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Management reduced full-year organic growth guidance to 6.5%-8% due to unanticipated headwinds in the EP, WATCHMAN, and Urology business units.

WATCHMAN growth slowed as the market transitioned toward concomitant procedures, creating capacity constraints and softening stand-alone case volumes.

Electrophysiology (EP) performance faced higher-than-expected share erosion in the U.S. despite maintaining a leadership position in the Pulsed Field Ablation (PFA) market.

Urology underperformed due to China Volume-Based Procurement (VBP) impacts and commercial disruption within the sacral neuromodulation franchise following high sales force turnover.

Interventional Cardiology and Vascular Therapies (ICVT) remained a strength, driven by double-digit growth in coronary therapies and imaging despite the ACURATE discontinuation.

Operating margins reached 28.8% in Q1, supported by disciplined spend controls and organizational efficiency initiatives to offset lower product mix benefits.

Full-year adjusted EPS guidance was revised to $3.34-$3.41, assuming 50 to 75 basis points of operating margin expansion through aggressive OpEx leverage.

The second quarter is expected to be the most challenging period of 2026 due to difficult year-over-year comparisons in the EP and WATCHMAN segments.

Management anticipates a return to market-level growth in 2027, supported by a robust product launch cadence including third-generation FARAPULSE and seismic peripheral IVL.

The Penumbra acquisition is expected to close in the second half of 2026, which management views as a critical driver for the Long-Range Plan (LRP) growth trajectory.

Free cash flow for the full year is projected at approximately $4 billion, with a priority on funding the $2 billion share repurchase program starting in Q2.

The POLARx Cryoablation system was discontinued ahead of schedule due to recent safety events, resulting in an estimated $35 million impact on the global EP business. and the rapid market shift toward nonthermal ablation technologies.

Gross margins were impacted by 100 basis points in Q1, primarily due to inventory charges from the POLARx exit and ongoing tariff pressures.

The company is implementing restrictive spend controls and optimizing organizational structures to protect earnings growth amid the revenue guidance reduction.

Management flagged evolving reimbursement dynamics and hospital capacity as transient risks affecting the timing of stand-alone structural heart procedures.

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Management attributed the reduction to three specific areas: declining stand-alone WATCHMAN volumes, higher share erosion in U.S. EP, and execution gaps in Urology.

Confidence in the Long-Range Plan remains high for 2027 and 2028, citing easier comparisons and a significant pipeline of next-generation PFA and coronary technologies.

The slowdown reflects a shift where 25% of procedures are now concomitant, causing workflow bottlenecks as hospitals adapt lab capacity and move simple cases to ASCs.

Boston Scientific is increasing direct commercial and marketing investments to re-engage the interventional cardiology call point for stand-alone cases.

Management acknowledged losing more share than anticipated to three large competitors but expects to remain the global PFA leader through 2026.

The strategy relies on the expanding OPAL mapping footprint and the upcoming launch of FARAWAVE Ultra in early 2027 to regain momentum.

The repurchase program is viewed as an attractive use of capital given the current stock price and long-term outlook, despite the pending Penumbra acquisition.

The buyback will be funded through cash on hand and is expected to commence following the Penumbra shareholder vote on May 6.

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