currency, the Euro, which is the currency of the primary foreign economic environment in which this subsidiary operates. Upon consolidating this entity with the Company, its assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and its 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 this entity’s financial statements are reported in accumulated other comprehensive income (loss) in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive loss.
Lessee LeasesLessee Leases The Company accounts for its lessee leases under ASC 842, Leases In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election.
Cost of Products SoldCost 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 DevelopmentResearch and Development The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. 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 AdministrativeSelling, General and Administrative Selling, general and administrative (“SG&A”) expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs. The Company expenses all SG&A costs as incurred.
Fair Value MeasurementsFair Value Measurements Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy has been used in determining the inputs used in measuring fair value: Level 1—Quoted prices in active markets for identical assets or liabilities. Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace. Level 3—Unobservable inputs which are supported by little or no market activity and that are financial instruments whose values are determined using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation. Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for three months ended March 31, 2021 and 2020. As of March 31, 2021 and December 31, 2020, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of the instruments. The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt. The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of March 31, 2021 and December 31, 2020 (in thousands):
Fair Value Measured as of March 31, 2021
(unaudited)
Quoted Prices in Active Markets for Identical Assets (Level 1)
Significant Other Observable Inputs (Level 2)
Significant Unobservable Inputs (Level 3)
Fair Value at March 31, 2021
Assets included in:
Cash and cash equivalents
Money market securities
$
7,569
$

$

$
7,569
Marketable securities at fair value
Corporate debt securities

34,359

34,359
U.S. treasury securities

20,354

20,354
Commercial paper

32,175

32,175
Asset-backed securities

11,225

11,225
Total fair value
$
7,569
$
98,113
$

$
105,682
Liabilities included in:
Contingent consideration
$

$

$
5,600
$
5,600
Total fair value
$

$

$
5,600
$
5,600
Fair Value Measured as of December 31, 2020
Quoted Prices in Active Markets for Identical Assets (Level 1)
Significant Other Observable Inputs (Level 2)
Significant Unobservable Inputs (Level 3)
Fair Value at December 31, 2020
Assets included in:
Cash and cash equivalents
Money market securities
$
19,070
$

$

$
19,070
Marketable securities at fair value
Corporate debt securities

31,353

31,353
Asset-backed securities

8,726

8,726
U.S. treasury securities

20,531

20,531
Commercial paper

53,955

53,955
Total fair value
$
19,070
$
114,565
$

$
133,635
Liabilities included in:
Contingent consideration
$

$

$
9,300
$
9,300
Total fair value
$

$

$
9,300
$
9,300
The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets. The Company’s portfolio of marketable securities is comprised of commercial paper, asset-backed securities, U.S. treasury securities and short-term highly liquid, high credit quality corporate debt securities. The fair value for the available-for-sale marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets or liabilities, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments or debt, broker and dealer quotes, as well as other relevant economic measures. The following table presents changes in Level 3 liabilities measured at fair value for the three months ended March 31, 2021 (in thousands):
Contingent Consideration
Balance, December 31, 2020
$
9,300
Payment of contingent consideration
(2,547
)
Change in fair value
(1,153
)
Balance, March 31, 2021 (unaudited)
$
5,600
Unrealized gains and losses associated with liabilities within the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long-dated volatilities) inputs. The fair value of the contingent consideration from the acquisition of Rhythm Xience represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective earn-out period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales or earnings; (iii) risk-free interest rate and (iv) expected volatility of earnings. Estimated payments, as determined through the respective model, were further discounted by a credit spread assumption to account for credit risk. The fair value of the milestones-based contingent consideration was determined by probability weighting and discounting to the respective valuation date at the Company’s cost of debt. The Company’s cost of debt was determined by performing a synthetic credit rating for the Company and selecting yields based on companies with a similar credit rating. The contingent consideration is revalued to fair value each period, and any increase or decrease is recorded in operating loss. The fair value of the contingent consideration may be impacted by certain unobservable inputs, most significantly with regard to discount rates, expected volatility and historical and projected performance. Significant changes to these inputs in isolation could result in a significantly different fair value measurement. The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of March 31, 2021 and December 31, 2020 were as follows:
March 31, 2021
December 31, 2020
(unaudited)
Risk-free interest rate
0.30%
0.20%
Expected term in years
1.0 - 2.0
1.0 - 2.0
Expected volatility
20.6%
17.2%
Stock-Based CompensationStock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock awards (“RSAs”), restricted stock units (“RSUs”) and restricted stock units with non-market performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs, RSUs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSAs and RSUs over the requisite service period. As the PSUs have a performance condition, compensation expense was recognized for each vesting tranche over the respective requisite service period of each tranche upon the registration statement used in connection with the Company’s IPO being declared effective on August 5, 2020, when the Company’s management deemed it probable that the performance conditions were satisfied. The Company recognized a cumulative true-up adjustment related to PSUs once the conditions became probable of being satisfied as the related service period had been completed in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive loss based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See “Note 16—Stock-Based Compensation” below.
Income TaxesIncome Taxes Income taxes are recorded in accordance with ASC 740, Income Taxes 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 will 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 LiabilityWarrant Liability The Company accounted for certain common stock warrants and convertible preferred stock warrants outstanding as a liability, in accordance with ASC 815, Derivatives and Hedging
Business CombinationsBusiness Combinations The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805, which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in the acquisition. Goodwill represents the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Subsequent adjustments to fair value of any contingent consideration are recorded to the Company’s condensed consolidated statements of operations and comprehensive loss.
Recently Adopted Accounting Pronouncements and Accounting Pronouncements to Be AdoptedRecently Adopted Accounting Pronouncements In December 2019, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes The Company adopted this guidance in the first quarter of 2021, which did not have a material impact on its condensed consolidated financial statements. Accounting Pronouncements to Be Adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326) In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)3 Months Ended
Mar. 31, 2021
Accounting Policies [Abstract]
Summary of Cash and Cash Equivalents and Restricted CashThe following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total shown on the condensed consolidated statement of cash flows (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Cash and cash equivalents
$
8,631
$
25,234
Restricted cash
150
150
Total cash, cash equivalents and restricted cash
$
8,781
$
25,384
Summary of Disaggregation of RevenueThe following table sets forth the Company’s revenue for disposables, systems, and service/other for the three months ended March 31, 2021 and 2020 (in thousands):
Three Month Ended March 31,
2021
2020
(unaudited)
Acutus Direct
Disposables
$
1,783
$
1,017
Systems
613
520
Service/Other
35
10
Total Acutus direct revenue
2,431
1,547
Distribution agreements
1,160
36
Total revenue
$
3,591
$
1,583
Summary of Revenue from External Customers by Geographic AreasThe following table provides revenue by geographic location for the three months ended March 31, 2021 and 2020 (in thousands):
Year Ended December 31,
2021
2020
(unaudited)
Acutus Direct
United States
$
1,468
$
770
Europe
963
777
Total Acutus direct revenue
2,431
1,547
Distribution Agreements
United States
113

Europe
1,047
36
Total revenue through distribution
1,160
36
Total revenue
$
3,591
$
1,583
Summary of Fair Value, Liabilities Measured on Recurring BasisThe 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 March 31, 2021 and December 31, 2020 (in thousands):
Fair Value Measured as of March 31, 2021
(unaudited)
Quoted Prices in Active Markets for Identical Assets (Level 1)
Significant Other Observable Inputs (Level 2)
Significant Unobservable Inputs (Level 3)
Fair Value at March 31, 2021
Assets included in:
Cash and cash equivalents
Money market securities
$
7,569
$

$

$
7,569
Marketable securities at fair value
Corporate debt securities

34,359

34,359
U.S. treasury securities

20,354

20,354
Commercial paper

32,175

32,175
Asset-backed securities

11,225

11,225
Total fair value
$
7,569
$
98,113
$

$
105,682
Liabilities included in:
Contingent consideration
$

$

$
5,600
$
5,600
Total fair value
$

$

$
5,600
$
5,600
Fair Value Measured as of December 31, 2020
Quoted Prices in Active Markets for Identical Assets (Level 1)
Significant Other Observable Inputs (Level 2)
Significant Unobservable Inputs (Level 3)
Fair Value at December 31, 2020
Assets included in:
Cash and cash equivalents
Money market securities
$
19,070
$

$

$
19,070
Marketable securities at fair value
Corporate debt securities

31,353

31,353
Asset-backed securities

8,726

8,726
U.S. treasury securities

20,531

20,531
Commercial paper

53,955

53,955
Total fair value
$
19,070
$
114,565
$

$
133,635
Liabilities included in:
Contingent consideration
$

$

$
9,300
$
9,300
Total fair value
$

$

$
9,300
$
9,300
Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input ReconciliationThe following table presents changes in Level 3 liabilities measured at fair value for the three months ended March 31, 2021 (in thousands):
Contingent Consideration
Balance, December 31, 2020
$
9,300
Payment of contingent consideration
(2,547
)
Change in fair value
(1,153
)
Balance, March 31, 2021 (unaudited)
$
5,600
Weighted-average Unobservable Inputs to Measure Contingent ConsiderationThe weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of March 31, 2021 and December 31, 2020 were as follows:
March 31, 2021
December 31, 2020
(unaudited)
Risk-free interest rate
0.30%
0.20%
Expected term in years
1.0 - 2.0
1.0 - 2.0
Expected volatility
20.6%
17.2%

Marketable Securities (Tables)

Marketable Securities (Tables)3 Months Ended
Mar. 31, 2021
Investments Debt And Equity Securities [Abstract]
Summary of Marketable SecuritiesMarketable securities consisted of the following as of March 31, 2021 and December 31, 2020 (in thousands):
March 31, 2021 (unaudited)
Amortized Cost
Gross Unrealized Gains
Gross Unrealized Losses
Fair Value
Available-for-sale securities - short-term:
Corporate debt securities
$
34,366
$

$
(7
)
$
34,359
U.S. treasury securities
20,350
4

20,354
Commercial paper
32,175


32,175
Total available-for-sale securities - short-term
86,891
4
(7
)
86,888
Asset-backed securities, long-term
11,224
1

11,225
Total available-for-sale securities
$
98,115
$
5
$
(7
)
$
98,113
December 31, 2020
Amortized Cost
Gross Unrealized Gains
Gross Unrealized Losses
Fair Value
Available-for-sale securities - short-term:
Corporate debt securities
$
31,359
$

$
(6
)
$
31,353
U.S. treasury securities
20,533

(2
)
20,531
Commercial paper
53,955


53,955
Total available-for-sale securities - short-term
105,847

(8
)
105,839
Asset-backed securities, long-term
8,726


8,726
Total available-for-sale securities
$
114,573
$

$
(8
)
$
114,565

Inventory (Tables)

Inventory (Tables)3 Months Ended
Mar. 31, 2021
Inventory Disclosure [Abstract]
Summary of InventoryInventory as of March 31, 2021 and December 31, 2020 consisted of the following (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Raw materials
$
7,114
$
7,960
Work in process
2,362
1,267
Finished goods
4,361
3,731
Total inventory
$
13,837
$
12,958

Lessor Sales-Type Leases (Table

Lessor Sales-Type Leases (Tables)3 Months Ended
Mar. 31, 2021
Leases [Abstract]
Estimated Future Maturities of Sales-Type Lease ReceivablesAs of March 31, 2021, estimated future maturities of sales-type lease receivables for each of the following years are as follows (in thousands):
Nine months ending December 31, 2021
$
304
Year ending December 31, 2022
378
Year ending December 31, 2023
149
Year ending December 31, 2024
72
Year ending December 31, 2025
22
Lease receivable
$
925

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)3 Months Ended
Mar. 31, 2021
Property Plant And Equipment [Abstract]
Summary of Property and Equipment, NetThe Company’s property and equipment, net, consisted of the following as of March 31, 2021 and December 31, 2020 (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Medical diagnostic equipment
$
15,360
$
13,242
Furniture and fixtures
426
388
Office equipment
1,494
1,392
Laboratory equipment and software
3,699
3,491
Leasehold improvements
661
608
Construction in process
1,468
468
Total property and equipment
23,108
19,589
Less: accumulated depreciation
(8,460
)
(7,233
)
Property and equipment, net
$
14,648
$
12,356

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)3 Months Ended
Mar. 31, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Summary Of Goodwill And Intangible Assets ActivitiesThe table below summarizes goodwill and intangible assets activities as of March 31, 2021 and December 31, 2020 (in thousands):
Goodwill
Intangible Assets
Balance, December 31, 2020
$
12,026
$
5,653
Amortization expense

(160
)
Balance, March 31, 2021 (unaudited)
$
12,026
$
5,493
Summary of Finite Lived Intangible AssetsEstimated Useful
Weighted Average Remaining
Life (in years)
Life (in years)
Intangible Assets
Accumulated Amortization
March 31, 2021
(unaudited)
Developed technology
10
8.3
$
4,200
$
(705
)
$
3,495
Customer-related intangible
5
3.3
100
(35
)
65
Licensed intangibles
10
9.7
2,000
(67
)
1,933
Total
$
6,300
$
(807
)
$
5,493
Estimated Useful
Weighted Average Remaining
Life (in years)
Life (in years)
Intangible Assets
Accumulated Amortization
December 31, 2020
Developed technology
10
8.6
$
4,200
$
(600
)
$
3,600
Customer-related intangible
5
3.5
100
(30
)
70
Licensed intangibles
10
9.9
2,000
(17
)
1,983
Total
$
6,300
$
(647
)
$
5,653
Summary Of Remaining Amortization ExpenseThe following table shows the remaining amortization expense associated with amortizable intangible assets as of March 31, 2021 (in thousands):
Developed Technology
Customer- Related Intangible
Licensed Intangibles
Total Amortization
Nine months ending December 31, 2021
$
315
$
15
$
150
$
480
Year ending December 31, 2022
420
20
200
640
Year ending December 31, 2023
420
20
200
640
Year ending December 31, 2024
420
10
200
630
Year ending December 31, 2025
420

200
620
Thereafter
1,500

983
2,483
Total
$
3,495
$
65
$
1,933
$
5,493

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)3 Months Ended
Mar. 31, 2021
Payables And Accruals [Abstract]
Summary Of Accrued LiabilitiesAccrued liabilities consisted of the following as of March 31, 2021 and December 31, 2020 (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
Compensation and related expenses
$
6,957
$
6,250
Professional fees
304
120
Deferred revenue
479
301
Sales and use tax
206
169
Other
862
468
Total accrued liabilities
$
8,808
$
7,308

Debt (Tables)

Debt (Tables)3 Months Ended
Mar. 31, 2021
Debt Instruments [Abstract]
Summary of Outstanding DebtOutstanding debt as of March 31, 2021 and December 31, 2020 consisted of the following (in thousands):
March 31,
December 31,
2021
2020
(unaudited)
2019 Credit Agreement (1)
$
44,550
$
44,550
Total debt, gross
44,550
44,550
Less: Unamortized debt discount and fees
(5,211
)
(5,539
)
Total long-term debt
$
39,339
$
39,011
(1)

Operating Leases (Tables)

Operating Leases (Tables)3 Months Ended
Mar. 31, 2021
Leases [Abstract]
Summary Of Quantitative Information About Operating LeasesThe following table summarizes quantitative information about the Company’s operating leases for the three months ended March 31, 2021 and 2020 (dollars in thousands):
Three Months Ended March 31,
Three Months Ended March 31,
2021
2020
(unaudited)
Operating cash flows from operating leases
$
261
$
253
Right-of-use assets exchanged for operating lease liabilities
$
-
$
-
Weighted average remaining lease term – operating leases (in years)
1.4
1.9
Weighted average discount rate – operating leases
7.0
%
7.0
%
Summary Of Components Of Lease CostThree Months Ended March 31,
Three Months Ended March 31,
2021
2020
(unaudited)
Operating leases
Operating lease cost
$
216
$
216
Variable lease cost
83
73
Total rent expense
$
299
$
289
Summary Of Future Minimum Payments Under The Non-cancelable Operating LeasesAs of March 31, 2021, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):
Nine months ending December 31, 2021
$
791
Year ending December 31, 2022
1,074
Year ending December 31, 2023
51
Year ending December 31, 2024
51
Year ending December 31, 2025

Total
1,967
Less: present value discount
(136
)
Operating lease liabilities
$
1,831

Warrants (Tables)

Warrants (Tables)3 Months Ended
Mar. 31, 2021
Warrants And Rights Note Disclosure [Abstract]
Schedule of Outstanding Warrants to Purchase the Company's Common StockAs of March 31, 2021 and December 31, 2020, the outstanding warrants to purchase the Company’s common stock were comprised of the following:
Equity Upon
Exercise
March 31,
December 31,
(After Conversion)
Exercise Price
Expiration Date
2021
2020
(unaudited)
Warrants issued in 2015
Common stock
$
5.25
1/30/25
3,808
3,808
Warrants issued with 2018 Convertible Notes
Common stock
$
0.10
6/7/28
373,810
373,810
Warrants issued with 2018 Term Loan
Common stock
$
16.67
7/31/28
26,998
26,998
Warrants issued with 2019 Credit Agreement
Common stock
$
16.67
5/20/29
419,992
419,992
Total Warrants
824,608
824,608

Convertible Preferred Stock (Ta

Convertible Preferred Stock (Tables)3 Months Ended
Mar. 31, 2021
Temporary Equity [Abstract]
Schedule of Initial Conversion Price per Share for each Series of Convertible Preferred StockThe initial conversion price per share for each series of convertible preferred stock was the original issue price applicable to such series as follows:
Series
Conversion Price
Series A convertible preferred stock
$
8.295
Series B convertible preferred stock
$
13.370
Series C convertible preferred stock
$
16.667
Series D convertible preferred stock
$
16.667

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)3 Months Ended
Mar. 31, 2021
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Schedule of Estimate of the Fair Value of Stock OptionThe following assumptions were used to estimate the fair value of stock option for the three months ended March 31, 2021 and 2020:
Three Months Ended March 31,
2021
2020
(unaudited)
Risk-free interest rate
0.76% - 1.28%
0.90%
Expected dividend yield


Expected term in years
7.0
7.0
Expected volatility
60% - 75%
70%
Summary of Stock Option ActivityThe following table summarizes stock option activity during the three months ended March 31, 2021:
Stock Options
Weighted Average Exercise Price
Weighted Average Remaining Contractual Life (in years)
Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2020
3,403,607
$
13.32
8.1
$
52,866
Options granted
32,749
23.02
Options exercised
(27,509
)
6.15
$
323
Options forfeited
(29,272
)
17.03
Outstanding as of March 31, 2021
3,379,575
$
13.45
7.9
$
6,252
Options vested and exercisable as of March 31, 2021 (unaudited)
1,564,993
$
10.19
6.6
$
5,672
Schedule of PSU and RSA ActivityThe Company’s PSU and RSU activity for the three months ended March 31, 2021 was as follows:
Number of Shares
Weighted Average Grant Price
Unvested as of December 31, 2020
545,466
$
16.53
Granted
23,375
23.88
Forfeited
(8,011
)
18.39
Vested
(94,045
)
13.37
Unvested as of March 31, 2021 (unaudited)
466,785
$
17.50
Schedule of RSA ActivityThe Company’s RSA activity for the three months ended March 31, 2021 was as follows:
Number of Shares
Weighted Average Grant Price
Unvested as of December 31, 2020
-
$
-
Granted
186
14.75
Vested
(186
)
14.75
Unvested as of March 31, 2021 (unaudited)
-
$
-
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 LossThe following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2021 and 2020 (in thousands):
Three Months Ended March 31,
2021
2020
(unaudited)
Cost of products sold
$
144
$
108
Research and development
417
211
Selling, general and administrative
2,268
1,422
Total stock-based compensation
$
2,829
$
1,741

Net Loss Per Common Share (Tabl

Net Loss Per Common Share (Tables)3 Months Ended
Mar. 31, 2021
Earnings Per Share [Abstract]
Summary of Calculation of the Diluted Net Loss per Common ShareThe table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:
Three Months Ended March 31,
Shares issuable upon:
2021
2020
(unaudited)
Conversion of Series A preferred stock

391,210
Conversion of Series B preferred stock

3,088,444
Conversion of Series C preferred stock

4,499,921
Conversion of Series D preferred stock

8,593,360
Exercise of stock options
3,379,575
2,746,088
Exercise of common stock warrants
824,608
509,562
Exercise of preferred stock warrants

446,990
Vesting of PSUs and RSUs
466,785

Total
4,670,968
20,275,575

Organization and Description _2

Organization and Description of Business - Additional Information (Detail) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Dec. 31, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Date of incorporationMar. 25,
2011
Accumulated deficit $ 390,196 $ 361,015
Working capital deficit $ 97,600 $ 129,500

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Detail)3 Months Ended
Mar. 31, 2021USD ($)SegmentReportingUnitMar. 31, 2020USD ($)Dec. 31, 2020USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segment | Segment1
Other-than-temporary impairments related to marketable securities $ 0 $ 0
Cash, FDIC insured amount250,000
Inventory Write-down100,000 100,000
Allowance for uncollectible accounts $ 0 $ 0
Number of reporting unit | ReportingUnit1
Impairment of property and equipment or intangible assets $ 0 $ 0
Interest or penalties charged in relation to the unrecognized tax benefits $ 0
ASU No. 2019-12 [Member]
Summary Of Significant Accounting Policies [Line Items]
Change In Accounting Principle Accounting Standards Update Adoptedtrue
Change In Accounting Principle Accounting Standards Update Immaterial Effecttrue
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Customers payment period30 days
Property and equipment, estimated useful lives3 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Customers payment period60 days
Contracts with customers, expected duration1 year
Property and equipment, estimated useful lives5 years
Deferred Equipment Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Cash, FDIC insured amount $ 0
Deferred Equipment Agreements [Member] | Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Contract term2 years
Deferred Equipment Agreements [Member] | Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Contract term4 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Summary of Cash and Cash Equivalents and Restricted Cash (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020Mar. 31, 2020Dec. 31, 2019
Accounting Policies [Abstract]
Cash and cash equivalents $ 8,631 $ 25,234
Restricted cash150 150
Total cash, cash equivalents and restricted cash $ 8,781 $ 25,384 $ 21,150 $ 9,602

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Detail) - USD ($) $ in Thousands3 Months Ended12 Months Ended
Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020
Summary Of Significant Accounting Policies [Line Items]
Total revenue $ 3,591 $ 1,583 $ 1,583
Distribution Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue1,160 36
Acutus Direct Revenue [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue2,431 1,547 $ 1,547
Acutus Direct Revenue [Member] | Disposables [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue1,783 1,017
Acutus Direct Revenue [Member] | Systems [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue613 520
Acutus Direct Revenue [Member] | Product and Service, Other [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue $ 35 $ 10

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Summary of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands3 Months Ended12 Months Ended
Mar. 31, 2021Mar. 31, 2020Dec. 31, 2021Dec. 31, 2020
Summary Of Significant Accounting Policies [Line Items]
Total revenue $ 3,591 $ 1,583 $ 1,583
Acutus Direct Revenue [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue $ 2,431 $ 1,547 1,547
Distribution Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue36
Scenario Forecast [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue $ 3,591
Scenario Forecast [Member] | Acutus Direct Revenue [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue2,431
Scenario Forecast [Member] | Distribution Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue1,160
United States [Member] | Acutus Direct Revenue [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue770
United States [Member] | Scenario Forecast [Member] | Acutus Direct Revenue [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue1,468
United States [Member] | Scenario Forecast [Member] | Distribution Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue113
Europe [Member] | Acutus Direct Revenue [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue777
Europe [Member] | Distribution Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue $ 36
Europe [Member] | Scenario Forecast [Member] | Acutus Direct Revenue [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue963
Europe [Member] | Scenario Forecast [Member] | Distribution Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Total revenue $ 1,047

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Assets
Total Assets Fair Value $ 105,682 $ 133,635
Liabilities
Total Liabilities Fair Value5,600 9,300
Contingent Consideration [Member]
Liabilities
Total Liabilities Fair Value5,600 9,300
Money Market Securities [Member]
Assets
Money market securities7,569 19,070
Corporate Debt Securities [Member]
Assets
Marketable securities34,359 31,353
US Treasury Securities [Member]
Assets
Marketable securities20,354 20,531
Commercial Paper [Member]
Assets
Marketable securities32,175 53,955
Asset-backed Securities [Member]
Assets
Marketable securities11,225 8,726
Fair Value, Inputs, Level 1 [Member]
Assets
Total Assets Fair Value7,569 19,070
Fair Value, Inputs, Level 1 [Member] | Money Market Securities [Member]
Assets
Money market securities7,569 19,070
Fair Value, Inputs, Level 2 [Member]
Assets
Total Assets Fair Value98,113 114,565
Fair Value, Inputs, Level 2 [Member] | Corporate Debt Securities [Member]
Assets
Marketable securities34,359 31,353
Fair Value, Inputs, Level 2 [Member] | US Treasury Securities [Member]
Assets
Marketable securities20,354 20,531
Fair Value, Inputs, Level 2 [Member] | Commercial Paper [Member]
Assets
Marketable securities32,175 53,955
Fair Value, Inputs, Level 2 [Member] | Asset-backed Securities [Member]
Assets
Marketable securities11,225 8,726
Fair Value, Inputs, Level 3 [Member]
Liabilities
Total Liabilities Fair Value5,600 9,300
Fair Value, Inputs, Level 3 [Member] | Contingent Consideration [Member]
Liabilities
Total Liabilities Fair Value $ 5,600 $ 9,300

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Detail) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Summary Of Significant Accounting Policies [Line Items]
Change in fair value of contingent consideration $ (1,153) $ (2,219)
Fair Value, Inputs, Level 3 [Member] | Contingent Consideration [Member]
Summary Of Significant Accounting Policies [Line Items]
Balance, December 31, 20209,300
Payment of contingent consideration(2,547)
Change in fair value of contingent consideration(1,153)
Balance, March 31, 2021 (unaudited) $ 5,600

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Summary of Weighted Average Fair Value Assumptions on Contingent Consideration (Detail) - Fair Value, Inputs, Level 3 [Member] - Rhythm Xience [Member]Mar. 31, 2021Dec. 31, 2020
Measurement Input, Risk Free Interest Rate [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs0.0030 0.0020
Measurement Input, Maturity [Member] | Minimum [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs0.010 0.010
Measurement Input, Maturity [Member] | Maximum [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs0.020 0.020
Measurement Input, Price Volatility [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs0.206 0.172

Asset Acquisition and Busines_2

Asset Acquisition and Business Combination - Additional Information (Detail) - USD ($) $ in ThousandsJun. 18, 2019Feb. 29, 2020Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020Dec. 31, 2019
Business Acquisition [Line Items]
Research and development expense $ 9,370 $ 7,973
Payments for contingent consideration2,547 2,584
Business combination, acquisition costs0 0
Biotronik Asset Acquisition [Member]
Business Acquisition [Line Items]
Consideration paid in cash $ 10,000
Equity interests issued and issuable $ 5,000
Consideration transferred15,000
Payments for contingent consideration2,000
Contingent milestone and royalty payments8,000 $ 8,000
Potential milestone payments capitalized2,000
Biotronik Asset Acquisition [Member] | Maximum [Member]
Business Acquisition [Line Items]
Potential milestone payments payable10,000
Biotronik Asset Acquisition [Member] | Intellectual Property [Member]
Business Acquisition [Line Items]
Research and development expense15,000
Rhythm Xience [Member]
Business Acquisition [Line Items]
Consideration paid in cash $ 3,000
Payments for contingent consideration2,500 $ 2,500
Date of business acquisitionJun. 18,
2019
Contingent consideration liability $ 13,400 5,600
Business combination contingent consideration liability change in amount $ 1,200 $ 2,200
Rhythm Xience [Member] | Earnout Consideration [Member]
Business Acquisition [Line Items]
Potential milestone payments payable $ 17,000
Series D Convertible Preferred Stock [Member] | Biotronik Asset Acquisition [Member]
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable273,070
Equity interests issued and issuable $ 5,000
Series D Convertible Preferred Stock [Member] | Rhythm Xience [Member]
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable119,993
Series D Convertible Preferred Stock [Member] | Rhythm Xience [Member] | Earnout Consideration [Member]
Business Acquisition [Line Items]
Equity interests issued and issuable $ 2,200

Marketable Securities - Summary

Marketable Securities - Summary of Marketable Securities (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost $ 98,115 $ 114,573
Gross Unrealized Gains5
Gross Unrealized Losses(7)(8)
Fair Value98,113 114,565
Short-term debt [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost86,891 105,847
Gross Unrealized Gains4
Gross Unrealized Losses(7)(8)
Fair Value86,888 105,839
Corporate Debt Securities [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost34,366 31,359
Gross Unrealized Losses(7)(6)
Fair Value34,359 31,353
US Treasury Securities [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost20,350 20,533
Gross Unrealized Gains4
Gross Unrealized Losses(2)
Fair Value20,354 20,531
Commercial Paper [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost32,175 53,955
Fair Value32,175 53,955
Asset-backed Securities [Member]
Schedule Of Available For Sale Securities [Line Items]
Amortized Cost11,224 8,726
Gross Unrealized Gains1
Fair Value $ 11,225 $ 8,726

Marketable Securities - Additio

Marketable Securities - Additional Information (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Schedule Of Available For Sale Securities [Line Items]
Available-for-sale Securities $ 98,113 $ 114,565
Short-term debt [Member]
Schedule Of Available For Sale Securities [Line Items]
Available-for-sale Securities $ 86,888 $ 105,839
Debt securities, available-for-sale, maturity1 year1 year
Long-term debt [Member]
Schedule Of Available For Sale Securities [Line Items]
Available-for-sale Securities $ 11,200 $ 8,700
Debt securities, available-for-sale, maturity2 years2 years

Inventory - Summary of Inventor

Inventory - Summary of Inventory (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw materials $ 7,114 $ 7,960
Work in process2,362 1,267
Finished goods4,361 3,731
Total inventory $ 13,837 $ 12,958

Lessor Sales-Type Leases - Addi

Lessor Sales-Type Leases - Additional Information (Detail) - USD ($)3 Months Ended
Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020
Lessor Lease Description [Line Items]
Lease revenue $ 900,000 $ 0
Sales-type Lease, Income, Comprehensive Income [Extensible List]Revenue
Prepaid Expenses and Other Current Assets [Member]
Lessor Lease Description [Line Items]
Lease receivable $ 400,000 $ 400,000
Other Assets [Member]
Lessor Lease Description [Line Items]
Lease receivable $ 500,000 $ 400,000

Lessor Sales-Type Leases - Esti

Lessor Sales-Type Leases - Estimated Future Maturities of Sales-Type Lease Receivables (Detail) $ in ThousandsMar. 31, 2021USD ($)
Leases [Abstract]
Nine months ending December 31, 2021 $ 304
Year ending December 31, 2022378
Year ending December 31, 2023149
Year ending December 31, 202472
Year ending December 31, 202522
Lease receivable $ 925

Property and Equipment, Net - S

Property and Equipment, Net - Summary Of Property And Equipment, Net (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Property, Plant and Equipment [Line Items]
Total property and equipment $ 23,108 $ 19,589
Less: accumulated depreciation(8,460)(7,233)
Property and equipment, net14,648 12,356
Medical diagnostic equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment15,360 13,242
Furniture and fixtures [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment426 388
Office equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment1,494 1,392
Laboratory equipment and software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment3,699 3,491
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment661 608
Construction in process [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment $ 1,468 $ 468

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Property Plant And Equipment [Abstract]
Depreciation $ 1,241 $ 429

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Summary Of Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill, Beginning Balance $ 12,026
Goodwill, Ending Balance12,026
Intangible Assets, Beginning Balance5,653
Amortization expense(160) $ (110)
Intangible Assets, Ending Balance $ 5,493

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Summary of Finite and Indefinite Lived Intangible Assets (Detail) - USD ($) $ in Thousands3 Months Ended12 Months Ended
Mar. 31, 2021Dec. 31, 2020
Finite And Indefinite Lived Intangible Assets [Line Items]
Finite Intangible Assets, Gross $ 6,300 $ 6,300
Finite Intangible Assets, Accumulated Amortization(807)(647)
Finite Intangible Assets $ 5,493 $ 5,653
Developed Technology [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Estimated Useful Life (in Years)10 years10 years
Weighted Average Remaining Life (in Years)8 years 3 months 18 days8 years 7 months 6 days
Finite Intangible Assets, Gross $ 4,200 $ 4,200
Finite Intangible Assets, Accumulated Amortization(705)(600)
Finite Intangible Assets $ 3,495 $ 3,600
Customer-Related Intangible [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Estimated Useful Life (in Years)5 years5 years
Weighted Average Remaining Life (in Years)3 years 3 months 18 days3 years 6 months
Finite Intangible Assets, Gross $ 100 $ 100
Finite Intangible Assets, Accumulated Amortization(35)(30)
Finite Intangible Assets $ 65 $ 70
Licensed Intangibles [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Estimated Useful Life (in Years)10 years10 years
Weighted Average Remaining Life (in Years)9 years 8 months 12 days9 years 10 months 24 days
Finite Intangible Assets, Gross $ 2,000 $ 2,000
Finite Intangible Assets, Accumulated Amortization(67)(17)
Finite Intangible Assets $ 1,933 $ 1,983

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Goodwill And Intangible Assets Disclosure [Abstract]
Amortization of intangible assets $ 160 $ 110

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Summary of remaining amortization expense associated with amortizable intangible assets (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Finite Lived Intangible Assets [Line Items]
Nine months ending December 31, 2021 $ 480
Year ending December 31, 2022640
Year ending December 31, 2023640
Year ending December 31, 2024630
Year ending December 31, 2025620
Thereafter2,483
Finite Intangible Assets5,493 $ 5,653
Developed Technology [Member]
Finite Lived Intangible Assets [Line Items]
Nine months ending December 31, 2021315
Year ending December 31, 2022420
Year ending December 31, 2023420
Year ending December 31, 2024420
Year ending December 31, 2025420
Thereafter1,500
Finite Intangible Assets3,495 3,600
Customer-Related Intangible [Member]
Finite Lived Intangible Assets [Line Items]
Nine months ending December 31, 202115
Year ending December 31, 202220
Year ending December 31, 202320
Year ending December 31, 202410
Finite Intangible Assets65 70
Licensed Intangibles [Member]
Finite Lived Intangible Assets [Line Items]
Nine months ending December 31, 2021150
Year ending December 31, 2022200
Year ending December 31, 2023200
Year ending December 31, 2024200
Year ending December 31, 2025200
Thereafter983
Finite Intangible Assets $ 1,933 $ 1,983

Accrued Liabilities - Summary O

Accrued Liabilities - Summary Of Accrued Liabilities (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Payables And Accruals [Abstract]
Compensation and related expenses $ 6,957 $ 6,250
Professional fees304 120
Deferred revenue479 301
Sales and use tax206 169
Other862 468
Total accrued liabilities $ 8,808 $ 7,308

Debt - Summary of Outstanding D

Debt - Summary of Outstanding Debt (Detail) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Debt Instrument [Line Items]
Long-term Debt, Gross $ 44,550 $ 44,550
Less: Unamortized debt discount and fees(5,211)(5,539)
Total long-term debt39,339 39,011
Two Thousand And Nineteen Convertible Notes [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross $ 44,550 $ 44,550

Debt - Summary of Outstanding_2

Debt - Summary of Outstanding Debt (Parenthetical) (Detail) - USD ($) $ in MillionsMar. 31, 2021Dec. 31, 2020
Two Thousand And Nineteen Credit Agreement [Member]
Debt Instrument [Line Items]
Debt instrument, fee amount $ 4.6 $ 4.6

Debt - Additional Information (

Debt - Additional Information (Detail) - USD ($) $ / shares in Units, $ in ThousandsMay 20, 2019Mar. 31, 2021Dec. 31, 2020
Two Thousand And Nineteen Credit Agreement [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate7.75%
Debt instrument, fee amount $ 4,600 $ 4,600
Warrants liability fair value $ 900
Class of warrants number of securities called by the warrants or rights419,992
Debt instrument, direct fees $ 1,200
Two Thousand And Nineteen Credit Agreement [Member] | Series C Convertible Preferred Stock [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate term7.75% plus LIBOR
Class of warrants, exercise price $ 16.67
Two Thousand And Nineteen Credit Agreement [Member] | Series D Convertible Preferred Stock [Member]
Debt Instrument [Line Items]
Class of warrants, exercise price $ 16.67
Two Thousand And Nineteen Credit Agreement [Member] | Senior Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument, face amount $ 70,000
Proceeds from senior term loan40,000
Debt instrument, remaining amount30,000
Debt instrument unused borrowing capacity $ 0
Debt instrument, fee amount $ 4,600
Long-term debt, maturity dateMay 20,
2024
Debt instrument, Initial debt discount before inception $ 6,700
Default Event [Member] | Senior Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate, increase (decrease)10.00%

Operating Leases - Additional I

Operating Leases - Additional Information (Detail)3 Months Ended
Mar. 31, 2021ft²
Lessee, Lease, Description [Line Items]
Office space50,800
Corporate Office Space and Manufacturing Facility
Lessee, Lease, Description [Line Items]
Lease expiration dateDec. 31,
2022
Office Space And Manufacturing Facility
Lessee, Lease, Description [Line Items]
Operating lease option to extend renewal term descriptionfive-year term
Office Space Zaventem Belgium
Lessee, Lease, Description [Line Items]
Office space3,900
Lease expiration dateDec. 31,
2021
Operating lease option to extend renewal term descriptionthree-year term

Operating Leases - Summary Of Q

Operating Leases - Summary Of Quantitative Information About Operating Leases (Detail) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Lessee Disclosure [Abstract]
Operating cash flows from operating leases $ 261 $ 253
Weighted average remaining lease term – operating leases (in years)1 year 4 months 24 days1 year 10 months 24 days
Weighted average discount rate – operating leases7.00%7.00%

Operating Leases - Summary Of C

Operating Leases - Summary Of Components Of Lease Cost (Detail) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Operating leases
Operating lease cost $ 216 $ 216
Variable lease cost83 73
Total rent expense $ 299 $ 289

Operating Leases - Summary Of F

Operating Leases - Summary Of Future Minimum Payments Under The Non-Cancelable Operating Leases (Detail) $ in ThousandsMar. 31, 2021USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
Nine months ending December 31, 2021 $ 791
Year ending December 31, 20221,074
Year ending December 31, 202351
Year ending December 31, 202451
Total1,967
Less: present value discount(136)
Operating lease liabilities $ 1,831

Warrants - Schedule of Outstand

Warrants - Schedule of Outstanding Warrants to Purchase the Company's Common Stock (Detail) - $ / shares3 Months Ended
Mar. 31, 2021Dec. 31, 2020
Class of Warrant or Right [Line Items]
Class of Warrant or Right, Outstanding824,608 824,608
Common Stock [Member] | Warrants Issued in 2015 [Member]
Class of Warrant or Right [Line Items]
Equity Upon Exercise (After Conversion)Common stock
Exercise Price $ 5.25
Expiration DateJan. 30,
2025
Class of Warrant or Right, Outstanding3,808 3,808
Common Stock [Member] | Warrants Issued with 2018 Convertible Notes [Member]
Class of Warrant or Right [Line Items]
Equity Upon Exercise (After Conversion)Common stock
Exercise Price $ 0.10
Expiration DateJun. 7,
2028
Class of Warrant or Right, Outstanding373,810 373,810
Common Stock [Member] | Warrants Issued with 2018 Term Loan [Member]
Class of Warrant or Right [Line Items]
Equity Upon Exercise (After Conversion)Common stock
Exercise Price $ 16.67
Expiration DateJul. 31,
2028
Class of Warrant or Right, Outstanding26,998 26,998
Common Stock [Member] | Warrants Issued with 2019 Credit Agreement [Member]
Class of Warrant or Right [Line Items]
Equity Upon Exercise (After Conversion)Common stock
Exercise Price $ 16.67
Expiration DateMay 20,
2029
Class of Warrant or Right, Outstanding419,992 419,992

Warrants - Additional Informati

Warrants - Additional Information (Detail) - USD ($) $ in Millions3 Months Ended
Mar. 31, 2021Aug. 10, 2020
Class of Warrant or Right [Line Items]
Weighted average remaining contractual life of warrants7 years 2 months 12 days
ASC 815 [Member]
Class of Warrant or Right [Line Items]
Common and preferred stock warrant liability $ 14.5

Convertible Preferred Stock - A

Convertible Preferred Stock - Additional Information (Detail) - USD ($) $ / shares in Units, $ in MillionsAug. 10, 2020Feb. 29, 2020Mar. 31, 2021
Firm Underwritten Commitment [Member] | Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity [Member]
Temporary Equity [Line Items]
Stock issue share price per unit $ 50
Firm Underwritten Commitment [Member] | Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity [Member] | Minimum [Member]
Temporary Equity [Line Items]
Sale of stock consideration received $ 50
Redeemable Convertible Series D Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared $ 1.36
Series A Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Conversion of stock shares converted391,210
Series B Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Conversion of stock shares converted3,088,444
Series C Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Conversion of stock shares converted4,499,921
Series D Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Conversion of stock shares converted8,593,360
Redeemable Convertible Series A Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared0.68
Redeemable Convertible Series B Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared1.07
Redeemable Convertible Series C Preferred Stock [Member] | Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared $ 1.36
Rhythm xcience acquisition [Member] | Redeemable Convertible Series D Preferred Stock [Member]
Temporary Equity [Line Items]
Business combination contingent consideration shares issued shares119,993
Business combination contingent consideration shares issued value $ 2.2
Biotonik Asset Acquisition [Member] | Redeemable Convertible Series D Preferred Stock [Member]
Temporary Equity [Line Items]
Business combination contingent consideration shares issued shares273,070
Business combination contingent consideration shares issued value $ 5

Convertible Preferred Stock - S

Convertible Preferred Stock - Schedule of Initial Conversion Price Per Share for each Series of Convertible Preferred Stock (Detail)Mar. 31, 2021$ / shares
Redeemable Convertible Series A Preferred Stock [Member]
Temporary Equity [Line Items]
Temporary equity initial conversion price per share $ 8.295
Redeemable Convertible Series B Preferred Stock [Member]
Temporary Equity [Line Items]
Temporary equity initial conversion price per share13.370
Redeemable Convertible Series C Preferred Stock [Member]
Temporary Equity [Line Items]
Temporary equity initial conversion price per share16.667
Redeemable Convertible Series D Preferred Stock [Member]
Temporary Equity [Line Items]
Temporary equity initial conversion price per share $ 16.667

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($) $ / shares in Units, $ in ThousandsAug. 10, 2020Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020
Class of Stock [Line Items]
Common stock shares authorized260,000,000 260,000,000 260,000,000
Convertible preferred stock, shares authorized5,000,000
Proceeds from stock options exercises $ 169
Common Stock [Member]
Class of Stock [Line Items]
Stock option exercises, shares27,509 0
IPO [Member]
Class of Stock [Line Items]
Number of shares issued during the period10,147,058
Gross proceeds from IPO $ 182,600
Proceeds from issuance of common stock upon IPO, net of issuance costs $ 166,300
Over-Allotment Option [Member]
Class of Stock [Line Items]
Number of shares issued during the period1,323,529
IPO and Over Allotment [Member]
Class of Stock [Line Items]
Price per share $ 18

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($)1 Months Ended3 Months Ended12 Months Ended
Jun. 30, 2019Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020Aug. 10, 2020
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Fair value exercise price to calculate aggregate intrinsic value of options $ 13.37 $ 28.81
Share based compensation by share based payment arrangement weighted-average grant date fair value per share of stock option grants $ 13.89
Unrecognized compensation related to stock options not vested $ 25,700,000
Share based compensation non vested award period for recognition2 years 7 months 6 days
Total stock-based compensation $ 2,829,000 $ 1,741,000
Performance Based Restricted Stock Units [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based compensation by share based payment arrangement instruments other than options granted567,509 23,375
Share based compensation by share based payment arrangement instruments other than options granted weighted average grant date fair value $ 13.37 $ 23.88
2020 Equity Incentive Plan [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance3,313,017
Share based payment arrangement number of shares available for issuance2,132,646
2011 Plan [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance2,636,188
Share based payment arrangement number of shares available for issuance0
Share based compensation by share based payment arrangement stock options vesting term4 years
Share based compensation by share based payment arrangement stock options contractual term10 years
2020 ESPP [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance387,063
Total stock-based compensation $ 100,000 $ 0
2020 ESPP [Member] | Maximum [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Participants purchase price of common stock, percent85.00%

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Estimate of the Fair Value of Stock Option (Detail)3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Risk-free interest rate0.90%
Risk-free interest rate, minimum0.76%
Risk-free interest rate, maximum1.28%
Expected term in years7 years7 years
Expected volatility70.00%
Expected volatility, minimum60.00%
Expected volatility, maximum75.00%

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock Option Activity (Detail) - Stock Option [Member] - USD ($) $ / shares in Units, $ in Thousands3 Months Ended12 Months Ended
Mar. 31, 2021Dec. 31, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options outstanding as of December 31, 20203,403,607
Options granted32,749
Options exercised(27,509)
Options forfeited(29,272)
Stock options outstanding as of March 31, 20213,379,575 3,403,607
Stock options vested and exercisable as of March 31, 2021 (unaudited)1,564,993
Weighted average exercise price outstanding as of December 31, 2020 $ 13.32
Options granted23.02
Options exercised6.15
Options forfeited17.03
Weighted average exercise price outstanding as of March 31, 202113.45 $ 13.32
Weighted average exercise price of options vested and exercisable as of March 31, 2021 (unaudited) $ 10.19
Weighted average remaining contractual life outstanding7 years 10 months 24 days8 years 1 month 6 days
Weighted average remaining contractual life of options vested and exercisable as of March 31, 2021 (unaudited)6 years 8 months 12 days
Aggregate intrinsic value outstanding beginning balance $ 52,866
Aggregate intrinsic value, options exercised323
Aggregate intrinsic value outstanding ending balance6,252 $ 52,866
Aggregate intrinsic value options vested and exercisable as of March 31, 2021 (unaudited) $ 5,672

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of PSU and RSA Activity (Detail) - Performance Based Restricted Stock Units [Member] - $ / shares1 Months Ended3 Months Ended
Jun. 30, 2019Mar. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares Unvested as of December 31, 2020545,466
Granted567,509 23,375
Forfeited(8,011)
Vested(94,045)
Number of shares Unvested as of March 31, 2021 (unaudited)466,785
Weighted Average Grant Price Unvested as of December 31, 2020 $ 16.53
Granted $ 13.37 23.88
Forfeited18.39
Vested13.37
Weighted Average Grant Price Unvested as of March 31, 2021 (unaudited) $ 17.50

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of RSA Activity (Detail) - Restricted Stock [Member]3 Months Ended
Mar. 31, 2021$ / sharesshares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares, Granted | shares186
Number of shares, Vested | shares(186)
Weighted average grant price, Granted | $ / shares $ 14.75
Weighted average grant price, Vested | $ / shares $ 14.75

Stock-Based Compensation - Su_2

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 (Detail) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation $ 2,829 $ 1,741
Cost of Sales [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation144 108
Research and Development Expense [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation417 211
SG&A Expense [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation $ 2,268 $ 1,422

Net Loss Per Common Share - Sum

Net Loss Per Common Share - Summary of Calculation of the Diluted Net Loss per Common Share (Detail) - shares3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable4,670,968 20,275,575
Conversion of Series A Preferred Stock [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable391,210
Conversion of Series B Preferred Stock [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable3,088,444
Conversion of Series C Preferred Stock [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable4,499,921
Conversion of Series D Preferred Stock [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable8,593,360
Exercise of Stock Options [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable3,379,575 2,746,088
Exercise of Common Stock Warrants [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable824,608 509,562
Exercise of Preferred Stock Warrants [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable446,990
Vesting of PSUs and RSUs [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Shares issuable466,785

401(k) Retirement Plan - Additi

401(k) Retirement Plan - Additional Information (Detail) - USD ($)3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Four Zero One K Retirement Plan [Member]
Defined Contribution Plan Disclosure [Line Items]
Employer contribution to defined benefit plan $ 0 $ 0

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($)3 Months Ended
Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020Dec. 31, 2019
Former Director and Shareholder [Member] | Patent Rights from Former Director and Shareholder [Member] | Maximum [Member]
Related Party Transaction [Line Items]
Royalty expense $ 100,000
Former Director and Shareholder [Member] | Patent Rights from Former Director and Shareholder [Member] | Royalty Expenses [Member]
Related Party Transaction [Line Items]
Royalty expense as a percentage of net sales3.00%
Beneficial Customer [Member] | Sales [Member]
Related Party Transaction [Line Items]
Revenue from related parties300,000
Director and the Chairman [Member] | Consulting Agreement [Member] | SG&A Expense [Member] | Maximum [Member]
Related Party Transaction [Line Items]
Consulting fees incurred for related party $ 100,000 100,000
Orbimed Royalty Oppurtunities Two LP and Deerfield Private Design Fund LP [Member] | 2019 Credit Agreement [Member]
Related Party Transaction [Line Items]
Line of credit maximum borrowing capacity $ 70,000,000
Line of credit cumulative drawdowns till date40,000,000 $ 40,000,000
Interest expenses related party $ 1,400,000 $ 1,300,000