Acutus Medical (AFIB) 10-Q13 Aug 212021 Q2 Quarterly reportFinancial data

Company Profile

Cover Page

Cover Page - shares	6 Months Ended
Cover Page - shares	Jun. 30, 2021	Aug. 09, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2021
Document Transition Report	false
Entity File Number	001-39430
Entity Registrant Name	ACUTUS MEDICAL, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-1306615
Entity Address, Address Line One	2210 Faraday Ave.
Entity Address, Address Line Two	Suite 100,
Entity Address, City or Town	Carlsbad
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92008
City Area Code	442
Local Phone Number	232-6080
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	AFIB
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		34,607,593
Amendment Flag	false
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001522860
Document Fiscal Year Focus	2021
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 7,127	$ 25,234
Marketable securities, short-term	73,894	105,839
Restricted cash	150	150
Accounts receivable	3,359	2,160
Inventory	14,663	12,958
Prepaid expenses and other current assets	2,859	5,047
Total current assets	102,052	151,388
Marketable securities, long-term	0	8,726
Property and equipment, net	15,335	12,356
Right-of-use assets, net	4,841	1,669
Intangible assets, net	5,333	5,653
Goodwill	12,026	12,026
Other assets	1,006	717
Total assets	140,593	192,535
Current liabilities:
Accounts payable	5,794	8,266
Accrued liabilities	8,908	7,308
Contingent consideration, short-term	2,700	5,400
Operating lease liabilities, short-term	454	933
Total current liabilities	17,856	21,907
Operating lease liabilities, long-term	4,798	1,134
Long-term debt	39,683	39,011
Contingent consideration, long-term	2,400	3,900
Total liabilities	64,737	65,952
Commitments and contingencies
Stockholders' equity
Preferred stock, $0.001 par value; 5,000,000 shares authorized as of June 30, 2021 and December 31, 2020; no shares issued and outstanding as of June 30, 2021 and December 31, 2020	0	0
Common stock, $0.001 par value; 260,000,000 shares authorized as of June 30, 2021 and December 31, 2020; 28,211,626 and 27,991,425 shares issued and outstanding as of June 30, 2021 and December 31, 2020, respectively	28	28
Additional paid-in capital	494,595	487,290
Accumulated deficit	(418,923)	(361,015)
Accumulated other comprehensive income	156	280
Total stockholders' equity	75,856	126,583
Total liabilities and stockholders' equity	$ 140,593	$ 192,535

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	260,000,000	260,000,000
Common stock, shares issued (in shares)	28,211,626	27,991,425
Common stock, shares outstanding (in shares)	28,211,626	27,991,425

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Statement of Comprehensive Income [Abstract]
Revenue	$ 4,709	$ 1,134	$ 8,300	$ 2,717
Costs and operating expenses:
Cost of products sold	7,492	2,663	14,447	5,857
Research and development	9,174	8,176	18,544	16,149
Selling, general and administrative	15,601	9,125	31,853	19,360
Change in fair value of contingent consideration	(258)	635	(1,411)	(1,584)
Total costs and operating expenses	32,009	20,599	63,433	39,782
Loss from operations	(27,300)	(19,465)	(55,133)	(37,065)
Other income (expense):
Change in fair value of warrant liability	0	(2,453)	0	(1,872)
Interest income	29	95	69	370
Interest expense	(1,456)	(1,370)	(2,844)	(2,724)
Total other expense, net	(1,427)	(3,728)	(2,775)	(4,226)
Loss before income taxes	(28,727)	(23,193)	(57,908)	(41,291)
Income tax benefit	0	0	0	0
Net loss	(28,727)	(23,193)	(57,908)	(41,291)
Other comprehensive income (loss)
Unrealized gain (loss) on marketable securities	4	(14)	10	(41)
Foreign currency translation adjustment	92	96	(134)	69
Comprehensive loss	$ (28,631)	$ (23,111)	$ (58,032)	$ (41,263)
Net loss per common share, basic (in dollars per share)	$ (1.02)	$ (32.24)	$ (2.06)	$ (58.16)
Net loss per common share, diluted (in dollars per share)	$ (1.02)	$ (32.24)	$ (2.06)	$ (58.16)
Weighted average shares outstanding, basic (in shares)	28,152,305	719,421	28,092,329	709,961
Weighted average shares outstanding, diluted (in shares)	28,152,305	719,421	28,092,329	709,961

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Convertible Preferred Stock and Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Accumulated Other Comprehensive Income (Loss)	Series A Convertible Preferred Stock	Series B Convertible Preferred Stock	Series C Convertible Preferred Stock	Series D Convertible Preferred Stock
Balance at beginning of period (in shares) at Dec. 31, 2019						391,210	3,088,444	4,499,921	8,200,297
Balance at beginning of period (in shares) at Dec. 31, 2019						$ 3,059	$ 40,685	$ 74,575	$ 135,039
Increase (Decrease) in Temporary Equity [Roll Forward]
Issuance of Series D convertible preferred stock for the Biotronik Asset Purchase (in shares)									273,070
Issuance of Series D convertible preferred stock for the Biotronik Asset Purchase									$ 5,000
Issuance of Series D convertible-preferred stock for the contingent consideration related to the Rhythm Xience Acquisition (in shares)									119,993
Issuance of Series D convertible preferred stock for the contingent consideration related to the Rhythm Xience Acquisition									$ 2,197
Balance at end of period (in shares) at Jun. 30, 2020						391,210	3,088,444	4,499,921	8,593,360
Balance at end of period (in shares) at Jun. 30, 2020						$ 3,059	$ 40,685	$ 74,575	$ 142,236
Balance at beginning of period (in shares) at Dec. 31, 2019		695,902
Balance at beginning of period at Dec. 31, 2019	$ (225,811)	$ 1	$ 33,252	$ (259,034)	$ (30)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain (loss) on marketable securities	(41)				(41)
Foreign currency translation adjustment	69				69
Stock option exercises (in shares)		64,562
Stock option exercises	205		205
Stock-based compensation (in shares)		14,939
Stock-based compensation	2,898		2,898
Net loss	(41,291)			(41,291)
Balance at end of period (in shares) at Jun. 30, 2020		775,403
Balance at end of period at Jun. 30, 2020	(263,971)	$ 1	36,355	(300,325)	(2)
Balance at beginning of period (in shares) at Mar. 31, 2020						391,210	3,088,444	4,499,921	8,593,360
Balance at beginning of period (in shares) at Mar. 31, 2020						$ 3,059	$ 40,685	$ 74,575	$ 142,236
Balance at end of period (in shares) at Jun. 30, 2020						391,210	3,088,444	4,499,921	8,593,360
Balance at end of period (in shares) at Jun. 30, 2020						$ 3,059	$ 40,685	$ 74,575	$ 142,236
Balance at beginning of period (in shares) at Mar. 31, 2020		710,841
Balance at beginning of period at Mar. 31, 2020	(242,222)	$ 1	34,993	(277,132)	(84)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain (loss) on marketable securities	(14)				(14)
Foreign currency translation adjustment	96				96
Stock option exercises (in shares)		64,562
Stock option exercises	205		205
Stock-based compensation (in shares)		0
Stock-based compensation	1,157	$ 0	1,157
Net loss	(23,193)			(23,193)
Balance at end of period (in shares) at Jun. 30, 2020		775,403
Balance at end of period at Jun. 30, 2020	(263,971)	$ 1	36,355	(300,325)	(2)
Balance at beginning of period (in shares) at Dec. 31, 2020		27,991,425
Balance at beginning of period at Dec. 31, 2020	126,583	$ 28	487,290	(361,015)	280
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain (loss) on marketable securities	10				10
Foreign currency translation adjustment	$ (134)				(134)
Stock option exercises (in shares)	98,969	98,969
Stock option exercises	$ 619		619
Stock-based compensation (in shares)		94,274
Stock-based compensation	6,686		6,686
Issuance of common stock for cashless warrant exercise (in shares)		26,958
Net loss	(57,908)			(57,908)
Balance at end of period (in shares) at Jun. 30, 2021		28,211,626
Balance at end of period at Jun. 30, 2021	75,856	$ 28	494,595	(418,923)	156
Balance at beginning of period (in shares) at Mar. 31, 2021		28,113,165
Balance at beginning of period at Mar. 31, 2021	100,261	$ 28	490,369	(390,196)	60
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain (loss) on marketable securities	4				4
Foreign currency translation adjustment	92				92
Stock option exercises (in shares)		71,460
Stock option exercises	450		450
Stock-based compensation (in shares)		43
Stock-based compensation	$ 3,776		3,776
Issuance of common stock for cashless warrant exercise (in shares)	26,958
Net loss	$ (28,727)			(28,727)
Balance at end of period (in shares) at Jun. 30, 2021		28,211,626
Balance at end of period at Jun. 30, 2021	$ 75,856	$ 28	$ 494,595	$ (418,923)	$ 156

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Cash flows from operating activities
Net loss	$ (57,908)	$ (41,291)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense	2,747	978
Amortization of intangible assets	320	220
Stock-based compensation expense	6,686	2,898
Amortization of premiums on marketable securities, net	797	5
Amortization of debt issuance costs	672	314
Amortization of right-of-use assets	343	336
Change in fair value of warrant liability	0	1,872
Change in fair value of contingent consideration	(1,411)	(1,584)
Changes in operating assets and liabilities:
Accounts receivable	(1,199)	(597)
Inventory	(1,705)	(3,616)
Prepaid expenses and other current assets	2,501	666
Other assets	(289)	8
Accounts payable	(2,727)	5,286
Accrued liabilities	1,600	155
Operating lease liabilities	(342)	(411)
Net cash used in operating activities	(49,915)	(34,761)
Cash flows from investing activities
Purchases of available-for-sale marketable securities	(9,134)	0
Sales of available-for-sale marketable securities	4,590	17,095
Maturities of available-for-sale marketable securities	44,407	40,000
Purchases of property and equipment	(5,841)	(4,445)
Net cash provided by investing activities	34,022	52,650
Cash flows from financing activities
Payment of deferred offering costs	(10)	(701)
Payment of contingent consideration	(2,758)	(2,619)
Proceeds from stock options exercises	619	205
Net cash used in financing activities	(2,149)	(3,115)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(65)	69
Net change in cash, cash equivalents and restricted cash	(18,107)	14,843
Cash, cash equivalents and restricted cash, at the beginning of the period	25,384	9,602
Cash, cash equivalents and restricted cash, at the end of the period	7,277	24,445
Supplemental disclosure of cash flow information:
Cash paid for income taxes	38	0
Cash paid for interest	2,263	2,376
Supplemental disclosure of noncash investing and financing activities:
Issuance of Series D convertible preferred stock for Biotronik asset purchase	0	5,000
Issuance of Series D convertible preferred stock for Rhythm Xience Acquisition	0	2,197
Change in unrealized (gain) loss on marketable securities	(10)	41
Right-of-use assets exchanged for operating lease liabilities	3,527	0
Unpaid purchases of property and equipment	58	55
Unpaid deferred offering costs	$ 313	$ 1,805

Organization and Description of

Organization and Description of Business	6 Months Ended
Organization and Description of Business	Jun. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	Organization and Description of Business Acutus Medical, Inc. (the “Company”) is an arrhythmia management company focused on improving the way cardiac arrhythmias are diagnosed and treated. The Company designs, manufactures and markets a range of tools for catheter-based ablation procedures to treat various arrhythmias. The Company’s product portfolio includes novel access sheaths, transseptal crossing tools, diagnostic and mapping catheters, ablation catheters, mapping and imaging consoles and accessories, as well as supporting algorithms and software programs. The Company was incorporated in the state of Delaware on March 25, 2011, and is located in Carlsbad, California. Public Offering In July 2021, the Company issued 6,325,000 shares of common stock in a public offering, which included 825,000 shares of common stock issued upon the underwriter's exercise in full of an option to purchase additional shares of common stock. The price to the public for each share was $14.00 for approximately $82.7 million in net proceeds to the Company. Going Concern, Liquidity and Capital Resources The Company has limited revenue, has incurred operating losses since inception and expects to continue to incur significant operating losses for at least the next several years and may never become profitable. As of June 30, 2021 and December 31, 2020, the Company had an accumulated deficit of $418.9 million and $361.0 million, respectively, and working capital of $84.2 million and $129.5 million, respectively. The Company has historically funded its operations primarily through the sale of debt and equity securities, as well as other indebtedness. With the closing of the Company’s initial public offering (“IPO”) in August 2020 and secondary offering in July 2021, the Company’s current cash, cash equivalents and marketable securities are sufficient to fund operations for at least the next 12 months. However, the Company may need to raise additional funds through the issuance of additional debt, equity or both. Until such time, if ever, the Company can generate revenue sufficient to achieve profitability, the Company expects to finance its operations through equity or debt financings, which may not be available to the Company on the timing needed or on terms that the Company deems to be favorable. To the extent that the Company raises additional capital through the sale of equity or convertible debt securities, the ownership interest of its stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect the rights of common stockholders. Debt financing and preferred equity financing, if available, may involve agreements that include covenants limiting or restricting the Company’s ability to take specific actions, such as incurring additional debt, making acquisitions or capital expenditures or declaring dividends. If the Company is unable to maintain sufficient financial resources, its business, financial condition and results of operations will be materially and adversely affected. The Company may be required to delay, limit, reduce or terminate its product discovery and development activities or future commercialization efforts. There can be no assurance that the Company will be able to obtain the needed financing on acceptable terms or at all. Impact of COVID-19 Beginning in March 2020, the COVID-19 pandemic and the measures imposed to contain this pandemic disrupted and are expected to continue to impact the Company's business. For example, on March 19, 2020, the Executive Department of the State of California issued Executive Order N-33-20, ordering all individuals in the State of California to stay home or at their place of residence except as needed to maintain continuity of operations of the federal critical infrastructure sectors. The Company's primary operations are located in Carlsbad, California. As a result of such order, the majority of the Company’s employees have telecommuted, which may impact certain of its operations over the near term and long term. Moreover, beginning in March 2020, access to hospitals and other customer sites was restricted to essential personnel, which negatively impacted the Company’s ability to install its AcQMap consoles and workstations in new accounts and for sales representatives and mappers to promote the use of the Company’s products with physicians. Moreover, hospitals and other therapeutic centers suspended many elective procedures, resulting in a significantly reduced volume of procedures using the Company's products. In addition, all clinical trials in Europe were suspended with follow-ups for clinical trials done via telecom, and the Company believes enrollment timing in its planned clinical trials will be slowed due to COVID-19 driven delayed access to enrollment sites. As a result of the interruptions to the business due to COVID-19, the Company enacted a cash conservation program, which included delaying certain non-critical capital expenditures and other projects and implementing a hiring freeze, headcount reductions and temporary compensation reductions (through August 2020). The effects of the pandemic began to decrease in late April 2020 as electrophysiology labs began reopening and procedure volumes began increasing as compared to COVID-19 related low points in March 2020. The Company’s IPO in August 2020 provided resources sufficient to restore

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
Summary of Significant Accounting Policies	Jun. 30, 2021
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period. Principles of Consolidation The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiary Acutus Medical NV (“Acutus NV”), which was incorporated under the laws of Belgium in August 2013. All intercompany balances and transactions have been eliminated in consolidation. Use of Estimates and Assumptions The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, expenses and disclosures of contingent assets and liabilities. The most significant estimates and assumptions in the Company’s condensed consolidated financial statements include, but are not limited to, revenue recognition, useful lives of intangible assets, assessment of impairment of goodwill, measurement of operating lease liabilities, and the fair value of common stock, stock options, warrants, intangible assets, contingent consideration and goodwill. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are not readily apparent from other sources. Actual results could differ from those estimates. Segments Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business in one operating segment. Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of June 30, 2021 and December 31, 2020, exceeded federally insured limits. Restricted cash serves as collateral for the Company’s corporate credit card program. The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total shown on the condensed consolidated statement of cash flows (in thousands): June 30, December 31, (unaudited) Cash and cash equivalents $ 7,127 $ 25,234 Restricted cash 150 150 Total cash, cash equivalents and restricted cash $ 7,277 $ 25,384 Marketable Securities The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets. Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ equity (deficit) until their disposition or maturity. See “Fair Value Measurements” below. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method. Marketable securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive loss for the three and six months ended June 30, 2021 and 2020. Concentrations of Credit Risk and Off-Balance Sheet Risk Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions, which, at times may exceed the Federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant. The Company’s marketable securities portfolio consists of investments in commercial paper, U.S. treasury securities, asset-backed securities and short-term high credit quality corporate debt securities. Revenue from Contracts with Customers The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers (“ASC 606”). The core principle of the revenue standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle: • Step 1: Identify the contract with the customer. • Step 2: Identify the performance obligations in the contract. • Step 3: Determine the transaction price. • Step 4: Allocate the transaction price to the performance obligations in the contract. • Step 5: Recognize revenue when, or as, the company satisfies a performance obligation. The Company places its medical diagnostic equipment, AcQMap System, at customer sites under evaluation agreements and generates revenue from the sale of disposable products used with the AcQMap System. Disposable products include AcQMap Catheters and AcQGuide Steerable Sheaths. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company also sells the AcQMap System to customers along with software updates on a when-and-if-available basis and equipment service. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation. The Company also enters into deferred equipment agreements that are generally structured such that the Company agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two The Company’s contracts primarily include fixed consideration. Generally, there are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days. The delivery of disposable products are performance obligations satisfied at a point in time. The disposable products are shipped Free on Board (“FOB”) shipping point or FOB destination. For disposable products that are shipped FOB shipping point, the customer has the significant risks and rewards of ownership and legal title to the assets when the disposable products leave the Company’s shipping facilities, thus the customer obtains control and revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination. The installation and delivery of the AcQMap System is satisfied at a point in time when the installation is complete, which is when the customer can benefit and has control of the system. The Company’s software updates and equipment service performance obligations are satisfied evenly over time as the customer simultaneously receives and consumes the benefits of the Company’s performance for these services throughout the service period. The Company allocates the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company determines SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which includes, but is not limited to, transactions where the specific performance obligations are sold separately, list prices, and offers to customers. Except for the deferred equipment agreements noted above, the Company’s contracts with customers generally have an expected duration of one year or less, and therefore the Company has elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts are recorded as selling, general and administrative expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of June 30, 2021 and December 31, 2020. In May 2020, the Company entered into bi-lateral distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the “Bi-Lateral Distribution Agreements”). Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non-exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a co-exclusive right to distribute these products in Hong Kong. Each party will pay to the other party specified transfer prices on the sale of the other party’s products and, accordingly, will earn a distribution margin on the sale of the other party’s products. The following table sets forth the Company’s revenue for disposables, systems and service/other for the three and six months ended June 30, 2021 and 2020 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (unaudited) (unaudited) Acutus Direct Disposables $ 2,816 $ 899 $ 4,599 $ 1,919 Systems 672 — 1,285 520 Service/Other 33 12 68 18 Total Acutus direct revenue 3,521 911 5,952 2,457 Distribution agreements 1,188 223 2,348 260 Total revenue $ 4,709 $ 1,134 $ 8,300 $ 2,717 The following table provides revenue by geographic location for the three and six months ended June 30, 2021 and 2020 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (unaudited) (unaudited) Acutus Direct United States $ 2,344 $ 544 $ 3,812 $ 1,313 Europe 1,177 367 2,140 1,144 Total Acutus direct revenue 3,521 911 5,952 2,457 Distribution Agreements United States 143 15 256 15 Europe 1,045 208 2,092 245 Total revenue through distribution agreements 1,188 223 2,348 260 Total revenue $ 4,709 $ 1,134 $ 8,300 $ 2,717 Inventory Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $0.1 million for both of the three months ended June 30, 2021 and 2020, and $0.9 million and $0.1 million for the six months ended June 30, 2021 and 2020, respectively. Accounts Receivable Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of June 30, 2021 and December 31, 2020. Property and Equipment, Net Property and equipment are recorded at cost. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the related assets, generally three Intangible Assets Intangible assets consist of acquired developed technology, acquired in-process technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired in-process technology was classified as an indefinite-lived intangible asset, until the receipt of Food and Drug Administration (the “FDA”) approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was classified as a finite-lived intangible and amortization for in-process technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite - lived intangible assets are impaired if their estimated fair values are less than their carrying value. Goodwill Goodwill represents the excess of the purchase price of an entity over the estimated fair value of the assets acquired and liabilities assumed, and it is presented as goodwill in the accompanying condensed consolidated balance sheets. Under ASC 350, Intangibles – Goodwill and Other (“ASC 350”), goodwill is not amortized but is subject to periodic impairment testing. ASC 350 requires that an entity assign its goodwill to reporting units and test each reporting unit’s goodwill for impairment at least on an annual basis and between annual tests if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. In the evaluation of goodwill for impairment, which is performed annually during the fourth quarter, the Company first assesses qualitative factors to determine whether the existence of events or circumstances led to a determination that it was more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events or circumstances, it is determined that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, the Company is required to perform the quantitative goodwill impairment test. The Company has one reporting unit. For the six months ended June 30, 2021, the qualitative testing did not indicate any impairment for the carrying amount of goodwill. Impairment of Long-Lived Assets The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three and six months ended June 30, 2021 and 2020, the Company determined that there was no impairment of property and equipment or intangible assets. Foreign Currency Translation and Transactions The assets, liabilities and results of operations of Acutus NV are measured using their functional currency, the Euro, which is the currency of the primary foreign economic environment in which this subsidiary operates. Upon consolidating this entity with the Company, its assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and its revenues and expenses are translated at the weighted average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating this entity’s financial statements are reported in accumulated other comprehensive income (loss) in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive loss. Lessee Leases The Company accounts for its lessee leases under ASC 842, Leases (“ASC 842”). Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases, and are recorded on the condensed consolidated balance sheet as both a right-of-use asset and a lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred. In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election. Cost of Products Sold Cost of products sold includes raw materials, direct labor, manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products. Research and Development The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. In April 2021, the Company and Biotronik entered into a Feasibility and Development Agreement to pursue the development of hardware, software and IT infrastructure to implement the Qubic Connect System ("QBS"). The QBS will allow data transfer from multiple diagnostic and therapeutic medical products during an electrophysiology procedure to be aggregated and analyzed for the purposes of designing improved treatment protocols. Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials. Selling, General and Administrative Selling, general and administrative (“SG&A”) expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs. The Company expenses all SG&A costs as incurred. Fair Value Measurements Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy has been used in determining the inputs used in measuring fair value: Level 1—Quoted prices in active markets for identical assets or liabilities. Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace. Level 3—Unobservable inputs which are supported by little or no market activity and that are financial instruments whose values are determined using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation. Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for the three and six months ended June 30, 2021 and 2020. As of June 30, 2021 and December 31, 2020, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of the instruments. The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt. The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of June 30, 2021 and December 31, 2020 (in thousands): Fair Value Measured as of June 30, 2021 (unaudited) Quoted Significant Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 4,821 $ — $ — $ 4,821 Marketable securities at fair value Corporate debt securities — 24,854 — 24,854 U.S. treasury securities — 20,273 — 20,273 Commercial paper — 22,191 — 22,191 Asset-backed securities — 6,576 — 6,576 Total fair value $ 4,821 $ 73,894 $ — $ 78,715 Liabilities included in: Contingent consideration $ — $ — $ 5,100 $ 5,100 Total fair value $ — $ — $ 5,100 $ 5,100 Fair Value Measured as of December 31, 2020 Quoted Significant Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 19,070 $ — $ — $ 19,070 Marketable securities at fair value Corporate debt securities — 31,353 — 31,353 U.S. treasury securities — 20,531 — 20,531 Commercial paper — 53,955 — 53,955 Asset-backed securities — 8,726 — 8,726 Total fair value $ 19,070 $ 114,565 $ — $ 133,635 Liabilities included in: Contingent consideration $ — $ — $ 9,300 $ 9,300 Total fair value $ — $ — $ 9,300 $ 9,300 The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets. The Company’s portfolio of marketable securities is comprised of commercial paper, asset-backed securities, U.S. treasury securities and short-term highly liquid, high credit quality corporate debt securities. The fair value for the available-for-sale marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets or liabilities, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments or debt, broker and dealer quotes, as well as other relevant economic measures. The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2021 (in thousands): Contingent Balance, December 31, 2020 $ 9,300 Payment of contingent consideration (2,758) Escrow release (1) (31) Change in fair value (1,411) Balance, June 30, 2021 (unaudited) $ 5,100 (1) As part of the Rhythm Xience acquisition (see Note 3), the first $0.5 million earned related to revenue success payments was paid at the end of the first month following the end in which the revenue success payments were earned, into an escrow account until the expiration of an additional 18 month hold-back period commencing with the end of the quarter during which such revenue success payment amounts were earned. Amounts noted above were released from the escrow account. Unrealized gains and losses associated with liabilities within the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long-dated volatilities) inputs. The fair value of the contingent consideration from the acquisition of Rhythm Xience (see Note 3) represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective earn-out period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales or earnings; (iii) risk-free interest rate and (iv) expected volatility of earnings. Estimated payments, as determined through the respective model, were further discounted by a credit spread assumption to account for credit risk. The fair value of the milestones-based contingent consideration was determined by probability weighting and discounting to the respective valuation date at the Company’s cost of debt. The Company’s cost of debt was determined by performing a synthetic credit rating for the Company and selecting yields based on companies with a similar credit rating. The contingent consideration is revalued to fair value each period, and any increase or decrease is recorded in operating loss. The fair value of the contingent consideration may be impacted by certain unobservable inputs, most significantly with regard to discount rates, expected volatility and historical and projected performance. Significant changes to these inputs in isolation could result in a significantly different fair value measurement. The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of June 30, 2021 and December 31, 2020 were as follows: June 30, 2021 December 31, 2020 (unaudited) Risk-free interest rate 0.30% 0.20% Expected term in years 1.0 - 2.0 1.0 - 2.0 Expected volatility 21.2% 17.2% Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock awards (“RSAs”), restricted stock units (“RSUs”) and restricted stock units with non-market performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs, RSUs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSAs and RSUs over the requisite service period. As the PSUs have a performance condition, compensation expense was recognized for each vesting tranche over the respective requisite service period of each tranche upon the registration statement used in connection with the Company’s IPO being declared effective on August 5, 2020, when the Company’s management deemed it probable that the performance conditions were satisfied. The Company recognized a cumulative true-up adjustment related to PSUs once the conditions became probable of being satisfied as the related service period had been completed in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive loss based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See “Note 16—Stock-Based Compensation” below. Income Taxes Income taxes are re

Asset Acquisition and Business

Asset Acquisition and Business Combination	6 Months Ended
Asset Acquisition and Business Combination	Jun. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Asset Acquisition and Business Combination	Asset Acquisition and Business Combination Biotronik Asset Acquisition In July 2019, the Company entered into a License and Distribution Agreement with Biotronik and VascoMed GmbH (the “Biotronik Parties”) to obtain certain licenses to the Biotronik Parties’ patents, whereby the Company acquired certain manufacturing equipment and obtained from the Biotronik Parties a license under certain patents and technology to develop, commercialize, distribute and manufacture the AcQBlate Force ablation catheters and Qubic Force device (the “Biotronik Asset Acquisition"). In exchange for the rights granted to the Company, the Company made cash payments totaling $10.0 million during the year ended December 31, 2019, and issued 273,070 shares of Series D convertible preferred stock valued at $5.0 million during the three months ended March 31, 2020. The implied value of $5.0 million was recorded as an accrued liability as of December 31, 2019. In accordance with ASC 805, the Biotronik Asset Acquisition was accounted for as an asset acquisition as substantially all of the $15.0 million value transferred to Biotronik was allocated to intellectual property. On the acquisition date, the products licensed had not yet received regulatory approval and the intellectual property did not have an alternative use. Accordingly, the $15.0 million paid to Biotronik was immediately charged to research and development expense—licensed acquired in the condensed consolidated statement of operations and comprehensive loss in July 2019. Additional contingent milestone payments of up to $10.0 million, of which $2.0 million has been paid as of June 30, 2021, are to be made to the Biotronik Parties contingent upon certain regulatory approvals and first commercial sale. In further consideration of the rights granted, beginning with the Company’s first commercial sale of the first force sensing ablation catheter within the licensed product line, the Company will also make per unit royalty payments. The Company determined that the remaining $8.0 million contingent milestone and royalty payments are not probable and estimable and therefore have not been recorded as a liability as of June 30, 2021 and December 31, 2020. Upon regulatory approval in December 2020 of the Company’s force sensing ablation catheter in Europe, the $2.0 million milestone was capitalized and is being amortized, and the royalty payments are recorded as cost of products sold as sales of catheters are recognized. Rhythm Xience Business Combination On June 18, 2019 (the “Acquisition Date”), the Company acquired an integrated family of transseptal crossing and steerable introducer systems through its acquisition of Rhythm Xience for $3.0 million in cash in exchange for all of the stock of Rhythm Xience (the “Rhythm Xience Acquisition”). The cash payment did not include the potential $17.0 million in earn out consideration, of which $2.2 million was paid with the issuance of Series D convertible preferred stock in February 2020 and the remainder is to be paid based on the achievement of certain regulatory milestones and revenue milestones. In accordance with ASC 805, the Rhythm Xience Acquisition was accounted for as a business combination. As part of the Rhythm Xience Acquisition, the Company recorded a contingent consideration liability for potential additional payments due to the sellers of Rhythm Xience if certain regulatory approval milestones and revenue milestones are achieved. The initial contingent consideration liability of $13.4 million was based on the fair value of the contingent consideration liability at the acquisition date. During the year ended December 31, 2020, the Company issued 119,993 shares of Series D convertible preferred stock and paid $2.5 million of the contingent consideration for the achievement of certain regulatory and revenue milestones. During the six months ended June 30, 2021, the Company paid an additional $2.8 million of the contingent consideration for the achievement of certain regulatory and revenue milestones. Additionally, the Company recorded a $0.3 million decrease and $0.6 million increase for the three months ended June 30, 2021 and 2020, respectively, and a $1.4 million and $1.6 million decrease to the fair value of the contingent consideration liability for the six months ended June 30, 2021 and 2020, respectively, which is included in change in fair value of contingent consideration in the condensed consolidated statements of operations and comprehensive loss. As of June 30, 2021, the contingent consideration liability of $5.1 million is the fair value of the remaining payments due to the sellers of Rhythm Xience if certain additional regulatory approval milestones and revenue milestones are achieved. For the three and six months ended June 30, 2021 and 2020, no acquisition costs were incurred or recorded.

Marketable Securities

Marketable Securities	6 Months Ended
Marketable Securities	Jun. 30, 2021
Investments, Debt and Equity Securities [Abstract]
Marketable Securities	Marketable Securities Marketable securities consisted of the following as of June 30, 2021 and December 31, 2020 (in thousands): June 30, 2021 (unaudited) Amortized Gross Gross Fair Value Available-for-sale securities - short-term: Corporate debt securities $ 24,855 $ — $ (1) $ 24,854 U.S. treasury securities 20,270 3 — 20,273 Commercial paper 22,191 — — 22,191 Asset-backed securities 6,576 — — 6,576 Total available-for-sale securities $ 73,892 $ 3 $ (1) $ 73,894 December 31, 2020 Amortized Gross Gross Fair Value Available-for-sale securities - short-term: Corporate debt securities $ 31,359 $ — $ (6) $ 31,353 U.S. treasury securities 20,533 — (2) 20,531 Commercial paper 53,955 — — 53,955 Total available-for-sale securities - short-term 105,847 — (8) 105,839 Asset-backed securities, long-term 8,726 — — 8,726 Total available-for-sale securities $ 114,573 $ — $ (8) $ 114,565 As of June 30, 2021, the Company’s available-for-sale securities classified as short-term of $73.9 million mature in one year or less. As of December 31, 2020, the Company’s available-for-sale securities classified as short-term of $105.8 million mature in one year or less and the available-for-sale securities classified as long-term of $8.7 million mature within two years.

Inventory

Inventory	6 Months Ended
Inventory	Jun. 30, 2021
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory as of June 30, 2021 and December 31, 2020 consisted of the following (in thousands): June 30, December 31, (unaudited) Raw materials $ 6,469 $ 7,960 Work in process 2,322 1,267 Finished goods 5,872 3,731 Total inventory $ 14,663 $ 12,958

Lessor Sales-Type Leases

Lessor Sales-Type Leases	6 Months Ended
Lessor Sales-Type Leases	Jun. 30, 2021
Leases [Abstract]
Lessor Sales-Type Leases	Lessor Sales-Type Leases The Company recognizes revenue and costs, as well as a lease receivable, at the time embedded sales-type leases within its deferred equipment agreements commence. Lease revenue related to sales-type leases for the three and six months ended June 30, 2021 was $0.3 million and $1.2 million, respectively, and is included within revenue in the accompanying condensed consolidated statements of operations and comprehensive loss. There was no lease revenue for the three and six months ended June 30, 2020. Costs related to embedded leases within the Company’s deferred equipment agreements are included in cost of products sold in the accompanying condensed consolidated statements of operations and comprehensive loss. The Company has a short-term lease receivable of $0.5 million and $0.4 million included in prepaid expenses and other current assets as of June 30, 2021 and December 31, 2020, respectively. The Company has a long-term lease receivable of $0.7 million and $0.4 million included in other assets as of June 30, 2021 and December 31, 2020, respectively. As of June 30, 2021, estimated future maturities of sales-type lease receivables for each of the following years are as follows (in thousands): Six months ending December 31, 2021 $ 255 Year ending December 31, 2022 477 Year ending December 31, 2023 236 Year ending December 31, 2024 161 Year ending December 31, 2025 69 Lease receivable $ 1,198

Property and Equipment, Net

Property and Equipment, Net	6 Months Ended
Property and Equipment, Net	Jun. 30, 2021
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and Equipment, Net The Company’s property and equipment, net, consisted of the following as of June 30, 2021 and December 31, 2020 (in thousands): June 30, December 31, (unaudited) Medical diagnostic equipment $ 16,636 $ 13,242 Furniture and fixtures 426 388 Office equipment 1,539 1,392 Laboratory equipment and software 4,289 3,491 Leasehold improvements 589 608 Construction in process 1,573 468 Total property and equipment 25,052 19,589 Less: accumulated depreciation (9,717) (7,233) Property and equipment, net $ 15,335 $ 12,356 Property and equipment includes certain medical diagnostic equipment, including AcQMap Systems, located at customer premises under evaluation agreements. The Company retains the ownership of the equipment and has the right to remove the equipment if it is not being used according to expectations. Depreciation expense was $1.5 million and $0.6 million for the three months ended June 30, 2021 and 2020, respectively, and $2.7 million and $1.0 million for the six months ended June 30, 2021 and 2020, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
Goodwill and Intangible Assets	Jun. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets The table below summarizes goodwill and intangible assets activities as of June 30, 2021 and December 31, 2020 (in thousands): Goodwill Intangible Balance, December 31, 2020 $ 12,026 $ 5,653 Amortization expense — (320) Balance, June 30, 2021 (unaudited) $ 12,026 $ 5,333 Estimated Weighted Intangible Accumulated June 30, (unaudited) Developed technology 10.0 8.1 $ 4,200 $ (810) $ 3,390 Customer-related intangible 5.0 3.0 100 (40) 60 Licensed intangibles 10.0 9.4 2,000 (117) 1,883 Total $ 6,300 $ (967) $ 5,333 Estimated Weighted Intangible Accumulated December 31, 2020 Developed technology 10.0 8.6 $ 4,200 $ (600) $ 3,600 Customer-related intangible 5.0 3.5 100 (30) 70 Licensed intangibles 10.0 9.9 2,000 (17) 1,983 Total $ 6,300 $ (647) $ 5,653 Acquired in-process technology was classified as an indefinite-lived intangible asset until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was reclassified as developed technology and amortization began. The Company recorded amortization expense related to the above intangible assets of $0.2 million and $0.1 million for the three months ended June 30, 2021 and 2020, respectively, and $0.3 million and $0.2 million for the six months ended June 30, 2021 and 2020, respectively. The following table shows the remaining amortization expense associated with amortizable intangible assets as of June 30, 2021 (in thousands): Developed Customer- Licensed Total Six months ending December 31, 2021 $ 210 $ 10 $ 100 $ 320 Year ending December 31, 2022 420 20 200 640 Year ending December 31, 2023 420 20 200 640 Year ending December 31, 2024 420 10 200 630 Year ending December 31, 2025 420 — 200 620 Thereafter 1,500 — 983 2,483 Total $ 3,390 $ 60 $ 1,883 $ 5,333

Accrued Liabilities

Accrued Liabilities	6 Months Ended
Accrued Liabilities	Jun. 30, 2021
Payables and Accruals [Abstract]
Accrued Liabilities	Accrued Liabilities Accrued liabilities consisted of the following as of June 30, 2021 and December 31, 2020 (in thousands): June 30, December 31, (unaudited) Compensation and related expenses $ 6,806 $ 6,250 Professional fees 447 120 Deferred revenue 304 301 Sales and use tax 218 169 Clinical studies 520 91 Other 613 377 Total accrued liabilities $ 8,908 $ 7,308

Debt

Debt	6 Months Ended
Debt	Jun. 30, 2021
Debt Disclosure [Abstract]
Debt	Debt Outstanding debt as of June 30, 2021 and December 31, 2020 consisted of the following (in thousands): June 30, December 31, (unaudited) 2019 Credit Agreement (1) $ 44,550 $ 44,550 Total debt, gross 44,550 44,550 Less: Unamortized debt discount and fees (4,867) (5,539) Total long-term debt $ 39,683 $ 39,011 (1) The 2019 Credit Agreement includes final payment fees of $4.6 million. 2019 Credit Agreement On May 20, 2019, the Company entered into a Credit Agreement (the “2019 Credit Agreement”). The 2019 Credit Agreement provided the Company with a senior term loan facility in aggregate principal amount of $70.0 million, of which the Company borrowed $40.0 million upon closing. Of the remaining $30.0 million, none is available for borrowing. The 2019 Credit Agreement bears interest per annum at 7.75% plus LIBOR for such interest period and the principal amount of term loans outstanding under the 2019 Credit Agreement is due on May 20, 2024. The 2019 Credit Agreement provides for final payment fees of an additional $4.6 million that are due upon prepayment or on the maturity date or upon acceleration. Upon the occurrence and during an event of default, which includes but is not limited to payment default, covenant default or the occurrence of a material adverse change, the lenders may declare all outstanding principal and accrued and unpaid interest immediately due and payable, all unfunded commitments would be terminated, there would be an increase in the applicable interest rate by 10% per annum, and the lenders would be entitled to exercise their other rights and remedies provided for under the 2019 Credit Agreement. Additionally, the lenders may request repayment of a portion of obligations outstanding under the 2019 Credit Agreement to the extent of the Company’s receipt of any (i) net casualty proceeds or (ii) net asset sales proceeds, as defined. These acceleration and early payment features are an embedded derivative that is separately measured from the loan host instrument and classified with the loan host instrument. In connection with the issuance of the 2019 Credit Agreement, the Company issued liability-classified warrants with a fair value of $0.9 million to purchase 419,992 shares of Series C convertible preferred stock at $16.67 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at $16.67 per share and then were automatically converted into warrants to purchase an equal number of shares of common stock at $16.67 per share. The initial recognition of the warrant liability and direct fees of $1.2 million and final payment fees of $4.6 million for the 2019 Credit Agreement resulted in a discount of $6.7 million, which is being amortized to interest expense over the term of the 2019 Credit Agreement using the effective interest method.

Operating Leases

Operating Leases	6 Months Ended
Operating Leases	Jun. 30, 2021
Leases [Abstract]
Operating Leases	Note 11—Operating Leases The Company leases approximately 50,800 square feet of office space for its corporate headquarters and manufacturing facility in Carlsbad, California under a noncancelable operating lease that expires on December 31, 2027. The lease is subject to variable charges for common area maintenance and other costs that are determined annually based on actual costs. The base rent is subject to an annual increase each year. The Company has a renewal option for an additional five-year term upon the expiration date of the lease, which has been excluded from the calculation of the right-of-use asset as it is not reasonably certain to be exercised. The Company also leases approximately 3,900 square feet of office space in Zaventem, Belgium under a noncancelable operating lease that expires on December 31, 2024. The lease is subject to variable charges that are determined annually for common area maintenance and other costs based on actual costs, and base rent is subject to an annual increase each year based on an index rate. The Company has a renewal option for an additional three-year term upon the expiration date of the lease, which has been included in the calculation of the right-of-use asset as it is reasonably certain to be exercised. The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 2021 and 2020 (dollars in thousands): Six Months Ended June 30, 2021 Six Months Ended June 30, 2020 (unaudited) Operating cash flows from operating leases $ 439 $ 507 Weighted average remaining lease term – operating leases (in years) 3.9 1.8 Weighted average discount rate – operating leases 7.0 % 7.0 % The following table provides the components of the Company’s lease cost (in thousands): Three Months Ended Three Months Ended Six Months Ended June 30, 2021 Six Months Ended June 30, 2020 (unaudited) (unaudited) Operating leases Operating lease cost $ 237 $ 216 $ 454 $ 432 Variable lease cost 77 92 160 165 Total rent expense $ 314 $ 308 $ 614 $ 597 As of June 30, 2021, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands): Six months ending December 31, 2021 $ 433 Year ending December 31, 2022 897 Year ending December 31, 2023 1,129 Year ending December 31, 2024 1,161 Year ending December 31, 2025 1,151 Thereafter 2,406 Total 7,177 Less: present value discount (1,925) Operating lease liabilities $ 5,252

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
Commitments and Contingencies	Jun. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and ContingenciesThe Company is not a party to any material legal proceedings and is not aware of any material pending or threatened claims. From time to time however, the Company may be subject to various legal proceedings and claims that arise in the ordinary course of its business activities.

Warrants

Warrants	6 Months Ended
Warrants	Jun. 30, 2021
Warrants and Rights Note Disclosure [Abstract]
Warrants	Warrants As of June 30, 2021 and December 31, 2020, the outstanding warrants to purchase the Company’s common stock were comprised of the following: Equity Upon Exercise Price Expiration Date June 30, December 31, (unaudited) Warrants issued in 2015 Common stock $ 5.25 1/30/25 3,808 3,808 Warrants issued with 2018 Convertible Notes Common stock $ 0.10 6/7/28 346,689 373,810 Warrants issued with 2018 Term Loan Common stock $ 16.67 7/31/28 26,998 26,998 Warrants issued with 2019 Credit Agreement Common stock $ 16.67 5/20/29 419,992 419,992 Total Warrants 797,487 824,608 The Company’s warrant activity for the six months ended June 30, 2021 is as follows: Warrants Weighted Average Exercise Price Weighted Average Remaining Contractual Life (in years) Balance - December 31, 2020 824,608 $ 9.10 7.9 Exercised (27,121) 0.10 6.9 Balance - June 30, 2021 797,487 $ 9.41 7.4 Warrants Classified as Liabilities The Company’s warrants provide the holder the option to purchase a specified number of shares for a specified price. The holder may exercise the warrant in cash or exercise pursuant to a cashless exercise whereby a calculated number of shares are withheld upon exercise to satisfy the exercise price. The warrants do not provide the holder any voting rights until the warrants are exercised. Prior to the IPO, in accordance with ASC 815, other than the warrants issued in 2015, the warrants were recorded as liabilities at fair value at the issuance date. Changes in the fair value were recognized in change in fair value of warrant liability in the condensed consolidated statements of operations and comprehensive loss at the end of each reporting period. On August 10. 2020, in connection with the closing of the IPO, the warrants recorded as liabilities no longer met the definition of a derivative. Accordingly, the fair value of the common and preferred stock warrant liability of $14.5 million was reclassified to stockholders’ equity in the condensed consolidated balance sheet. Warrants Classified as Equity In accordance with ASC 815, the warrants issued in 2015 do not meet the definition of a derivative and are classified in stockholders’ equity in the condensed consolidated balance sheets.

Convertible Preferred Stock

Convertible Preferred Stock	6 Months Ended
Convertible Preferred Stock	Jun. 30, 2021
Temporary Equity [Abstract]
Convertible Preferred Stock	Convertible Preferred Stock In February 2020, the Company issued 119,993 shares of its Series D convertible preferred stock with an implied value of $2.2 million in connection with a contingent consideration payment related to the Rhythm Xience Acquisition. In February 2020, the Company issued 273,070 shares of its Series D convertible preferred stock with an implied value of $5.0 million for the stock issuance portion of the purchase consideration of the Biotronik Asset Acquisition. On August 10, 2020, in connection with the closing of the IPO, all of the 391,210 shares of Series A, 3,088,444 shares of Series B, 4,499,921 shares of Series C and 8,593,360 shares of Series D convertible preferred stock, respectively, automatically converted into an equal number of shares of common stock. Redemption The convertible preferred stock was not unconditionally redeemable at the option of the holder thereof. However, the convertible preferred stock was contingently redeemable upon certain liquidation events. As redemption by the holders was not solely within the control of the Company, all of the outstanding convertible preferred stock was classified as temporary equity in the condensed consolidated balance sheet, prior to the conversion to common stock on August 10, 2020. Dividends The holders of shares of convertible preferred stock were entitled to receive dividends, out of any assets legally available therefore, prior and in preference to any declaration or payment of any dividend on the common stock of the Company, at the applicable dividend rate, payable on a pro rata , pari passu basis when, as and if declared by the Company’s board of directors. The dividend rate was $0.68 per annum for each share of Series A convertible preferred stock, $1.07 per annum for each share of Series B convertible preferred stock and $1.36 per annum for each share of Series C convertible preferred stock and Series D convertible preferred stock, as adjusted. The dividend rights were not cumulative. Liquidation The holders of the Series D convertible preferred stock were entitled to receive a liquidation preference prior to any distribution to the holders of Series A convertible preferred stock, Series B convertible preferred stock and Series C convertible preferred stock (collectively the “Junior Preferred Stock”) and the holders of common stock, in the amount of the original issue price plus declared but unpaid dividends on such shares (the “Series D Liquidation Preference”). The holders of the Junior Preferred Stock were entitled to receive a liquidation preference prior to any distribution to the holders of common stock, after payment of the Series D Liquidation Preference, in the amount of the applicable original issue price plus declared but unpaid dividends on such shares. Voting Rights Holders of convertible preferred stock had the right to one vote for each share of common stock into which such preferred stock could then be converted, and with respect to such vote, such holder had full voting rights and powers equal to the voting rights and powers of the holders of common stock. As long as any shares of Series D convertible preferred stock were outstanding, the holders of such shares of Series D convertible preferred stock (voting exclusively as a separate series) were entitled to elect one director. As long as any shares of Series C convertible preferred stock were outstanding, the holders of such shares of Series C convertible preferred stock (voting exclusively as a separate series) were entitled to elect three directors. As long as any shares of Series A convertible preferred stock or Series B convertible preferred stock were outstanding, the holders of such shares (voting together as a single class and not as separate series, and on an as converted basis) were entitled to elect four directors. The holders of outstanding common stock were entitled to elect one director. The holders of convertible preferred stock and common stock (voting together as a single class and not as separate series, and on an as converted basis) were entitled to elect any remaining directors. Conversion Each share of preferred stock was convertible, at the option of the holder thereof, at any time after the date of issuance of such share, into such number of fully paid and nonassessable shares of the Company’s common stock as was determined by dividing the original issue price, as adjusted, for such series by the applicable conversion price for such series in effect on the date the certificate is surrendered for conversion. The initial conversion price per share for each series of convertible preferred stock was the original issue price applicable to such series as follows: Series Conversion Series A convertible preferred stock $ 8.295 Series B convertible preferred stock $ 13.370 Series C convertible preferred stock $ 16.667 Series D convertible preferred stock $ 16.667 Each share of convertible preferred stock was automatically convertible into fully-paid, non-assessable shares of common stock at the conversion rate at the time in effect for such series of preferred stock immediately upon: (i) the date, or the occurrence of an event, specified by vote or written consent or agreement of the requisite investors; or (ii) the closing of the sale of shares of common stock to the public, at a price of at least $50.00 per share, as adjusted, in a firm-commitment underwritten public offering pursuant to an effective registration statement under the Securities Act of 1933, as amended, resulting in at least $50.0 million of net proceeds to the Company. As noted above, on August 10, 2020, all shares of Series A, Series B, Series C and Series D convertible preferred stock were converted into common stock.

Stockholders_ Equity

Stockholders’ Equity	6 Months Ended
Stockholders’ Equity	Jun. 30, 2021
Equity [Abstract]
Stockholders Equity	Stockholders’ Equity On August 10, 2020, the Company issued 10,147,058 shares of common stock in its IPO, which included 1,323,529 shares of common stock issued upon the underwriters’ exercise in full of an option to purchase, at the public offering price less underwriting discounts and commissions, up to an additional 1,323,529 shares. The price to the public for each share was $18.00. The Company received gross proceeds of $182.6 million from the IPO. Net of underwriting discounts and commission and other offering expenses, the Company received net proceeds of $166.3 million from the IPO. On August 10, 2020, in connection with the closing of the IPO, the Company filed an amended and restated certificate of incorporation (the “A&R Certificate”) with the Secretary of State of the State of Delaware. The A&R Certificate amended and restated the Company’s authorized shares of common stock to 260,000,000 and authorized shares of undesignated preferred stock to 5,000,000.

Stock-Based Compensation

Stock-Based Compensation	6 Months Ended
Stock-Based Compensation	Jun. 30, 2021
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation 2020 Equity Incentive Plan The 2020 Equity Incentive Plan (the “2020 Plan”) which permits the granting of nonstatutory stock options, RSAs, RSUs, stock appreciation rights, PSUs, performance shares and other equity-based awards to employees, directors and consultants became effective on August 5, 2020. As of June 30, 2021, 3,313,017 shares of common stock were authorized for issuance under the 2020 Plan and 807,610 shares remain available for issuance under the 2020 Plan. 2011 Equity Incentive Plan The Company’s 2011 Equity Incentive Plan (the “2011 Plan”) permits the granting of incentive stock options, non-statutory stock options, RSAs, RSUs and other stock-based awards to employees, directors, officers and consultants. As of June 30, 2021, 2,553,536 shares of common stock were authorized for issuance under the 2011 Plan and no shares remain available for issuance under the 2011 Plan. No additional awards will be granted under the 2011 Plan. Shares that become available for issuance from the outstanding awards under the 2011 Plan due to forfeiture, or otherwise, will become available for issuance of future awards under the 2020 Plan. Stock Options The stock options generally vest over four years and have a ten years contractual term. The fair value of each employee and non-employee stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The Company's common stock became publicly traded in August 2020 and lacks company-specific historical and implied volatility information. Therefore, the Company estimates its expected stock volatility based on the historical volatility of a set of publicly traded peer companies. Due to the lack of historical exercise history, the expected term of the Company’s stock options has been determined using the “simplified” method for awards. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is zero based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future. The following assumptions were used to estimate the fair value of stock options for the six months ended June 30, 2021 and 2020: Six Months Ended June 30, 2021 2020 (unaudited) Risk-free interest rate 0.76% - 1.39% 0.90% Expected dividend yield — — Expected term in years 7.0 7.0 Expected volatility 60.0% - 84.0% 70.0% The following table summarizes stock option activity during the six months ended June 30, 2021: Stock Weighted Weighted Aggregate Outstanding as of December 31, 2020 3,403,607 $ 13.32 8.1 $ 52,866 Options granted 940,406 14.10 Options exercised (98,969) 6.25 $ 2,010 Options forfeited (52,472) 17.32 Outstanding as of June 30, 2021 4,192,572 $ 13.62 8.1 $ 15,964 Options vested and exercisable as of June 30, 2021 (unaudited) 1,625,259 $ 10.61 6.6 $ 10,480 For options in the money, the aggregate intrinsic value for options outstanding in the above table represents the product of the number of options outstanding multiplied by the difference between the per share fair value of the Company’s stock on the last day of the fiscal period, which was $16.98 and $28.81 as of June 30, 2021 and December 31, 2020, respectively, and the exercise price. The aggregate intrinsic value for options exercised in the above table represents the product of the number of options exercised multiplied by the difference between the per share fair value of the Company’s stock on the date of exercise and the exercise price. The weighted average grant date fair value per share for the stock option awards granted during the six months ended June 30, 2021 was $9.29. As of June 30, 2021, the total unrecognized compensation related to unvested stock option awards granted was $36.1 million, which the Company expects to recognize over a weighted-average period of approximately 2.8 years. Performance-Based Restricted Stock Units and Restricted Stock Units In June 2019, the Company granted 567,509 PSUs, with a grant date fair value of $13.37. Vesting of the PSUs was dependent upon the satisfaction of both a service condition and a performance condition, which is an IPO or a change of control. The Company began recording compensation expense related to the PSUs upon the registration statement used in connection with the Company’s IPO being declared effective on August 5, 2020, as the performance conditions were satisfied. The compensation expense was determined using the original grant date fair value and is being recognized over the remaining service period. The Company’s PSU and RSU activity for the six months ended June 30, 2021 was as follows: Number Weighted Unvested as of December 31, 2020 545,466 $ 16.53 Granted 484,468 14.25 Forfeited (28,495) 17.84 Vested (94,119) 13.38 Unvested as of June 30, 2021 (unaudited) 907,320 $ 15.60 Restricted Stock The Company’s RSA activity for the six months ended June 30, 2021 was as follows: Number Weighted Unvested as of December 31, 2020 — $ — Granted 186 14.75 Vested (186) 14.75 Unvested as of June 30, 2021 (unaudited) — $ — The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three and six months ended June 30, 2021 and 2020 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (unaudited) (unaudited) Cost of products sold $ 204 $ 58 $ 347 $ 166 Research and development 598 167 1,015 378 Selling, general and administrative 2,861 932 5,129 2,354 Total stock-based compensation $ 3,663 $ 1,157 $ 6,491 $ 2,898 Employee Stock Purchase Plan The 2020 Employee Stock Purchase Plan (the “2020 ESPP”), which permits employees to purchase shares of the Company’s common stock, became effective on August 10, 2020 and 387,063 shares of common stock were authorized for sale under the 2020 ESPP. The 2020 ESPP will be implemented by consecutive offering periods with a new offering period commencing on the first trading day on or after February 1 and August 1 of each year and terminating on the last trading day on or before July 31 and January 31, respectively. The first offering period began on February 1, 2021. On each purchase date, which falls on the last date of each offering period, 2020 ESPP participants will purchase shares of common stock at a price per share equal to 85% of the lesser of (1) the fair market value per share of the common stock on the offering date or (2) the fair market value of the common stock on the purchase date. The occurrence and duration of offering periods under the 2020 ESPP are subject to the determinations of the Compensation Committee of the Company’s Board of Directors, in its sole discretion. The fair value of the 2020 ESPP shares is estimated using the Black-Scholes option pricing model. The Company recorded $0.1 million and $0.2 million of stock-based compensation expense related to the 2020 ESPP for the three and six months ended June 30, 2021, respectively. No expense was recorded for the three or six months ended June 30, 2020.

Net Loss Per Common Share

Net Loss Per Common Share	6 Months Ended
Net Loss Per Common Share	Jun. 30, 2021
Earnings Per Share [Abstract]
Net Loss Per Common Share	Net Loss Per Common Share Basic net loss per common share is computed by dividing net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. Diluted net loss per common share excludes the potential impact of the Company’s convertible preferred stock, common stock options and warrants because their effect would be anti-dilutive due to the Company’s net loss. Since the Company had a net loss in the periods presented, basic and diluted net loss per common share are the same. The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive: Six Months Ended June 30, Shares issuable upon: 2021 2020 (unaudited) Conversion of Series A preferred stock — 391,210 Conversion of Series B preferred stock — 3,088,444 Conversion of Series C preferred stock — 4,499,921 Conversion of Series D preferred stock — 8,593,360 Exercise of stock options 4,192,572 2,596,087 Exercise of common stock warrants 797,487 509,562 Exercise of preferred stock warrants — 446,990 Vesting of PSUs and RSUs 907,320 — Total 5,897,379 20,125,574

401(k) Retirement Plan

401(k) Retirement Plan	6 Months Ended
401(k) Retirement Plan	Jun. 30, 2021
Retirement Benefits [Abstract]
401(k) Retirement Plan	401(k) Retirement PlanThe Company has a 401(k) retirement savings plan that provides retirement benefits to substantially all full-time U.S. employees. Eligible employees may contribute a percentage of their annual compensation, subject to Internal Revenue Service limitations. The Company did not provide any contributions to the 401(k) retirement savings plan for the three and six months ended June 30, 2021 and 2020.

Related Party Transactions

Related Party Transactions	6 Months Ended
Related Party Transactions	Jun. 30, 2021
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions The Company licenses certain patent rights from a former director and shareholder. The license agreement provides for royalty payments to the shareholder of 3% of net product sales, as defined in the agreement. Royalties earned prior to the director’s resignation were less than $0.1 million for each of the three and six months ended June 30, 2020. Additionally, the former director and shareholder also works for one of the Company’s customers and can significantly influence the customer to purchase the Company’s product. Prior to the director’s resignation, the Company recorded sales to this customer of $0.2 million and $0.5 million for the three and six and months ended June 30, 2020, respectively. The Company has a consulting agreement with a director and chairman of the Company’s board of directors. The Company recorded less than $0.1 million in SG&A expense in the condensed consolidated statements of operations and comprehensive loss for the consulting services for each of the three and six months ended June 30, 2021 and 2020. Multiple preferred stock shareholders entered into the 2018 and 2019 Convertible Notes that also contained detached warrants. Additionally, Orbimed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P. entered into the 2019 Credit Agreement with the Company in 2019 for a total of $70.0 million, with $40.0 million being drawn as of June 30, 2021 and December 31, 2020. The Company recorded $1.4 million and $1.3 million for the three months ended June 30, 2021 and 2020, respectively, and $2.7 million for each of the six months ended June 30, 2021 and 2020, in interest expense related to these debt agreements.

Subsequent Events

Subsequent Events	6 Months Ended
Subsequent Events	Jun. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events The Company has completed an evaluation of all subsequent events through August 12, 2021 to ensure that these condensed consolidated financial statements include appropriate disclosure of events both recognized in the condensed consolidated financial statements and events which occurred but were not recognized in the condensed consolidated financial statements. Except as described below, the Company has concluded that no subsequent event has occurred that requires disclosure. Public Offering In July 2021, the Company issued 6,325,000 shares of common stock in a public offering, which included 825,000 shares of common stock issued upon the underwriter's exercise in full of an option to purchase additional shares of common stock. The price to the public for each share was $14.00 for approximately $82.7 million in net proceeds to the Company. Exchange Agreements On July 11, 2021, the Company entered into a letter agreement with each of Deerfield Partners, L.P. and Deerfield Private Design Fund III, L.P. (collectively, “Deerfield”) and OrbiMed Private Investments IV, LP and OrbiMed Royalty Opportunities II, LP (collectively, “OrbiMed”), pursuant to which, within 30 days following and contingent upon the completion of the public offering, each of Deerfield and OrbiMed agreed to negotiate, enter into and consummate exchanges, pursuant to exchange agreements, which would provide, among other things, for the exchange of all of the Company’s common stock held by Deerfield and OrbiMed (including any shares of common stock purchased in the Company’s secondary offering), other than such number of shares of common stock representing 9.5% of the outstanding shares of the Company’s common stock held by each of Deerfield and OrbiMed, for newly issued shares of a new series of the Company’s preferred stock to be designated as Series A Preferred Stock, par value $0.001 per share (the “Series A Preferred Stock”), which would be substantially equivalent to the Company’s common stock except that it would have no voting rights (subject to limited exceptions), would be subject to a beneficial ownership limitation of 4.9% of the Company’s outstanding common stock for each of Deerfield and OrbiMed and would have a liquidation preference of $0.001 per share of Series A Preferred Stock.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
Summary of Significant Accounting Policies (Policies)	Jun. 30, 2021
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiary Acutus Medical NV (“Acutus NV”), which was incorporated under the laws of Belgium in August 2013. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates and Assumptions	Use of Estimates and Assumptions The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, expenses and disclosures of contingent assets and liabilities. The most significant estimates and assumptions in the Company’s condensed consolidated financial statements include, but are not limited to, revenue recognition, useful lives of intangible assets, assessment of impairment of goodwill, measurement of operating lease liabilities, and the fair value of common stock, stock options, warrants, intangible assets, contingent consideration and goodwill. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are not readily apparent from other sources. Actual results could differ from those estimates.
Segments	Segments Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business in one operating segment.
Cash and Cash Equivalents and Restricted Cash	Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of June 30, 2021 and December 31, 2020, exceeded federally insured limits. Restricted cash serves as collateral for the Company’s corporate credit card program. The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total shown on the condensed consolidated statement of cash flows (in thousands): June 30, December 31, (unaudited) Cash and cash equivalents $ 7,127 $ 25,234 Restricted cash 150 150 Total cash, cash equivalents and restricted cash $ 7,277 $ 25,384
Marketable Securities	Marketable Securities The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets. Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ equity (deficit) until their disposition or maturity. See “Fair Value Measurements” below. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method. Marketable securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive loss for the three and six months ended June 30, 2021 and 2020.
Concentrations of Credit Risk and Off-Balance Sheet Risk	Concentrations of Credit Risk and Off-Balance Sheet Risk Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions, which, at times may exceed the Federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant. The Company’s marketable securities portfolio consists of investments in commercial paper, U.S. treasury securities, asset-backed securities and short-term high credit quality corporate debt securities.
Revenue from Contracts with Customers	Revenue from Contracts with Customers The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers (“ASC 606”). The core principle of the revenue standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle: • Step 1: Identify the contract with the customer. • Step 2: Identify the performance obligations in the contract. • Step 3: Determine the transaction price. • Step 4: Allocate the transaction price to the performance obligations in the contract. • Step 5: Recognize revenue when, or as, the company satisfies a performance obligation. The Company places its medical diagnostic equipment, AcQMap System, at customer sites under evaluation agreements and generates revenue from the sale of disposable products used with the AcQMap System. Disposable products include AcQMap Catheters and AcQGuide Steerable Sheaths. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company also sells the AcQMap System to customers along with software updates on a when-and-if-available basis and equipment service. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation. The Company also enters into deferred equipment agreements that are generally structured such that the Company agrees to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranges from two The Company’s contracts primarily include fixed consideration. Generally, there are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days. The delivery of disposable products are performance obligations satisfied at a point in time. The disposable products are shipped Free on Board (“FOB”) shipping point or FOB destination. For disposable products that are shipped FOB shipping point, the customer has the significant risks and rewards of ownership and legal title to the assets when the disposable products leave the Company’s shipping facilities, thus the customer obtains control and revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination. The installation and delivery of the AcQMap System is satisfied at a point in time when the installation is complete, which is when the customer can benefit and has control of the system. The Company’s software updates and equipment service performance obligations are satisfied evenly over time as the customer simultaneously receives and consumes the benefits of the Company’s performance for these services throughout the service period. The Company allocates the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company determines SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which includes, but is not limited to, transactions where the specific performance obligations are sold separately, list prices, and offers to customers. Except for the deferred equipment agreements noted above, the Company’s contracts with customers generally have an expected duration of one year or less, and therefore the Company has elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts are recorded as selling, general and administrative expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of June 30, 2021 and December 31, 2020. In May 2020, the Company entered into bi-lateral distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the “Bi-Lateral Distribution Agreements”). Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non-exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to
Inventory	Inventory Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $0.1 million for both of the three months ended June 30, 2021 and 2020, and $0.9 million and $0.1 million for the six months ended June 30, 2021 and 2020, respectively.
Accounts Receivable	Accounts Receivable Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of June 30, 2021 and December 31, 2020.
Property and Equipment, Net	Property and Equipment, Net Property and equipment are recorded at cost. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the related assets, generally three
Intangible Assets	Intangible Assets Intangible assets consist of acquired developed technology, acquired in-process technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired in-process technology was classified as an indefinite-lived intangible asset, until the receipt of Food and Drug Administration (the “FDA”) approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was classified as a finite-lived intangible and amortization for in-process technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite - lived intangible assets are impaired if their estimated fair values are less than their carrying value.
Goodwill	Goodwill Goodwill represents the excess of the purchase price of an entity over the estimated fair value of the assets acquired and liabilities assumed, and it is presented as goodwill in the accompanying condensed consolidated balance sheets. Under ASC 350, Intangibles – Goodwill and Other (“ASC 350”), goodwill is not amortized but is subject to periodic impairment testing. ASC 350 requires that an entity assign its goodwill to reporting units and test each reporting unit’s goodwill for impairment at least on an annual basis and between annual tests if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. In the evaluation of goodwill for impairment, which is performed annually during the fourth quarter, the Company first assesses qualitative factors to determine whether the existence of events or circumstances led to a determination that it was more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events or circumstances, it is determined that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, the Company is required to perform the quantitative goodwill impairment test. The Company has one reporting unit. For the six months ended June 30, 2021, the qualitative testing did not indicate any impairment for the carrying amount of goodwill.
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three and six months ended June 30, 2021 and 2020, the Company determined that there was no impairment of property and equipment or intangible assets.
Foreign Currency Translation and Transactions	Foreign Currency Translation and Transactions The assets, liabilities and results of operations of Acutus NV are measured using their functional currency, the Euro, which is the currency of the primary foreign economic environment in which this subsidiary operates. Upon consolidating this entity with the Company, its assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and its revenues and expenses are translated at the weighted average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating this entity’s financial statements are reported in accumulated other comprehensive income (loss) in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive loss.
Lessee Leases	Lessee Leases The Company accounts for its lessee leases under ASC 842, Leases (“ASC 842”). Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases, and are recorded on the condensed consolidated balance sheet as both a right-of-use asset and a lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred. In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election.
Cost of Products Sold	Cost of Products Sold Cost of products sold includes raw materials, direct labor, manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products.
Research and Development	Research and Development The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. In April 2021, the Company and Biotronik entered into a Feasibility and Development Agreement to pursue the development of hardware, software and IT infrastructure to implement the Qubic Connect System ("QBS"). The QBS will allow data transfer from multiple diagnostic and therapeutic medical products during an electrophysiology procedure to be aggregated and analyzed for the purposes of designing improved treatment protocols. Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials.
Selling, General and Administrative	Selling, General and Administrative Selling, general and administrative (“SG&A”) expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs. The Company expenses all SG&A costs as incurred.
Fair Value Measurements	Fair Value Measurements Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy has been used in determining the inputs used in measuring fair value: Level 1—Quoted prices in active markets for identical assets or liabilities. Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace. Level 3—Unobservable inputs which are supported by little or no market activity and that are financial instruments whose values are determined using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation. Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for the three and six months ended June 30, 2021 and 2020. As of June 30, 2021 and December 31, 2020, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of the instruments. The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt. The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of June 30, 2021 and December 31, 2020 (in thousands): Fair Value Measured as of June 30, 2021 (unaudited) Quoted Significant Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 4,821 $ — $ — $ 4,821 Marketable securities at fair value Corporate debt securities — 24,854 — 24,854 U.S. treasury securities — 20,273 — 20,273 Commercial paper — 22,191 — 22,191 Asset-backed securities — 6,576 — 6,576 Total fair value $ 4,821 $ 73,894 $ — $ 78,715 Liabilities included in: Contingent consideration $ — $ — $ 5,100 $ 5,100 Total fair value $ — $ — $ 5,100 $ 5,100 Fair Value Measured as of December 31, 2020 Quoted Significant Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 19,070 $ — $ — $ 19,070 Marketable securities at fair value Corporate debt securities — 31,353 — 31,353 U.S. treasury securities — 20,531 — 20,531 Commercial paper — 53,955 — 53,955 Asset-backed securities — 8,726 — 8,726 Total fair value $ 19,070 $ 114,565 $ — $ 133,635 Liabilities included in: Contingent consideration $ — $ — $ 9,300 $ 9,300 Total fair value $ — $ — $ 9,300 $ 9,300 The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets. The Company’s portfolio of marketable securities is comprised of commercial paper, asset-backed securities, U.S. treasury securities and short-term highly liquid, high credit quality corporate debt securities. The fair value for the available-for-sale marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets or liabilities, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments or debt, broker and dealer quotes, as well as other relevant economic measures. The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2021 (in thousands): Contingent Balance, December 31, 2020 $ 9,300 Payment of contingent consideration (2,758) Escrow release (1) (31) Change in fair value (1,411) Balance, June 30, 2021 (unaudited) $ 5,100 (1) As part of the Rhythm Xience acquisition (see Note 3), the first $0.5 million earned related to revenue success payments was paid at the end of the first month following the end in which the revenue success payments were earned, into an escrow account until the expiration of an additional 18 month hold-back period commencing with the end of the quarter during which such revenue success payment amounts were earned. Amounts noted above were released from the escrow account. Unrealized gains and losses associated with liabilities within the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long-dated volatilities) inputs. The fair value of the contingent consideration from the acquisition of Rhythm Xience (see Note 3) represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective earn-out period, corresponding targets and
Stock-Based Compensation	Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock awards (“RSAs”), restricted stock units (“RSUs”) and restricted stock units with non-market performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs, RSUs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options, RSAs and RSUs over the requisite service period. As the PSUs have a performance condition, compensation expense was recognized for each vesting tranche over the respective requisite service period of each tranche upon the registration statement used in connection with the Company’s IPO being declared effective on August 5, 2020, when the Company’s management deemed it probable that the performance conditions were satisfied. The Company recognized a cumulative true-up adjustment related to PSUs once the conditions became probable of being satisfied as the related service period had been completed in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive loss based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See “Note 16—Stock-Based Compensation” below.
Income Taxes	Income Taxes Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the condensed consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse, and net operating loss carryforwards and research and development tax credit carryforwards. Valuation allowances are provided if, based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit will more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. To date, there have been no interest or penalties charged in relation to the unrecognized tax benefits.
Warranty Liability	Warrant Liability The Company accounted for certain common stock warrants and convertible preferred stock warrants outstanding as a liability, in accordance with ASC 815, Derivatives and Hedging (“ASC 815”), at fair value. This liability was subject to re-measurement at each reporting period and upon conversion to equity-classified warrants, and any change in fair value was recognized in the condensed consolidated statements of operations and comprehensive loss. In connection with the IPO on August 10, 2020, the common stock warrants and convertible preferred stock warrants that had been liability-classified were automatically converted into an equal number of warrants to purchase common stock and became equity-classified. The fair value of the outstanding liability on the conversion date was reclassified to additional paid-in capital in the Company’s condensed consolidated balance sheet.
Business Combinations	Business Combinations The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805, which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in the acquisition. Goodwill represents the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Subsequent adjustments to fair value of any contingent consideration are recorded to the Company’s condensed consolidated statements of operations and comprehensive loss.
Recently Adopted Accounting Pronouncements and Accounting Pronouncements to Be Adopted	Recently Adopted Accounting Pronouncements In December 2019, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes , which is intended to simplify various aspects related to accounting for income taxes. ASU No. 2019-12 removes certain exceptions to the general principles in ASC 740 and also clarifies and amends existing guidance to improve consistent application. This guidance is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2020, with early adoption permitted. The Company adopted this guidance in the first quarter of 2021, which did not have a material impact on its condensed consolidated financial statements. Accounting Pronouncements to Be Adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326) . The ASU sets forth a “current expected credit loss” model which requires the Company to measure all expected credit losses for financial instruments held at the reporting date based on historical experience, current conditions and reasonable supportable forecasts. This replaces the existing incurred loss model and is applicable to the measurement of credit losses on financial assets measured at amortized cost, available-for-sale debt securities and applies to certain off-balance sheet credit exposures. This ASU is effective for smaller reporting companies in 2023. The Company is currently assessing the impact of the adoption of this ASU on its condensed consolidated financial statements. In March 2020, the FASB issued ASU No. 2020-4, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting , which provides temporary optional guidance to ease the potential burden in accounting for reference rate reform. The new guidance provides optional expedients and exceptions for applying U.S. GAAP to transactions affected by reference rate reform if certain criteria are met. These transactions include contract modifications, hedging relationships and sale or transfer of debt securities classified as held-to-maturity. Entities may apply the provisions of the new standard as of the beginning of the reporting period when the election is made (i.e., as early as the first quarter of 2020). Unlike other topics, the provisions of this update are only available until December 31, 2022, when the reference rate replacement activity is expected to have been completed. The Company is currently evaluating the impact of this standard on its condensed consolidated financial statements and has yet to elect an adoption date. In April 2021, the FASB issued ASU No. 2021-04, Earnings Per Share (Topic 260), Debt Modifications and Extinguishments (Subtopic 470-50), Compensation Stock Compensation (Topic 718), and Derivatives and Hedging Contracts in Entity’s Own Equity (Subtopic 815-40) , which provides clarification on how to account for a modification or exchange of free-standing equity-classified written call options that remain equity classified after the modification or exchange. This ASU is effective for smaller reporting companies in 2022. The Company is currently assessing the impact of the adoption of this ASU on its condensed consolidated financial statements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	6 Months Ended
Summary of Significant Accounting Policies (Tables)	Jun. 30, 2021
Accounting Policies [Abstract]
Summary of Cash and Cash Equivalents and Restricted Cash	The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total shown on the condensed consolidated statement of cash flows (in thousands): June 30, December 31, (unaudited) Cash and cash equivalents $ 7,127 $ 25,234 Restricted cash 150 150 Total cash, cash equivalents and restricted cash $ 7,277 $ 25,384
Summary of Cash and Cash Equivalents and Restricted Cash	The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the total shown on the condensed consolidated statement of cash flows (in thousands): June 30, December 31, (unaudited) Cash and cash equivalents $ 7,127 $ 25,234 Restricted cash 150 150 Total cash, cash equivalents and restricted cash $ 7,277 $ 25,384
Summary of Disaggregation of Revenue	The following table sets forth the Company’s revenue for disposables, systems and service/other for the three and six months ended June 30, 2021 and 2020 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (unaudited) (unaudited) Acutus Direct Disposables $ 2,816 $ 899 $ 4,599 $ 1,919 Systems 672 — 1,285 520 Service/Other 33 12 68 18 Total Acutus direct revenue 3,521 911 5,952 2,457 Distribution agreements 1,188 223 2,348 260 Total revenue $ 4,709 $ 1,134 $ 8,300 $ 2,717
Summary of Revenue from External Customers by Geographic Areas	The following table provides revenue by geographic location for the three and six months ended June 30, 2021 and 2020 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (unaudited) (unaudited) Acutus Direct United States $ 2,344 $ 544 $ 3,812 $ 1,313 Europe 1,177 367 2,140 1,144 Total Acutus direct revenue 3,521 911 5,952 2,457 Distribution Agreements United States 143 15 256 15 Europe 1,045 208 2,092 245 Total revenue through distribution agreements 1,188 223 2,348 260 Total revenue $ 4,709 $ 1,134 $ 8,300 $ 2,717
Summary of Fair Value, Liabilities Measured on Recurring Basis	The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of June 30, 2021 and December 31, 2020 (in thousands): Fair Value Measured as of June 30, 2021 (unaudited) Quoted Significant Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 4,821 $ — $ — $ 4,821 Marketable securities at fair value Corporate debt securities — 24,854 — 24,854 U.S. treasury securities — 20,273 — 20,273 Commercial paper — 22,191 — 22,191 Asset-backed securities — 6,576 — 6,576 Total fair value $ 4,821 $ 73,894 $ — $ 78,715 Liabilities included in: Contingent consideration $ — $ — $ 5,100 $ 5,100 Total fair value $ — $ — $ 5,100 $ 5,100 Fair Value Measured as of December 31, 2020 Quoted Significant Significant Fair Value at Assets included in: Cash and cash equivalents Money market securities $ 19,070 $ — $ — $ 19,070 Marketable securities at fair value Corporate debt securities — 31,353 — 31,353 U.S. treasury securities — 20,531 — 20,531 Commercial paper — 53,955 — 53,955 Asset-backed securities — 8,726 — 8,726 Total fair value $ 19,070 $ 114,565 $ — $ 133,635 Liabilities included in: Contingent consideration $ — $ — $ 9,300 $ 9,300 Total fair value $ — $ — $ 9,300 $ 9,300
Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2021 (in thousands): Contingent Balance, December 31, 2020 $ 9,300 Payment of contingent consideration (2,758) Escrow release (1) (31) Change in fair value (1,411) Balance, June 30, 2021 (unaudited) $ 5,100 (1) As part of the Rhythm Xience acquisition (see Note 3), the first $0.5 million earned related to revenue success payments was paid at the end of the first month following the end in which the revenue success payments were earned, into an escrow account until the expiration of an additional 18 month hold-back period commencing with the end of the quarter during which such revenue success payment amounts were earned. Amounts noted above were released from the escrow account.
Weighted-Average Unobservable Inputs to Measure Contingent Consideration	The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of June 30, 2021 and December 31, 2020 were as follows: June 30, 2021 December 31, 2020 (unaudited) Risk-free interest rate 0.30% 0.20% Expected term in years 1.0 - 2.0 1.0 - 2.0 Expected volatility 21.2% 17.2%

Marketable Securities (Tables)

Marketable Securities (Tables)	6 Months Ended
Marketable Securities (Tables)	Jun. 30, 2021
Investments, Debt and Equity Securities [Abstract]
Summary of Marketable Securities	Marketable securities consisted of the following as of June 30, 2021 and December 31, 2020 (in thousands): June 30, 2021 (unaudited) Amortized Gross Gross Fair Value Available-for-sale securities - short-term: Corporate debt securities $ 24,855 $ — $ (1) $ 24,854 U.S. treasury securities 20,270 3 — 20,273 Commercial paper 22,191 — — 22,191 Asset-backed securities 6,576 — — 6,576 Total available-for-sale securities $ 73,892 $ 3 $ (1) $ 73,894 December 31, 2020 Amortized Gross Gross Fair Value Available-for-sale securities - short-term: Corporate debt securities $ 31,359 $ — $ (6) $ 31,353 U.S. treasury securities 20,533 — (2) 20,531 Commercial paper 53,955 — — 53,955 Total available-for-sale securities - short-term 105,847 — (8) 105,839 Asset-backed securities, long-term 8,726 — — 8,726 Total available-for-sale securities $ 114,573 $ — $ (8) $ 114,565

Inventory (Tables)

Inventory (Tables)	6 Months Ended
Inventory (Tables)	Jun. 30, 2021
Inventory Disclosure [Abstract]
Summary of Inventory	Inventory as of June 30, 2021 and December 31, 2020 consisted of the following (in thousands): June 30, December 31, (unaudited) Raw materials $ 6,469 $ 7,960 Work in process 2,322 1,267 Finished goods 5,872 3,731 Total inventory $ 14,663 $ 12,958

Lessor Sales-Type Leases (Table

Lessor Sales-Type Leases (Tables)	6 Months Ended
Lessor Sales-Type Leases (Tables)	Jun. 30, 2021
Leases [Abstract]
Estimated Future Maturities of Sales-Type Lease Receivables	As of June 30, 2021, estimated future maturities of sales-type lease receivables for each of the following years are as follows (in thousands): Six months ending December 31, 2021 $ 255 Year ending December 31, 2022 477 Year ending December 31, 2023 236 Year ending December 31, 2024 161 Year ending December 31, 2025 69 Lease receivable $ 1,198

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	6 Months Ended
Property and Equipment, Net (Tables)	Jun. 30, 2021
Property, Plant and Equipment [Abstract]
Summary of Property and Equipment, Net	The Company’s property and equipment, net, consisted of the following as of June 30, 2021 and December 31, 2020 (in thousands): June 30, December 31, (unaudited) Medical diagnostic equipment $ 16,636 $ 13,242 Furniture and fixtures 426 388 Office equipment 1,539 1,392 Laboratory equipment and software 4,289 3,491 Leasehold improvements 589 608 Construction in process 1,573 468 Total property and equipment 25,052 19,589 Less: accumulated depreciation (9,717) (7,233) Property and equipment, net $ 15,335 $ 12,356

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
Goodwill and Intangible Assets (Tables)	Jun. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Goodwill and Intangible Assets Activities	The table below summarizes goodwill and intangible assets activities as of June 30, 2021 and December 31, 2020 (in thousands): Goodwill Intangible Balance, December 31, 2020 $ 12,026 $ 5,653 Amortization expense — (320) Balance, June 30, 2021 (unaudited) $ 12,026 $ 5,333
Summary of Finite Lived Intangible Assets	Estimated Weighted Intangible Accumulated June 30, (unaudited) Developed technology 10.0 8.1 $ 4,200 $ (810) $ 3,390 Customer-related intangible 5.0 3.0 100 (40) 60 Licensed intangibles 10.0 9.4 2,000 (117) 1,883 Total $ 6,300 $ (967) $ 5,333 Estimated Weighted Intangible Accumulated December 31, 2020 Developed technology 10.0 8.6 $ 4,200 $ (600) $ 3,600 Customer-related intangible 5.0 3.5 100 (30) 70 Licensed intangibles 10.0 9.9 2,000 (17) 1,983 Total $ 6,300 $ (647) $ 5,653
Summary of Remaining Amortization Expense	The following table shows the remaining amortization expense associated with amortizable intangible assets as of June 30, 2021 (in thousands): Developed Customer- Licensed Total Six months ending December 31, 2021 $ 210 $ 10 $ 100 $ 320 Year ending December 31, 2022 420 20 200 640 Year ending December 31, 2023 420 20 200 640 Year ending December 31, 2024 420 10 200 630 Year ending December 31, 2025 420 — 200 620 Thereafter 1,500 — 983 2,483 Total $ 3,390 $ 60 $ 1,883 $ 5,333

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)	6 Months Ended
Accrued Liabilities (Tables)	Jun. 30, 2021
Payables and Accruals [Abstract]
Summary of Accrued Liabilities	Accrued liabilities consisted of the following as of June 30, 2021 and December 31, 2020 (in thousands): June 30, December 31, (unaudited) Compensation and related expenses $ 6,806 $ 6,250 Professional fees 447 120 Deferred revenue 304 301 Sales and use tax 218 169 Clinical studies 520 91 Other 613 377 Total accrued liabilities $ 8,908 $ 7,308

Debt (Tables)

Debt (Tables)	6 Months Ended
Debt (Tables)	Jun. 30, 2021
Debt Disclosure [Abstract]
Summary of Outstanding Debt	Outstanding debt as of June 30, 2021 and December 31, 2020 consisted of the following (in thousands): June 30, December 31, (unaudited) 2019 Credit Agreement (1) $ 44,550 $ 44,550 Total debt, gross 44,550 44,550 Less: Unamortized debt discount and fees (4,867) (5,539) Total long-term debt $ 39,683 $ 39,011 (1) The 2019 Credit Agreement includes final payment fees of $4.6 million.

Operating Leases (Tables)

Operating Leases (Tables)	6 Months Ended
Operating Leases (Tables)	Jun. 30, 2021
Leases [Abstract]
Summary of Quantitative Information About Operating Leases and Components of Lease Cost	The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 2021 and 2020 (dollars in thousands): Six Months Ended June 30, 2021 Six Months Ended June 30, 2020 (unaudited) Operating cash flows from operating leases $ 439 $ 507 Weighted average remaining lease term – operating leases (in years) 3.9 1.8 Weighted average discount rate – operating leases 7.0 % 7.0 % The following table provides the components of the Company’s lease cost (in thousands): Three Months Ended Three Months Ended Six Months Ended June 30, 2021 Six Months Ended June 30, 2020 (unaudited) (unaudited) Operating leases Operating lease cost $ 237 $ 216 $ 454 $ 432 Variable lease cost 77 92 160 165 Total rent expense $ 314 $ 308 $ 614 $ 597
Summary of Future Minimum Payments Under the Non-cancelable Operating Leases	As of June 30, 2021, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands): Six months ending December 31, 2021 $ 433 Year ending December 31, 2022 897 Year ending December 31, 2023 1,129 Year ending December 31, 2024 1,161 Year ending December 31, 2025 1,151 Thereafter 2,406 Total 7,177 Less: present value discount (1,925) Operating lease liabilities $ 5,252

Warrants (Tables)

Warrants (Tables)	6 Months Ended
Warrants (Tables)	Jun. 30, 2021
Warrants and Rights Note Disclosure [Abstract]
Schedule of Outstanding Warrants to Purchase the Company's Common Stock	As of June 30, 2021 and December 31, 2020, the outstanding warrants to purchase the Company’s common stock were comprised of the following: Equity Upon Exercise Price Expiration Date June 30, December 31, (unaudited) Warrants issued in 2015 Common stock $ 5.25 1/30/25 3,808 3,808 Warrants issued with 2018 Convertible Notes Common stock $ 0.10 6/7/28 346,689 373,810 Warrants issued with 2018 Term Loan Common stock $ 16.67 7/31/28 26,998 26,998 Warrants issued with 2019 Credit Agreement Common stock $ 16.67 5/20/29 419,992 419,992 Total Warrants 797,487 824,608 The Company’s warrant activity for the six months ended June 30, 2021 is as follows: Warrants Weighted Average Exercise Price Weighted Average Remaining Contractual Life (in years) Balance - December 31, 2020 824,608 $ 9.10 7.9 Exercised (27,121) 0.10 6.9 Balance - June 30, 2021 797,487 $ 9.41 7.4
Warrant Activity	As of June 30, 2021 and December 31, 2020, the outstanding warrants to purchase the Company’s common stock were comprised of the following: Equity Upon Exercise Price Expiration Date June 30, December 31, (unaudited) Warrants issued in 2015 Common stock $ 5.25 1/30/25 3,808 3,808 Warrants issued with 2018 Convertible Notes Common stock $ 0.10 6/7/28 346,689 373,810 Warrants issued with 2018 Term Loan Common stock $ 16.67 7/31/28 26,998 26,998 Warrants issued with 2019 Credit Agreement Common stock $ 16.67 5/20/29 419,992 419,992 Total Warrants 797,487 824,608 The Company’s warrant activity for the six months ended June 30, 2021 is as follows: Warrants Weighted Average Exercise Price Weighted Average Remaining Contractual Life (in years) Balance - December 31, 2020 824,608 $ 9.10 7.9 Exercised (27,121) 0.10 6.9 Balance - June 30, 2021 797,487 $ 9.41 7.4

Convertible Preferred Stock (Ta

Convertible Preferred Stock (Tables)	6 Months Ended
Convertible Preferred Stock (Tables)	Jun. 30, 2021
Temporary Equity [Abstract]
Schedule of Initial Conversion Price per Share for each Series of Convertible Preferred Stock	The initial conversion price per share for each series of convertible preferred stock was the original issue price applicable to such series as follows: Series Conversion Series A convertible preferred stock $ 8.295 Series B convertible preferred stock $ 13.370 Series C convertible preferred stock $ 16.667 Series D convertible preferred stock $ 16.667

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	6 Months Ended
Stock-Based Compensation (Tables)	Jun. 30, 2021
Share-based Payment Arrangement [Abstract]
Schedule of Estimate of the Fair Value of Stock Option	The following assumptions were used to estimate the fair value of stock options for the six months ended June 30, 2021 and 2020: Six Months Ended June 30, 2021 2020 (unaudited) Risk-free interest rate 0.76% - 1.39% 0.90% Expected dividend yield — — Expected term in years 7.0 7.0 Expected volatility 60.0% - 84.0% 70.0%
Summary of Stock Option Activity	The following table summarizes stock option activity during the six months ended June 30, 2021: Stock Weighted Weighted Aggregate Outstanding as of December 31, 2020 3,403,607 $ 13.32 8.1 $ 52,866 Options granted 940,406 14.10 Options exercised (98,969) 6.25 $ 2,010 Options forfeited (52,472) 17.32 Outstanding as of June 30, 2021 4,192,572 $ 13.62 8.1 $ 15,964 Options vested and exercisable as of June 30, 2021 (unaudited) 1,625,259 $ 10.61 6.6 $ 10,480
Schedule of PSU and RSU Activity	The Company’s PSU and RSU activity for the six months ended June 30, 2021 was as follows: Number Weighted Unvested as of December 31, 2020 545,466 $ 16.53 Granted 484,468 14.25 Forfeited (28,495) 17.84 Vested (94,119) 13.38 Unvested as of June 30, 2021 (unaudited) 907,320 $ 15.60
Schedule of RSA Activity	The Company’s RSA activity for the six months ended June 30, 2021 was as follows: Number Weighted Unvested as of December 31, 2020 — $ — Granted 186 14.75 Vested (186) 14.75 Unvested as of June 30, 2021 (unaudited) — $ —
Summary of the Total Stock-Based Compensation Expense for the Stock Options, PSUs and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss	The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three and six months ended June 30, 2021 and 2020 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (unaudited) (unaudited) Cost of products sold $ 204 $ 58 $ 347 $ 166 Research and development 598 167 1,015 378 Selling, general and administrative 2,861 932 5,129 2,354 Total stock-based compensation $ 3,663 $ 1,157 $ 6,491 $ 2,898

Net Loss Per Common Share (Tabl

Net Loss Per Common Share (Tables)	6 Months Ended
Net Loss Per Common Share (Tables)	Jun. 30, 2021
Earnings Per Share [Abstract]
Summary of Calculation of the Diluted Net Loss per Common Share	The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive: Six Months Ended June 30, Shares issuable upon: 2021 2020 (unaudited) Conversion of Series A preferred stock — 391,210 Conversion of Series B preferred stock — 3,088,444 Conversion of Series C preferred stock — 4,499,921 Conversion of Series D preferred stock — 8,593,360 Exercise of stock options 4,192,572 2,596,087 Exercise of common stock warrants 797,487 509,562 Exercise of preferred stock warrants — 446,990 Vesting of PSUs and RSUs 907,320 — Total 5,897,379 20,125,574

Organization and Description _2

Organization and Description of Business (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	1 Months Ended
	Jul. 31, 2021	Jun. 30, 2021	Dec. 31, 2020
Subsidiary, Sale of Stock [Line Items]
Accumulated deficit		$ 418,923	$ 361,015
Working capital deficit		$ 84,200	$ 129,500
Subsequent Event \| Public Stock Offering - Shares Issued Upon Underwriters Exercise
Subsidiary, Sale of Stock [Line Items]
Number of shares issued in transaction (in shares)	825
Price to public (in dollars per share)	$ 14
Consideration received on transaction	$ 82,700
Common Stock \| Subsequent Event \| Public Stock Offering - Shares Issued Upon Underwriters Exercise
Subsidiary, Sale of Stock [Line Items]
Number of shares issued in transaction (in shares)	6,325

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Narrative (Details)	3 Months Ended		6 Months Ended
	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)segmentreportingUnit	Jun. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segment \| segment			1
Other-than-temporary impairments related to marketable securities	$ 0	$ 0	$ 0	$ 0
Cash, FDIC insured amount	250,000		250,000
Inventory write-down	100,000	100,000	900,000	100,000
Allowance for uncollectible accounts	0		$ 0		$ 0
Number of reporting unit \| reportingUnit			1
Impairment of property and equipment or intangible assets	0	$ 0	$ 0	$ 0
Interest or penalties charged in relation to the unrecognized tax benefits	$ 0		$ 0
Minimum
Summary Of Significant Accounting Policies [Line Items]
Customers payment period			30 days
Property and equipment, estimated useful lives			3 years
Maximum
Summary Of Significant Accounting Policies [Line Items]
Customers payment period			60 days
Contracts with customers, expected duration	1 year		1 year
Property and equipment, estimated useful lives			5 years
Deferred Equipment Agreements
Summary Of Significant Accounting Policies [Line Items]
Up-front charge			$ 0
Deferred Equipment Agreements \| Minimum
Summary Of Significant Accounting Policies [Line Items]
Contract term			2 years
Deferred Equipment Agreements \| Maximum
Summary Of Significant Accounting Policies [Line Items]
Contract term			4 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Summary of Cash and Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020	Jun. 30, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Cash and cash equivalents	$ 7,127	$ 25,234
Restricted cash	150	150
Total cash, cash equivalents and restricted cash	$ 7,277	$ 25,384	$ 24,445	$ 9,602

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Disaggregation of Revenue [Line Items]
Total revenue	$ 4,709	$ 1,134	$ 8,300	$ 2,717
Distribution Agreements
Disaggregation of Revenue [Line Items]
Total revenue	1,188	223	2,348	260
Acutus Direct
Disaggregation of Revenue [Line Items]
Total revenue	3,521	911	5,952	2,457
Acutus Direct \| Disposables
Disaggregation of Revenue [Line Items]
Total revenue	2,816	899	4,599	1,919
Acutus Direct \| Systems
Disaggregation of Revenue [Line Items]
Total revenue	672	0	1,285	520
Acutus Direct \| Service/Other
Disaggregation of Revenue [Line Items]
Total revenue	$ 33	$ 12	$ 68	$ 18

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Summary of Revenue from External Customers by Geographic Areas (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Disaggregation of Revenue [Line Items]
Total revenue	$ 4,709	$ 1,134	$ 8,300	$ 2,717
Acutus Direct
Disaggregation of Revenue [Line Items]
Total revenue	3,521	911	5,952	2,457
Distribution Agreements
Disaggregation of Revenue [Line Items]
Total revenue	1,188	223	2,348	260
United States \| Acutus Direct
Disaggregation of Revenue [Line Items]
Total revenue	2,344	544	3,812	1,313
United States \| Distribution Agreements
Disaggregation of Revenue [Line Items]
Total revenue	143	15	256	15
Europe \| Acutus Direct
Disaggregation of Revenue [Line Items]
Total revenue	1,177	367	2,140	1,144
Europe \| Distribution Agreements
Disaggregation of Revenue [Line Items]
Total revenue	$ 1,045	$ 208	$ 2,092	$ 245

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Assets included in:
Available-for-sale securities		$ 114,565
Total fair value	$ 78,715	133,635
Liabilities included in:
Total fair value	5,100	9,300
Contingent consideration
Liabilities included in:
Total fair value	5,100	9,300
Money market securities
Assets included in:
Money market securities	4,821	19,070
Corporate debt securities
Assets included in:
Available-for-sale securities	24,854	31,353
U.S. treasury securities
Assets included in:
Available-for-sale securities	20,273	20,531
Commercial paper
Assets included in:
Available-for-sale securities	22,191	53,955
Asset-backed securities
Assets included in:
Available-for-sale securities	6,576	8,726
Quoted Prices in Active Markets for Identical Assets (Level 1)
Assets included in:
Total fair value	4,821	19,070
Liabilities included in:
Total fair value	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Contingent consideration
Liabilities included in:
Total fair value	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Money market securities
Assets included in:
Money market securities	4,821	19,070
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Corporate debt securities
Assets included in:
Available-for-sale securities	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| U.S. treasury securities
Assets included in:
Available-for-sale securities	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Commercial paper
Assets included in:
Available-for-sale securities	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Asset-backed securities
Assets included in:
Available-for-sale securities	0	0
Significant Other Observable Inputs (Level 2)
Assets included in:
Total fair value	73,894	114,565
Liabilities included in:
Total fair value	0	0
Significant Other Observable Inputs (Level 2) \| Contingent consideration
Liabilities included in:
Total fair value	0	0
Significant Other Observable Inputs (Level 2) \| Money market securities
Assets included in:
Money market securities	0	0
Significant Other Observable Inputs (Level 2) \| Corporate debt securities
Assets included in:
Available-for-sale securities	24,854	31,353
Significant Other Observable Inputs (Level 2) \| U.S. treasury securities
Assets included in:
Available-for-sale securities	20,273	20,531
Significant Other Observable Inputs (Level 2) \| Commercial paper
Assets included in:
Available-for-sale securities	22,191	53,955
Significant Other Observable Inputs (Level 2) \| Asset-backed securities
Assets included in:
Available-for-sale securities	6,576	8,726
Significant Unobservable Inputs (Level 3)
Assets included in:
Total fair value	0	0
Liabilities included in:
Total fair value	5,100	9,300
Significant Unobservable Inputs (Level 3) \| Contingent consideration
Liabilities included in:
Total fair value	5,100	9,300
Significant Unobservable Inputs (Level 3) \| Money market securities
Assets included in:
Money market securities	0	0
Significant Unobservable Inputs (Level 3) \| Corporate debt securities
Assets included in:
Available-for-sale securities	0	0
Significant Unobservable Inputs (Level 3) \| U.S. treasury securities
Assets included in:
Available-for-sale securities	0	0
Significant Unobservable Inputs (Level 3) \| Commercial paper
Assets included in:
Available-for-sale securities	0	0
Significant Unobservable Inputs (Level 3) \| Asset-backed securities
Assets included in:
Available-for-sale securities	$ 0	$ 0

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Contingent Consideration
Change in fair value	$ (258)	$ 635	$ (1,411)	$ (1,584)
Contingent consideration
Contingent Consideration
Additional holdback period			18 months
Significant Unobservable Inputs (Level 3) \| Contingent consideration
Contingent Consideration
Balance at beginning of period			$ 9,300
Payment of contingent consideration			(2,758)
Escrow release			(31)
Change in fair value			(1,411)
Balance at end of period (unaudited)	$ 5,100		5,100
Revenue success payments			$ 500

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Summary of Weighted-Average Fair Value Assumptions on Contingent Consideration (Details) - Significant Unobservable Inputs (Level 3) - Rhythm Xience	Jun. 30, 2021	Dec. 31, 2020
Risk-free interest rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.0030	0.0020
Expected term in years \| Minimum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	1	1
Expected term in years \| Maximum
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	2	2
Expected volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.212	0.172

Asset Acquisition and Busines_2

Asset Acquisition and Business Combination (Details) - USD ($) $ in Thousands	Jun. 18, 2019	Feb. 29, 2020	Jul. 31, 2019	Jun. 30, 2021	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Research and development				$ 9,174	$ 8,176		$ 18,544	$ 16,149
Payments for contingent consideration							2,758	2,619
Biotronik Asset Acquisition
Business Acquisition [Line Items]
Consideration paid in cash										$ 10,000
Equity interests issued and issuable										$ 5,000
Consideration transferred			$ 15,000
Payments for contingent consideration							2,000
Contingent milestone and royalty payments				8,000			8,000		$ 8,000
Potential milestone payments capitalized									2,000
Biotronik Asset Acquisition \| Maximum
Business Acquisition [Line Items]
Potential milestone payments payable				10,000			10,000
Biotronik Asset Acquisition \| Intellectual Property
Business Acquisition [Line Items]
Research and development			$ 15,000
Rhythm Xience
Business Acquisition [Line Items]
Consideration paid in cash	$ 3,000
Payments for contingent consideration							2,800		$ 2,500
Contingent consideration liability	13,400			5,100			5,100
Business combination contingent consideration liability change in amount				$ (300)	$ 600		$ (1,400)	$ (1,600)
Rhythm Xience \| Earnout Consideration
Business Acquisition [Line Items]
Potential milestone payments payable	$ 17,000
Series D Convertible Preferred Stock \| Biotronik Asset Acquisition
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable (in shares)						273,070
Equity interests issued and issuable						$ 5,000
Series D Convertible Preferred Stock \| Rhythm Xience
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable (in shares)									119,993
Series D Convertible Preferred Stock \| Rhythm Xience \| Earnout Consideration
Business Acquisition [Line Items]
Equity interests issued and issuable		$ 2,200

Marketable Securities - Summary

Marketable Securities - Summary of Marketable Securities (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		$ 114,573
Gross Unrealized Gains		0
Gross Unrealized Losses		(8)
Fair Value		114,565
Short-term debt
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 73,892	105,847
Gross Unrealized Gains	3	0
Gross Unrealized Losses	(1)	(8)
Fair Value	73,894	105,839
Long-term debt
Debt Securities, Available-for-sale [Line Items]
Fair Value		8,700
Corporate debt securities \| Short-term debt
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	24,855	31,359
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(1)	(6)
Fair Value	24,854	31,353
U.S. treasury securities \| Short-term debt
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	20,270	20,533
Gross Unrealized Gains	3	0
Gross Unrealized Losses	0	(2)
Fair Value	20,273	20,531
Commercial paper \| Short-term debt
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	22,191	53,955
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	22,191	53,955
Asset-backed securities \| Short-term debt
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	6,576
Gross Unrealized Gains	0
Gross Unrealized Losses	0
Fair Value	$ 6,576
Asset-backed securities \| Long-term debt
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		8,726
Gross Unrealized Gains		0
Gross Unrealized Losses		0
Fair Value		$ 8,726

Marketable Securities - Narrati

Marketable Securities - Narrative (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Debt Securities, Available-for-sale [Line Items]
Available-for-sale securities		$ 114,565
Short-term debt
Debt Securities, Available-for-sale [Line Items]
Available-for-sale securities	$ 73,894	$ 105,839
Debt securities, available-for-sale, maturity period	1 year	1 year
Long-term debt
Debt Securities, Available-for-sale [Line Items]
Available-for-sale securities		$ 8,700
Debt securities, available-for-sale, maturity period		2 years

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw materials	$ 6,469	$ 7,960
Work in process	2,322	1,267
Finished goods	5,872	3,731
Total inventory	$ 14,663	$ 12,958

Lessor Sales-Type Leases - Narr

Lessor Sales-Type Leases - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
Lessor Sales-Type Leases - Narrative (Details) - USD ($)	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Lessor, Lease, Description [Line Items]
Lease revenue	$ 300,000	$ 0	$ 1,200,000	$ 0
Prepaid Expenses and Other Current Assets
Lessor, Lease, Description [Line Items]
Lease receivable	500,000		500,000		$ 400,000
Other Assets
Lessor, Lease, Description [Line Items]
Lease receivable	$ 700,000		$ 700,000		$ 400,000

Lessor Sales-Type Leases - Esti

Lessor Sales-Type Leases - Estimated Future Maturities of Sales-Type Lease Receivables (Details) $ in Thousands	Jun. 30, 2021USD ($)
Leases [Abstract]
Six months ending December 31, 2021	$ 255
Year ending December 31, 2022	477
Year ending December 31, 2023	236
Year ending December 31, 2024	161
Year ending December 31, 2025	69
Lease receivable	$ 1,198

Property and Equipment, Net - S

Property and Equipment, Net - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 25,052	$ 19,589
Less: accumulated depreciation	(9,717)	(7,233)
Property and equipment, net	15,335	12,356
Medical diagnostic equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	16,636	13,242
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Total property and equipment	426	388
Office equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	1,539	1,392
Laboratory equipment and software
Property, Plant and Equipment [Line Items]
Total property and equipment	4,289	3,491
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total property and equipment	589	608
Construction in process
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 1,573	$ 468

Property and Equipment, Net - N

Property and Equipment, Net - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Property, Plant and Equipment [Abstract]
Depreciation	$ 1,500	$ 600	$ 2,747	$ 978

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Summary of Goodwill and Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Goodwill
Balance at beginning of period			$ 12,026
Balance at end of period (unaudited)	$ 12,026		12,026
Intangible Assets
Balance at beginning of period			5,653
Amortization expense	(200)	$ (100)	(320)	$ (220)
Balance at end of period (unaudited)	$ 5,333		$ 5,333

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Summary of Finite and Indefinite Lived Intangible Assets (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2021	Dec. 31, 2020
Finite-Lived Intangible Assets [Line Items]
Intangible Assets	$ 6,300	$ 6,300
Accumulated Amortization	(967)	(647)
Finite-Lived Intangible Assets, Net	$ 5,333	$ 5,653
Developed technology
Finite-Lived Intangible Assets [Line Items]
Estimated Useful Life	10 years	10 years
Weighted Average Remaining Life	8 years 1 month 6 days	8 years 7 months 6 days
Intangible Assets	$ 4,200	$ 4,200
Accumulated Amortization	(810)	(600)
Finite-Lived Intangible Assets, Net	$ 3,390	$ 3,600
Customer-related intangible
Finite-Lived Intangible Assets [Line Items]
Estimated Useful Life	5 years	5 years
Weighted Average Remaining Life	3 years	3 years 6 months
Intangible Assets	$ 100	$ 100
Accumulated Amortization	(40)	(30)
Finite-Lived Intangible Assets, Net	$ 60	$ 70
Licensed intangibles
Finite-Lived Intangible Assets [Line Items]
Estimated Useful Life	10 years	10 years
Weighted Average Remaining Life	9 years 4 months 24 days	9 years 10 months 24 days
Intangible Assets	$ 2,000	$ 2,000
Accumulated Amortization	(117)	(17)
Finite-Lived Intangible Assets, Net	$ 1,883	$ 1,983

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 200	$ 100	$ 320	$ 220

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Summary of Remaining Amortization Expense (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2021	$ 320
Year ending December 31, 2022	640
Year ending December 31, 2023	640
Year ending December 31, 2024	630
Year ending December 31, 2025	620
Thereafter	2,483
Finite-Lived Intangible Assets, Net	5,333	$ 5,653
Developed technology
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2021	210
Year ending December 31, 2022	420
Year ending December 31, 2023	420
Year ending December 31, 2024	420
Year ending December 31, 2025	420
Thereafter	1,500
Finite-Lived Intangible Assets, Net	3,390	3,600
Customer-related intangible
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2021	10
Year ending December 31, 2022	20
Year ending December 31, 2023	20
Year ending December 31, 2024	10
Year ending December 31, 2025	0
Thereafter	0
Finite-Lived Intangible Assets, Net	60	70
Licensed intangibles
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2021	100
Year ending December 31, 2022	200
Year ending December 31, 2023	200
Year ending December 31, 2024	200
Year ending December 31, 2025	200
Thereafter	983
Finite-Lived Intangible Assets, Net	$ 1,883	$ 1,983

Accrued Liabilities (Details)

Accrued Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Payables and Accruals [Abstract]
Compensation and related expenses	$ 6,806	$ 6,250
Professional fees	447	120
Deferred revenue	304	301
Sales and use tax	218	169
Clinical studies	520	91
Other	613	377
Total accrued liabilities	$ 8,908	$ 7,308

Debt - Summary of Outstanding D

Debt - Summary of Outstanding Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020	May 20, 2019
Debt Instrument [Line Items]
Long-term debt, gross	$ 44,550	$ 44,550
Less: Unamortized debt discount and fees	(4,867)	(5,539)
Total long-term debt	39,683	39,011
Fee amount			$ 4,600
2019 Convertible Notes
Debt Instrument [Line Items]
Long-term debt, gross	$ 44,550	$ 44,550

Debt - Narrative (Details)

Debt - Narrative (Details) - USD ($)	May 20, 2019	Jun. 30, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Fee amount	$ 4,600,000
Class of warrants, exercise price (in dollars per share)		$ 9.41	$ 9.10
2019 Credit Agreement
Debt Instrument [Line Items]
Interest rate	7.75%
Fee amount		$ 4,600,000	$ 4,600,000
Warrants liability fair value	$ 900,000
Direct fees	$ 1,200,000
2019 Credit Agreement \| Series C Convertible Preferred Stock
Debt Instrument [Line Items]
Class of warrants number of securities called by the warrants or rights (in shares)	419,992
Class of warrants, exercise price (in dollars per share)	$ 16.67
2019 Credit Agreement \| Series D Convertible Preferred Stock
Debt Instrument [Line Items]
Class of warrants, exercise price (in dollars per share)	$ 16.67
2019 Credit Agreement \| Senior Term Loan
Debt Instrument [Line Items]
Face amount	$ 70,000,000
Proceeds from senior term loan	40,000,000
Remaining amount	30,000,000
Unused borrowing capacity	0
Fee amount	4,600,000
Initial debt discount before inception	$ 6,700,000
Default Event \| Senior Term Loan
Debt Instrument [Line Items]
Interest rate, increase (decrease)	10.00%

Operating Leases - Narrative (D

Operating Leases - Narrative (Details)	Jun. 30, 2021ft²
Corporate Office Space and Manufacturing Facility
Lessee, Lease, Description [Line Items]
Office space	50,800
Operating lease, renewal term	5 years
Office Space Zaventem Belgium
Lessee, Lease, Description [Line Items]
Office space	3,900
Operating lease, renewal term	3 years

Operating Leases - Summary of Q

Operating Leases - Summary of Quantitative Information About Operating Leases (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Lessee Disclosure [Abstract]
Operating cash flows from operating leases	$ 439	$ 507
Weighted average remaining lease term – operating leases	3 years 10 months 24 days	1 year 9 months 18 days
Weighted average discount rate – operating leases	7.00%	7.00%

Operating Leases - Summary of C

Operating Leases - Summary of Components of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Operating leases
Operating lease cost	$ 237	$ 216	$ 454	$ 432
Variable lease cost	77	92	160	165
Total rent expense	$ 314	$ 308	$ 614	$ 597

Operating Leases - Summary of F

Operating Leases - Summary of Future Minimum Payments Under the Non-Cancelable Operating Leases (Details) $ in Thousands	Jun. 30, 2021USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
Six months ending December 31, 2021	$ 433
Year ending December 31, 2022	897
Year ending December 31, 2023	1,129
Year ending December 31, 2024	1,161
Year ending December 31, 2025	1,151
Thereafter	2,406
Total	7,177
Less: present value discount	(1,925)
Operating lease liabilities	$ 5,252

Warrants - Schedule of Outstand

Warrants - Schedule of Outstanding Warrants to Purchase the Company's Common Stock (Details) - $ / shares	Jun. 30, 2021	Dec. 31, 2020
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 9.41	$ 9.10
Warrants outstanding (in shares)	797,487	824,608
Common Stock \| Warrants issued in 2015
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 5.25
Warrants outstanding (in shares)	3,808	3,808
Common Stock \| Warrants issued with 2018 Convertible Notes
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 0.10
Warrants outstanding (in shares)	346,689	373,810
Common Stock \| Warrants issued with 2018 Term Loan
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 16.67
Warrants outstanding (in shares)	26,998	26,998
Common Stock \| Warrants issued with 2019 Credit Agreement
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 16.67
Warrants outstanding (in shares)	419,992	419,992

Warrants - Warrant Activity (De

Warrants - Warrant Activity (Details) - $ / shares	6 Months Ended	12 Months Ended
Warrants - Warrant Activity (Details) - $ / shares	Jun. 30, 2021	Dec. 31, 2020
Class of Warrant or Right [Roll Forward]
Warrants, Balance at beginning of period (in shares)	824,608
Warrants, Exercised (in shares)	(27,121)
Warrants, Balance at end of period (in shares)	797,487	824,608
Weighted Average Exercise Price, Balance at beginning of period (in dollars per share)	$ 9.10
Weighted Average Exercise Price, Exercised (in dollars per share)	0.10
Weighted Average Exercise Price, Balance at end of period (in dollars per share)	$ 9.41	$ 9.10
Weighted Average Remaining Contractual Life	7 years 4 months 24 days	7 years 10 months 24 days
Weighted Average Remaining Contractual Life, Exercised	6 years 10 months 24 days

Warrants - Narrative (Details)

Warrants - Narrative (Details) $ in Millions	Aug. 10, 2020USD ($)
Warrants and Rights Note Disclosure [Abstract]
Common and preferred stock warrant liability	$ 14.5

Convertible Preferred Stock - N

Convertible Preferred Stock - Narrative (Details) $ / shares in Units, $ in Millions	Aug. 10, 2020USD ($)directorvote$ / sharesshares	Feb. 29, 2020USD ($)shares
Temporary Equity [Line Items]
Number of votes per share of common stock \| vote	1
Firm Underwritten Commitment \| Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity
Temporary Equity [Line Items]
Stock issue share price per unit (in dollars per share) \| $ / shares	$ 50
Firm Underwritten Commitment \| Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity \| Minimum
Temporary Equity [Line Items]
Sale of stock consideration received \| $	$ 50
Redeemable Convertible Series D Preferred Stock \| Non Cumulative Dividends
Temporary Equity [Line Items]
Temporary equity dividend per share declared (in dollars per share) \| $ / shares	$ 1.36
Series A Convertible Preferred Stock
Temporary Equity [Line Items]
Conversion of stock shares converted (in shares)	391,210
Number of elected directors entitled \| director	4
Series B Convertible Preferred Stock
Temporary Equity [Line Items]
Conversion of stock shares converted (in shares)	3,088,444
Number of elected directors entitled \| director	4
Series C Convertible Preferred Stock
Temporary Equity [Line Items]
Conversion of stock shares converted (in shares)	4,499,921
Number of elected directors entitled \| director	3
Series D Convertible Preferred Stock
Temporary Equity [Line Items]
Conversion of stock shares converted (in shares)	8,593,360
Number of elected directors entitled \| director	1
Redeemable Convertible Series A Preferred Stock \| Non Cumulative Dividends
Temporary Equity [Line Items]
Temporary equity dividend per share declared (in dollars per share) \| $ / shares	$ 0.68
Redeemable Convertible Series B Preferred Stock \| Non Cumulative Dividends
Temporary Equity [Line Items]
Temporary equity dividend per share declared (in dollars per share) \| $ / shares	1.07
Redeemable Convertible Series C Preferred Stock \| Non Cumulative Dividends
Temporary Equity [Line Items]
Temporary equity dividend per share declared (in dollars per share) \| $ / shares	$ 1.36
Common Stock
Temporary Equity [Line Items]
Number of elected directors entitled \| director	1
Rhythm Xcience Acquisition \| Redeemable Convertible Series D Preferred Stock
Temporary Equity [Line Items]
Business combination contingent consideration shares issued (in shares)		119,993
Business combination contingent consideration shares issued value \| $		$ 2.2
Biotonik Asset Acquisition \| Redeemable Convertible Series D Preferred Stock
Temporary Equity [Line Items]
Business combination contingent consideration shares issued (in shares)		273,070
Business combination contingent consideration shares issued value \| $		$ 5

Convertible Preferred Stock - S

Convertible Preferred Stock - Schedule of Initial Conversion Price Per Share for each Series of Convertible Preferred Stock (Details)	Aug. 10, 2020$ / shares
Redeemable Convertible Series A Preferred Stock
Temporary Equity [Line Items]
Temporary equity initial conversion price per share (in dollars per share)	$ 8.295
Redeemable Convertible Series B Preferred Stock
Temporary Equity [Line Items]
Temporary equity initial conversion price per share (in dollars per share)	13.370
Redeemable Convertible Series C Preferred Stock
Temporary Equity [Line Items]
Temporary equity initial conversion price per share (in dollars per share)	16.667
Redeemable Convertible Series D Preferred Stock
Temporary Equity [Line Items]
Temporary equity initial conversion price per share (in dollars per share)	$ 16.667

Stockholders_ Equity (Details)

Stockholders’ Equity (Details) - USD ($) $ / shares in Units, $ in Thousands	Aug. 10, 2020	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Class of Stock [Line Items]
Common stock, shares authorized (in shares)	260,000,000	260,000,000		260,000,000		260,000,000
Convertible preferred stock, shares authorized (in shares)	5,000,000
Stock option exercises (in shares)				98,969
Proceeds from stock options exercises				$ 619	$ 205
Common Stock
Class of Stock [Line Items]
Stock option exercises (in shares)		71,460	64,562	98,969	64,562
IPO
Class of Stock [Line Items]
Stock issued during period (in shares)	10,147,058
Gross proceeds from IPO	$ 182,600
Proceeds from issuance, initial public offering	$ 166,300
Over-Allotment Option
Class of Stock [Line Items]
Stock issued during period (in shares)	1,323,529
IPO and Over Allotment
Class of Stock [Line Items]
Price per share (in dollars per share)	$ 18

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details) - USD ($)	1 Months Ended	3 Months Ended		6 Months Ended		12 Months Ended
Stock-Based Compensation - Narrative (Details) - USD ($)	Jun. 30, 2019	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020	Aug. 10, 2020
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Fair value exercise price to calculate aggregate intrinsic value of options (in dollars per share)				$ 16.98		$ 28.81
Share based compensation by share based payment arrangement weighted-average grant date fair value per share of stock option grants (in dollars per share)				$ 9.29
Unrecognized compensation related to stock options not vested		$ 36,100,000		$ 36,100,000
Share based compensation non vested award period for recognition				2 years 9 months 18 days
Stock-based compensation		$ 3,663,000	$ 1,157,000	$ 6,491,000	$ 2,898,000
Performance Based Restricted Stock Units
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based compensation by share based payment arrangement instruments other than options granted (in shares)	567,509			484,468
Share based compensation by share based payment arrangement instruments other than options granted weighted average grant date fair value (in dollars per share)	$ 13.37			$ 14.25
2020 Equity Incentive Plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)		3,313,017		3,313,017
Share based payment arrangement number of shares available for issuance (in shares)		807,610		807,610
2011 Plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)		2,553,536		2,553,536
Share based payment arrangement number of shares available for issuance (in shares)		0		0
Share based compensation by share based payments arrangement, remain available for issuance (in shares)				0
Share based compensation by share based payment arrangement stock options vesting term				4 years
Share based compensation by share based payment arrangement stock options contractual term				10 years
2020 ESPP
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)							387,063
Stock-based compensation		$ 100,000	$ 0	$ 200,000	$ 0
2020 ESPP \| Maximum
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Participants purchase price of common stock				85.00%

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Estimate of the Fair Value of Stock Option (Details)	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Share-based Payment Arrangement [Abstract]
Risk-free interest rate, minimum	0.76%
Risk-free interest rate, maximum	1.39%
Risk-free interest rate		0.90%
Expected dividend yield	0.00%	0.00%
Expected term	7 years	7 years
Expected volatility, minimum	60.00%
Expected volatility, maximum	84.00%
Expected volatility		70.00%

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock Option Activity (Details) $ / shares in Units, $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2021USD ($)$ / sharesshares	Dec. 31, 2020USD ($)$ / sharesshares
Stock Options
Outstanding at beginning of period (in shares) \| shares	3,403,607
Options granted (in shares) \| shares	940,406
Options exercised (in shares) \| shares	(98,969)
Options forfeited (in shares) \| shares	(52,472)
Outstanding at end of period (in shares) \| shares	4,192,572	3,403,607
Options vested and exercisable as of June 30, 2021 (unaudited) (in shares) \| shares	1,625,259
Weighted Average Exercise Price
Outstanding at beginning of period (in dollars per share) \| $ / shares	$ 13.32
Options granted (in dollars per share) \| $ / shares	14.10
Options exercised (in dollars per share) \| $ / shares	6.25
Options forfeited (in dollars per share) \| $ / shares	17.32
Outstanding at end of period (in dollars per share) \| $ / shares	13.62	$ 13.32
Options vested and exercisable as of June 30, 2021 (unaudited) (in dollars per share) \| $ / shares	$ 10.61
Stock Options Activity, Additional Disclosures
Weighted average remaining contractual life, Outstanding	8 years 1 month 6 days	8 years 1 month 6 days
Weighted average remaining contractual life, Options vested and exercisable as of June 30, 2021 (unaudited)	6 years 7 months 6 days
Aggregate intrinsic value, Outstanding balance at beginning of period \| $	$ 52,866
Aggregate intrinsic value, Options exercised \| $	2,010
Aggregate intrinsic value, Outstanding balance at end of period \| $	15,964	$ 52,866
Aggregate intrinsic value, Options vested and exercisable as of June 30, 2021 (unaudited) \| $	$ 10,480

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of PSU and RSU Activity (Details) - Performance Based Restricted Stock Units - $ / shares	1 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2021
Number of Shares
Unvested balance at beginning of period (in shares)		545,466
Granted (in shares)	567,509	484,468
Forfeited (in shares)		(28,495)
Vested (in shares)		(94,119)
Unvested balance at end of period (unaudited) (in shares)		907,320
Weighted Average Grant Price
Unvested balance at beginning of period (in dollars per share)		$ 16.53
Granted (in dollars per share)	$ 13.37	14.25
Forfeited (in dollars per share)		17.84
Vested (in dollars per share)		13.38
Unvested balance at end of period (unaudited) (in dollars per share)		$ 15.60

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of RSA Activity (Details) - Restricted Stock	6 Months Ended
	Jun. 30, 2021$ / sharesshares
Number of Shares
Unvested balance at beginning of period (in shares) \| shares	0
Granted (in shares) \| shares	186
Vested (in shares) \| shares	(186)
Unvested balance at end of period (unaudited) (in shares) \| shares	0
Weighted Average Grant Price
Unvested balance at beginning of period (in dollars per share) \| $ / shares	$ 0
Granted (in dollars per share) \| $ / shares	14.75
Vested (in dollars per share) \| $ / shares	14.75
Unvested balance at end of period (unaudited) (in dollars per share) \| $ / shares	$ 0

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of the Total Stock-Based Compensation Expense for the Stock Options, PSUs and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 3,663	$ 1,157	$ 6,491	$ 2,898
Cost of products sold
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	204	58	347	166
Research and development
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	598	167	1,015	378
Selling, general and administrative
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 2,861	$ 932	$ 5,129	$ 2,354

Net Loss Per Common Share (Deta

Net Loss Per Common Share (Details) - shares	6 Months Ended
Net Loss Per Common Share (Details) - shares	Jun. 30, 2021	Jun. 30, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	5,897,379	20,125,574
Conversion of Series A preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	0	391,210
Conversion of Series B preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	0	3,088,444
Conversion of Series C preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	0	4,499,921
Conversion of Series D preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	0	8,593,360
Exercise of stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	4,192,572	2,596,087
Exercise of common stock warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	797,487	509,562
Exercise of preferred stock warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	0	446,990
Vesting of PSUs and RSUs
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	907,320	0

401(k) Retirement Plan (Details

401(k) Retirement Plan (Details) - USD ($)	3 Months Ended		6 Months Ended
401(k) Retirement Plan (Details) - USD ($)	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
401(k) Retirement Plan
Defined Contribution Plan Disclosure [Line Items]
Employer contribution to defined benefit plan	$ 0	$ 0	$ 0	$ 0

Related Party Transactions (Det

Related Party Transactions (Details) - USD ($)	3 Months Ended		6 Months Ended
Related Party Transactions (Details) - USD ($)	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
2019 Credit Agreement
Related Party Transaction [Line Items]
Line of credit cumulative drawdowns till date	$ 40,000,000		$ 40,000,000		$ 40,000,000
Former Director and Shareholder \| Patent Rights from Former Director and Shareholder \| Maximum
Related Party Transaction [Line Items]
Royalty expense		$ 100,000		$ 100,000
Beneficial Customer \| Sales
Related Party Transaction [Line Items]
Revenue from related parties		200,000		500,000
Director and the Chairman \| Consulting Agreement \| Selling, general and administrative \| Maximum
Related Party Transaction [Line Items]
Consulting fees incurred for related party	100,000	100,000	100,000	100,000
Orbimed Royalty Oppurtunities Two LP and Deerfield Private Design Fund LP \| 2019 Credit Agreement
Related Party Transaction [Line Items]
Line of credit maximum borrowing capacity						$ 70,000,000
Interest expenses related party	$ 1,400,000	$ 1,300,000	$ 2,700,000	$ 2,700,000
Revenue from Contract with Customer Benchmark \| Product Concentration Risk \| Former Director and Shareholder \| Patent Rights from Former Director and Shareholder
Related Party Transaction [Line Items]
Royalty expense as a percentage of net sales			3.00%

Subsequent Events (Details)

Subsequent Events (Details) $ / shares in Units, shares in Thousands, $ in Millions	Jul. 11, 2021$ / shares	Jul. 31, 2021USD ($)$ / sharesshares	Jun. 30, 2021$ / shares	Dec. 31, 2020$ / shares
Subsequent Event [Line Items]
Preferred stock, par value (in dollars per share)			$ 0.001	$ 0.001
Subsequent Event \| Deerfield Partners, LP
Subsequent Event [Line Items]
Letter agreement, negotiation period	30 days
Subsequent Event \| Deerfield Partners, LP \| Series A Preferred Stock
Subsequent Event [Line Items]
Preferred stock, par value (in dollars per share)	$ 0.001
Preferred stock, ownership interest limitation	0.049
Preferred stock, liquidation preference (in dollars per share)	$ 0.001
Subsequent Event \| OrbiMed Private Investments IV, LP
Subsequent Event [Line Items]
Letter agreement, negotiation period	30 days
Subsequent Event \| OrbiMed Private Investments IV, LP \| Series A Preferred Stock
Subsequent Event [Line Items]
Preferred stock, par value (in dollars per share)	$ 0.001
Preferred stock, ownership interest limitation	0.049
Preferred stock, liquidation preference (in dollars per share)	$ 0.001
Subsequent Event \| Public Stock Offering - Shares Issued Upon Underwriters Exercise
Subsequent Event [Line Items]
Number of shares issued in transaction (in shares) \| shares		825
Price to public (in dollars per share)		$ 14
Consideration received on transaction \| $		$ 82.7
Subsequent Event \| Common Stock \| Deerfield Partners, LP
Subsequent Event [Line Items]
Percentage of common stock, shares outstanding, held by counterparty	0.095
Subsequent Event \| Common Stock \| OrbiMed Private Investments IV, LP
Subsequent Event [Line Items]
Percentage of common stock, shares outstanding, held by counterparty	0.095
Subsequent Event \| Common Stock \| Public Stock Offering - Shares Issued Upon Underwriters Exercise
Subsequent Event [Line Items]
Number of shares issued in transaction (in shares) \| shares		6,325