Good afternoon. Thank you all for joining us today. My name is Henry Jiang. I'm with the banking team here at JP Morgan, and today I have the pleasure of introducing Pulse Biosciences. Presenting today will be the CEO, Paul LaViolette. And just a quick note, we'll have time for Q&A at the end of the session, so please wait until then and we can get you a microphone. But without further ado, I'll turn it over to you, Paul.
Thank you very much, Henry. It's a pleasure to be here presenting on behalf of Pulse and the team, and I am actually celebrating my one-year anniversary. I joined the company just before JP Morgan of 2025, so this is a perfect opportunity to reflect on the prior year, what we've been able to accomplish, where we stand today, and what we have to look forward to as we go forward into 2026. I'll be making forward-looking statements today, so this is our forward-looking statements disclosure. Our mission is to really capitalize on something that we think we have exclusive control over, which is nanosecond pulsed field ablation.
We have the benefit of participating and riding the tailwind of the PFA dynamic, which many investors are familiar with, while actually possessing an energy in pulsed electric fields that is truly unique, highly differentiated, and that differentiation translates both to technical and clinical advantages. And we'll spend some time talking about that. Our mission is to build a viable and thriving company and to do that by participating in multiple large clinical markets. And we have many to address. We've selected three initially, and we'll talk about those three today. Our strategy really is to capitalize on that exclusive nsPFA energy and to deliver it into multiple markets on an optimized timeline. We believe we are moving faster than predicate PFA companies. We'll describe that a little bit for you.
We also, in an effort to be fast and to optimize capital efficiency, our goal is to select business models based on market entry criteria. We'll talk about having a partnership or a direct business strategy as a function of how directly penetrable that market is with our resources as compared to the ability to expedite time to market and access of this technology by patients through partnership strategies. The team that we have is outstanding. I had the privilege of joining this team a year ago, as I mentioned. I bring, I'm sorry to say, 45 years of experience in the medical device industry. That is, as an operator, an investor, as a director, I've had a chance to be exposed to an innumerable list of highly disruptive technologies.
I've never been associated with a technology in that 45-year period that has more clinical and financial potential than nsPFA. I'm joined by a management team that has a lot of experience, experience with innovation, experience launching technologies, experience with growth strategies, both in exciting markets like robotics, but also specific in energy delivery. We are invested specifically in technology, and I would say one of our strengths is technology development. One of our other strengths is clinical development. We have a strong lineup of clinical leaders, key opinion leaders, physicians, medical officers, and they participate directly in defining and leading our clinical strategy. We have a world-class board. It's an extremely unique board. We'll talk about our inside ownership in a minute. Bob Duggan is here. Bob is a legendary investor, a serial entrepreneur, a visionary that has created markets and built spectacular shareholder value.
That team brings in really a difficult-to-describe asset to Pulse Biosciences. And I will say we were very pleased to announce a few weeks ago, Maria Sainz joined us as an independent director. Maria also brings a lot of experience, a veteran executive in strategics in the med tech space, a multiple-time chief executive, currently chief executive of Hyperfine, a serial director as well, including helping lead companies like Shockwave. So we really have a very strong team, one that I'm proud to be a part of. If we look at our financial snapshot, we ended 2025 with $81 million, representing burn in Q3 of about $13 million, in Q4 of about $14 million. So a slight uptick in burn representing our conviction to invest in our strategic priorities.
We, as you may have seen, received IDE approval for the cardiac surgery initiative in the third quarter and in the fourth quarter for the PFA delivery in electrophysiology. And so as we scale up those IDE activities, of course, our burn will increase. But corresponding to that burn increase, we are moving those programs forward toward their commercialization dates. And we did initiate, for the very first time, recording revenues with the commercialization of our Vybrance platform. That is a platform that treats benign thyroid nodules, and we'll spend time specifically addressing that opportunity. So initiating revenue, using cash wisely, funded through our critical value inflection points, delivering IDE enrollment and critical clinical data throughout 2026. So let's talk a little bit about the markets that we're pursuing. And we have three selected thus far. We will have a list of markets that we can pursue after that.
nsPFA is a bountiful platform. It has the ability to address multiple applications. And we calculate that the addressable markets for that initial list is $6 billion. And of course, that increases over time as we would expand our footprint internationally and expand markets in some ways driven specifically by the availability of nsPFA to bring more patients in more rapidly. You see on the left-hand side an image of the console. What's important to understand is that that is the generator for our pulse, and it is a universal generator. We can apply that same generator across the various applications, which creates tremendous capital efficiency. And we then have software capability within that platform to vary all of the pulse parameters to allow us to modify the therapy delivery from one indication to the next to the next. So it's really a remarkable piece of technology.
The thyroid application is the first, and that's a market that we intend to create. There really is no interventional thyroid market today to speak of. We think that market has real scale potential and is one that we can have a true proprietary foothold in, and we'll describe that in more detail. Cardiac surgery is a market that we can enter and expand. That market exists today, but it is not as large as it should be based on low frequency of utilization for ablation technology, and we'll describe how nsPFA will totally change that dynamic and then lastly, and the largest of all, of course, is the EP ablation market. We'll get into that with some specificity. It's a very significant opportunity and rounds out the market potential that we're going to be addressing in the years ahead, but starting with thyroid in the immediate term.
A little bit about nsPFA. Everyone, I think, is by now familiar with pulsed field ablation, and it has really changed the dynamic of delivering energy to treat unwanted tissue versus what was available before. We broadly describe that as thermal energy, which could have been radio frequency or high-intensity focused ultrasound or microwave, but generating heat to destroy tissue, which can be effective, but also has substantial side effects. Most fundamentally, this is a non-thermal and irreversible energy delivery. We use electricity delivered in billionths of a second pulses at high amplitude to produce the same effect therapeutically that thermal energies would, but without all of the repercussions of using heat. That's point number one. Point number two, you are familiar with PFA. PFA exists, and it's been doing very well.
PFA in the first generation is delivered in microsecond pulses, which are pulses that are measured in millionths of a second. Those pulses enter cells and fragment them. They destroy the cell membrane. They cause the spilling out, if you will, of the contents of that cell and stimulate an inflammatory response. So they can affect cells and cause cell death, but they are not benign. Then we get to nanosecond pulsed field ablation, which is an entirely different really point on the spectrum of energy delivery where we measure those pulses in billionths of a second. We increase the amplitude of energy that we drive down that catheter or electrode system, and we totally introduce a novel mechanism of action. We actually induce regulated cell death. This is a means by which the cell effectively turns itself off. We don't fragment and destroy and distribute cell contents.
And as a result, we have a very different cell elimination process. It's much more natural, and it fundamentally allows us to change the way we deliver that electricity, that pulsed electric field, and allows us, I would say, both, as I mentioned earlier, technical and clinical advantages. And we'll talk about how those convert into real outcomes and workflow differences for physicians in each of these markets. Now, how do you protect a technology like that so that nsPFA, as it becomes commonly used in multiple markets, is used exclusively from Pulse Biosciences? And the answer to that, of course, is intellectual property. Over the past year, we have increased our IP portfolio by 144 issued and pending patents. That's an increase of one piece of intellectual property asset every two and a half days across the course of the year.
We have patent protection that covers every facet of the generation and delivery of nanosecond high voltage pulses through to the end application, the end electrode, and I would say it's going to be extremely difficult, if not inconceivable, for a company to come along and try to replicate nsPFA. So our job is to build clinical value, build evidence, develop markets, and deliver technologies to convert existing markets, and we think we have an extraordinary array of opportunities, market by market, all under an umbrella of proprietary innovation, so let's look at the first, and this is the largest, and this is the electrophysiology market. Now, we are familiar with several facts. Number one, atrial fibrillation is the number one arrhythmia on earth. Number two, it is currently treated with ablation, but that utilization of ablation is actually very low in total penetration. It's actually arguably in single-digit penetration.
So this is a very large opportunity with tremendous growth ahead. Number three, PFA has already been introduced in this category and has shown us that it can totally displace thermal energies, and the rate at which physicians change from prior energy sources to PFA has been exceptionally fast, and really, the vast majority of that market changed to a PFA opportunity in the first year. This is a very large market. This is hotly contested, and it's one that has demonstrated its willingness to change rapidly, so we think this represents an exceptional opportunity for Pulse Biosciences. Now, let's look at where we stand and what we're producing. As I mentioned in the beginning of 2025, we were really just in possession of limited initial feasibility data, and if you look at where we stand today, we have treated over 150 patients.
We have follow-up on those patients that is reaching 12 months in duration, and we'll talk about that in a minute. So we are in possession of data sets now today that tell us we really have a valid statement of lesion quality, speed, workflow gains, and soon to be described what we believe will be an efficacy advantage. So lesion quality, this is all about entering the left atrium, laying down lesion sets, and isolating arrhythmias. We can do that because of our unique energy delivery capabilities. We can do that with a single circumferential lesion. This is the first time really in the field of EP catheter development that a single shot technology has come to fruition. We deliver transmural lesions. We have lesion depth that is unmatched by any other PFA platform. Speed.
Speed is really what physicians are looking for, particularly in a market of this scale where the goal is to increase throughput to treat more patients over time. Our lesions are created in five-second pulse deliveries. The total speed of all lesions delivered, therefore, can be measured in low to mid-single-digit minutes in a case. With that limited procedure time, we can drive patient throughput much higher, and we simplify the number of work steps that a physician has to take to complete an AFib ablation procedure. Workflow, as I mentioned, speed, fewer number of ablations. We're lowering the number of ablations delivered with our catheter in comparison to the market leader by about 75%.
We also can map follow-up outcomes, electrical activity outcomes with our catheter, which allows us over time to create a single catheter workflow where you ablate and map without having to exchange catheters, without having to add a high-density mapping catheter to the procedure. We think that is a breakthrough that in concert with our energy, which has lower neuromuscular stimulation effects and therefore can treat patients with lower anesthesia levels, we believe lower anesthesia levels, higher speed, and the ability to complete procedures with a single catheter workflow will enable the movement of these procedures from the cath lab in the hospital to the ambulatory surgery center, and that's going to be a defining dynamic in the treatment of millions of AFib patients in the market over the next number of years.
And then lastly, the one area that has really not been changed or upgraded in AFib ablation is efficacy. What is the rate of efficacy loss from 100% acute efficacy leaving the lab to 12-month efficacy and what the AFib burden is following time? And unfortunately, with first-generation PFA, the efficacy loss of 25%-30% is really no better than what had been delivered with prior thermal energy. So the procedure can be faster. It is safer because it's non-thermal, but it has never really been improved. And what's important to think about for our program is that we have received an IDE. Just in December, we're going to be commencing enrollment of that study starting in the first quarter. We expect to complete enrollment of that study in the calendar year 2026.
With the follow-up evidence we have from the European feasibility study, we will be presenting for the first time efficacy outcomes at 12 months, replicating the U.S. pivotal trial endpoint at the Boston AF Symposium on February the 5th. We're very excited about unveiling that data set and beginning the discussion of the full value proposition of nsPFA in AFib, which is workflow gains, speed, safety, and efficacy. All right, let's move on to the second market. This is in, I would say, comparable stage to that first market. It also treats atrial fibrillation, but in this case, it treats atrial fibrillation that has afflicted patients who are undergoing cardiac open surgery. So these are older patients. They have cardiac comorbidities.
They're going in for open heart surgery to have coronary bypass or have a valve repaired or replaced, and they already have AFib because of their complex cardiovascular history. Now, if they already have AFib and if they are undergoing surgery, it would be a good time to treat them for that AFib, and that is what the guidelines direct to be done. However, only about 30% of all patients have that therapy despite the guidelines, and there is a basic reason for that. The current approach uses radio frequency ablation. It is not as reliable as surgeons want. It is not as fast as surgeons want, and these patients are frail, and they are on cardiopulmonary bypass.
So the goal is to move those patients to AFib-free status, but the surgeons are saying, "I'm not confident enough that the extra time and risk on bypass is worth the gain because I don't believe I'll get fast, efficient, and effective ablation every time." That's an opportunity for nsPFA, and that's why we've addressed this as our second opportunity. And so let's look at that. What is the status of that? Well, number one, we have treated about 40 patients in a European feasibility study. We have followed those patients with electroanatomical mapping follow-up. We have confirmed very high safety and efficacy for this therapy. We use that data to submit to the FDA. We received breakthrough designation on this technology and also received IDE approval. We received that in the third quarter of 2025 and have commenced enrollment of this patient population.
I will say anecdotally, as an example, we treated a patient today, and that patient was treated with a total ablation time of four minutes. That is the kind of therapy that will fundamentally change the rate at which ablations are performed in surgery compared to today. Our goal is to first convert that existing 30% of patients that are treated with RF, and then second, to increase the 30% to closer to 100% because the speed and efficacy and overall efficiency of that procedure becomes something that every surgeon wants to make available to their surgical patients. We're enrolling our IDE. We'll continue to report on longer-term outcome of our European data, and we're very excited about the ability to add this technology to the cardiac surgery marketplace. The third and final procedure for us to address today is the benign thyroid market opportunity.
Now, this is a very different opportunity. This is, first of all, non-cardiovascular, and second of all, it's a market that does not really exist today. There really is not a market of substance that one would define as I would say, interventional thyroid management. And that's really what nsPFA has the potential to create. So let's think about it this way. Every year in the United States, 250,000 patients are diagnosed with benign thyroid nodules, and 60% of them move to have their thyroid removed as the only viable therapy to treat those benign growths. So 150,000 patients a year are losing their thyroid. These patients tend to be young, and the cost of losing that thyroid is the elimination of hormones that control blood pressure and body temperature and heart rate and metabolism.
That's an extraordinary cost in addition to placing that patient then on hormone replacement therapy and endocrinology follow-up for the rest of their lives. That, I think we can all agree, is suboptimal, but there has been no energy that can treat the thyroid in that very confined space where it resides between the carotids immediately adjacent to the esophagus and trachea, and precisely a zone that one would avoid introducing thermal energy to create tissue ablation. That's the opportunity that nsPFA has to address, to address those thyroidectomy procedures and all of the patients who are not getting thyroidectomies, even though they've been diagnosed and are symptomatic, but choose to endure and tolerate the symptoms rather than undergo treatment because the treatment today is removal of that organ.
So today we are approved and under that clearance, commencing commercialization of a treatment, minimally invasive, introducing nanosecond pulsed field ablation to address thyroid nodules in this otherwise surgical patient population. And what have we learned? First of all, this therapy works. We have now seen and treated hundreds of patients with follow-up that show that the mechanism of action that we described, that regulated cell death that we introduce in all tissues, in all cells in the body, that is working to clear that volume. We see a very rapid procedure. This is a 45-minute procedure done under conscious sedation with a total of about seven or eight minutes of treatment time with lesions that are created in eight seconds apiece. The workflow is spectacular.
These patients leave the hospital with nothing more than a Steri-Strip or a Band-Aid on a small puncture that allowed that percutaneous electrode to treat that thyroid. And the data that we're showing is compelling. We see significant volume reduction in the thyroid. We now have data out long-term that shows that reduction in volume is durable, and we also see validated reduction in thyroid symptoms. And those symptoms are relieved in about two weeks. So imagine, instead of having a life-altering surgery, removing the thyroid and going on HRT, instead you have a 45-minute procedure, have symptoms amelioration in 14 days, and we can now say that that procedure will produce durable outcomes for that patient, all of which preserves the thyroid and preserves natural thyroid function in those patients. We are validating that further with additional data.
We are enrolling a trial called the PRECISE-BTN trial, PRECISE benign thyroid nodule trial, which is a 50-patient study, nearly completely enrolled. We'll complete that in this first quarter. That is generating additional data. We intend to add more feasibility and market expansion studies to this data set over the course of this year. We have commenced pilot commercialization. We initiated pilot sites with key opinion leaders in the United States to begin validating this commercial market and clinical practice, and now we're starting to expand that, and all of those pilot sites converting to commercial by the end of January, and from that point forward, we'll begin to build this business. We reported initial results financially in Q3. We'll report those updated in Q4. We're not giving guidance on this business.
We're very focused on developing the market, build the quality, build the metrics, build all the evidence that this is a really sizable and repeatable and profitable business for hospitals, and then we will expand from there. We're extremely excited about this opportunity. And so with that, let me just wrap up by saying two things. Number one, if you look at where we were a year ago, look at what we did in 2025. It was really a year fundamentally of building evidence, initiating trials, and converting that evidence into initial regulatory processes. And we've seen that commence with two IDEs, with multiple published data sets, and with data that will flow from those studies continuously throughout 2026. We have established and will now further make concrete in 2026 more evidence. We will enroll the cardiac surgery IDE. We will enroll the EP IDE.
We will present outcomes data for efficacy results in EP for the first time in January. We will publish and present long-term efficacy data in thyroid performance in March at the Thyroid Conference. And this will be a year of really advancing the clinical and regulatory processes as well as commercial for thyroid to a point where each of those businesses at the end of this year will be calculable. We'll have U.S. and European market launch timing based on CE mark and PMA timelines. It's going to be a very productive and exciting year in 2026. And with that, I'll conclude with this summary slide that tells us where we really are as a company. We are in possession of a revolutionary energy. We have extraordinary IP protection to keep that proprietary.
We are taking advantage of a momentous drive of PFA into markets, but nsPFA is truly uniquely differentiated technically, clinically, and we're starting to see that now with outcomes. Clinical evidence is mounting, and that evidence is quite impressive. We're going to add to that with two IDEs throughout the course of 2026. The markets that we're pursuing are very large, $6 billion in value near term. We have a list of markets that we can add to that, including oncology-related applications that we'll begin to explore further, including those supported by our alliance with MD Anderson. We've got initial commercialization underway to build the first thyroid intervention opportunity. We think that has very large business potential, and we have the cash on hand to run that set of plays in 2026 and produce significant value creation events.
With that, I'll conclude my comments and look forward to answering your questions.
Great. If you have a question, please raise your hand, and we can get you a microphone. If not, I have a few questions for you, Paul, that we can kick off with. Are there current updates on the progression of the cardiac catheter ablation system IDE?
Sure. So the current update is, as I mentioned, we received IDE approval in December. And with that, of course, you immediately begin to approach your sites and initiate their readiness to enroll patients. And so we are doing that. And so that's usually about a 30-60-day process that involves contracting and local IRB approval and our own site initiation activity with those investigators. So we've assembled a clinical steering committee that is the most renowned physicians in the EP world. We have sites that are gearing up and will prepare to enroll in Q1.
As I mentioned, our expectation, because of the size of the patient population with paroxysmal AF, because of the frequency with which those patients come into these major centers, because of the relatively, I'd say, common label that we're pursuing, right, which is almost an all-comers paroxysmal indication, we should have high patient flow. There's some inertia to overcome to initiate sites, get them up and running. Once we do that, we're enrolling 150 patients. If you think about a certain number of sites with high velocity enrollment, average enrollment, 10-15 patients per site per month, it does not take that much time to enroll a study like this. A single arm, 150-patient protocol with a conventional endpoint. We're looking forward to running the trial. I would say I've been associated with at least a dozen PMA studies.
We have exceptional physician interest in this study, and I think there's going to be really strong support by sites to enroll patients and to get this trial completed.
Got it. So given those numbers, when would you expect enrollment completion as well as the first data readout?
Our target is to complete enrollment by the end of the year, and our second target is to accelerate that enrollment by every means possible. So I personally would like to see that trial enrolled closer to the end of Q3 than by the end of Q4.
Got it. And how does the nanosecond PFA catheter differentiate from what's existing currently?
In too many ways for me to articulate in a short amount of time, but the catheter itself, importantly, is designed to carry our energy, and we start with energy that is extremely different. This is hard, I think, to describe because PFA sounds like a catch-all category. We're delivering ultra-fast pulsed electric fields, but there's a difference between a microsecond and a millisecond, and that, I'm sorry, a microsecond and a nanosecond. And that difference is 1,000-fold. It's hard to comprehend because when we think about gains in med tech development, we think about those gains on relatively minor increments, moving something from 3.1 French to 2.9 French in catheter size. This is a dramatic difference in physics and in energy capability. Then that translates to the catheter.
Let me just say, as a point of comparison, the most commonly used catheter today is the FARAPULSE catheter from Boston Scientific, which has done exceptionally well. That catheter delivers five small points of ablation. That catheter delivers five small points of ablation over a 30-second dose delivery. Then it has to be rotated and delivers those five again and again and again and again, overlapping, stacking lesion creation, all for the purpose of trying to create depth. Why can't you create depth the first time? Because your energy doesn't penetrate the tissue. Why don't you increase the size of your electrodes so that you can cover more tissue geography? Because the energy density of delivering those microsecond pulses is too great, and the catheters don't have the capacity to do that.
Nanosecond PFA allows us to change everything about catheter engineering and catheter design. We can cover larger geographic ablation footprint. We generate deeper penetration lesions, and so we can create one or two lesions in a pulmonary vein and be finished in two five-second energy deliveries plus 10 seconds to move the catheter. So you can literally create isolation in a vein in a minute, isolation in four veins in a handful of minutes, and be done with PVI in six minutes of operative time. That is unmatchable by catheters that are designed to endure the rigors of microsecond PFA.
Great. And then another question, what is your current partnership strategy for the EP market, and how does the IDE approval sort of affect those discussions?
So first of all, IDE approval is a big deal. I think anyone who's been through these processes understands that requires great rigor, great evidence development, in our case, I'd say a very impressive balance of preclinical and clinical evidence. And we have the benefit of what I mentioned earlier, which was the history of developing the generator and prior FDA clearances of the generator. So this is not an entirely new system in that regard. So the IDE is a big deal in the sense that it is a highly validating moment for the company. And in partnership terms, that means those partners can look at us and say, "You know what? This company really is producing tangible results. They have an IDE approved.
They understand in their own work how hard that was for them," and so I think there's enormous credibility cast upon Pulse Biosciences with the IDE. It also says that we're now moving into the market. We're now starting clinical. We're now starting to enroll patients, and everyone understands we're going to be mapping with a mapping system, and that drives a partnership dynamic because there's competition in mapping systems. I also think the data that we present at the AF Symposium in February will be another accelerant, if you will, in discussions because we'll start to really add illuminating evidence on further safety performance. The workflow has already been reported acutely, but for the first time, efficacy evidence.
And so I think as someone who's been, I'll call it, a strategic in the past, from a strategic perspective, from a partnership perspective, everything we've done, everything that represents the status of our EP program today has made it more and more and more compelling and more attractive over the last year. That will only increase as we enroll. And at that point, then once you enroll and then you know your follow-up timeline and you can predict your PMA approval timeline, you can put a stake in the ground and say, "This is going to be commercial at this time." And no partner wants to wait until that point. So I think it increases the likelihood of partnership discussions in the near term.
Okay. Thank you.
Yeah. I have a question, Paul. Can you explain the importance of mapping navigation, especially with FARAPULSE, and how our approach is similar or dissimilar to those? And then as an additional topic, any advancements in ultrasound, as you see into the future, how that might impact the benefits of the technology you've addressed today?
Yeah. Great questions. So when you think about mapping, mapping is, I would say it's an essential part of the practice, right? We're trying to create electrical isolation, and we know that we either have or have not by virtue of mapping for that conduction. So it is really important to map. What has happened, though, I think really importantly in the last year, particularly with the launch of PFA, is that we have seen that ablation energy has become more important, I think, than mapping, and I say that with all due respect to mapping systems, which are elegant and critical. The launch of FARAPULSE showed that physicians will drop a catheter that is integrated with a mapping system in order to get a better energy.
And that, I think, came to the surprise and consternation of the large mapping companies that had held on to ablation market share because of mapping integration. So I think it's important for Pulse Biosciences to bring the best ablation energy forward. And I think we're going to do that. I think it's important for us to work with mapping systems so that we are rendering clear images to physicians and making their cases easier to do and more accurate. And I think better and better mapping can produce better and better ablation results because you really are able to direct that energy where you want. But I think, in my opinion, what has happened is that ablation has become the predominant and first choice a physician has to make, and then mapping may be secondary to that. So that's my opinion on mapping.
On ultrasound, I'll give you an example. With the thyroid, we use ultrasound guidance to deliver that electrode into the thyroid and create needle tracks and ablation zones in three dimensions. That is somewhat tedious, and it's a skill. It's a skill that is predicated on the ultrasound capabilities of delivering and interpreting images in the hands of that physician. That's hard to do. I think ultrasound is going to be a transformative technology for guided therapies. We're doing more ablation. What does that allow? Less surgery, increase of image-guided therapies. How often is ultrasound used? Almost all the time. How can better, easier, faster, more intuitive ultrasound capabilities, how much can that enable and accelerate the adoption of elegant energy ablation technologies? I think they can almost go hand in hand.
So as ablation becomes better and better and more capable, if you can pair that with better and better imaging, it's going to accelerate the speed with which markets convert.
Back to the FARAPULSE, you're basically saying the FARAPULSE has achieved its success without bringing a commitment for navigation ablation? It is what's available in the market to do that.
That is correct. That is correct. FARAPULSE, of course, now is paired with its own mapping system, but that's really an option. The physician does not need to use the Boston Scientific mapping system to use the FARAPULSE ablation technology. So I think the best way to think about it is that the market for mapping has moved to open architecture. The ability to close that loop and mandate a single catheter with a single mapping system, I think for the most part those days are behind us. And what is going forward is ultimate optionality where physicians can choose the ablation technology they prefer. They can map with the mapping system for which they have the greatest comfort level, and they shouldn't be forced to choose one because of the other.
What are the opportunities to reduce or eliminate fluoroscopy and/or anesthesia?