美敦力 (MDT) 2020 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Medtronic third quarter earnings conference call. (Operator Instructions) Please be advised that today's conference is being recorded. (Operator Instructions)

女士們，先生們，感謝你們的支持，歡迎參加美敦力第三季財報電話會議。（操作員指示）請注意，今天的會議正在錄音。（操作員指示）

I would now like to hand the conference over to Ryan Weispfenning, Vice President, Head of Investor Relations. Please go ahead, sir.

現在，我想將會議交給副總裁兼投資者關係主管 Ryan Weispfenning。先生，請繼續。

Thank you. Good morning, and welcome to Medtronic's Fiscal Year 2020 Third Quarter Conference Call and Webcast. During the next hour, Omar Ishrak, Medtronic Chairman and Chief Executive Officer; Karen Parkhill, Medtronic Chief Financial Officer; and Geoff Martha, Medtronic President, will provide comments on the results of our third quarter, which ended on January 24, 2020. After our prepared remarks, we'll be happy to take your questions.

謝謝。早安，歡迎參加美敦力 2020 財年第三季電話會議和網路廣播。在接下來的一個小時裡，美敦力董事長兼執行長奧馬爾·伊什拉克 (Omar Ishrak)、美敦力首席財務官凱倫·帕克希爾 (Karen Parkhill) 和美敦力總裁傑夫·瑪莎 (Geoff Martha) 將對截至 2020 年 1 月 24 日的第三季度業績發表評論。在我們準備好發言之後，我們很樂意回答您的問題。

First, a few logistical comments. Earlier this morning, we issued a press release containing our financial statements and the revenue by division summary. We also issued an earnings presentation that provides additional details on our performance and outlook.

首先，談幾點後勤方面的評論。今天早些時候，我們發布了一份新聞稿，其中包含我們的財務報表和各部門的收入摘要。我們還發布了一份收益報告，提供了有關我們的業績和前景的更多詳細資訊。

During today's earnings call, many of the statements made may be considered forward-looking statements, and actual results may differ materially from those projected in any forward-looking statement. Additional information concerning factors that could cause actual results to differ is contained in our periodic reports and other filings that we make with the SEC, and we do not undertake to update any forward-looking statement.

在今天的財報電話會議上，許多陳述可能被視為前瞻性陳述，實際結果可能與任何前瞻性陳述中的預測有重大差異。有關可能導致實際結果不同的因素的更多資​​訊包含在我們向美國證券交易委員會提交的定期報告和其他文件中，我們不承諾更新任何前瞻性聲明。

For this call, unless we say otherwise, rates and ranges are given on a constant-currency basis, which compares to the third quarter of fiscal year 2019 after adjusting for foreign currency. References to organic revenue growth exclude the impact of our Titan Spine acquisition and currency. Reconciliations of all non-GAAP financial measures can be found in the attachment to our earnings press release or on our website at investorrelations.medtronic.com. Finally, our EPS guidance does not include any charges or gains that would be reported as non-GAAP adjustments to earnings during the fiscal year.

對於本次電話會議，除非我們另有說明，利率和範圍均以固定匯率為基礎給出，與 2019 財年第三季度相比，進行了外匯調整。提及有機收入成長時不包括收購 Titan Spine 和貨幣的影響。所有非 GAAP 財務指標的對帳表可在我們的收益新聞稿附件中或我們的網站 investorrelations.medtronic.com 上找到。最後，我們的每股盈餘指引不包括任何將作為財政年度非公認會計準則收益調整報告的費用或收益。

With that, I'm now pleased to turn the call over to Medtronic Chairman and Chief Executive Officer, Omar Ishrak. Omar?

現在，我很高興將電話轉給美敦力公司董事長兼執行長 Omar Ishrak。奧馬爾？

Thank you, Ryan, and thank you to everyone for joining us. This morning, we reported results for the third fiscal quarter. Revenue growth was light this quarter, reflecting a series of largely transient issues, which I'll walk you through in a minute.

謝謝你，瑞安，也謝謝大家的參與。今天上午，我們報告了第三財季的表現。本季營收成長緩慢，反映了一系列基本上是暫時的問題，我將在稍後向您介紹。

The good news, however, is that this was more than offset by 90 basis points of operating margin expansion, well ahead of our expectations, resulting in strong EPS and free cash flow growth, both ahead of plan. Importantly, despite the top line shortfall this quarter, our Q4 outlook is unchanged as we expect significant revenue growth acceleration excluding any impact from the coronavirus.

然而，好消息是，這被 90 個基點的營業利潤率擴張所抵消，遠遠超出了我們的預期，從而實現了強勁的每股收益和自由現金流增長，均超出了計劃。重要的是，儘管本季營收出現下滑，但我們對第四季度的展望保持不變，因為我們預計，除冠狀病毒的影響外，收入成長將顯著加速。

Q3 revenue grew 2.9% constant currency and 2.6% organic. Revenue growth fell short of our expectations, driven in part by customers curbing their purchasing ahead of our new product launches, principally in CVG and RTG. In MITG, we upgraded the group's ERP system in the U.S. and Canada to our company-wide system, resulting in a temporary slowdown in our ability to supply customers, which in some cases, resulted in lost procedures and lasted longer in the quarter than we anticipated. That upgrade is now complete, and as of early this quarter, we're in the process of returning to full supply.

第三季營收以固定匯率計算成長 2.9%，有機成長 2.6%。營收成長低於我們的預期，部分原因是客戶在我們推出新產品之前抑制了購買，主要是 CVG 和 RTG。在 MITG，我們將集團在美國和加拿大的 ERP 系統升級為我們全公司的系統，這導致我們向客戶供貨的能力暫時放緩，在某些情況下，這會導致流程丟失，並且在本季度持續時間比我們預期的要長。此次升級現已完成，截至本季初，我們正在恢復全面供應。

All of these items led to our quarterly revenue underperformance. We weren't able to offset these issues given that many of them emerged late in the quarter. I'm not happy with this top line performance, and we are focused on quickly addressing the dynamics that led to this result. Geoff will provide a little more color on this later in the call.

所有這些因素都導致我們的季度收入表現不佳。由於許多問題都是在本季結束時出現的，我們無法抵消這些問題。我對這項業績表現並不滿意，我們正致力於迅速解決導致這結果的動態問題。傑夫稍後將在電話會議中對此進行更詳細的說明。

Looking down the P&L. We drove significant operating leverage despite the softer top line. Our adjusted operating margin expanded 90 basis points as we continued to see the benefits of our enterprise excellence initiatives, particularly on the SG&A line. We also had strong financial leverage, driven in part by the debt refinancing that we completed earlier this fiscal year. This resulted in an adjusted EPS of $1.44, which was $0.06 above the midpoint of our guidance and up 11.6% year-over-year.

查看損益表。儘管營業收入有所下降，但我們仍實現了顯著的經營槓桿。我們的調整後營業利潤率擴大了 90 個基點，因為我們繼續看到企業卓越計畫帶來的好處，特別是在銷售、一般和行政費用方面。我們也擁有強大的財務槓桿，部分原因是我們在本財年早些時候完成的債務再融資。調整後的每股收益為 1.44 美元，比我們的預期中位數高出 0.06 美元，年增 11.6%。

Let's take a look now at the drivers for our group performances, starting with our Restorative Therapies Group which grew 3.6% organic this quarter. RTG's performance was affected by customer buying patterns in BMP and the continued market slowdown and slight share loss in Pain Stim ahead of our DTM therapy launch. On an organic basis, our overall Spine division was flat this quarter, reflecting customer drawdown of Infuse inventory.

現在讓我們來看看我們集團業績的驅動因素，首先是我們的恢復性療法集團，本季有機成長了 3.6%。RTG 的業績受到 BMP 客戶購買模式以及我們推出 DTM 療法之前持續的市場放緩和 Pain Stim 份額略有損失的影響。從有機基礎來看，本季我們的 Spine 部門整體表現持平，反映出客戶對 Infuse 庫存的減少。

Despite this, our Core Spine business grew 2%, both globally and in the U.S. In addition, when you include sales of enabling technologies sold by our Brain Therapies division, which is how our competitors report, Core Spine grew 5% organically both globally and in the U.S., well above market.

儘管如此，我們的 Core Spine 業務在全球和美國都成長了 2%。此外，如果算上我們大腦治療部門銷售的支援技術的銷售額（我們的競爭對手也報告了這一數據），Core Spine 在全球和美國都實現了 5% 的有機成長，遠高於市場水平。

Our Surgical Synergy strategy is resulting in increased sales of our Core Spine implants, driven by surgeons' use of our capital equipment, in particular our Mazor robot. It is also benefiting our Brain Therapies division, which sells the capital equipment used in spine surgery. Brain Therapies delivered another above-market quarter of 9.2% growth. In Neurosurgery, which grew low double digits, we had strong growth in Mazor robotics where we are meaningfully outpacing the competition as well as in StealthStation navigation, O-arm imaging and our new Midas Rex MR8 systems.

我們的外科協同策略導致核心脊椎植入物的銷售增加，這得益於外科醫生對我們的資本設備（尤其是 Mazor 機器人）的使用。這也使我們的腦部治療部門受益，該部門銷售脊椎手術中使用的資本設備。腦部治療業務再次實現高於市場水平的 9.2% 的季度成長。在神經外科領域，我們的收入實現了兩位數的低增長，其中 Mazor 機器人技術取得了強勁增長，並且在 StealthStation 導航、O 型臂成像和我們的新款 Midas Rex MR8 系統方面也取得了顯著的超越競爭對手。

In Brain Therapies, our market-leading Neurovascular business had another strong quarter with mid-teens growth driven by mid-20s growth in ischemic stroke on strong adoption of our Solitaire X stent retriever, Riptide Aspiration System and React catheters. In pain therapies, the pain Stim market had another sluggish quarter, and we had some slight share loss ahead of the launch of the Stimgenics DTM therapy on our Intellis platform.

在腦部治療領域，我們市場領先的神經血管業務又取得了一個強勁的季度，其中十幾歲的增長得益於缺血性中風的二十多歲增長，這得益於我們的 Solitaire X 支架回收器、Riptide 抽吸系統和 React 導管的廣泛採用。在疼痛治療領域，疼痛刺激市場又經歷了一個低迷的季度，在我們的 Intellis 平台上推出 Stimgenics DTM 療法之前，我們的市佔率略有下降。

We're excited about the response we've received from physicians and the broader SCS community following the acquisition announcement and Stimgenics data presentation last month at NANS as well as on our 9-year battery warranty on Intellis. We continue to be optimistic about the outlook for the Pain Stim market and have begun training physicians on the DTM waveform.

上個月在 NANS 上宣布收購、展示 Stimgenics 數據以及為 Intellis 提供 9 年電池保固後，我們對醫生和更廣泛的 SCS 社群的反應感到非常興奮。我們繼續對疼痛刺激市場的前景持樂觀態度，並已開始對醫生進行 DTM 波形培訓。

Our Minimally Invasive Therapies Group grew 3.2% organic, including flat results in the U.S. MITG's performance this quarter was affected by the upgrade of its ERP system in the U.S. and Canada, which caused some temporary slowdown in our ability to supply customers with the full breadth of our products and, in some cases, resulted in lost procedures. This was, however, a transient issue. The ERP upgrade is now complete, and the related supply slowdown are behind us as of this month.

我們的微創治療集團有機成長了 3.2%，其中美國 MITG 的業績持平。本季 MITG 的業績受到其在美國和加拿大的 ERP 系統升級的影響，這導致我們向客戶提供全系列產品的能力暫時放緩，並且在某些情況下導致程序丟失。然而，這只是一個暫時的問題。ERP 升級現已完成，相關的供應放緩現象自本月起已過去。

Within MITG, our Surgical Innovations division grew 3.6% this quarter, driven by our Advanced Surgical business, particularly in Advanced Energy, which grew in the high single digits on strength in our LigaSure franchise and sales of our Valleylab FT10 energy platform. Respiratory, GI and renal division grew 2.2%, driven by low double-digit growth in our GI solutions business and high single-digit growth in pulse oximetry sensors and advanced parameter sensors.

在 MITG 內部，我們的外科創新部門本季成長了 3.6%，這得益於我們的先進外科業務，尤其是先進能源業務，由於我們的 LigaSure 特許經營權的強勁增長和 Valleylab FT10 能源平台的銷售，該部門實現了高個位數增長。呼吸、胃腸道和腎臟部門成長了 2.2%，這得益於胃腸道解決方案業務的低兩位數成長以及脈搏血氧儀感測器和高階參數感測器的高個位數成長。

In our Cardiac and Vascular Group, we grew 1.8% this quarter, which was below our expectations, due in part to customers holding back their purchasing ahead of new product launches in CRHF. We saw high single-digit declines in our High Power business as customers awaited approval of our Cobalt and Crome devices, which have launched this month in Europe and are expected to launch in the U.S. during Q1. In heart failure, although our LVAD business has anniversaried the headwinds we faced over the past year, the business declined in the low single digits and hasn't returned to the growth levels we were expecting.

在我們的心臟和血管集團，本季我們的銷售額成長了 1.8%，低於我們的預期，部分原因是客戶在 CRHF 新產品發布之前抑制了購買。由於客戶等待我們的鈷和鉻設備的批准，我們的高功率業務出現了高個位數的下滑，這些設備本月已在歐洲推出，預計將於第一季在美國推出。在心臟衰竭方面，儘管我們的 LVAD 業務已經度過了過去一年面臨的逆風，但業務下滑幅度僅為個位數，尚未恢復到我們預期的成長水平。

The other driver of our below expectation CVG performance was our U.S. TAVR business, which grew 13% this quarter, below the market growth rate. While the TAVR market has been rapidly expanding, we currently have fully experienced field support coverage in a little more than 2/3 of the approximately 700 U.S. centers performing TAVR. We began aggressively hiring and training new field personnel months ago. However, our data shows that it's taking longer than expected for our new reps to reach full productivity. We plan to certify an additional 70 field personnel by the end of this fiscal year.

我們的 CVG 業績低於預期的另一個驅動因素是我們的美國 TAVR 業務，本季成長了 13%，低於市場成長率。雖然 TAVR 市場一直在快速擴張，但目前，我們僅在美國約 700 個進行 TAVR 的中心中的 2/3 多一點的範圍內提供了全面的現場支援覆蓋。幾個月前，我們就開始積極招募和培訓新的現場人員。然而，我們的數據顯示，我們的新銷售代表達到完全生產力所需的時間比預期的要長。我們計劃在本財政年度結束前認證另外 70 名現場人員。

We expect our U.S. TAVR performance to improve relative to the market going forward as our expanded field organization reaches full productivity and we focus the market on the hemodynamic benefits of Evolut PRO+ platform and the launch of our new Confida sheath. Outside the U.S., our TAVR market share grew modestly in Q3.

我們預計，隨著我們擴大的現場組織達到全面生產力，並且我們將市場重點放在 Evolut PRO+ 平台的血流動力學優勢和我們新的 Confida 鞘的推出上，我們在美國 TAVR 的表現將相對於市場有所改善。在美國以外，我們的 TAVR 市佔率在第三季小幅成長。

Our pacing business grew in the high single digits, well above the market, driven by our exclusive Micra leadless pacemaker and AZURE family of conventional pacemakers. We announced the Micra AV approval in the last week of our quarter and are excited about its growth potential as it expands the Micra target population from 15% to 55% of pacemaker patients. While we did not have revenue from Micra AV in the third quarter, we are already seeing strong interest and early adoption of this new technology in the fourth quarter.

在我們獨特的 Micra 無導線起搏器和 AZURE 系列傳統起搏器的推動下，我們的起搏業務實現了高個位數成長，遠高於市場水平。我們在本季度的最後一周宣布了 Micra AV 的批准，並對其增長潛力感到興奮，因為它將 Micra 的目標人群從起搏器患者的 15% 擴大到 55%。雖然我們在第三季沒有從 Micra AV 獲得收入，但我們已經看到人們對這項新技術的濃厚興趣和早期採用。

In Diabetes, we grew 0.8%, slightly ahead of expectations. Our U.S. business declined in the low double digits, which is anticipated and resulted from competitive challenges while we await our new products. We're seeing strong enrollment in our Next Tech Pathway program, which allows purchasers of the MiniMed 670G to upgrade for free to our next-generation pump when launched. Keep in mind that as a result of this program, we are currently deferring a portion of the revenue for our pump sales, which we will recognize when patients trade in their 670G for the next-generation pump.

在糖尿病領域，我們成長了 0.8%，略高於預期。我們的美國業務下滑了兩位數，這是可以預料到的，也是我們在等待新產品時面臨的競爭挑戰所致。我們看到 Next Tech Pathway 計劃的報名人數正在不斷增加，該計劃允許 MiniMed 670G 的購買者在下一代泵推出時免費升級到該泵。請記住，由於該計劃，我們目前正在推遲泵銷售的部分收入，當患者用他們的 670G 換取下一代泵時，我們將確認這筆收入。

In markets outside the United States, which represents just under half of our Diabetes revenue, we had solid mid-teens growth, driven by the continued adoption of the MiniMed 670G. This demand is not only driving strong growth in our installed base. It is also resulting in double-digit growth in recurring revenue from CGM and other consumables.

在美國以外的市場，占我們糖尿病收入的近一半，在 MiniMed 670G 的持續採用的推動下，我們實現了穩健的中十幾歲的增長。這種需求不僅推動了我們安裝基數的強勁成長。這也使得 CGM 和其他消耗品的經常性收入實​​現了兩位數的成長。

Now turning to emerging markets, which represented 17% of our revenue. In Q3, we grew emerging markets 14% with contributions from geographies around the globe. China grew 14%, as is Southeast Asia. And Eastern Europe grew 16%, which included 39% growth in Russia. In addition, South Asia grew 13%, as did the Middle East and Africa. And Latin America grew 12%. We continue to drive strong growth in these markets as we optimize the distribution channel and, in certain markets, localize R&D and manufacturing.

現在轉向新興市場，占我們收入的 17%。第三季度，由於全球各地的貢獻，新興市場實現了 14% 的成長。中國成長了 14%，東南亞也成長了 14%。東歐成長了 16%，其中俄羅斯成長了 39%。此外，南亞、中東和非洲也成長了 13%。拉丁美洲成長了12%。隨著我們優化分銷管道，並在某些市場實現研發和製造的在地化，我們繼續在這些市場推動強勁成長。

Regarding the coronavirus, our top concern is the health and well-being of our employees in China and across the globe. We have activated response teams in China, the Asia Pacific region and globally, and we remain vigilant in monitoring the virus and taking action as necessary. All of our manufacturing operations are up and running in China. We're committed to helping the Chinese government and Chinese physicians address this crisis.

關於冠狀病毒，我們最關心的是中國和全球員工的健康和福祉。我們已經在中國、亞太地區和全球啟動了應對小組，並將繼續保持警惕，監測病毒並在必要時採取行動。我們所有的製造業務均在中國開展。我們致力於幫助中國政府和中國醫生應對這場危機。

As the Chinese health care system is focused on containing the spread of the virus, hospitals in China have experienced a slowing of medical device procedure rates, and we are seeing procedure delays. We do expect this to have a negative impact on our fourth quarter financial results. But given the fluidity of this situation, the duration and magnitude of the impact are difficult to quantify at this time.

由於中國醫療保健系統致力於遏制病毒的傳播，中國醫院的醫療器械處理速度有所放緩，並且我們看到了處理延遲。我們確實預計這會對我們第四季的財務業績產生負面影響。但鑑於局勢的不確定性，目前很難量化影響的持續時間和程度。

Now turning to our product pipeline. As we look forward, we're excited about what lies ahead as the investments we've made in our product pipeline begin to pay off by accelerating our revenue growth and creating value for our shareholders. We have recently received approval or launched a number of new products that we expect to contribute to our growth going forward.

現在轉向我們的產品線。展望未來，我們對未來充滿期待，因為我們在產品線方面的投資開始獲得回報，加速了我們的收入成長並為股東創造了價值。我們最近獲得了批准或推出了一些新產品，我們預計這些產品將有助於我們未來的成長。

I mentioned earlier the U.S. approval of our Micra AV pacemaker and the launch that is now underway. We also received U.S. approval for our IN. PACT Admiral AV fistula indication, which expands the market potential of our drug-coated balloons. We received U.S. approval and are launching our Stealth Autoguide cranial robotic system. In Europe, we recently received CE mark approval for our Cobalt and Crome portfolio of BlueSync-enabled high-power devices, our InterStim Micro rechargeable implantable sacral neuromodulation device and InterStim SureScan MRI leads as well as our Percept PC DBS device with BrainSense technology.

我之前提到美國批准我們的 Micra AV 起搏器，目前正在進行上市。我們的 IN 也獲得了美國批准。PACT Admiral AV 瘻管適應症，擴大了我們藥物塗層球囊的市場潛力。我們獲得了美國的批准，並正在推出我們的 Stealth Autoguide 顱腦機器人系統。在歐洲，我們最近獲得了 CE 標誌認證，認證的產品包括支援 BlueSync 的鈷和鉻合金高功率設備、InterStim Micro 可充電植入式骶神經調節設備和 InterStim SureScan MRI 導線以及採用 BrainSense 技術的 Percept PC DBS 設備。

And over the next few quarters, we expect approval and launch of a number of additional new products. We expect U.S. approval of the Cobalt and Crome high-power devices, Reveal LINQ 2.0 insertable cardiac monitor, InterStim Micro and InterStim SureScan MRI leads and our Percept PC DBS device. We're also expecting European launch of the MiniMed 780G and our DiamondTemp ablation catheter.

在接下來的幾個季度中，我們預計將批准並推出更多新產品。我們期待美國批准鈷和鉻高功率設備、Reveal LINQ 2.0 可插入心臟監視器、InterStim Micro 和 InterStim SureScan MRI 導線以及我們的 Percept PC DBS 設備。我們也期待在歐洲推出 MiniMed 780G 和 DiamondTemp 消融導管。

Regarding our MiniMed 780G in the U.S., we intend to file our adult clinical data with the FDA in March, which will push expected approval beyond the fiscal year-end. In Pain Stim, we unveiled DTM spinal cord stim last month at the NANS conference and are now training our field force on this novel waveform, with an expected limited launch in Q4 and full launch in Q1.

關於我們在美國的 MiniMed 780G，我們打算在 3 月向 FDA 提交成人臨床數據，這將使預期的批准推遲到財政年度結束之後。在疼痛刺激方面，我們上個月在 NANS 會議上推出了 DTM 脊髓刺激，目前正在對我們的現場人員進行這種新型波形的培訓，預計將於第四季度有限推出，並於第一季全面推出。

In MITG, we continue to make progress in our soft tissue robotics program. Last week, we announced the acquisition of Digital Surgery, a pioneer in artificial intelligence and analytics for surgery. They lead the industry with their unique Touch Surgery ecosystem of products, including AI that identify surgical steps and instrumentation. These products can be leveraged to provide insight into the procedure time, cost and process to improve surgical care. We're excited about utilizing the strength and capability of Digital Surgery to advance our minimally invasive and robotic surgery platforms.

在 MITG，我們的軟組織機器人計畫繼續取得進展。上週，我們宣布收購手術人工智慧和分析領域的先驅 Digital Surgery。他們憑藉其獨特的 Touch Surgery 產品生態系統引領業界，其中包括識別手術步驟和儀器的人工智慧。這些產品可以用來深入了解手術時間、成本和流程，以改善手術護理。我們很高興能夠利用數位外科手術的優勢和能力來推進我們的微創和機器人手術平台。

We also have a number of important upcoming data presentations, starting with use case data under extreme conditions for our advanced hybrid closed-loop algorithm at ATTD later this week. Next month, ACC will be a big conference for us. Data from our OFF-MED renal denervation pivotal trial will be presented as well as data for both low-risk bicuspid and leaflet immobility for our TAVR program. Also, we will share risk stratification data for our TYRX anti-infection product. And finally, in June, at ADA, we expect to present the U.S. pivotal data for our MiniMed 780G advanced hybrid closed-loop system.

我們還將進行一系列重要的數據演示，首先是本週稍後在 ATTD 上展示的我們先進的混合閉環演算法在極端條件下的用例數據。下個月，ACC 對我們來說將是一個重要的會議。我們將展示 OFF-MED 腎臟去神經支配關鍵試驗的數據以及 TAVR 計劃的低風險二尖瓣和瓣葉固定的數據。此外，我們還將分享我們的 TYRX 抗感染產品的風險分層數據。最後，我們預計將於 6 月在 ADA 上展示我們的 MiniMed 780G 先進混合閉環系統的美國關鍵數據。

This is just some of the near-term highlights from our pipeline. Importantly, we're continuing to invest in building out a robust long-term pipeline of continuous innovation, invention and disruption.

這只是我們近期產品線中的一些亮點。重要的是，我們將繼續投資建立一個強大的長期持續創新、發明和顛覆的管道。

I mentioned earlier that we expect significant acceleration in our fourth quarter revenue growth, driven in part by our pipeline and excluding the impact of the coronavirus. And as we look to FY '21, we expect our top line momentum to continue as we get the increasing benefit of the FY '20 product launches as well as the products slated to launch next fiscal year.

我之前提到過，我們預計第四季度營收成長將大幅加速，部分原因是我們的產品線正在推進，並且不包括冠狀病毒的影響。展望 21 財年，我們預計我們的營收成長動能將持續下去，因為我們將從 20 財年的產品發布以及計劃於下一財年推出的產品中獲得越來越多的收益。

With that, let me now ask Karen to take you through a discussion of our third quarter financials and forward outlook. Karen?

現在，請容許我請凱倫帶大家討論我們第三季的財務狀況和未來展望。卡倫？

Thank you. As Omar mentioned, we delivered third quarter organic revenue growth of 2.6%, and adjusted EPS was $1.44, growing 11.6%. We ultimately came in $0.06 above the midpoint of our guidance and would attribute $0.02 to better-than-expected foreign exchange and $0.04 to operational outperformance, including tax.

謝謝。正如奧馬爾所提到的，我們第三季的有機收入成長了 2.6%，調整後的每股盈餘為 1.44 美元，成長了 11.6%。我們最終的獲利比預期中點高出 0.06 美元，其中 0.02 美元歸因於好於預期的外匯，0.04 美元歸因於包括稅收在內的營運表現優異。

Our adjusted gross margin was 69.7%, down year-over-year due in part to increased China tariffs. We more than offset that decline with strong operating leverage as we continue to implement and drive efficiencies and improvements across the company while, at the same time, making investments ahead of upcoming product launches. This led to an adjusted operating margin improvement of 90 basis points or 70 basis points excluding the impact of currency.

我們的調整後毛利率為 69.7%，年減，部分原因是中國關稅上調。我們透過強大的營運槓桿抵消了這一下滑，因為我們繼續在整個公司範圍內實施和推動效率和改進，同時在即將推出的產品之前進行投資。這導致調整後的營業利潤率提高了 90 個基點，如果排除貨幣影響則提高了 70 個基點。

Below the operating profit line, our adjusted interest expense declined 36%, driven by our successful debt issuance and tender transactions that we completed last spring and summer. Our adjusted nominal tax rate was 13.6%, lower than we expected, due to increased deductions from the exercise of employee stock options and benefit from finalizing taxes owed on certain returns.

在營業利潤線以下，我們的調整後利息支出下降了 36%，這得益於我們去年春季和夏季成功完成的債務發行和招標交易。我們的調整後名目稅率為 13.6%，低於我們的預期，原因是行使員工股票選擇權的扣除額增加以及最終確定某些回報所欠稅款的收益。

As you know, generating strong free cash flow remains a priority across the company, and you are seeing this focus come through in our results. Third quarter free cash flow was $2.1 billion, up 21% from last year. And year-to-date, free cash flow was $4.9 billion, representing a conversion ratio of 90%, well above our full year target of 80%-plus.

如您所知，創造強勁的自由現金流仍然是整個公司的首要任務，您可以從我們的業績中看到這一點。第三季自由現金流為 21 億美元，比去年同期成長 21%。今年迄今為止，自由現金流為 49 億美元，轉換率為 90%，遠高於我們全年 80% 以上的目標。

We remain committed to disciplined capital deployment, balancing investment in R&D and tuck-in acquisitions to drive future growth while returning a minimum of 50% of our annual free cash flow to our shareholders, and year-to-date, we've returned $2.8 billion or 57% of the cash we generated, resulting in a total shareholder payout of 51% on adjusted net earnings.

我們仍致力於嚴謹的資本配置，平衡研發投資和補充收購以推動未來成長，同時將至少 50% 的年度自由現金流返還給股東，年初至今，我們已返還 28 億美元或 57% 的現金，使股東總支出達到調整後淨收益的 51%。

Now turning to guidance. For the fourth quarter, we are comfortable with current Street consensus on organic revenue growth and EPS prior to any impact from the coronavirus. We expect overall organic top line growth of approximately 4.5%. By group, we expect CVG to grow 4.25% to 4.5%; MITG, 6.25% to 6.5%; RTG, approximately 4% organic; and Diabetes to be flat to down low single digits. And based on recent rates, currency would have a negative impact of 80 to 140 basis points.

現在轉向指導。對於第四季度，在冠狀病毒造成影響之前，我們對華爾街目前對有機收入成長和每股盈餘的共識感到滿意。我們預計整體有機營收成長率約為 4.5%。按類別劃分，我們預計 CVG 將成長 4.25% 至 4.5%；MITG 將成長 6.25% 至 6.5%；RTG 將有機成長約 4%；糖尿病將持平或下降個位數。根據最近的匯率，貨幣將產生 80 至 140 個基點的負面影響。

On margins, we continue to expect our full year operating margin to expand by roughly 40 basis points on a constant-currency basis, driven by our enterprise excellence initiatives. For the fourth quarter, we expect our operating margin to be up slightly, including the impact of currency, or roughly flat on a constant-currency basis as we invest to support current and upcoming product launches.

在利潤率方面，我們繼續預計，在企業卓越計畫的推動下，我們的全年營業利潤率將在固定匯率基礎上擴大約 40 個基點。對於第四季度，我們預計營業利潤率將略有上升（包括貨幣的影響），或者由於我們投資支持當前和即將推出的產品，按固定匯率計算營業利潤率將大致持平。

Below the operating line, we expect our fourth quarter interest expense to be approximately $160 million to $165 million and our fourth quarter adjusted nominal tax rate to be around 16%, which would put our annual rate at approximately 15%, lower than we originally expected and reflecting the benefits we have had so far this year. We are raising our fiscal year '20 EPS guidance to a range of $5.63 to $5.65, up from $5.57 to $5.63 and reflecting our third quarter bottom line outperformance. For the fourth quarter, we expect $1.62 to $1.64.

在營業線以下，我們預計第四季度利息支出約為 1.6 億至 1.65 億美元，第四季度調整後的名義稅率約為 16%，這將使我們的年稅率約為 15%，低於我們最初的預期，並反映了我們今年迄今為止獲得的收益。我們將 20 財年每股收益預期從 5.57 美元至 5.63 美元上調至 5.63 美元至 5.65 美元，以反映我們第三季的獲利表現優異。對於第四季度，我們預計價格為 1.62 美元至 1.64 美元。

As mentioned upfront, all of the guidance I just gave excludes the impact of the coronavirus. Because the situation is so fluid, it is difficult to truly quantify the impact just a few weeks into our quarter. And for that reason, we plan to provide an update for you later this quarter. Finally, I would like to note that we plan to hold our Biennial Institutional Investor and Analyst Day on Tuesday, June 2 in New York City.

如同前面提到的，我剛才給出的所有指引都不包括冠狀病毒的影響。由於情況如此不穩定，很難在本季開始的幾週內真正量化其影響。因此，我們計劃在本季稍後為您提供更新資訊。最後，我想指出，我們計劃在 6 月 2 日星期二在紐約市舉辦兩年一度的機構投資者和分析師日。

Back to you, Omar.

回到你身邊，奧馬爾。

Thanks, Karen. I'd now like Geoff to make some remarks on the quarter and the outlook. Geoff?

謝謝，凱倫。現在我想請傑夫就本季和前景發表一些評論。傑夫？

Thank you, Omar. There are a number of positive things from the quarter that I want to highlight, but first, I'd like to address our top line performance.

謝謝你，奧馬爾。我想強調本季的一些正面因素，但首先，我想談談我們的營收表現。

Even though much of it was transient, we did not perform at the level we were expecting, and the drivers surfaced at the end of the quarter. We just can't have surprises like this, for us nor for you. And we are making changes. At our upcoming Investor Day in June, I'm going to walk you through what innovation-driven growth means for Medtronic and the comprehensive set of initiatives to take full advantage of the pipeline. These initiatives are meant to ensure we see the acceleration of our revenue from the pipeline and to improve our predictability.

儘管其中大部分都是暫時的，但我們的表現並未達到預期水平，而驅動因素在本季末浮出水面。我們不能讓這樣的驚喜發生，無論對我們還是對您來說。我們正在做出改變。在我們即將於六月舉行的投資者日上，我將向您介紹創新驅動成長對美敦力的意義，以及充分利用管道的綜合舉措。這些舉措旨在確保我們看到管道收入的成長並提高我們的可預測性。

On that note, I want to discuss an aspect of our plan to address the surprise we saw this quarter. One issue is the weighting of our revenue to the final month of the quarter, which leaves us susceptible to surprises late in the game, like what happened this quarter. Too often, our largest orders come in at the end of the month. This dynamic makes the business challenging to manage, it stresses our operations, and it really makes it difficult to mitigate headwinds that pop up within the quarter. So to fix this, we will change our current operating mechanisms, certain internal metrics and some incentives as well.

關於這一點，我想討論一下我們計劃解決本季出現的意外情況的一個方面。一個問題是我們的收入集中在季度的最後一個月，這使得我們容易受到後期意外的影響，就像本季發生的情況一樣。我們最大的訂單往往是在月底到來的。這種動態使業務管理變得具有挑戰性，給我們的營運帶來了壓力，並且確實使得緩解本季出現的逆風變得非常困難。因此，為了解決這個問題，我們將改變目前的營運機制、某些內部指標以及一些激勵措施。

And I want to flag the opportunity coming up with our extra week in Q1. The impact of the changes that I just mentioned likely won't be contained in a given quarter, so I'd like to use a good portion of the benefit that we would get from the extra week in Q1 to launch these initiatives. So when we guide to the first quarter, we will give you guidance on an underlying basis excluding the benefit of the extra week, and we'll give you an estimate of the benefit of the extra week net of these changes. Like I said, we plan to discuss these and other changes during our Investor Day. But I want to assure you one thing, that I'm on this and we are taking the appropriate actions to improve consistency and avoid future surprises.

我想強調我們在第一季額外一周所獲得的機會。我剛才提到的變化的影響可能不會在某個季度內得到控制，所以我想利用第一季額外一周所獲得的大部分收益來啟動這些舉措。因此，當我們指導第一季時，我們將在不包括額外一周收益的基本基礎上為您提供指導，並且我們將為您提供扣除這些變化後的額外一周收益的估算。正如我所說，我們計劃在投資者日期間討論這些和其他變化。但我想向你們保證一件事，我正在處理此事，我們正在採取適當的行動來提高一致性並避免將來出現意外。

Now before I close and we get to Q&A, I've got to highlight a number of good things that occurred this quarter, accomplishments that I believe can't get lost in this quarter's narrative. First, we drove a better operating margin despite the light top line and free cash flow was outstanding. These are 2 things that we've been working on for a long time. Over the past couple of years, we've taken action on both of these areas, and we feel really good about the operating rigor and the culture we put in place to drive the bottom line and improve cash flow.

現在，在我結束並進入問答環節之前，我必須強調本季發生的一些好事，我相信這些成就在本季度的敘述中不會被忽視。首先，儘管營業收入較低，但我們的營業利潤率仍然較高，而且自由現金流非常出色。這是我們長期致力於的兩件事。在過去的幾年裡，我們在這兩個領域都採取了行動，我們對我們為推動底線和改善現金流而建立的營運嚴謹性和文化感到非常滿意。

Also, emerging markets growth continues to be strong for us. They represented 17% of our revenue and, once again, grew strong double digits, 14% this quarter. We think of emerging markets actually as an independent growth vector for the company, and we have to acknowledge the progress with our pipeline. We are starting to see approvals and launches come through for important and innovative products, and there's more to come. Yes, the slow purchasing ahead of these launches hurt us in some businesses this quarter, but this is going to turn. Customers are really excited about our new offerings.

此外，新興市場的成長對我們來說依然強勁。它們占我們營收的 17%，本季再次實現了強勁的兩位數成長，達到 14%。我們認為新興市場實際上是公司的獨立成長載體，我們必須承認我們的產品線取得了進展。我們開始看到重要創新產品獲得批准並上市，未來將有更多產品獲得批准並上市。是的，這些產品發布前的緩慢採購對我們本季的一些業務造成了損害，但這種情況將會好轉。客戶對我們的新產品感到非常興奮。

I'd like to end by saying that the underlying fundamentals of the business are strong. We have a full pipeline that will accelerate our revenue growth and take share not just next quarter but next year and beyond. We're very excited about the future of the company, the new technology that we're bringing to market, the impact this will have on patients and physicians and the value we're going to bring and generate for our shareholders.

最後我想說的是，該業務的基本面非常強勁。我們擁有完善的管道，這將加速我們的收入成長，並不僅會在下個季度、而且在明年及以後佔據市場份額。我們對公司的未來、我們推向市場的新技術、它將對患者和醫生產生的影響以及我們將為股東帶來和創造的價值感到非常興奮。

All right. Back to you, Omar.

好的。回到你身邊，奧馬爾。

Thanks, Geoff. I couldn't agree more with the approach that we are taking, and I'm just as excited about our outlook going forward. Before we start Q&A, I'd like to briefly note that we currently anticipate holding our Q4 earnings call, which will be my last earnings call, on Thursday, May 21.

謝謝，傑夫。我完全同意我們採取的方法，並且對我們未來的前景感到興奮。在我們開始問答之前，我想簡要說明一下，我們目前預計將於 5 月 21 日星期四舉行第四季度財報電話會議，這也是我的最後一次財報電話會議。

Let's now move on to Q&A. In addition to Karen, Geoff and me, our 4 group presidents: Mike Coyle, Bob White, Brett Wall and Sean Salmon, are also here to answer your questions. (Operator Instructions) If you have additional questions, please contact Ryan and our Investor Relations team after the call.

現在我們進入問答環節。除了 Karen、Geoff 和我之外，我們的 4 位小組主席：Mike Coyle、Bob White、Brett Wall 和 Sean Salmon 也在這裡回答您的問題。（操作員指示）如果您還有其他問題，請在通話後聯絡 Ryan 和我們的投資者關係團隊。

Operator, first question please.

接線員，請問第一個問題。

Your first question comes from the line of Bob Hopkins with Bank of America.

您的第一個問題來自美國銀行的鮑伯霍普金斯。

Just I'll state both questions upfront to make it easy. First, I was wondering, in CVG, if we could drill down a little bit on ICDs given the weakness in the quarter. And I asked because Boston Scientific also saw weakness in the quarter in their high-power ICD business, and the timing of your new launches shouldn't really be a surprise. So I guess my first question is how can you have confidence that this isn't just a slower market? So that's question #1.

為了方便起見，我先把這兩個問題都提出來。首先，我想知道，在 CVG 中，考慮到本季的疲軟表現，我們是否可以對 ICD 進行一些深入研究。我之所以問這個問題，是因為波士頓科學公司在本季也發現其高功率 ICD 業務表現疲軟，因此你們推出新產品的時機並不令人意外。所以我想我的第一個問題是，你怎麼能確信這不只是一個較慢的市場？這就是問題 1。

And then the thing I'd also love a quick comment on is -- I realize it's too early for formal fiscal 2021 guidance, but you guys have talked a lot about accelerating growth in fiscal 2021. So are you still comfortable accelerating off of that 4.5% that we'll see hopefully in the fourth quarter on a same selling day basis?

然後，我還想快速評論一下——我知道現在發布正式的 2021 財年指引還為時過早，但你們已經談了很多關於加速 2021 財年增長的事情。那麼，您是否仍願意以我們希望在第四季度看到的 4.5% 的同日銷售成長率為基礎進行加速？

Thanks, Bob. Mike Coyle is the right person to address the ICD questions. Go ahead, Mike.

謝謝，鮑伯。麥克‧科伊爾 (Mike Coyle) 是解決 ICD 問題的合適人選。繼續吧，麥克。

Yes, Bob. We're not seeing anything that would cause us to have a concern that the overall market for ICDs is somehow slowing significantly. Most of the challenges that we have on ICDs remain the issue associated with the replacement cycle and the fact that we were seeing essentially mid-teens declines in year-over-year comparisons on replacement. As I've mentioned before, that actually gets better as we get through the year and into next year, especially in the CRT-D area, and that is going to help us in terms of acceleration in the ICD side.

是的，鮑伯。我們沒有看到任何讓我們擔心 ICD 整體市場正在大幅放緩的跡象。我們在 ICD 方面面臨的大多數挑戰仍然是與更換週期相關的問題，事實上，我們看到更換量比去年同期下降了 15% 左右。正如我之前提到的，隨著我們度過今年並進入明年，情況實際上會變得更好，特別是在 CRT-D 領域，這將有助於我們加速 ICD 的發展。

But the other point -- and you pointed out the surprise to us in terms of weakness in the number for the quarter. It was really in EMEA, in Europe and Middle East and Africa. That was where, essentially, we believe customers were holding off given the imminent launch of our Cobalt/Crome product families, which now have launched into the market. And those products will be coming to the United States during the first quarter.

但另一點是——您指出了本季數據疲軟令我們感到驚訝。它實際上位於 EMEA，即歐洲、中東和非洲。從本質上講，我們認為客戶之所以猶豫不決，是因為我們即將推出鈷/鉻產品系列，而這些產品系列目前已經推出市場。這些產品將於第一季進入美國市場。

The other thing that depressed the overall performance relative to where we thought we would be during the quarter is the fact that the TYRX anti-infective envelopes get captured under the ICD numbers when we report externally. And I think -- you may recall, last quarter, we had a fairly major quality-driven back order situation that we expected would be resolved completely during the course of Q3. We actually lost a number of -- lots of product -- manufacturing lots of product early in the quarter, which now has stabilized. In fact, through the second half, we're completely out of any kind of constraints on supply.

相對於我們預期的本季整體表現而言，另一個導致整體表現下降的因素是，當我們對外報告時，TYRX 抗感染藥物包膜被計入 ICD 編號中。我認為——您可能還記得，上個季度，我們遇到了相當嚴重的質量驅動型積壓訂單問題，我們預計這個問題將在第三季度得到徹底解決。我們實際上在本季初損失了大量產品，生產了大量產品，現在已經穩定下來。事實上，到下半年，我們將完全擺脫任何供應限制。

So we expect that will flow through into the numbers in Q4 and obviously into next year, especially as we have new data that we'll be presenting at ACC on risk stratification for TYRX. So we think all of those things are going to help us accelerate the ICD market, not only in Q4 but into next year.

因此，我們預計這將體現在第四季度的數據中，顯然也會體現在明年的數據中，特別是因為我們有新的數據將在 ACC 上展示 TYRX 的風險分層。因此，我們認為所有這些因素都將幫助我們加速 ICD 市場的發展，不僅在第四季度，而且在明年。

Okay. Thanks, Mike. I think, Karen, you're the best person to take the question about '21.

好的。謝謝，麥克。凱倫，我認為你是回答有關『21』問題的最佳人選。

Yes. Thanks for the question on '21, Bob. Yes, we're really excited about our pipeline and what it has to offer for FY '21. I'd love to talk a lot about it, but we're close to finalizing our plan so we'll give the official guidance on our Q4 call, as you know. That said, I would think about accelerating growth for next year off of a full year basis as opposed to off of a sequential basis. And we're very confident in our growth acceleration of FY '21 over FY '20.

是的。謝謝你關於‘21’的問題，鮑伯。是的，我們對我們的產品線以及它為 21 財年帶來的收益感到非常興奮。我很樂意談論它，但我們已經接近完成我們的計劃，因此我們將在第四季度電話會議上提供官方指導，正如你所知。話雖如此，我會考慮以全年為基礎而不是以連續為基礎來加速明年的成長。我們對 21 財年較 20 財年的成長加速非常有信心。

Okay. Thanks, Bob.

好的。謝謝，鮑伯。

Your next question comes from the line of David Lewis with Morgan Stanley.

您的下一個問題來自摩根士丹利的戴維·劉易斯。

Just maybe just one question for me here. Karen, just to confirm from your last question, is the right way to think about fiscal '20 -- I'm assuming a sort of 3.5% to 4%. But my one question, I'll keep it to one, is just thinking about 4Q guidance. I appreciate it's in line with consensus, but when I think about Omar and Geoff's comments about RTG and CVG, it seems like the 3Q dynamic is getting better into the fourth. Should the fourth quarter be stronger as we see some of this catch-up revenue? So can you just help us quantify the third quarter issues and offer some clarity of what fourth quarter implies in terms of recovery and drivers of acceleration?

這裡也許只有一個問題需要我問。凱倫，我只是想確認你最後一個問題，這是思考 20 財年的正確方式——我假設是 3.5% 到 4% 左右。但我的一個問題，我會保留它，只是考慮第四季度的指導。我很欣賞它符合共識，但當我想到奧馬爾和傑夫對 RTG 和 CVG 的評論時，似乎第三季的動態在第四季變得更好。隨著我們看到部分追趕性收入，第四季業績是否應該更加強勁？那麼，您能否幫助我們量化第三季的問題，並闡明第四季度在復甦和加速驅動方面意味著什麼？

Okay. So let me take the beginning of it, and then I'll let my colleagues jump in, too. So in terms of FY '20, David, our fourth quarter guidance would imply FY '20 growth of 3.6%, 3.7%-ish. And then on fourth quarter, clearly, because of the transient issues in the third quarter, we expect some of that to come back. If you look at MITG and the ERP issues that we've talked about, we fully expect that to come back. And that's one of the reasons that we've guided MITG to above trend for the quarter. But we have lost some procedures, and those won't come back.

好的。讓我先開始，然後讓我的同事也加入進來。因此，就 20 財年而言，David，我們的第四季指引意味著 20 財年的成長率為 3.6% 至 3.7% 左右。然後在第四季度，顯然，由於第三季度的暫時性問題，我們預計其中一些問題將會恢復。如果您看一下我們討論過的 MITG 和 ERP 問題，我們完全希望它能夠再次出現。這就是我們指導 MITG 本季業績高於趨勢的原因之一。但我們已經失去了一些程序，而且這些程序不會再回來了。

Yes. I think -- I don't know if I can add anything to that. Really, the procedure losses in a business like MITG where the procedures happen, that just isn't going to come back. We'll recover fully. I think in other areas like in the MCS business, or LVAD business, that was share loss. And there is pressure there, and our growth is probably going to be lower than we were originally anticipating.

是的。我認為——我不知道我是否可以補充什麼。事實上，在 MITG 這樣的企業中，程序損失是無法挽回的。我們會完全康復的。我認為在其他領域，例如 MCS 業務或 LVAD 業務，都存在份額損失。那裡有壓力，我們的成長可能會低於我們最初的預期。

So in balance, we felt that holding the Q4 sort of previous guidance was the appropriate thing to do at this stage. We're obviously doing everything we can to maximize that number.

因此，總的來說，我們認為在現階段維持第四季之前的指導是適當的做法。我們顯然正在盡一切努力來最大化這個數字。

Okay. Thank you, David.

好的。謝謝你，大衛。

Your next question comes from the line of Robbie Marcus with JPMorgan.

您的下一個問題來自摩根大通的羅比馬庫斯。

Maybe if we could shift to some of the product lines and specifically TAVR here, 13% worldwide growth, came in a lot lower than The Street was expecting. You had the first full quarter of the low-risk launch in the U.S. Your competitor did a lot better than this. Maybe talk to exactly what happened in the quarter, the dynamics in the U.S. and how you expect this continue throughout fourth quarter and '21.

也許如果我們可以轉向一些產品線，特別是 TAVR，那麼全球 13% 的成長率將遠低於華爾街的預期。您在美國進行了低風險發布的第一個完整季度。您的競爭對手的表現比這好得多。也許可以談談本季究竟發生了什麼，美國的動態以及您預計這種情況將如何持續到第四季和 21 年。

Mike, do you want to take that?

麥克，你想接受這個嗎？

Yes, Robbie. Obviously, we were very disappointed with the performance in the U.S. If you look outside the U.S., we -- the implant growth rates were in the high teens and pretty much in line with the overall market, actually a little better than the overall market because of the Japan influence, but in the United States, obviously well below market with implant rates in the mid-teens, whereas we would estimate the market in the quarter probably grew on the order of the low 30s. As we dug into that, we obviously headed into the holidays actually feeling pretty good that we were looking at implant rates in the low 20s. Obviously, in retrospect, that turns out to be lower than the market.

是的，羅比。顯然，我們對美國市場的表現非常失望。如果你看看美國以外的情況，我們——植入物的增長率在十幾歲左右，與整體市場基本一致，實際上由於日本的影響，比整體市場要好一點，但在美國，植入物的增長率顯然遠低於市場水平，在十幾歲左右，而我們估計本季度的市場增長率可能在 30% 出頭左右。當我們深入研究這個問題時，我們顯然在假期到來時感覺非常好，因為我們看到植入率在 20% 出頭。顯然，回想起來，這個價格低於市場價格。

But as we headed into the end of the year and into January, we saw a pretty meaningful decline in overall growth rates for implants, and we dug deeply into that to figure out which accounts and where we were having the issues. And basically, I think learning from that analysis was that it takes longer than we thought to have our reps become fully competitive in this market. It's probably a 9- to 12-month training exercise, which, in retrospect, we probably should have ramped up in advance of this several quarters earlier than we did.

但隨著我們進入年底和一月份，我們發現植入物的整體增長率出現了相當明顯的下降，我們深入研究了這一情況，以找出哪些帳戶以及哪裡存在問題。基本上，我認為從該分析中我們可以了解到，讓我們的銷售代表在這個市場上具有完全的競爭力所花的時間比我們想像的要長。這可能是為期 9 到 12 個月的訓練演習，回想起來，我們可能應該比現在提前幾季就開始做準備。

The good news is that as we look at the hiring that we did do, this quarter, we expect to bring on 70 new sales reps and support personnel, which is going to help us go from -- given the 700 accounts that are selling ICD or selling -- that are servicing this market, we probably have seasoned sales reps, that is those who have a year or more experience in about 2/3 of those accounts. By the time we exit with these new certifications, we would expect to be closer to 80% in terms of supporting that. And we're also accelerating new hiring based on driving support for our next fiscal year.

好消息是，從我們本季的招聘情況來看，我們預計將招聘 70 名新的銷售代表和支援人員，這將幫助我們——考慮到有 700 個帳戶在銷售 ICD 或服務於這個市場，我們可能擁有經驗豐富的銷售代表，即在大約 2/3 的帳戶中擁有一年或一年以上經驗的銷售代表。當我們獲得這些新認證時，我們預計支持率將接近 80%。我們也將加快招募新員工，為下一財年提供強力支持。

So we think those just catch up in terms of training and deployment. Plus we're pushing much more closed interval management of the reps that are out there to make sure that we're staying on top of developments in these accounts. We think that, coupled with, obviously, our new product launch around Evolut PRO+; the launch of the Confida sheath, which really improves the performance of our overall device systems; and then new data that will be coming out here at ACC around both bicuspid and leaflet immobility, should basically give us an opportunity to accelerate from where we were in Q4 -- or in Q3.

因此我們認為這些只是在培訓和部署方面趕上來。此外，我們正在推動對銷售代表進行更封閉的間隔管理，以確保我們能夠掌握這些帳戶的發展。我們認為，顯然，我們推出了圍繞 Evolut PRO+ 的新產品；推出了 Confida 護套，這確實提高了我們整體設備系統的性能；然後，ACC 上將公佈有關雙尖瓣和瓣葉不動性的新數據，這基本上應該給我們一個機會，讓我們從第四季度或第三季度的水平加速發展。

And basically, looking at just the daily sales rates here as we've headed into the new quarter with this new focus on rep productivity, we are seeing some acceleration from those numbers that you see in terms of the mid-teens implant rates. And so I'm confident we're going to see acceleration. Whether we'll get all the way back to market, given that we have 2 competitors who are driving share in those accounts, it may take more than a quarter to do that. But on the other hand, I do expect to see acceleration during the quarter.

基本上，隨著我們進入新的季度並將重點放在銷售代表的生產力上，只看這裡的每日銷售率，我們可以看到，就十幾歲的植入率而言，這些數字正在加速增長。因此我相信我們將會看到加速。無論我們是否能夠重返市場，考慮到我們有兩家競爭對手在這些帳戶中佔據份額，可能需要超過四分之一的時間才能做到這一點。但另一方面，我確實預期本季會出現加速。

Okay. Thank you, Robbie.

好的。謝謝你，羅比。

Your next question comes from the line of Vijay Kumar with Evercore.

您的下一個問題來自 Evercore 的 Vijay Kumar。

I had 2 quick ones. One, on Surgical Robotics, I think you mentioned some software updates, just on time line there. MITG, you have sequential acceleration. Is there anything baked on the robotic side there?

我有兩個快速的。首先，關於手術機器人，我想您提到了一些軟體更新，只是在時間線上。MITG，您有順序加速。機器人方面有烘焙過什麼東西嗎？

And second, on margins. I appreciate the comments on FX hedge gains. When you look at next year, I think Geoff made some comments on changing incentives. So maybe just talk about margins for next year. Are we still looking at constant currency in that 40 to 50 basis points of expansion?

其次，關於利潤。我很欣賞關於外匯對沖收益的評論。展望明年，我認為傑夫會對改變激勵措施發表一些評論。所以也許只談明年的利潤率。我們是否仍在關注 40 至 50 個基點擴張中的恆定貨幣？

Okay. Let me -- Bob will probably answer this, but I'll just say off the bat that robotics is not in our financial numbers yet. And the overall program is more or less on track, so...

好的。讓我——鮑伯可能會回答這個問題，但我首先要說的是，機器人技術還沒有納入我們的財務數據中。整體來說，計劃基本上進展順利，所以…

Yes, that's right, Omar. Thanks, Vijay, for the question. To reiterate, first off, no update from what we talked about at JPMorgan relative to the program. So it's just good news. And then the sequential acceleration of MITG's business is really all about us coming out of the ERP implementation now that we've got that back on track and the system is running smooth. So hopefully, that does it for you, Vijay.

是的，沒錯，奧馬爾。謝謝 Vijay 提出這個問題。首先要重申的是，我們在摩根大通討論的有關該計劃的進展沒有任何更新。所以這只是個好消息。然後，MITG 業務的連續加速實際上都與我們 ERP 實施有關，因為現在我們已經回到正軌並且系統運作順暢。所以希望這對你有幫助，Vijay。

Yes. And then on the margins, guys?

是的。那麼在邊緣呢，夥計們？

Yes. Thanks, Vijay. On margins, for next year, we're going to continue to look at margin expansion as we drive bottom line growth above top line growth every year. At this stage, we haven't changed our long-range guidance of 40 basis points constant-currency margin expansion so you can assume that at this stage.

是的。謝謝，維傑。關於利潤率，明年，我們將繼續關注利潤率的擴大，因為我們每年都會推動底線成長超過頂線成長。在現階段，我們還沒有改變 40 個基點的恆定貨幣保證金擴張的長期指導，因此您可以在現階段進行假設。

I can tell you, Vijay, there's a focus in the organization around that. We've worked very hard to get an accountability around that, and we're going to -- that's going to stay. We just need to fix our top line growth back to where it deserves to be based on our product pipeline.

我可以告訴你，維傑，組織非常關注這一點。我們已經非常努力地去追究這方面的責任，而且我們將會堅持下去。我們只需要根據我們的產品線將我們的營業額成長調整到應有的水準。

Okay. Thanks, Vijay.

好的。謝謝，維傑。

Your next question comes from the line of Matt Taylor with UBS.

您的下一個問題來自瑞銀的馬特泰勒 (Matt Taylor)。

So the first one I wanted to ask was just on MITG ERP transition. I was wondering if that impacted any of the business lines within MITG more than the others. And are you seeing underlying share loss there or share gains? Can you talk about the underlying trends?

所以我想問的第一個問題是關於 MITG ERP 轉型。我想知道這是否對 MITG 內部的某條業務線的影響比其他業務線更大。您是否看到那裡的潛在份額正在下降還是在上升？您能談談潛在的趨勢嗎？

Go ahead.

前進。

Yes. Let me take that, Omar. Yes, Matt, thanks for the question. The impact of the ERP transition affected all of the MIT product lines as we migrated into the single SAP system for Medtronic. And certainly, we lost some procedures when we weren't able to ship products to customers. So while we think we lost procedures given the middle months of the quarter, we don't believe we necessarily lost significant amounts of share. But certainly, now that we're back on track with the ERP system, we're back to fulfilling those customer requirements.

是的。讓我來接手，奧馬爾。是的，馬特，謝謝你的提問。當我們遷移到美敦力的單一 SAP 系統時，ERP 轉換的影響波及了所有 MIT 產品線。當然，當我們無法將產品運送給客戶時，我們就會失去一些程序。因此，儘管我們認為我們在本季度中期幾個月失去了一些業務，但我們並不認為我們一定會失去大量的份額。但可以肯定的是，現在我們已經重新回到了 ERP 系統的正軌上，我們又可以滿足這些客戶的要求了。

And just a follow-up for Mike or the team here. So it sounds like you're seeing a little bit of an improvement in the DCB trends, at least in the U.S. Could you speak to that and whether you think we could see a kind of continued uptick there or a change in the FDA stance at some point during the year?

這只是對 Mike 或這裡的團隊的後續跟進。因此，聽起來您看到 DCB 趨勢有所改善，至少在美國是如此。您能否談談這一點，以及您是否認為我們會看到 DCB 趨勢持續上升，或者在今年某個時候 FDA 的立場會發生變化？

Sure. We are seeing some modest improvement. Obviously, as more datasets come in, they're providing more comfort to physicians and the FDA for that matter, I believe, that the signal that had been observed in those first 3 randomized trials around SFA seem not consistent with the new data coming in. Obviously, one big dataset that we filed and got approval for was the AV fistula indication for DCB, which did not show this mortality signal in the paclitaxel arm. And we expect additional data to be coming out on that topic, including at the ACC, where we think there will be a presentation of a major dataset based on claims analysis.

當然。我們看到了一些適度的改善。顯然，隨著更多數據集的出現，它們為醫生和 FDA 提供了更多的安慰，我相信，在圍繞 SFA 的前 3 次隨機試驗中觀察到的信號似乎與新獲得的數據不一致。顯然，我們提交並獲得批准的一個大數據集是 DCB 的 AV 瘻管指徵，該資料集並未顯示紫杉醇組的這種死亡訊號。我們期望有關該主題的更多數據能夠出現，包括在 ACC 上，我們認為將會展示基於索賠分析的主要數據集。

So that is creating a greater sense of confidence in the physician base that the significant morbidity issues that come with not using these drug-coated balloons and just using PTA balloons are beginning to get attention. And I think what we expect to see is continued improvement as datasets provide that level of comfort. So in this quarter, we did see, on a sort of selling adjusted basis, some sequential growth, which is encouraging in DCB. And we expect, if the data continue to come in as positive as they have, that we'll see that continue.

因此，這讓醫生群體更有信心，不使用這些藥物塗層球囊而僅使用 PTA 球囊所帶來的嚴重發病率問題開始受到關注。我認為，隨著數據集提供這種程度的舒適度，我們期望看到的是持續的改進。因此，在本季度，我們確實看到了在銷售調整基礎上的一些連續成長，這對 DCB 來說是令人鼓舞的。我們預計，如果數據繼續保持積極態勢，我們將看到這種情況持續下去。

Thanks, Matt.

謝謝，馬特。

Your next question comes from the line of Kristen Stewart with Barclays.

您的下一個問題來自巴克萊銀行的克莉絲汀史都華。

I just wanted to ask Sean if he could just provide his overall thoughts on Diabetes since he's kind of taken over the role and then if we could just kind of get an update on 780G. It sounds like that is getting pushed a little in the U.S. into next fiscal year. Maybe just some thoughts around the time line there.

我只是想問肖恩，既然他已經接手了這個角色，他是否可以提供他對糖尿病的整體看法，然後我們是否可以獲得有關 780G 的最新消息。聽起來，美國這項計劃將被推遲到下一個財政年度。也許只是一些關於時間軸的想法。

Sure. Thanks, Kristen. So as you know, the Diabetes business certainly has no small challenges to overcome. But I can tell you I'm really very encouraged with how we're seeing some derisking of the pipeline that we have going forward. In particular, that sensor pipeline, I'm convinced that we've figured that out, and it's just a bit of time for us to get the product line flowing there.

當然。謝謝，克里斯汀。所以，如您所知，糖尿病業務肯定面臨著不小的挑戰。但我可以告訴你，看到我們未來的管道風險正在降低，我真的感到非常鼓舞。特別是那個感測器管道，我相信我們已經解決了這個問題，我們只需要一點時間就可以讓產品線流入那裡。

The 780G is an important catalyst for us to drive growth, and we expect that to begin. We have filed the CE mark for that device, and we are anticipating, as Omar said, putting the clinical data module in, in the March time frame. That review is going well. We're very interactive with FDA. In fact, we'll be meeting with them later this week. And we'll give more update on exactly what the timing is as we get more information on it.

780G 是我們推動成長的重要催化劑，我們期待它能開始成長。我們已經為該設備申請了 CE 標誌，正如 Omar 所說，我們預計在三月將臨床數據模組放入其中。審查進展順利。我們與 FDA 的互動非常密切。事實上，我們將在本週晚些時候與他們會面。當我們獲得更多相關資訊時，我們將更新具體時間。

So, so far, we're happy with what we're seeing both from the algorithms, and you'll see some of that later this week as we stress the algorithm into some challenging conditions that will be announced at ATTD; and the data front, and you'll see the full dataset coming up at the ADA in June. So I've seen a lot of encouraging things. There are things to clean up obviously. We've got to get the new product flow going, and we're confident that we'll be doing that starting soon.

所以，到目前為止，我們對演算法方面的結果感到滿意，本週晚些時候，當我們將演算法應用於一些具有挑戰性的條件時，您將會看到其中的一些結果，這些條件將在 ATTD 上宣布；在數據方面，您將在 6 月份的 ADA 上看到完整的數據集。所以我看見了很多令人鼓舞的事。顯然有些事情需要清理。我們必須讓新產品流程順利進行，我們有信心很快就會開始這樣做。

And then just your comments around the derisking, particularly around the sensors, can you maybe just expand upon that? Do you think there's an opportunity to bring forward some of the sensor time lines?

然後，您對降低風險的評論，特別是有關感測器的評論，您能否詳細說明一下？您認為有機會提前一些感測器時間軸嗎？

Kristen, I think the first thing is to meet the criteria for iCGM, and I'm confident that we're going to be able to demonstrate that. We'll have more information on that in the coming meeting. But probably at Analyst Day, we'll show you some more of that. It's too early to comment on accelerated timing, but that's certainly the goal, to push as fast as we can into the marketplace.

克里斯汀，我認為首先要滿足 iCGM 的標準，我相信我們能夠證明這一點。我們將在即將召開的會議上提供更多相關資訊。但可能在分析師日，我們會向您展示更多內容。現在評論加速時間還為時過早，但這肯定是我們的目標，即盡快進入市場。

Thank you, Kristen.

謝謝你，克里斯汀。

Your next question comes from the line of Kaila Krum with SunTrust.

您的下一個問題來自 SunTrust 的 Kaila Krum。

So one quick one to clarify and then a question on the business. So on the coronavirus, I think you may have mentioned this, but again, just to clarify. Will you give full transparency on your China business performance in the fourth quarter?

因此，首先要澄清一個問題，然後問一個有關業務的問題。關於冠狀病毒，我想您可能已經提到過這一點，但再次澄清一下。您會全面透明地介紹第四季中國業務的表現嗎？

Yes, we will. And we did disclose our growth rates in China already so we will continue to disclose that. We will be transparent about the impact of the coronavirus.

是的，我們會的。我們已經披露了我們在中國的成長率，因此我們將繼續披露這一點。我們將公開冠狀病毒的影響。

Perfect. And then there's obviously a lot of new product launches coming in the next few quarters. But -- I mean obviously, it can be challenging to predict the timing and the impact of when those new launches contribute. So I'm just curious how you're modeling new product contribution in the fourth quarter as part of that reacceleration in the business.

完美的。顯然，未來幾季將會有很多新產品推出。但是——我的意思是，顯然，預測這些新產品的推出時間和影響是具有挑戰性的。所以我很好奇，作為業務重新加速的一部分，您如何模擬第四季度新產品的貢獻。

Well, there are some that are pretty clear. Things like the Micra AV, which launched last quarter, is now in full steam and moving ahead well, and that one, we're projecting a strong success. There are others, like the -- in the spinal cord stimulation market, we just launched the Stimgenics waveform on the Intellis platform. That's picking up. That's -- we're a little more guarded about that because that's newer, but for sure, that's going to help us in the spinal cord stimulation market.

嗯，有些是相當清楚的。上個季度推出的 Micra AV 等產品目前正全力推進，進展順利，我們預計它將取得巨大成功。還有其他的，例如——在脊髓刺激市場，我們剛剛在 Intellis 平台上推出了 Stimgenics 波形。情況正在好轉。那是——我們對此更加謹慎，因為這是較新的技術，但可以肯定的是，這將有助於我們進入脊髓刺激市場。

Things like Cobalt/Crome in Europe, again, we have a history there, and we can project historically what such -- that kind of improvement has caused and we're going to put that into our model. So there's a mix of the level of sort of confidence intervals we have in these projections, some very tight, and Micra being one of the biggest drivers is very tight. The other is a little more unknown but positive nonetheless.

像歐洲的鈷/鉻這樣的產品，我們在那裡有歷史，我們可以從歷史上預測這種改進會帶來什麼，我們將把它納入我們的模型中。因此，我們在這些預測中擁有各種置信區間，有些非常嚴格，而 Micra 作為最大的驅動因素之一，其置信區間非常嚴格。另一個則不太為人所知，但仍具有積極意義。

I think that's the best I can do. I don't know, anyone else here, any products I've missed or any comments, you guys?

我認為這是我能做的最好的事情。我不知道，這裡還有其他人嗎，我錯過了什麼產品或有什麼評論嗎？

Well, we've recently launched the Micro, which is the new public health product in Europe, which -- we're excited about that and the possibility for that looking to a late spring launch in the United States. And then Percept, which is the new DBS device with BrainSense technology, has just launched in Europe. Similar time frames in the U.S. approval and we're getting good uptake on that. So those are 2 very interesting platforms for us in the neuromodulation space.

嗯，我們最近推出了 Micro，這是歐洲的新型公共衛生產品，我們對此感到很興奮，並期待它能在春末在美國推出。然後，Percept，一款採用 BrainSense 技術的新型 DBS 設備，剛剛在歐洲推出。美國批准的時間框架類似，我們對此的接受度也很好。因此，對我們來說，這是神經調節領域的兩個非常有趣的平台。

The other thing I would mention is the DiamondTemp ablation catheter CE mark that we expect during the quarter, which would obviously be even more of a benefit in Q1 of next year. As well as we're just in the early stages of the launch of the AV fistula indication for the IN. PACT Admiral balloon, so those will now get full quarter benefit during Q4.

我想提到的另一件事是，我們預計 DiamondTemp 消融導管 CE 標誌將在本季度發布，這顯然會對明年第一季帶來更大的好處。而我們才剛開始推出 IN 的 AV 瘻管適應症的早期階段。PACT Admiral 氣球，因此它們將在第四季度獲得全季度利益。

I think to your question about how we project this, there's a historical sort of comparison that we can make against similar such launches. And based on that, we make a judgment in our planning, and from that, we derive guidance and our plan going forward. So there's a variety of that, but there is some judgment involved with this.

對於您提出的我們如何預測這一問題，我認為我們可以將其與類似的發射進行歷史比較。在此基礎上，我們在規劃中做出判斷，並由此得出未來的指導和計畫。因此，存在多種情況，但其中也涉及一些判斷。

Thank you, Kaila.

謝謝你，凱拉。

Your next question comes from the line of Larry Biegelsen with Wells Fargo.

您的下一個問題來自富國銀行的拉里·比格爾森。

Mike, could you please put a finer point on the launch timing of Cobalt and Crome in the U.S. and LINQ 2.0? What quarter are you expecting it?

Mike，您能否更詳細地介紹一下 Cobalt 和 Crome 在美國以及 LINQ 2.0 的發佈時間？您預計哪個季度會發布？

And Brett, on SNM, what are you seeing -- for sacral neuromodulation, what are you seeing from the new competitor? And what are your expectations for that business before Micro is approved in the U.S. in late spring, which is what I heard you say a minute ago?

布雷特，關於 SNM，您看到了什麼——對於骶神經調節，您從新的競爭對手那裡看到了什麼？在春末 Micro 在美國獲得批准之前，您對這項業務有何期望，我剛剛聽到您這麼說過？

So Larry, on Cobalt and Crome, we would expect that in the first quarter of next year, probably in the first half of that quarter. And then for LINQ 2.0, we would expect that product also in Q1 but in the second half of the quarter.

因此，拉里，關於鈷和鉻，我們預計會在明年第一季度，可能是在該季度的上半年。對於 LINQ 2.0，我們預計該產品也將在第一季度，但在本季度的下半段推出。

Yes. And then, Larry, on public health and on the Micro, I think we expect some near-term slowing here with that particular product given the competition. The Micro itself in Europe has been received very well. Just as a reminder, it's about half the size of the competitive device. The recharge experience is significantly better. And with the SureScan leads, it is 1.5 and 3 Tesla full body conditional. So we're very, very excited about that product when it comes to the market in the United States.

是的。然後，拉里，關於公共衛生和微軟，我認為考慮到競爭，我們預計該產品的短期增長會有所放緩。Micro 本身在歐洲受到了熱烈歡迎。需要提醒的是，它的尺寸大約是競爭設備的一半。儲值體驗明顯更好。並且透過 SureScan 導線，可以實現 1.5 和 3 特斯拉全身條件。因此，當該產品進入美國市場時，我們感到非常興奮。

Thank you, Larry.

謝謝你，拉里。

Your next question comes from the line of Matt Miksic with Crédit Suisse.

您的下一個問題來自瑞士信貸的 Matt Miksic。

So I just have one on coronavirus and one on sort of the Symplicity Spyral time line and post the data at ACC. So on corona, I understand it's a little bit early to put a finer point on the impact for Q4, but if you could maybe give us some sense of what the major moving parts are. I think we have about $2 billion in China revenue round numbers, an approximately kind of an annual run rate there. Obviously, it's a moving target, but things like -- would an impact in Q4 likely, based on what you know now, sort of come back in early Q -- how transitory is that impact? And then on Spyral, just maybe walk through for us the time line of what happens after OFF-MED and what that looks like as you continue to develop that program.

因此，我只有一個關於冠狀病毒的數據和一個關於 Symplicity Spyral 時間軸的數據，並將數據發佈在 ACC 上。因此，關於冠狀病毒，我知道現在就精確指出其對第四季度的影響還為時過早，但您能否讓我們了解一下主要的變化因素是什麼。我認為我們在中國的收入大約為 20 億美元，這大約是那裡的年運行率。顯然，這是一個不斷變化的目標，但諸如——根據您現在所了解的情況，第四季度的影響是否可能在 Q 月初再次出現——這種影響有多短暫？然後關於 Spyral，請為我們介紹一下 OFF-MED 之後的時間線，以及在您繼續開發該計劃時的情況。

Okay. Let me take the coronavirus question first. First of all, we're pretty clear about what our China business is. It's roughly 7% of our global business, so you can do the estimate there. The variables right now -- one variable is that we've got to get our factories up and running so that we can supply different places in the world, including China, and that is actually progressing well. But the main factor driving the number there will be the procedure uptake in China. China was in a complete shutdown mode for the first half of February, and they're just beginning to start. And even now, even in places like Beijing and others, procedures are only just beginning. It's too early to tell how they will ramp up through the rest of the quarter. We know that in Hubei province, for example, obviously, it shut down, but that's only 5% of China. But the rest of China, in places like Beijing and Shanghai, right now, there are procedure delays.

好的。我首先來回答一下冠狀病毒的問題。首先，我們非常清楚我們的中國業務是什麼。這大約占我們全球業務的 7%，因此您可以在那裡進行估算。目前的變數——一個變數是我們必須讓我們的工廠運作起來，以便我們能夠向世界各地（包括中國）供貨，而這實際上進展順利。但推動這一數字成長的主要因素將是中國的手術吸收量。中國在二月上半月處於完全停工狀態，現在才剛開始恢復。即使是現在，即使在北京等地，相關程序也才剛開始。現在判斷他們將如何在本季度剩餘時間內實現成長還為時過早。例如，我們知道湖北省顯然已經關閉，但那隻佔中國的 5%。但在中國其他地區，例如北京和上海，目前有手續延誤的情況。

In addition to that, a lot of physicians are being asked to actually go and help with the virus. And so there are many dynamics here that are really difficult to predict now. Once things stabilize, there could well be a ramp back up. And because people need the procedures, they will get them at some point. When that happens is very difficult to predict right now. So that's why we're saying that wait until a little later in the quarter when we have some more data and see how things progress and we'll give you a full update.

除此之外，許多醫生也被要求親自前往幫助對抗病毒。因此，這裡有很多動態現在確實很難預測。一旦情況穩定下來，就有可能再次出現成長。因為人們需要這些程序，所以他們會在某個時候得到它們。目前很難預測這種情況何時發生。所以這就是為什麼我們說等到本季晚些時候，當我們有更多數據並觀察事情進展時，我們會給你一個完整的更新。

So with that, I'm going to ask Mike to take the renal.

因此，我要請麥克來做腎臟檢查。

So our renal denervation, obviously, the first big milestone will be the pivotal trial on the OFF-MED, which will be presented here at ACC. But there is the second trial that is ongoing in parallel, which is the ON MED trial. Unlike the OFF-MED, it has a 6-month efficacy endpoint. So if I were to set expectations for when those data were to become available, I would expect that about a year from now, so about this time next year.

因此，我們的腎臟去神經支配術顯然第一個重要里程碑將是 OFF-MED 的關鍵試驗，該試驗將在 ACC 上展示。但第二項試驗正在同時進行，即 ON MED 試驗。與 OFF-MED 不同，它的療效終點為 6 個月。因此，如果我要對這些數據何時可用進行預期，我預計大約一年後，也就是明年這個時候。

In terms of the FDA interaction, the ON MED -- or the OFF-MED data will be used in a modular submission as we -- along with, obviously, the device-supporting materials. So we think we can get the process with FDA to move forward. We do think we need the OFF-MED -- or excuse me, the ON MED dataset in order to get final approval for the product, and certainly, it will be very important in terms of reimbursement to have those data. So that would be how I would set expectations.

就 FDA 互動而言，ON MED 或 OFF-MED 數據將與設備支援材料一起用於模組化提交。因此我們認為我們可以與 FDA 一起推動這一進程。我們確實認為我們需要 OFF-MED——或者對不起，ON MED 資料集才能獲得該產品的最終批准，而且，就報銷而言，擁有這些資料當然非常重要。這就是我設定期望的方式。

Obviously, I think you know the Spyral product is available in Europe currently. It does have CE mark. So as these datasets become available, customers can evaluate them and decide how they want to use that product.

顯然，我想您知道 Spyral 產品目前在歐洲有售。它確實有 CE 標誌。因此，當這些資料集可用時，客戶可以對其進行評估並決定如何使用該產品。

Thanks, Matt.

謝謝，馬特。

Your next question comes from the line of Chris Pasquale with Guggenheim.

您的下一個問題來自古根漢美術館的 Chris Pasquale。

Mike, I just want to circle back on the 4Q CVG growth outlook. It sounds like some of the headwinds there, like LVADs and TAVR, may take at least another quarter to address. I'd imagine that there's potentially some risk that U.S. ICD growth slows ahead of those launches, just like we saw in Europe. So Micra AV should help. There's a couple of other things that go your way, which is the confidence in driving that acceleration in the fourth quarter.

麥克，我只是想回顧一下第四季 CVG 的成長前景。聽起來那裡的一些不利因素，例如 LVAD 和 TAVR，可能至少還需要一個季度才能解決。我認為，美國 ICD 的成長在這些產品推出之前可能會放緩，就像我們在歐洲看到的那樣。所以 Micra AV 應該會有所幫助。還有一些其他的事情對你有利，那就是對推動第四季加速發展的信心。

Sure. I think as you point out, we have lowered our expectations for the LVAD numbers just based on not seeing the sequential share capture in Q3 that we had seen in Q2 and some competitive indications approvals. But on the other hand, obviously, we got the Micra AV early in terms of we expected that it will be later in the quarter when we were setting guidance last quarter. And the customer response has been strong in terms of interest in the technology.

當然。我認為，正如您所指出的，我們降低了對 LVAD 數據的預期，只是因為第三季度沒有看到我們在第二季度看到的連續份額增長以及一些競爭適應症的批准。但另一方面，顯然，我們很早就獲得了 Micra AV，因為我們預計它將在本季度晚些時候推出，當時我們上個季度製定了指導方針。客戶對該技術的興趣也十分強烈。

And as a reminder, this is a product that carries a 3x price uplift relative to a standard dual-chamber system and our indications for use cover all AV block patients. So we expect an opportunity to drive this product meaningfully into the market above what we were thinking a quarter ago when we were giving guidance for Q4.

需要提醒的是，該產品的價格比標準雙腔系統高出 3 倍，且我們的適應症涵蓋所有房室傳導阻滯患者。因此，我們預計有機會將該產品推向市場，超出我們一個季度前給出第四季度指導時的預期。

In addition, although, obviously, the Cobalt and Crome products won't be in the U.S., they will be in Europe. And so unlike last quarter where we really had no meaningful new products and we saw the customers pausing and -- while waiting for new products, now we have a number of new products globally that are obviously going to make a difference for us. And so net-net, we're pretty much holding our expectations for growth where we were a quarter ago despite the moving pieces in this quarter.

此外，雖然鈷和鉻產品顯然不會在美國銷售，但它們會在歐洲銷售。因此，與上一季不同的是，當時我們確實沒有推出任何有意義的新產品，我們看到客戶在等待新產品，而現在我們在全球範圍內推出了許多新產品，這些產品顯然會給我們帶來影響。因此，儘管本季出現了一些變化，但我們對成長的預期基本上與上一季持平。

And does the guidance contemplate a pause in U.S. ICD orders ahead of those launches?

該指南是否考慮在這些措施發布之前暫停美國 ICD 訂單？

Yes, it certainly shows no meaningful acceleration in those numbers, so something along the lines of what we've had. But as I said, we're also seeing some improvement in the replacement cycle generally because of the CRT-D side of things. And the other thing I should mention is, obviously, we will anniversary in March the paclitaxel issue, which was a big step down in the prior year quarter, which gives us just an easier comp to work with as we've seen sequential growth on a selling days basis the last couple of quarters in DCB.

是的，這些數字確實沒有顯示出任何有意義的加速，所以與我們所經歷的情況類似。但正如我所說，由於 CRT-D 方面的原因，我們也看到更換週期有所改善。另外我應該要提到的是，顯然，我們將在三月份慶祝紫杉醇問題的周年紀念日，這比去年同期大幅下降，這讓我們更容易進行對比，因為我們已經看到 DCB 在過去幾個季度的銷售天數連續增長。

And I don't disagree that TYRX, although we won't get to share capture mode this quickly, we'll certainly have sequential growth over the quarter.

我並不反對 TYRX 的觀點，儘管我們不會這麼快進入份額捕獲模式，但本季度我們肯定會實現連續成長。

Absolutely. That -- we were constrained for more than half of last quarter in terms of supply, and now we are essentially unconstrained. And in addition, we are expecting to get labeling expansion to 1-year dating on that product in the United States, which will help us significantly in terms of just the logistics of its growth.

絕對地。上個季度，我們的供應有一半以上都受到了限制，但現在基本上不受限制了。此外，我們期望將該產品在美國的標籤有效期延長至 1 年，這將對我們在其成長的物流方面提供極大幫助。

Thanks, Chris.

謝謝，克里斯。

Your next question comes from the line of Pito Chickering with Deutsche Bank.

您的下一個問題來自德意志銀行的 Pito Chickering。

To follow up on Robbie's question on U.S. TAVR. I understand the sales rep issues are holding back growth of new accounts. But are the sales reps really holding back growth in established accounts? Is that where the growth is falling? Is it from the new accounts or from the established accounts?

繼續回答 Robbie 關於美國 TAVR 的問題。我知道銷售代表的問題阻礙了新客戶的成長。但銷售代表真的會阻礙現有客戶的成長嗎？那裡的成長率正在下降嗎？是來自新帳戶還是來自現有帳戶？

Yes. It's a great question. Actually, what happened was there was a tremendous focus on launching the Evolut PRO+ as well as opening up the NCD accounts. And what we wound up doing because of the relative immaturity of a good bit of our field force is pulling reps who are supporting large accounts to help with that expansion into new accounts.

是的。這是一個很好的問題。實際上，人們非常關注推出 Evolut PRO+ 以及開放 NCD 帳戶。由於我們的現場人員大多相對不成熟，我們最終採取的措施是拉動支援大客戶的銷售代表來幫助我們拓展新客戶。

And obviously, with a new competitor entering the market and some complex messaging having to come in as low-risk patients were approved, it just proved to be too much. We were spreading our field too thin. And so obviously, we've refocused back into those large accounts to make sure that our messaging around improved hemodynamics, the benefits of the Evolut PRO+ in terms of both profile and now adding the pericardial wrap into the large device segment and then, obviously, just selling the benefits of the hemodynamic data that was presented at ACC a year ago. Those are things now that we believe are helping to show this acceleration in growth that I referenced as we head into this quarter versus where we were in January.

顯然，隨著新競爭對手進入市場，以及低風險患者在獲得批准時必須傳達一些複雜的訊息，這被證明是難以承受的。我們的領域太分散了。因此，顯然，我們重新將重點放在這些大客戶身上，以確保我們的信息傳遞圍繞改善血液動力學、Evolut PRO+ 在外形方面的優勢以及現在將心包包裹添加到大型設備部分的優勢，然後，顯然，只是銷售一年前在 ACC 上展示的血液動力學數據的優勢。我們相信，這些因素有助於反映我之前提到的本季與一月份相比的成長加速。

Thanks, Pito.

謝謝，Pito。

Your next question comes from the line of Matthew O'Brien with Piper Sandler.

您的下一個問題來自派珀·桑德勒 (Piper Sandler) 的馬修·奧布萊恩 (Matthew O'Brien)。

I'll just stick with one. Geoff, I appreciate you don't want to say much about this new program that you're going to implement until Investor Day in June, but we've seen contract manufacturers do something like this before, but never really a manufacturing company do something like this. So can you just talk about the potential economic impacts to Medtronic? I mean do you have the scale to kind of work through some of these things on the top line? Is there going to be better pricing so there could be a little bit of gross margin pressure longer term, so there's some free cash flow impacts here? So just how do we think about some of the puts and takes here of this new program?

我只會堅持一個。傑夫，我很感激你不想在六月投資者日之前透露太多關於你將要實施的這個新計劃的消息，但我們以前見過合約製造商做過類似的事情，但從來沒有一家製造公司真正做過這樣的事情。那麼您能談談這對美敦力的潛在經濟影響嗎？我的意思是，您是否有足夠的規模來解決這些頂線上的問題？是否會有更好的定價，長期內可能會有一點毛利率壓力，從而對自由現金流產生一些影響？那麼我們該如何看待這個新計劃的一些優點和缺點呢？

Yes. Well, look, I didn't -- just one clarification on what I spoke about. I think this is the second question around will some of these changes impact our margins. And the answer to that is no, right? We're talking about focus on increasing our revenue and the overall revenue growth as well as the consistency and predictability of that revenue growth, but we don't want to take a step back on the margin improvement that we've built up and the cash flow conversion improvements that we had done over the last couple of years as a result of our -- these are sustainable changes from our Enterprise Excellence Program so we don't want to take a step back on that.

是的。嗯，你看，我沒有——我只是想澄清一下我所說的內容。我認為這是第二個問題，這些變化是否會影響我們的利潤率。答案是否定的，對嗎？我們正在討論重點增加我們的收入和整體收入增長以及收入增長的一致性和可預測性，但我們不想在我們已經建立的利潤率改善和過去幾年我們通過企業卓越計劃實現的現金流轉換改善方面倒退——這些都是我們企業卓越計劃帶來的可持續變化，所以我們不想在這方面倒退。

What I mentioned this morning -- on this morning's call was the very specific changes that we want to make to improve orders that are coming in late in the quarter. We have a couple of our larger orders, some of our -- coming in late in the quarter, which stresses our system, and we've got to execute better really to get those in earlier. We're putting too much pressure on the last month, and that's specifically what I spoke of this morning. And when I hinted at for Investor Day was more on what are we doing to realize the full benefits of the pipeline.

我今天早上在電話會議上提到了我們希望做出的非常具體的改變，以改善本季末的訂單。我們有幾個較大的訂單，其中一些是在本季末到達的，這給我們的系統帶來了壓力，我們必須更好地執行才能更早完成這些訂單。我們對上個月施加了太大的壓力，這就是我今天早上所說的。當我暗示投資者日時，更多的是談論我們正在做什麼來充分發揮管道的優勢。

Look, like the fundamentals of the business are strong. What I mean by that specifically, you guys know the markets are doing well, we have good market share positions. But more importantly in terms of momentum, the product pipeline is coming to fruition here. So we need to make sure that we put the right programs in place to realize the full benefits of that pipeline around commercial execution. So that's -- we'll get into more of that on Investor Day. What I talked about this morning was more having a regular -- moving some of our back-end loading of our quarter and spreading that more evenly throughout the quarter, but nothing regarding -- nothing changed regarding margin.

看起來，該業務的基本面很強勁。我具體想說的是，你們知道市場表現良好，我們擁有良好的市佔率。但就勢頭而言，更重要的是，產品線正在取得成果。因此，我們需要確保實施正確的計劃，以充分發揮該管道在商業執行方面的優勢。所以——我們將在投資者日討論更多相關內容。我今天早上談論的更多的是定期——移動我們季度的一些後端負載，並在整個季度中更均勻地分配，但關於利潤率沒有任何變化。

All right. Thanks, Matt.

好的。謝謝，馬特。

Our final question will come from the line of Josh Jennings with Cowen.

我們的最後一個問題來自 Cowen 的 Josh Jennings。

Just 2 questions for Karen on margins. Just on the gross margin pressure you've experienced so far in fiscal '20, can you just help us understand the drivers of that? And is this kind of sub-70% level the new normal? Or is there a recovery path? And has it been FX, pricing pressure, mix shift? And then just on the other income tailwind that you've experienced in fiscal '20 outside of FX hedging, can you talk about the drivers of that benefit and then how sustainable and predictable that line item will be going forward?

關於利潤率，我只想問 Karen 兩個問題。就您在 20 財年迄今經歷的毛利率壓力而言，您能否幫助我們了解其驅動因素？那麼，這種低於 70% 的水平是否是新常態？或有恢復路徑嗎？這是外匯、定價壓力還是組合轉變？那麼，關於您在 20 財年經歷的除外匯對沖之外的其他收入順風，您能否談談這一收益的驅動因素，以及該項目未來的可持續性和可預測性如何？

Yes. Thank you, Josh. No problem. So on gross margins, one of the larger pressures that we've had on gross margin is the increase in China tariff, and as long as those stay, that will be a continued pressure. Gross margin is obviously impacted by mix. And as we introduce some of our key new products, that should help gross margin going forward.

是的。謝謝你，喬希。沒問題。因此，就毛利率而言，我們面臨的較大壓力之一就是中國關稅的上漲，只要這些因素持續存在，這種壓力就會持續存在。毛利率顯然受到產品組合的影響。隨著我們推出一些關鍵的新產品，這應該有助於提高未來的毛利率。

And as we think about the net other expense or income line item, we had a benefit this quarter. That was primarily driven by a swap program that we have in place to hedge the gains and losses that are part of our deferred compensation program and SG& A. And so it was really driven by that. Our SG&A line would have been even better if it didn't have a loss that was effectively offset by a gain in net other.

當我們考慮淨其他費用或收入項目時，我們本季獲得了收益。這主要是由我們實施的掉期計劃推動的，該計劃旨在對沖遞延薪酬計劃和銷售、一般及行政費用中的收益和損失。所以這確實是受此推動的。如果我們的銷售、一般和行政費用 (SG&A) 線沒有出現虧損，而該虧損又被其他淨收入的收益有效抵消，那麼我們的銷售、一般和行政費用 (SG&A) 線的表現會更好。

Thank you, Josh. Omar, do you want to wrap up?

謝謝你，喬希。奧馬爾，你想結束嗎？

Yes. Well, thank you all for your questions. And on behalf of the entire management team, I'd like to thank you again for your continued support and interest in Medtronic.

是的。好的，謝謝大家的提問。我謹代表整個管理團隊再次感謝您對美敦力的持續支持與關注。

Look, we'll get this thing right. We've got a task to do here. We'll get acceleration in our growth profile in Q4, and that will continue into FY '21. Our product pipeline is strong, and this team is committed behind it. We couldn't have had -- I couldn't have asked for a better team and more committed. And we'll get this thing right, I assure you.

瞧，我們會把這件事做好的。我們有一項任務要做。我們的成長動能將在第四季加速，並將持續到 21 財年。我們的產品線非常強大，並且我們的團隊致力於此。我們不可能擁有──我不可能要求一支更好的、更投入的團隊。我向你保證，我們會把這件事做好的。

And then we really look forward to updating you on our progress on our Q4 earnings call. Thank you.

然後，我們非常期待在第四季財報電話會議上向您通報我們的進度。謝謝。

Ladies and gentlemen, this does conclude today's meeting. Thank you all for joining, and you may now disconnect.

女士們、先生們，今天的會議到此結束。感謝大家的加入，現在可以斷開連線了。