Seeking Alpha: AtriCure Is Successfully Using Marketing And Training To Drive Revenue

Small-cap cardiology med-tech AtriCure (NASDAQ:ATRC) did see its stock price momentum slow down from the 100%-plus pace between two of my prior pieces, but the better than 20% rise since late April of 2014 still isn't bad at all. This growth isn't just about the Street turning up a previously overlooked name; the company is delivering good beat-and-raise quarters and posting the sort of revenue growth that growth investors like to see from med-techs.

It looks as though growth is going to slow in the next year due to currency movements, but the underlying growth story at AtriCure remains intact. The company remains the only company with FDA-approved surgical ablation products and surgical ablation remain an underpenetrated option for treating a-fib and reducing stroke risk. Add in the potential of the AtriClip as another option in reducing stroke risk and management may not be overstating an annual blue-sky potential market of $1 billion a year. Against a market cap of less than $600 million, that argues that AtriCure's shares still have more to offer.

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AtriCure Is Successfully Using Marketing And Training To Drive Revenue

The Motley Fool: St. Jude Medical, Inc. Still Feeling the Love

I thought St. Jude Medical (NYSE: STJ  ) was already getting a fair bit of the benefit of the doubt back in April, but Wall Street has continued to bid these shares up on growing hopes that new products from the pipeline will drive revenue growth back into the mid-single digits or higher. Up almost 10% over the last three months, St. Jude has modestly outperformed Medtronic (NYSE: MDT  ) , significantly outperformed Boston Scientific (NYSE: BSX  ) , and done rather well against Johnson & Johnson and the market as a whole. 

My basic outlook on St. Jude really hasn't changed much. I think many in the market overestimate the likelihood that the company will lose significant share in quadripolar systems and underestimate the potential for products like Portico (a transcatheter heart valve) and CardioMEMS (an implantable monitoring device for heart failure) to contribute meaningfully to results. All of that said, the market appears to be baking in low-to-mid teens annual cash flow growth over the next decade and that seems like a sufficiently bullish outlook.

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St. Jude Medical, Inc. Still Feeling the Love

The Motley Fool: Boston's Watchman Under New FDA Scrutiny

Pipeline development has proved frustratingly difficult for cardiology-focused companies like Medtronic, St. Jude Medical (NYSE: STJ  ) , and Boston Scientific (NYSE: BSX  ) over the last few quarters. St. Jude modified their clinical trial plans for renal denervation and left atrial appendage closure because of enrollment worries against competing devices from Medtronic and Boston Scientific, while Medtronic's renal denervation program failed a pivotal study and its peripheral drug-coated balloon program has likewise disappointed. 

When it comes to Boston Scientific, challenging reimbursement has already gotten in the way of the growth of its Alair bronchial thermoplasty system and now it looks like the Watchman LAA device will be coming to market a year later than expected, if the FDA lets it go to market at all.

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Boston's Watchman Under New FDA Scrutiny

The Motley Fool: Good News at Boston Scientific: What's Next

Flashy moves aren't always the best moves in med-tech. Medtronic (NYSE: MDT  ) shelled out big bucks for Aterial Vascular Engineering, CoreValve, and Ardian, and the first two led to significant patent infringement issues and the third may never lead to a marketable product (renal denervation). I don't want to pick on Medtronic alone, as Hologic, Johnson & Johnson, and Boston Scientific (NYSE: BSX  ) have all made some big deals that went south and squandered shareholder capital.

With that in mind, I like the recent updates from Boston Scientific. Between two clinical trial updates and a small acquisition, Boston Scientific is laying the groundwork for what should be some good incremental revenue and profit growth in the coming years. I don't believe these items are enough to vault the company's stock to the level of great buy, but they are positive developments nevertheless.

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Good News at Boston Scientific: What's Next

The Motley Fool: Why I'm Still Bullish on Medtronic

t seems like there's a cottage industry on the sell-side in "What's wrong with Medtronic (NYSE: MDT  ) ?" pieces, but the stock has actually done OK since I last wrote on the company in late February. With Covidien pretty much flat in that time and Boston Scientific (NYSE: BSX  ) and St. Jude Medical (NYSE: STJ  ) both down, drug-fueled Johnson & Johnson is one of the few peers to really exceed the company's performance (while Bard has basically kept pace). 
 
I continue to believe that Medtronic is undervalued as a low-growth/high-quality med-tech supergiant. The company has unquestionably seen multiple significant setbacks over the last year or so, but the company still has lucrative franchises in CRM, spine, neuromodulation, and diabetes that throw off plenty of cash and allow the company to buy its way into future growth markets.

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Why I'm Still Bullish on Medtronic

Seeking Alpha: AtriCure Making Progress, But Can It Maximize Value On Its Own?

These are good times for investors to start thinking about putting together shopping lists for speculative healthcare stocks, as the market has been bailing out on not only biotechs but also speculative med-techs. AtriCure (ATRC) isn't speculative in many important respects, as the company has approvals for its key products, but is still quite speculative insofar as the company's ability to convince doctors to adopt its surgical ablation approach and generate meaningful revenue and profits.

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AtriCure Making Progress, But Can It Maximize Value On Its Own?

The Motley Fool: St. Jude Medical Inc.: In-Line Is Just Not Good Enough

It's hard to call it a bad thing when Wall Street likes a stock, but rising expectations can create problems of their own. St. Jude Medical (NYSE: STJ  ) seems to have done a good job of selling the Street on the idea that it has turned over a new leaf and that accelerating growth is around the corner.

Sell-side price targets are about 20% higher now than at the beginning of 2014, and the buy/hold/sell recommendation breakdown has moved from 11-10-3 to 14-8-2 over the past three months, though the EPS targets for 2014 and 2015 have hardly budged. That optimism may well explain why St. Jude's "good enough" first quarter wasn't quite good enough for investors.

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St. Jude Medical Inc.: In-Line Is Just Not Good Enough

The Motley Fool: Edwards Lifesciences Corp Scores A Potentially Major Legal Ruling Against Medtronic

If a court ruling made late on Friday holds up, the battle for market share in the U.S. between Edwards Lifesciences'  (NYSE: EW  ) Sapien family of transcatheter heart valves and Medtronic's (NYSE: MDT  ) CoreValve may be over before it begins. In a rare move for the med-tech industry, a judge granted a motion for a preliminary injunction against sales of the CoreValve that would effectively put Medtronic on ice until at least 2016. Medtronic is going to fight this decision, but it definitely seems likely to reignite optimism for Edwards' position in this market.

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Edwards Lifesciences Corp Scores A Potentially Major Legal Ruling Against Medtronic

The Motley Fool: Does This Johnson & Johnson Product Have Blockbuster Potential?

It's not often that a single clinical trial wipes out an entire therapeutic opportunity, but that is what most sell-side analysts seem to believe about Medtronic's  (NYSE: MDT  )  U.S. pivotal trial failure with its Symplicity renal denervation device. In the wake of Medtronic's surprising setback, both St. Jude Medical  (NYSE: STJ  )  and Boston Scientific  (NYSE: BSX  )  have hit "pause" on their renal denervation programs, while Covidien  (NYSE: COV  )  has chosen to tap out, ending development of its OneShot system altogether.

There may be life in the approach yet, though. Johnson & Johnson  (NYSE: JNJ  )  recently announced that it received European approval (the CE Mark) for RENLANE system, a multi-electrode RF ablation device that many people didn't even know was in development. That begs the question of whether this means there is opportunity yet in what was once touted as a multibillion-dollar area.

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Does This Johnson & Johnson Product Have Blockbuster Potential?

The Motley Fool: Multiple Setbacks May Spell Opportunity at Medtronic, Inc.

In a pretty richly valued med-tech space, it takes some setbacks to uncover value and opportunity. Medtronic (NYSE: MDT  ) has certainly seen setbacks, as the company has abandoned renal denervation, has lost some momentum in CRM, and may not be as competitive as hoped in drug-coated balloons. On a more positive note, transcatheter heart valves look like a viable growth driver and Medtronic has several opportunities in areas like neuromodulation, diabetes, and atrial fibrillation.

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Multiple Setbacks May Spell Opportunity at Medtronic, Inc.

Seeking Alpha: Depression Likely The Biggest Incremental Driver For Cyberonics

Watching Cyberonics (CYBX) evolve over the years has been pretty compelling. I was part of a sell-side research team that covered the stock in the late 90s and early 00s and followed the company as it struggled to gain the acceptance of the FDA, physicians, and patients, not to mention overcome a particularly aggressive CEO. In more recent years, the company has settled into a solid growth trajectory driven by incremental market penetration and a very strong replacement cycle, while delivering impressive margins.

The question is what comes next. While I do believe the company's core addressable market in developed countries (epilepsy) remains significantly under-penetrated, I don't see that changing rapidly or dramatically. That puts even more significance on the under-developed opportunity in depression, where the company has only a limited opportunity to drive real change. Although these shares aren't all that expensive relative to other growth med-techs on the basis of multiples, it's going to take either accelerated penetration in epilepsy or upside in depression to drive a higher intrinsic fair value.

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Depression Likely The Biggest Incremental Driver For Cyberonics

The Motley Fool: Boston Scientific Corporation Needs Growth And Execution

Diversified large cap med-tech Boston Scientific (NYSE: BSX  ) has made meaningful progress in cleaning up its act, and the Street has returned to the stock in force, pushing the stock up almost 70% over the past year and over 100% over the past two years. That sort of performance has left rivals like Medtronic (NYSE: MDT  ) , Abbott Labs (NYSE: ABT  ) , and St. Jude Medical (NYSE: STJ  ) well in the dust, but now it's time to deliver. Can Boston Scientific actually produce the growth and margin improvements that have underpinned so much of this optimism?

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Boston Scientific Corporation Needs Growth And Execution

The Motley Fool: Edwards Lifesciences Corp. Still Trying To Regain Footing

Transcatheter valves still make up one of the relatively few therapeutic areas in med-tech that is both large and growing at a significant rate. That does not mean that it's all downhill for Edwards Lifesciences (NYSE: EW  ) , however, as the company continues to struggle to meet expectations in the U.S. and hold off Medtronic (NYSE: MDT  ) in the marketplace. Good market positions in tissue valves and critical care will help some, but the twin challenges of competing with Medtronic and overcoming disappointment with the company's growth are likely to still weigh on the stock.

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Edwards Lifesciences Corp. Still Trying To Regain Footing

The Motley Fool: St. Jude Medical Inc.'s Valuation Already Looking Pretty Racy

Having made a habit of defending St. Jude Medical (NYSE: STJ  ) as it navigated its way through a lull in growth, doubts about its clinical pipeline, and the controversy over its Riata leads, it feels a little strange to complain that the shares now appear to be overvalued. And yet, even though I'm bullish on the prospects for products like Portico, MediGuide, CardioMEMS, and Nanostim, it's hard to come up with a realistic set of growth expectations that suggest these shares are too cheap today.

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St. Jude Medical Inc.'s Valuation Already Looking Pretty Racy

The Motley Fool: Medtronic Unnerves a Major Rival

Competition in the med-tech space is fierce, and rival executives and sales reps live to take away accounts and revenue from other companies. In markets like cardiac rhythm management, cardiology, and neuromodulation, Medtronic  (NYSE: MDT  )  is a fierce competitor to Boston Scientific (NYSE: BSX  ) and St. Jude Medical (NYSE: STJ  ) , with the latter two often getting the worse of the head-to-head battles. Now there is word that Medtronic has once again thrown a spanner into St. Jude's works, and this time, it wasn't even deliberate.

Word has come out that St. Jude is going back to the drawing board with its pivotal trial for the EnligHTN IV renal denervation device -- a product that St. Jude clearly hopes will be a winner in a battle for a market that could ultimately be measured in the billions of dollars. While this delay is not likely to be fatal to the future of St. Jude's ambitions in renal denervation, it does underline how inadvertent competition can still take a toll.

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http://www.fool.com/investing/general/2013/12/12/medtronic-unnerves-a-major-rival.aspx

Seeking Alpha: AtriCure Finally Getting Its Due

It has taken a little longer than I might have liked, but my bullish call on AtriCure (ATRC) has been working out pretty well this year, with the shares up more than 100% over the past year and on a year-to-date basis. I believe the Street has been responding to a strong uptick in the company's growth rate, but I also believe that significant management turnover over the past year or so (including a new CEO, SVP, and VPs of marketing and R&D) has rebuilt confidence that AtriCure may at last have a winning strategy.

With the shares having doubled, "now what?" seems like a fair question. I am hesitant to chase off current shareholders, as though the stock is certainly not as cheap as it once was, expectations still don't appear to incorporate major share gains/positions for AtriCure. These shares do not look all that cheap by DCF or EV/revenue standards, but as investors have seen in cases like Spectranetics (SPNC) and Cardiovascular Systems (CSII), a renewed faith in a small med-tech's growth can take the shares a long way.

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AtriCure Finally Getting Its Due

The Motley Fool: Wall Street Fully On Board With Boston Scientific

For as many execution issues as Boston Scientific  (NYSE: BSX  ) has had over the years, current management deserves credit for the extent to which they have changed both the reality of the business and Wall Street's perception of it. The company is still behind large rivals in key growth areas like transcathether heart valves and renal denervation, but it is no longer a notable laggard in terms of reported growth.

The only real downside that I see to the story is that expectations have moved to a point where it seems like the Street is giving the company a lot of benefit of the doubt with respect to its execution in 2014. The next 12 months should see meaningful progress across multiple product lines, but it's hard to argue that the shares are notably undervalued after the big move over the past year.

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http://www.fool.com/investing/general/2013/10/28/wall-street-fully-on-board-with-boston-scientific.aspx

The Motley Fool: St. Jude Firmly Back In Wall Street's Good Graces

Wall Street can punish stocks quickly, but investors will return to a solid story almost as quickly. It was only about a year ago when St. Jude Medical  (NYSE: STJ  ) shares were hammered on worries that lead failures would severely compromise the company's ICD business and that the company was trailing major rivals like Medtronic  (NYSE: MDT  ) and Johnson & Johnson  (NYSE: JNJ  ) in key growth market opportunities.

Since then, sentiment has come back around in a big way. Not only does the company appear to be gaining some share in its cardiac rhythm management, or CRM, business, but the atrial fibrillation business has also been performing well. Add to that interesting opportunities in heart failure monitoring, neurostim, ablation, renal denervation, transcatheter heart valv
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http://www.fool.com/investing/general/2013/10/16/st-jude-firmly-back-in-wall-streets-good-graces.aspx

The Motley Fool: The Expectations Hangover Still Hurting Edwards Lifesciences

It really wasn't that long ago when rampant enthusiasm for minimally invasive heart valves sent the shares of Edwards Lifesciences rocketing from around $22 to almost $110 per share in about four and a half years. While the stock was in the $90s, I dutifully played my role of Cassandra -- pointing out that analysts and investors were getting carried away with their expectations for the adoption of transcatheter heart valves and underestimating the risks of competition from companies like Medtronic (NYSE: MDT  ) .

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http://www.fool.com/investing/general/2013/09/30/the-expectations-hangover-still-hurting-edwards-li.aspx

MassDevice: Despite A Long Road Ahead, Sunshine Heart Is Worth A Serious Look

If you've been following the medical device (and/or pharmaceutical) space for a while, you know that congestive heart failure is one of the nastiest, hardest to treat, chronic conditions out there. There's really no way to reverse the disease short of a heart transplant, and the drugs and device therapies available sort themselves out between "largely ineffective" and "effective, but with serious issues".

That's terrible news for those patients who have congestive heart failure, but it leaves a tremendous opportunity for Sunshine Heart (NSDQ:SSH). This small-cap med-tech from Minnesota appears to have an ingenious solution to the problem, one that is based around well-understood principles and relatively simple technology. Although it will be at least four to five years before commercialization in the U.S., and that's only if the pivotal study shows adequate efficacy and an acceptable risk/benefit profile, this is definitely a name to watch in the med-tech space as the company looks to bring a new option to the table for seriously ill CHF patients.

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http://www.massdevice.com/blogs/massdevice/despite-long-road-ahead-sunshine-heart-worth-serious-look