Boston Scientific has been one of the big winners of the pulsed field ablation revolution. Over the past two years, the company has reported strong electrophysiology sales growth — sometimes in the triple digits — and declared itself the clear market leader in PFA.
However, on a Wednesday morning earnings call, analysts questioned executives on the electrophysiology unit's potential after U.S. sales growth stalled in the fourth quarter compared with the third quarter.
CEO Mike Mahoney told investors that the company remains confident in PFA’s potential, even as the market becomes more penetrated and competition in the space ramps up. Mahoney said that the electrophysiology market should grow about 15% in 2026, and the company expects to grow above that rate.
Boston Scientific’s electrophysiology unit overall remained successful in the fourth quarter — as it did for all of last year. Last quarter, electrophysiology sales totaled $890 million, representing year-over-year growth of about 37%. However, U.S. sales remained flat quarter over quarter.
“This was not the quarter that was hoped for. Yes, management beat consensus organic sales and EPS growth, but both US [electrophysiology] and WATCHMAN missed, which was the big investor fear heading into today,” J.P. Morgan analyst Robbie Marcus wrote in an investor note. “The reason it's highly damaging, and why we expect the stock to be off a decent amount today, is that investors now have reason to question the trajectory of these two key growth drivers moving forward.”
Boston Scientific’s stock price was down nearly 16% to about $77 Wednesday.
Boston Scientific reported a slowdown in electrophysiology growth last year, after reporting growth upwards of 170% in 2024. For example, the company reported 143% year-over-year growth in the first quarter of 2025, 96% in the second, 64% in the third and then 37% in the fourth quarter.
The slowdown in electrophysiology sales growth could be partially due to market penetration now that devices have been on the market for several years and doctors have rapidly changed their approach to atrial fibrillation treatment to favor PFA. Mahoney said that about 70% of ablation procedures were done with PFA in the U.S. in 2025, and about 50% globally.
Boston Scientific’s electrophysiology unit has remained successful despite the slowdown in growth, even when compared to other rivals in the space. Electrophysiology brought in $3.33 billion of sales in 2025, representing year-over-year growth of nearly 75%. Meanwhile, Johnson & Johnson’s electrophysiology unit grew at 7% year over year, while taking in $5.63 billion. Medtronic, the other top competitor in electrophysiology and PFA, has not yet reported earnings this season.
Still, Mahoney remained confident in the business.
“We expect to continue to grow above market. Our PFA share will reduce somewhat, but we're very confident by year-end, likely, if you add all the other competitors together, our share will be equal to them, or in that area,” Mahoney said. “We're very confident that we'll maintain clear market leadership in PFA over the course of 2026 and beyond.”
