By the numbers
Q1 sales: $5.2 billion
11.6% growth year over year
Net income: $1.34 billion
Compared with $674 million in Q1 2025
Boston Scientific slashed its 2026 sales growth and earnings guidance on Wednesday as key businesses are facing challenges and setbacks.
The medtech company expects full-year sales growth in a range of 7% to 8.5%, down from a range of 10.5% to 11.5% given in February. Boston Scientific also lowered its adjusted earnings per share guidance from a range of $3.43 to $3.49 to a range of $3.34 to $3.41.
CEO Mike Mahoney told investors on an earnings call that the lowered guidance reflects challenges in several prominent businesses, including electrophysiology and the company’s Watchman franchise.
“This was a guide down that we, quite frankly, are not proud of, but we think it’s the right thing to do, and best reflects the current environment,” Mahoney said.
Mahoney attributed the lowered guidance to three main components: Watchman, electrophysiology and urology.
After seeing sales growth of nearly 30% for Watchman in 2025, Boston Scientific experienced declining Watchman volume for the first time beginning in February, according to Mahoney. The company is currently seeing strong demand for the left atrial appendage closure device in concomitant procedures; however, there has been a slowdown in standalone Watchman procedures.
Watchman sales totaled $506 million in the first quarter, representing year-over-year growth of 19.2%, which was below the company’s expectations. Boston Scientific expects mid-teens growth for the Watchman franchise for 2026.
In electrophysiology, which has continually been a bright spot for the company since it released its Farapulse pulsed field ablation device, Boston Scientific lost more market share than was expected, although the electrophysiology business overall had a “very nice first quarter,” Mahoney said.
PFA, a new procedure to treat atrial fibrillation, has been one of the hottest areas in medtech over the past several years, fueling growth for companies’ electrophysiology portfolios. Boston Scientific saw triple-digit growth for its electrophysiology business in the early days of its Farapulse release. However, competition is intensifying as rivals like Medtronic, Johnson & Johnson and Abbott expand their presence in the market.
When discussing the loss of market share in PFA, Mahoney called Medtronic a “solid competitor,” and pointed to the expanding footprint of J&J and Abbott.
While Boston Scientific’s electrophysiology business has been growing steadily over the past year, there has been a deceleration of growth in PFA since the technology’s release. On the latest earnings call, Mahoney maintained that the company is confident it will retain its leadership position in PFA despite losing more market share than anticipated.
The electrophysiology business grew in the first quarter despite challenges in PFA: the unit brought in $905 million, representing year-over-year growth of nearly 24%. However, the business once again struggled to grow meaningfully over the prior quarter.
Finally, the urology business barely generated growth. The segment grew at roughly 2% year over year, bringing in $646 million, which was below the company’s expectations. Mahoney said the business will grow below the market in 2026.
“Those are the three contributors overall to the guide down that were all done very objectively,” Mahoney said. “We think it’s prudent, and we think it’s the best guide to provide, to give shareholders confidence and to set up the business the right way.”
The company’s stock price was up more than 9% to $64.93 on Wednesday morning.
