Medtronic guides FY27 organic growth of 6.75-7.25%, a record high
Medtronic reported a strong Q4 FY26 with 6.6% organic growth, driven by a standout 78% growth in cardiac ablation, fueled by their PFA technology. The company raised its FY27 guidance, pointing to continued margin expansion and strong performance across multiple divisions, with notable momentum in Hugo robotics and AltaViva. Cardiac Ablation Solutions grew 78% in Q4, with PFA growing 145% and significant US share gains, positioning it as a major growth driver.
Buzzberg readMedtronic guides FY27 organic growth of 6.75-7.25%, a record highMedtronic reported a strong Q4 FY26 with 6.6% organic growth, driven by a standout 78% growth in cardiac ablation, fueled by their PFA technology. The company raised its FY27 guidance, pointing to continued margin expansion and strong performance across multiple divisions, with notable momentum in Hugo robotics and AltaViva. Cardiac Ablation Solutions grew 78% in Q4, with PFA growing 145% and significant US share gains, positioning it as a major growth driver.Read full analysisCollapse analysis
Medtronic reported a strong Q4 FY26 with 6.6% organic growth, driven by a standout 78% growth in cardiac ablation, fueled by their PFA technology. The company raised its FY27 guidance, pointing to continued margin expansion and strong performance across multiple divisions, with notable momentum in Hugo robotics and AltaViva. Cardiac Ablation Solutions grew 78% in Q4, with PFA growing 145% and significant US share gains, positioning it as a major growth driver.
AltaViva pelvic health product is scaling, seeing a 3x increase in active implanters and 2.5x increase in patients treated sequentially.
Hugo robotic surgery platform is expanding with FDA submissions for new indications, signaling a broader competitive threat to incumbents.
The company provided FY27 organic revenue growth guidance of 6.75% to 7.25%, including a boost from an extra selling week.
Revenue$9.807B
+9% QoQ
EPS$1.55
+14% QoQ
Gross margin75.87%
reported
Op margin15.95%
reported
What changed this quarter
01
Guidance
Medtronic guides FY27 organic growth of 6.75-7.25%, a record high
Guidance · revenue to 7%
02
Demand
AltaViva implants accelerate 2.5x sequentially as physicians ramp
Management highlighted strong execution, multiple growth drivers, and raised expectations for fiscal 2027, expressing confidence in continued acceleration.
03
Demand
CAS annualizing at $2B, market share marching toward leadership
AltaViva implants accelerate 2.5x sequentially as physicians ramp. Management highlighted strong execution, multiple growth drivers, and raised expectations for fiscal 2027, expressing confidence in continued acceleration.
04
Demand
Simplicity hypertension procedure now annualizing at $100M
AltaViva implants accelerate 2.5x sequentially as physicians ramp. Management highlighted strong execution, multiple growth drivers, and raised expectations for fiscal 2027, expressing confidence in continued acceleration.
AI, capex & demand read
AI
Platform & monetization
Management discussed AI in the context of the CathWorks FFR-Angio system, which uses AI and computational science to improve cath lab decision-making, positioning it to disrupt the traditional wire-based FFR market.
Demand
Bookings & conversion
AltaViva implants accelerate 2.5x sequentially as physicians ramp. Management highlighted strong execution, multiple growth drivers, and raised expectations for fiscal 2027, expressing confidence in continued acceleration.
Capex
Investment and capacity
Capital expenditure was up roughly $50 million in fiscal year 26, growing at a significantly lower rate than revenue, and management expects ongoing COGS efficiency programs to deliver savings.
Tone · Upbeat
Management highlighted strong execution, multiple growth drivers, and raised expectations for fiscal 2027, expressing confidence in continued acceleration.
Supply-chain alpha
A1
The CAS segment is now being used as the primary driver for growth, and comments about market share gains and installing base growth suggest a continued ramp that could significantly impact the competitive dynamics in the PFA space.
Management underscored the recent FDA clearance for new indications in their Hugo robotic system and suggested they are submitting for more, a proactive expansion that may directly threaten Intuitive Surgical's market share in general surgery.
“We are pleased to announce that in late April, we submitted to the FDA for 510 clearance for general surgery and gynecologic indications, as well as for our ligature RAS vessel sealer.”
Significant patient and physician traction for AltaViva, with a 3x increase in active implanters and 2.5x increase in patients treated sequentially, suggests early adoption for a product in a previously inadequately served market.
“Sequentially, active implanters are up three times, and patients treated are up two and a half times.”
The impact of the US low-risk TAVR data is reflected in a flattening of US revenue for this segment, but the company indicates stabilization over last 8 weeks, which could be a short-term bottoming in this market.
Management continues to detail a proactive expansion into the PNS market with the acquisition of SPR Therapeutics, but also noted growth over 20% annually, validating the attractiveness of this market segment.
… the select secure 3830 lead for CSP. Turning to structural heart, performance in the quarter was flat. We saw strong international performance, while the U.S. was softer, in part due to the low risk data. We're encouraged though by the trajectory we've seen in the field as weekly US procedure volumes have stabilized over the last eight weeks. Structural hard clearly remains a strategic priority for us with internal programs in mitral and tricuspid replacement and targeted external investment in TAVR, including anteris paving the way forward. Coronary declined in the quarter, but was offset by strength in renal denervation as described by Jeff. Importantly, we saw clear acceleration of simplicity in the back half of the year. We're pleased to see the sequential lift and feel well positioned to drive momentum going forward. Finally, peripheral vascular health delivered low single digit growth and cardiac surgery was up mid single digit. Moving to neuroscience, our position in neuroscience is strong. We have the most comprehensive portfolio and are the number one player and category leader across each of our segments. We're investing across the portfolio to advance pipeline …
The impact of the US low-risk TAVR data is reflected in a flattening of US revenue for this segment, but the company indicates stabilization over last 8 weeks, which could be a short-term bottoming in this market. — Signals a potential bottom in Medtronic's US TAVR market share and could relieve pressure on Edwards Lifesciences if the stabilization holds.
Hey guys, thank you for taking my question. And Jeff, congrats on a nice sprint here. Maybe Jeff, I'll start with the guidance question. Fiscal 27, excluding the extra week, I think underlying five and a half to six, that's an acceleration in line with the prior assumptions. I think as cash slows down, that's been a concern for the market, right? Can you just talk about what are the offsets, which segments accelerate to offset cash and drives the confidence in this five and a half to six organic?
Sure. Hi, Vijay. So, look, just maybe to give you a couple components of the growth rate here. The cardiovascular business should have a performance next year that's pretty much in line with what we've seen in 26. So it's got really, really strong momentum. Jeff just talked about CAS. We're clearly still in the early innings of the CAS development here. You probably saw in in the commentary that from an install base perspective, the install base was up 40% in the fourth quarter alone. So that gives us a ton of headroom to grow the catheter cells going forward. CRM will continue to be a strong mid-single digit. We have a lot of strength coming from innovation, from Micra, from Omnia. from EVICD, and that's going to carry into 27. And then, you know, staying in the cardiovascular portfolio, we expect to continue to see some strong lift coming from Ardian. You know, so Ardian is now annualizing about 100 million revenue a year, and we expect that to continue to grow significantly into 27 and beyond. And then we've incorporated a prudent guidance for structural heart. As we mentioned in the commentary, the business has been pretty stable over the last weeks. And that's what we've incorporated in the guidance going forward. So strong continuation in cardiovascular. Then we've got the neuroscience portfolio. You know, hey, look, in neuroscience, we're leading in every segment we're in. And we're gaining share. And on top of that, we've got meaningful innovation in almost every segment out there. If you take CST, we have Stealth Access. Stealth Access is off to a really good start. About 50% of the revenue we get in CST is coming from consumables. And the more we sell Stealth Access, the more we're going to have pull through on the consumables side. And we're super excited about that. In the neurovascular business, you know, you saw that we made progress this quarter. That's going to continue into 27. We've got a ton of innovation coming there with NeuroGuard product and with MMA. And that's going to continue going forward. And on top of that, we'll have the inorganic impact coming from the acquisitions. But expect neuroscience overall to continue to grow.
The CAS segment is now being used as the primary driver for growth, and comments about market share gains and installing base growth suggest a continued ramp that could significantly impact the competitive dynamics in the PFA space.
… capital in line with our capital allocation priorities and meaningfully increasing our investments in M&A, ventures, and partnerships. And I am incredibly proud of our teams. Through a dynamic macro environment, we have executed and we've executed with discipline to deliver an excellent fiscal 26 that will continue into fiscal 27. And now let's turn to the details of our fiscal fourth quarter, beginning with cardiac ablation solutions. Look, CAST delivered another outstanding quarter with 78% worldwide growth and gaining an additional eight points of US share. PFA saw exceptional global growth of 145%, with Sphere 9 continuing to demonstrate broad versatility. And we're still in the early innings for Afera. In the US, we increased our installed base by 40% sequentially, and we see significant runway for continued expansion. Globally, we're now rolling out Prism 2, our next-generation mapping software. Prism 2 unlocks meaningful benefits, including improved navigation using hybrid impedance and magnetic mapping to better visualize non-sensor-based catheters. As we look ahead, we're expanding our entire EP ecosystem, expanding geographically into new indications and with an …
Management underscored the recent FDA clearance for new indications in their Hugo robotic system and suggested they are submitting for more, a proactive expansion that may directly threaten Intuitive Surgical's market share in general surgery.
… starting to see meaningful impact from Hugo, our surgical robotic system. Our worldwide procedure volume growth is two to three X the market and utilization is increasing. Last quarter, we launched Hugo for urology in the United States, placing systems at leading institutions and treating our first patients. Feedback from surgical teams has been positive, both in terms of their experience and early clinical outcomes. We are pleased to announce that in late April, we submitted to the FDA for 510 clearance for general surgery and gynecologic indications, as well as for our ligature RAS vessel sealer. We also recently received FDA clearance for our ProGrip Advanced, a new mesh optimized for robotic-assisted ventral hernia repair procedures. And our touch surgery digital ecosystem, well, it continues to represent a clear advantage, with over 1400 installations, up 30% plus sequentially. We are complementing our strong foundation with data and analytics, driving a more precise, intelligent, and a predictable future in surgery. Digital is creating real value in the OR, and we are investing and innovating to lead in this space. We are building our robotics program deliberately. We …
Management continues to detail a proactive expansion into the PNS market with the acquisition of SPR Therapeutics, but also noted growth over 20% annually, validating the attractiveness of this market segment.
… mid-single-digit growth, including high single-digit in international markets. In pelvic health, results were flat as solid growth in AlteViva was offset by broader market softness and sacral nerve modulation. Given the progress our teams have made, we look forward to seeing AlteViva continue to scale into 2027. Finally, neuromodulation was up low single digit. This is another area of strategic focus and investment as demonstrated by our expansion in BVNA and planned acquisition of SPI Therapeutics, an attractive space growing over 20% annually. Now turning to medical surgical, which delivered 5% growth globally, including 8% in the US. Surgical revenue increased 3% globally, split evenly between the US and international markets. Performance was driven by high single digit growth in both advanced energy and wound management, as well as an increased contribution from Hugo. This was partially offset, like in prior quarters, by continued pressure in bariatrics. Endoscopy delivered high single-digit growth, driven by strong adoption of endoflip in the U.S. and Western Europe, and market share gain in Nexpowder in the U.S. And then acute care and monitoring was up 11%, including …
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