美敦力 (MDT) 2026 Q2 法說會逐字稿

(video playing) Hello, everyone, and thanks for joining us today for our fiscal '26 second quarter video earnings webcast. I'm Ryan Weispfenning, Vice President and Head of Medtronic Investor Relations. Joining me here today are Geoff Martha, Chairman and Chief Executive Officer; and Thierry Pieton, Chief Financial Officer. Geoff and Thierry will provide comments on the results of our second quarter, which ended on October 24, 2025, and our outlook for the remainder of fiscal year '26.

（影片播放）大家好，感謝大家今天收看我們2026財年第二季財報影片網路直播。我是瑞安‧魏斯芬寧，美敦力公司副總裁兼投資人關係主管。今天與我一同出席的有董事長兼執行長傑夫·馬薩，以及財務長蒂埃里·皮埃頓。Geoff 和 Thierry 將對我們截至 2025 年 10 月 24 日的第二季業績以及我們對 2026 財年剩餘時間的展望發表評論。

After our prepared remarks, we'll take questions from the sell-side analysts that cover the company. Today's program should last about an hour. Earlier this morning, we issued a press release discussing our results and containing several financial schedules. We also posted an earnings presentation that provides additional details on our performance. The presentation can be accessed in our earnings press release or on our website at investorrelations.medtronic.com.

在我們發表完準備好的演講後，我們將接受報道該公司的賣方分析師的提問。今天的節目大約持續一個小時。今天早些時候，我們發布了一份新聞稿，討論了我們的業績，其中包含幾個財務報表。我們還發布了一份收益報告，其中提供了有關我們業績的更多詳細資訊。您可以在我們的獲利新聞稿或公司網站 investorrelations.medtronic.com 上查看簡報。

During today's program, many of the statements we make 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 our 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.

在今天的節目中，我們所做的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預測的結果有重大差異。有關可能導致我們實際業績與預期業績存在差異的因素的更多信息，請參閱我們定期向美國證券交易委員會提交的報告和其他文件，我們不承諾更新任何前瞻性聲明。

Unless we say otherwise, all comparisons are on a year-over-year basis, and revenue comparisons are made on an organic basis, which excludes the impact of foreign exchange, second quarter revenue in the current and prior year from our divestiture this quarter of the Dutch Obesity Clinic, also known as NOK, and second quarter revenue in the current and prior year reported as other.

除非另有說明，所有比較均按同比計算，收入比較按有機增長計算，不包括外匯影響、本季度和上年度第二季度因剝離荷蘭肥胖診所（NOK）而產生的收入，以及本年度和上年度第二季度報告為“其他”的收入。

References to sequential revenue changes compared to the first quarter of fiscal '26 and are made on an as-reported basis. All share references are on a revenue and year-over-year basis and compare our second fiscal quarter to our competitors' third calendar quarter. Reconciliations of all non-GAAP financial measures can be found in our earnings press release or on our website at investorrelations.medtronic.com. And 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.

與 2026 財年第一季相比，季度營收變動均按報告數據計算。所有份額參考均以收入和年比為基礎，並將我們的第二財季與競爭對手的第三財季進行比較。所有非GAAP財務指標的調節表可在我們的獲利新聞稿或公司網站investorrelations.medtronic.com上查閱。最後，我們的每股盈餘預期不包括任何將在本會計年度作為非GAAP調整項計入收益的費用或收益。

With that, over to you, Geoff.

那麼，接下來就交給你了，傑夫。

Okay. Thanks, Ryan, and hello, everyone. Last quarter, I told you that Medtronic is on the cusp of an acceleration in our financial results and our strategy. Well, today, I'm pleased to share that because of our organization's relentless focus, that acceleration is indeed underway. We delivered a strong second quarter. Both our revenue and EPS beat expectations.

好的。謝謝瑞恩，大家好。上個季度，我告訴過你們，美敦力正處於財務表現和策略加速發展的風口浪尖。今天，我很高興地告訴大家，由於我們組織堅持不懈的專注，這種加速發展確實正在進行中。我們第二季業績表現強勁。我們的營收和每股盈餘均超出預期。

Looking across our business, procedure volumes and end markets are robust, and we're bringing Medtronic's full capabilities to bear as we launch innovative technologies and execute ahead of plan in some of the most attractive and fast-growing end markets in med-tech. We're glad to be able to raise our revenue growth and EPS guidance for the full year on the back of this building progress. This quarter, we accelerated our growth with significant contributions from our cardiac ablations business as promised.

從我們整個業務來看，手術量和終端市場都很強勁，我們正在充分發揮美敦力的全部能力，推出創新技術，並在醫療技術領域一些最具吸引力和增長最快的終端市場中提前執行計劃。我們很高興能夠基於這項建設進展，提高全年營收成長和每股盈餘預期。本季度，正如我們承諾的那樣，心臟消融業務做出了重大貢獻，加快了我們的成長步伐。

Looking ahead, there's even more that Medtronic is capable of. We're positioning ourselves for even greater acceleration in revenue growth in the back half of the year and beyond. And our momentum is fueled by our enterprise growth drivers, including our PFA franchise for Afib, Symplicity for hypertension, Hugo and soft tissue robotics and Altaviva for incontinence. Look, these are game changers, and they'll power our trajectory.

展望未來，美敦力還有更大的潛力。我們正在為下半年及以後營收成長的進一步加速做好準備。我們的發展勢頭得益於我們的企業成長驅動因素，包括我們的 PFA 房顫特許經營權、Symplicity 高血壓特許經營權、Hugo 和軟組織機器人以及 Altaviva 尿失禁特許經營權。瞧，這些都是顛覆性的變革，它們將推動我們前進。

And at this pivotal inflection point in our growth journey, we recognize the need to capitalize on the incredible market opportunities before us. So we've scaled manufacturing to support our acceleration. And this quarter, we took the opportunity to increase OpEx investments to support our revenue growth momentum. We did all this while still delivering outsized EPS growth relative to our guidance. Overall, we've shifted to a growth mindset. Besides our organic programs, we're focused on pursuing tuck-in M&A and executing strategic portfolio management.

在我們成長歷程的這個關鍵轉折點上，我們意識到需要抓住擺在我們面前的巨大市場機會。因此，我們擴大了生產規模以支持我們的加速發展。本季度，我們抓住機會增加了營運支出投資，以支持我們的收入成長動能。我們做到這一切的同時，每股盈餘成長也遠超預期。整體而言，我們已經轉變為成長型思維模式。除了我們的有機成長項目外，我們還專注於進行補充性併購和執行策略性投資組合管理。

Now let's get into the details on our enterprise growth drivers. One of them powered our growth acceleration this quarter. And together, all of them will fuel our total company revenue growth in the quarters ahead. In cardiac ablation, our PFA franchise is generating just a ton of momentum. We grew 71%, which is a strong acceleration from last quarter's nearly 50% CAS growth. This is the highest growth rate of any company in this large and fast-growing space.

現在讓我們詳細了解我們企業的成長驅動因素。其中一項舉措推動了我們本季的成長加速。它們共同推動了公司未來幾季的總收入成長。在心臟消融領域，我們的 PFA 產品線正在產生巨大的發展勢頭。我們實現了 71% 的成長，比上一季近 50% 的 CAS 成長率大幅提升。這是該龐大且快速成長領域中所有公司中最高的成長率。

We're winning share as our PFA franchise grew over 300% in the US as well as in international markets. This was based on the strength of our Affera mapping system and our Sphere-9 dual energy and high-density mapping catheter. Look, physicians tell us that they appreciate not only the shorter procedure times that they're seeing with Affera, but increasingly, they're calling out its outstanding durability as well. And demand continues to be extremely high as we hear repeatedly from customers that they want to purchase additional Affera systems to expand into even more of their labs. And in the vast majority of instances, when a new Affera system goes into a lab, we take the majority of the AF procedure share in that lab.

我們的 PFA 特許經營權在美國和國際市場上成長超過 300%，因此我們的市場份額正在不斷擴大。這是基於我們的 Affera 標測系統和 Sphere-9 雙能量高密度標測導管的強大功能。你看，醫生告訴我們，他們不僅欣賞 Affera 縮短的手術時間，而且越來越讚賞其出色的耐用性。而且需求仍然非常高，我們不斷聽到客戶表示，他們希望購買更多的 Affera 系統，以便擴展到他們更多的實驗室。在絕大多數情況下，當一個新的 Affera 系統進入實驗室時，我們會在實驗室佔據大部分的 AF 手術份額。

Our plants have scaled, as I mentioned earlier, to meet the challenge, and our mapping hiring is going really well. And as a result, we've doubled our installed base of Affera mapping systems during the quarter. And given the economics of this business with capital and consumables, our mapping system sales are a strong leading indicator of future revenue growth and margin expansion. So we're still in the early parts of this rollout, and we expect revenue acceleration to continue with an even higher CAS growth in Q3. We remain on track to double the revenue of this business soon, adding an incremental $1 billion off the $1 billion FY25 base.

正如我之前提到的，我們的工廠已經擴大規模以應對挑戰，而且我們的招募工作進展非常順利。因此，本季我們Affera測繪系統的安裝量翻了一番。鑑於該行業在資本和耗材方面的經濟狀況，我們的測繪系統銷售額是未來收入成長和利潤率擴張的有力領先指標。因此，我們仍處於推廣的早期階段，我們預計營收加速成長的勢頭將在第三季度繼續，CAS 成長將更加強勁。我們仍有望很快實現該業務收入翻倍的目標，在 2025 財年 10 億美元的基數基礎上增加 10 億美元。

Look, and we're not stopping there. With our pipeline, we're bringing Affera technology to the single-shot segment with Sphere-360. EPs tell us that 360 is the most anticipated PFA catheter out there given the strength of its early clinical data. We've submitted the IDE to the FDA to get approval for our US pivotal trial, which we're expecting to start in Q3.

聽著，我們不會就此止步。借助我們的生產線，我們將 Affera 技術引入 Sphere-360 單次注射領域。電生理專家告訴我們，鑑於早期臨床數據的強勁表現，360 是目前最受期待的 PFA 導管。我們已向 FDA 提交了 IDE 申請，以獲得我們在美國的關鍵性試驗的批准，我們預計將在第三季開始進行試驗。

So the EP ablation space is now over $12 billion. It's growing mid-20s. And with our low double-digit share and the high demand I just talked about for the current portfolio and our pipeline, we see a long runway to gain significant share and add meaningful growth to Medtronic.

因此，EP消融領域的市場規模現在超過120億美元。它的生長速度在20多歲。鑑於我們目前兩位數的市場份額以及我剛才提到的對現有產品組合和在研產品的高需求，我們看到了獲得顯著市場份額並為美敦力帶來實質性增長的長遠前景。

Now on top of that growth, we're launching as the clear market leader in two very large end markets, our Symplicity procedure for hypertension and Altaviva for incontinence. And we're excited to have received the final Medicare NCD for Symplicity three weeks ago. So now in addition to a broad label from the FDA, we have an excellent coverage outcome from CMS. The final NCD enables broad access and removes certain patient pathway barriers that were in the original proposal, including reducing in-person visits, removing a kidney function exclusion and cutting in half the time requirement for adherence to meds.

現在，除了這些成長之外，我們還將在兩個非常大的終端市場——高血壓的 Symplicity 手術和尿失禁的 Altaviva——中成為明顯的市場領導者。我們很高興三週前收到了 Symplicity 的最後一筆 Medicare NCD 款項。所以現在除了獲得 FDA 的廣泛批准外，我們還獲得了 CMS 的良好醫療覆蓋結果。最終的NCD實現了廣泛的覆蓋面，並消除了最初提案中的某些患者就醫途徑障礙，包括減少面對面就診次數、取消腎功能排除條件以及將服藥依從性所需時間縮短一半。

It also highlights patient quality of life as an important consideration. So the NCD gives physicians many avenues to bring Symplicity to patients. Additionally, we are currently the only company to meet the full NCD criteria with an approved continued evidence development plan. And on the commercial payer front, we picked up significant momentum with wins during the quarter, including HCSC, Regence, and several Blue Cross Blue Shield plans that collectively cover 30 million lives.

報告也強調了患者生活品質是一個重要的考慮因素。因此，NCD 為醫生提供了許多途徑，將 Symplicity 帶給患者。此外，我們是目前唯一一家符合 NCD 所有標準並擁有已批准的持續證據開發計劃的公司。在商業支付方方面，我們在本季度取得了顯著進展，贏得了 HCSC、Regence 和幾家藍十字藍盾保險公司的青睞，這些保險公司共覆蓋了 3000 萬人。

Shifting to efficacy. Medtronic is the runaway leader with Ardian clinical data, and we continue to add to it. Only Symplicity RF Ardian has consistently shown sustained and improving blood pressure reductions in the long term. This is definitively unique to us, as we've not seen this with the ultrasound devices. This sets the standard that all other devices must now meet. And last month at TCT, we shared three-year data from our ON MED trial that continued to show the procedure is effective over the long term.

轉向療效。美敦力憑藉Ardian臨床數據遙遙領先，我們仍在持續補充相關數據。只有 Symplicity RF Ardian 能夠持續、長期地降低血壓並持續改善血壓水平。這絕對是我們獨有的現象，因為我們在其他超音波設備上從未見過這種情況。這為所有其他設備設定了必須達到的標準。上個月在 TCT 會議上，我們分享了 ON MED 試驗的三年數據，這些數據繼續表明手術在長期內是有效的。

Patients who underwent the Symplicity procedure experienced an 18.5 point average drop in systolic blood pressure. We also completed enrollment in our SPYRAL AFFIRM trial, which aims to expand Symplicity into high-risk subgroups, including people with isolated systolic hypertension. The first data from a subset of this trial was also shown at TCT with very strong results. We're using these results in ongoing discussions with the FDA.

接受 Symplicity 手術的患者收縮壓平均下降了 18.5 點。我們也完成了 SPYRAL AFFIRM 試驗的招募工作，該試驗旨在將 Symplicity 推廣到高風險亞組，包括單純收縮期高血壓患者。該試驗部分數據的首批結果也在 TCT 上公佈，結果非常令人鼓舞。我們正在將這些結果用於與FDA的持續討論中。

So Symplicity represents a massive multibillion-dollar opportunity for Medtronic with an addressable market of 18 million people in the US with uncontrolled hypertension. And now with a broad NCD in place and commercial payers coming online faster than anticipated, this isn't a question of if or even how big, it's a question of how fast.

因此，Symplicity 代表美敦力公司數十億美元的龐大商機，其目標市場是美國 1,800 萬名未控制高血壓患者。現在，隨著廣泛的非傳染性疾病保險政策的實施，以及商業支付方比預期更快加入進來，這不再是規模大小的問題，而是速度的問題。

Now we have not incorporated much Symplicity revenue into our back half guidance, but we are sprinting after this opportunity. We have supply. We've ramped up physician training and market development activities with many hospitals initiating Symplicity programs across the country. And now we're increasing our consumer awareness programs. And as a result, we expect our revenue to pick up in the back half of the fiscal year and ramp over the next few quarters and meaningfully contribute to Medtronic for years to come.

目前我們尚未將 Symplicity 的收入大幅計入下半年業績預期，但我們正在全力以赴抓住這個機會。我們有貨源。我們加強了醫生培訓和市場開發力度，全國各地許多醫院都已啟動了Symplicity計畫。現在，我們正在加大消費者意識宣傳力道。因此，我們預計本財年下半年的營收將有所成長，並在接下來的幾季內穩步提升，為美敦力在未來幾年做出有意義的貢獻。

Now shifting to Altaviva. We're seeing very positive signs in the first several weeks of the US launch. Physician training programs are oversubscribed, and we're expanding training capacity to meet this demand. Physicians are stacking cases, and early media coverage has driven a surge in consumer search activity.

現在切換到 Altaviva。美國市場推出後的前幾週，我們看到了非常正面的跡象。醫師培訓計畫報名人數過多，我們正在擴大培訓能力以滿足此需求。醫生們正在積壓病例，而早期的媒體報導也推動了消費者搜尋量的激增。

Altaviva is a simple option to treat urinary urges and involuntary leaks, which affect 16 million people in the US. This small device is inserted just below the skin, but above the fascia near the ankle. The procedure is minimally invasive, doesn't require sedation, and the patient goes home with a therapy activated.

Altaviva 是一種治療尿急和尿失禁的簡單選擇，這種疾病影響著美國 1600 萬人。這個小型裝置插入到腳踝附近皮膚下方、筋膜上方的位置。此手術屬於微創手術，無需鎮靜，患者回家後即可啟動治療方案。

So they're not waiting for follow-up appointments to feel the results. The device is only recharged once or twice a year, eliminating the need for daily at-home charging equipment, and it has a 15-year battery. So we believe Altaviva will add meaningful growth to our public health business, and be a Medtronic growth driver again for years to come. And more importantly, it is meaningful for patients. This is our first patient in South Carolina, who is dancing to Jingle Bell Rock.

所以他們無需等待復診就能感受到效果。該設備每年只需充電一到兩次，無需每天在家充電，電池壽命長達 15 年。因此我們相信 Altaviva 將為我們的公共衛生業務帶來有意義的成長，並在未來幾年再次成為美敦力成長的驅動力。更重要的是，這對患者來說意義重大。這是我們在南卡羅來納州的第一位病人，他正在隨著《鈴兒響叮噹搖滾版》跳舞。

It's getting to be that time of the year, and it's a wonderful video. In addition to these enterprise growth drivers, we're seeing improvements in many of our other businesses as we execute on new product introductions, getting products to market ahead of schedule and ensuring strong commercial follow-through.

又到了一年中的這個時候，這是一段很棒的影片。除了這些企業成長驅動因素之外，隨著我們推動新產品上市、提前將產品推向市場並確保強勁的商業後續跟進，我們的許多其他業務也得到了改善。

So with that, I'm going to turn it over to Thierry to cover the details of our business performance, financials and our guidance.

那麼，接下來我將把發言權交給蒂埃里，讓他詳細介紹我們的業務表現、財務狀況和業績展望。

Thanks, Geoff. Hi, everyone. I appreciate everyone joining us today. So I'll start with our Cardiovascular portfolio, where we grew 9%. This was our strongest growth in over a decade, excluding the easy comparisons we had after the pandemic. The growth acceleration was driven by our building momentum in CAS, which Geoff walked you through. And it's worth noting that PFA is now 75% of our cardiac ablation revenue. Our PFA growth significantly offset the 40% declines we had in cryo and 90% of our remaining cryo revenue is in markets outside of the US.

謝謝你，傑夫。大家好。感謝今天各位的到來。那麼，我先從我們的心血管產品組合說起，該組合增加了 9%。這是我們十多年來最強勁的成長，當然，疫情後相對較低的基數效應除外。成長加速得益於我們在 CAS 領域不斷累積的勢頭，Geoff 已經向大家詳細介紹過了。值得注意的是，PFA 目前占我們心臟消融收入的 75%。我們的 PFA 業務成長顯著抵消了冷凍治療業務 40% 的下滑，而我們剩餘的冷凍治療收入中有 90% 來自美國以外的市場。

And look, it wasn't just CAS. The rest of our Cardiovascular portfolio grew a combined mid-single digits. Cardiac Rhythm Management grew 5% with 18% growth in Micra leadless pacemakers, and nearly 80% growth in AURORA EV-ICDs. In Structural Heart, we grew 7% on the strength of the Evolut TAVR platform. In Peripheral Vascular, we grew low single digits, and we expect growth to improve as we continue to launch the Neuroguard IEP carotid stent and begin the launch of our Liberant mechanical thrombectomy system.

而且，這不僅僅是 CAS 的問題。我們心血管產品組合的其他部分合計實現了中等個位數的成長。心臟節律管理業務成長了 5%，其中 Micra 無導線起搏器成長了 18%，AURORA EV-ICD 成長了近 80%。在結構性心臟病領域，我們憑藉 Evolut TAVR 平台實現了 7% 的成長。在周邊血管領域，我們的成長率僅為個位數，隨著我們繼續推出 Neuroguard IEP 頸動脈支架並開始推出 Liberant 機械血栓切除系統，我們預計成長率將會提高。

Next, in our Neuroscience portfolio, our growth returned to mid-single digits as expected, with growth of 4%. In Cranial & Spinal Technologies, we grew 5%. That included 8% growth in Core Spine, both globally and in the US, and 5% in Neurosurgery capital equipment. Our spine AiBLE ecosystem, which includes AI-enabled preoperative planning software, and enabling capital equipment, including robotics, navigation, imaging and powered surgical instruments continues to attract strong spine surgeon adoption and drive meaningful share gains. And this is enabling strong pull-through of our Core Spine hardware.

其次，在我們的神經科學投資組合中，我們的成長如預期般恢復到個位數中段，成長了 4%。在顱骨和脊椎技術領域，我們成長了 5%。其中包括核心脊椎業務在全球和美國市場成長 8%，以及神經外科資本設備成長 5%。我們的脊椎 AiBLE 生態系統，包括人工智慧術前規劃軟體和相關設備（包括機器人、導航、影像和電動手術器械），持續吸引脊椎外科醫生的廣泛採用，並推動了市場份額的顯著增長。這使得我們的核心脊椎硬體能夠得到強而有力的推廣。

Our Specialty Therapies businesses had flat results in Q2, an expected improvement from last quarter, driven by ENT and Neurovascular. We have clear line of sight to continued improvement in Specialty Therapies next quarter as we accelerate growth in both Neurovascular and Pelvic Health. In Neurovascular, growth will improve as we anniversary the vast majority of China VBP in January. We also expect an increasing growth contribution from the Neuroguard carotid stent launch, which is being sold by both our Peripheral Vascular and Neurovascular businesses. In Pelvic Health, we expect growth to accelerate on the Altaviva launch that Geoff outlined.

第二季度，我們的專科治療業務業績與上一季持平，較上一季度有所改善，這主要得益於耳鼻喉科和神經血管科的業績成長。隨著神經血管和骨盆底健康領域的成長加速，我們有一個清晰的願景在下一季繼續改善專科治療業務。在神經血管領域，隨著1月份中國絕大多數VBP計畫迎來週年紀念日，成長將會改善。我們也預計，Neuroguard 頸動脈支架的上市將帶來越來越大的成長貢獻，該產品由我們的周邊血管業務和神經血管業務共同銷售。在骨盆底健康領域，我們預計隨著 Geoff 概述的 Altaviva 的推出，成長速度將會加快。

In Neuromodulation, we grew 7%. Both Pain Stim and Brain Modulation grew high single digits as we continue the rollout of our Inceptiv SCS and BrainSense ADBS systems. The market continues to appreciate our differentiated fully closed-loop technology with responsive real-time therapy adjustments that's available in both of these products.

在神經調控領域，我們成長了 7%。隨著我們繼續推廣 Inceptiv SCS 和 BrainSense ADBS 系統，疼痛刺激和腦調節業務均實現了接近兩位數的成長。市場持續認可我們差異化的全閉環技術，可實現響應迅速的即時治療調整，而這兩款產品均具備此功能。

Next, our MedSurg portfolio grew 1% as expected. Our Surgical business also grew 1%, impacted, as we anticipated, by the timing of certain tenders in emerging markets and the ongoing but stable market pressures from bariatric surgery and the shift to robotics. We expect a slight rebound in surgical in the back half. And over time, we expect growth to continue to improve as we enter new markets with Hugo. In the back half of this fiscal year, we expect the FDA to approve Hugo with a urology indication and we'll start our entrance in the US. We also continue to make progress on expanding indications.

其次，我們的醫療外科產品組合如預期成長了 1%。我們的外科手術業務也成長了 1%，正如我們預期的那樣，受到了新興市場某些招標時機以及減肥手術和向機器人手術轉變帶來的持續但穩定的市場壓力的影響。我們預計下半年外科手術量將略有回升。隨著我們藉助 Hugo 進入新市場，我們預計成長將持續改善。在本財年的下半年，我們預計 FDA 將批准 Hugo 用於泌尿科適應症，屆時我們將開始進軍美國市場。我們在擴大適應症方面也持續取得進展。

During the quarter, we presented our Enable Hernia repair study, which met its safety and effectiveness endpoints. And we kicked off our Embrace Gynecology US pivotal study last month. This builds on the momentum from the positive results of our international gyn study, which we shared at SRS in July.

本季度，我們公佈了 Enable 疝氣修復研究，該研究達到了安全性和有效性終點。上個月，我們啟動了 Embrace Gynecology 美國關鍵研究。這建立在我們國際婦科研究取得的積極成果的基礎上，該研究成果已於 7 月在 SRS 會議上分享。

Given our experience in international markets, we've developed a clear understanding of the differentiated features that will make our robotics program successful. This includes Hugo's modularity and open console. It also includes continuously adding advanced technologies such as our ICG imaging and instrumentation like LigaSure RAS. Our Touch Surgery digital ecosystem is a force multiplier for robotics and for laparoscopic surgery. Adoption is building momentum and bringing AI into operating rooms in over 30 countries.

憑藉我們在國際市場的經驗，我們對能夠使我們的機器人專案成功的差異化特徵有了清晰的認識。這包括 Hugo 的模組化和開放式控制台。它還包括不斷添加先進技術，例如我們的 ICG 成像和 LigaSure RAS 等儀器。我們的 Touch Surgery 數位生態系統是機器人手術和腹腔鏡手術的倍增器。人工智慧的應用正在加速發展，並已在超過 30 個國家的手術室中應用。

Beyond the features, we're also leveraging our deep partnerships with customers through our training, support and through our service. We look forward to robotics becoming a more meaningful growth driver over time. Next, our Endoscopy business grew 8%. This was driven by double-digit growth in our esophageal products as well as in GI Genius, our AI-powered solution used to detect polyps during colonoscopies.

除了產品功能之外，我們還透過培訓、支援和服務，充分利用與客戶的深厚合作關係。我們期待隨著時間的推移，機器人技術能夠成為更重要的成長驅動力。其次，我們的內視鏡業務成長了 8%。這主要得益於我們的食道產品以及 GI Genius（一種用於在結腸鏡檢查期間檢測息肉的 AI 解決方案）的兩位數增長。

Wrapping up our business performance, our Diabetes business or MiniMed, as it will be called post separation, grew high single digits. We had particular strength in international markets, which grew 11%. As expected, the US was lower this quarter, in large part due to a decline in new orders as customers anticipated the launch of our new sensors. As we've started accepting orders, we're seeing this pent-up demand materialize. There's a lot of excitement behind both the Simplera Sync and Instinct sensors.

總結我們的業務表現，我們的糖尿病業務（或分拆後將稱為 MiniMed）實現了接近兩位數的成長。我們在國際市場擁有特別強大的實力，成長了 11%。正如預期的那樣，美國本季業績下滑，這主要是由於客戶預期我們的新感測器即將上市，導致新訂單減少。隨著我們開始接受訂單，我們看到這種被壓抑的需求正在轉化為現實。Simplera Sync 和 Instinct 感光元件都備受期待。

Look, with the Simplera Sync, we continue to ramp manufacturing volume to support its European launch. As that ramp continues, we plan to roll it out more broadly to US consumers later this fiscal year. And ahead of that, we started accepting orders during the quarter. With the Instinct sensor, we started taking preorders in the US during the last month of the quarter, and we expect to begin shipping in late November.

你看，隨著 Simplera Sync 的推出，我們正在不斷提高產量，以支持其在歐洲的上市。隨著這一成長勢頭的持續，我們計劃在本財年稍後將其更廣泛地推廣給美國消費者。在此之前，我們已開始接受季度訂單。搭載 Instinct 感測器的產品，我們已於本季最後一個月開始在美國接受預訂，預計將於 11 月下旬開始出貨。

We accumulated more than 35,000 US customer orders for Simplera Sync and preorders for Instinct. Around 25% of these orders are from new pump users or our Medtronic pump users who are not using our CGM. The rest of these orders are current customers in our installed base upgrading to the new sensors. We also saw over 9,000 HCPs in the US who are new Medtronic prescribers.

我們已累計收到超過 35,000 份美國客戶的 Simplera Sync 訂單和 Instinct 的預購訂單。這些訂單中約有 25% 來自新幫浦用戶或未使用我們 CGM 的美敦力幫浦用戶。其餘訂單均來自我們現有客戶群，他們正在升級到新型感測器。我們還發現，美國有超過 9,000 名醫療保健專業人員成為美敦力的新處方醫生。

Look, for those of you who follow this space, you know how big a deal these numbers are and the impact they're expected to have on increasing our installed base. We expect the demand for our new sensors to accelerate our US growth in the back half of the fiscal year.

關注這個領域的人都知道，這些數字意義重大，而且預計會對增加我們的用戶基數產生影響。我們預計，對我們新型感測器的需求將在本財年下半年加速我們在美國的成長。

Our Diabetes business is in a strong innovation cycle. We've had a lot of great news in the last few months as our teams execute on the pipeline. In July, the 780G system received CE Mark for three expanded indications, including for type two for children as young as age two and during pregnancy. In September, the US FDA also approved 780G for people with type two diabetes. And they cleared our SmartGuard algorithm that enabled integration with the Instinct sensor.

我們的糖尿病業務正處於強勁的創新週期。過去幾個月，隨著團隊在專案推進方面取得進展，我們收到了許多好消息。7 月，780G 系統獲得了 CE 認證，可用於三個擴展適應症，包括用於治療 2 歲及以上兒童的 II 型糖尿病以及妊娠期糖尿病。9 月，美國 FDA 也批准了 780G 用於治療二型糖尿病患者。他們清除了我們的 SmartGuard 演算法，該演算法能夠與 Instinct 感測器整合。

Earlier this month, we received FDA approval to start the US pivotal for Vivera, our third-generation algorithm. We also continue to make progress with our new AID systems, MiniMed Flex and MiniMed Fit. We remain on track to submit Flex, our next-generation durable pump, to the US FDA. And with Fit, our AID patch system, we intend to submit to the US FDA by the fall of next year.

本月初，我們獲得了 FDA 的批准，可以開始在美國進行 Vivera（我們的第三代演算法）的關鍵性試驗。我們的新型 AID 系統 MiniMed Flex 和 MiniMed Fit 也持續取得進展。我們仍按計畫向美國FDA提交我們的下一代耐用型幫浦Flex。我們計劃在明年秋季之前將我們的 AID 貼片系統 Fit 提交給美國 FDA。

Look, finally, our planned separation of MiniMed is on track. Our preferred path continues to be a two-step IPO and split. We continue to expect the separation to be complete by the end of calendar year '26. So we have a lot of momentum with diabetes given the order inflection and progress on the pipeline and separation. And you're hearing today that this momentum acceleration extends across the enterprise as we advance our pipeline and deliver growth.

瞧，我們計畫中的 MiniMed 分拆終於進展順利了。我們首選的方案仍然是分兩步驟進行IPO和拆分。我們仍預計到 2026 年底，分離工作將完成。鑑於訂單拐點以及研發管線和分離工作的進展，我們在糖尿病領域擁有很大的發展勢頭。今天大家也聽到，隨著我們推動業務發展並成長，這種加速成長的勢頭已經蔓延到整個企業。

Now turning to the financials. The second quarter revenue of $9 billion grew 6.6% reported and 5.5% organic. That's an acceleration from last quarter and 75 basis points ahead of the midpoint of our guidance. Our revenue from a geographic perspective was balanced with double-digit growth in Japan and mid-single-digit growth in the US, in Western Europe and China. In China, we're driving growth even as we go through ongoing but very manageable volume-based procurement in a few businesses.

現在來看財務數據。第二季營收達 90 億美元，其中報告營收成長 6.6%，有機營收成長 5.5%。這比上一季有所加速，比我們預期中位數高出 75 個基點。從地理角度來看，我們的收入保持平衡，日本實現了兩位數的成長，而美國、西歐和中國則實現了中等個位數的成長。在中國，即使我們在一些業務領域持續進行但可控的按量採購，我們仍然在推動成長。

Our adjusted gross margin was 65.9%, up 70 basis points year-over-year. Similar to last quarter, I'll walk you through the main components. So we got 30 basis points again from pricing as well as 40 basis points from our COGS efficiency programs, net of inflation. Importantly, margin headwinds from ramping up our manufacturing capacity on Affera are now behind us. So together, we drove a 70 basis point operational improvement in gross margin in the quarter.

經調整後的毛利率為 65.9%，較去年成長 70 個基點。與上個季度類似，我將帶你了解主要組成部分。因此，在扣除通貨膨脹因素後，我們再次從定價中獲得了 30 個基點，從我們的銷售成本效率計劃中獲得了 40 個基點。重要的是，Affera 產能提升帶來的利潤率不利因素現在已經過去。因此，我們共同努力，使本季的毛利率實現了 70 個基點的營運提升。

This was offset by business mix, which represented a headwind of 80 basis points, split roughly equally between Cardiac Ablation and Diabetes. As I noted last quarter, CAS is impacted by the mix of lower-margin capital to higher-margin catheters, and Diabetes is early in its manufacturing ramp-up of Simplera. Over time, we expect both of these to improve as we scale our CAS business and separate the Diabetes business.

業務組合抵消了這一影響，業務組合帶來了 80 個基點的不利影響，其中心臟消融術和糖尿病業務大致平分秋色。正如我在上個季度所指出的，CAS 受到低利潤資本與高利潤導管組合的影響，而糖尿病業務正處於 Simplera 生產爬坡的早期階段。隨著我們擴大 CAS 業務規模並剝離糖尿病業務，我們預計這兩項指標都會有所改善。

Next, tariffs were a 20 basis points headwind. And finally, FX was about 100 basis points tailwind. Adjusted R&D was 8.4% of revenue and increased 8.9%, which is 230 basis points ahead of reported revenue growth. We've increased R&D investments in our core right-to-win franchises, where we've identified opportunities to accelerate top line growth and improve our share in the near, mid and long term.

其次，關稅帶來了 20 個基點的不利影響。最後，外匯市場帶來了約 100 個基點的利多。經調整後的研發支出佔營收的 8.4%，成長了 8.9%，比公佈的營收成長高出 230 個基點。我們加大了對核心「制勝之道」特許經營業務的研發投入，在這些業務中，我們已經發現了加速營收成長和提高近期、中期和長期市場份額的機會。

SG&A was 32.7% of revenue, up 20 basis points versus last year. As Geoff mentioned, we proactively took the opportunity to increase spending to accelerate our PFA and RDN launches in light of the considerable market demand and compelling near- and medium-term outlooks. At the same time, we delivered disciplined leverage on G&A with growth at under half the rate of our revenue growth.

銷售、一般及行政費用佔收入的 32.7%，比去年增長 20 個基點。正如 Geoff 所提到的，鑑於巨大的市場需求和令人振奮的近期和中期前景，我們積極抓住機會增加支出，以加快 PFA 和 RDN 的推出。同時，我們嚴格控制了一般及行政費用，其成長速度不到收入成長速度的一半。

Our adjusted op profit was $2.2 billion, an increase of 6%. This resulted in an adjusted operating margin of 24.1%, down 20 basis points year-over-year, but an increase of 50 basis points sequentially. Our adjusted tax rate was 16.4%. Q2 tax expense was lower than expected, which is largely due to timing and which we expect to offset in the fourth quarter. All in all, adjusted EPS was $1.36, an increase of 8% and $0.05 above the midpoint of our guidance.

經調整後的營業利潤為 22 億美元，成長了 6%。這使得調整後的營業利潤率為 24.1%，年減 20 個基點，但較上季成長 50 個基點。我們調整後的稅率為16.4%。第二季稅收支出低於預期，這主要是由於時間安排的原因，我們預計將在第四季度抵消這一影響。綜上所述，調整後的每股收益為 1.36 美元，比我們預期的中點高出 8% 和 0.05 美元。

Now let's cover our guidance. Given our outperformance in the first half of the year as well as the confidence we have in our revenue growth acceleration, we're raising our full year revenue guidance today. Year-to-date, we've delivered 5.2% organic growth, and we expect this to further accelerate in the back half of the year. As a result, we now expect fiscal '26 revenue growth of approximately 5.5%, a 50 basis point increase from the prior guidance. In the third quarter, we're also expecting approximately 5.5% growth and Q4 will be even stronger. Based on recent rates, we now see an FX tailwind to fiscal '26 revenue of $625 million to $725 million, including $150 million to $200 million tailwind in the third quarter.

現在我們來談談我們的指導原則。鑑於我們上半年的出色表現以及我們對營收成長加速的信心，我們今天上調全年營收預期。今年迄今為止，我們實現了 5.2% 的自然成長，我們預計下半年這一成長速度將進一步加快。因此，我們現在預計 2026 財年營收成長約為 5.5%，比先前的預期高出 50 個基點。我們預計第三季也將實現約 5.5% 的成長，第四季成長動能會更加強勁。根據最近的匯率，我們現在預計 2026 財年的營收將獲得 6.25 億美元至 7.25 億美元的外匯利好，其中第三季將獲得 1.5 億美元至 2 億美元的利多。

Moving down the P&L. We expect our fiscal '26 gross margin to be slightly up ex tariffs with pricing, FX and COGS efficiency programs more than offsetting the negative impacts of business mix, primarily from Cardiac Ablation and Diabetes. We anticipate a tariff impact to COGS of approximately $185 million, including $90 million to $95 million in the third quarter. Including tariffs, we expect a fiscal '26 gross margin decrease of roughly 40 basis points.

向下移動損益表。我們預計，2026 財年的毛利率（不計關稅）將略有上升，定價、外匯和銷售成本效率計劃將足以抵消業務組合的負面影響，主要來自心臟消融術和糖尿病。我們預計關稅將對銷售成本產生約 1.85 億美元的影響，其中第三季將產生 9,000 萬至 9,500 萬美元的影響。計入關稅後，我們預計 2026 財年毛利率將下降約 40 個基點。

We'll continue to fund R&D to grow greater than sales. With SG&A, in light of the outsized demand and building momentum for our enterprise growth drivers, we're capitalizing on every opportunity to accelerate our top line by strategically increasing sales and marketing investment in key programs, but we'll still deliver SG&A leverage on the full year by rigorously managing our G&A line.

我們將繼續加大研發投入，以實現比銷售成長更快的成長速度。鑑於企業成長動力的巨大需求和不斷增強的勢頭，我們正在抓住每一個機會，透過策略性地增加關鍵項目的銷售和行銷投資來加速營收成長，但我們仍將透過嚴格管理一般及行政費用，在全年實現銷售、管理及行政費用的槓桿作用。

Taking all of this together, we expect fiscal '26 adjusted operating profit to grow approximately 5%, or 7% excluding tariffs. Our fiscal '26 operating margin is expected to be roughly flat ex tariffs and down about 50 basis points, including the tariffs impact.

綜合以上因素，我們預期 2026 財年調整後營業利潤將成長約 5%，若不計關稅則成長約 7%。預計我們 2026 財年的營業利潤率（不計關稅）將與上年持平，計入關稅影響後將下降約 50 個基點。

Now coming to EPS. Second quarter EPS came in $0.05 above the midpoint of our guidance. $0.035 of this beat was from reduced tax expense, as I mentioned earlier, that we now expect to occur in Q4. We're flowing through the remainder of the Q2 beat and increasing our fiscal '26 EPS guidance to a new range of $5.62 to $5.66 versus the prior range of $5.60 to $5.66. For Q3, we expect EPS in the range of $1.32 to $1.34.

接下來是EPS部分。第二季每股收益比我們先前預期的中位數高出0.05美元。正如我之前提到的，這其中0.035美元的超預期來自於稅項支出的減少，而我們現在預計這部分稅項支出將在第四季度發生。我們延續了第二季業績超預期的預期，並將2026財年每股收益預期從先前的5.60美元至5.66美元上調至5.62美元至5.66美元。對於第三季度，我們預計每股收益將在1.32美元至1.34美元之間。

We're expecting margins to be down a couple of hundred basis points in Q3 as the quarter includes half the annual impact of tariffs. In addition, the expected growth acceleration in CAS and Diabetes will continue to impact business mix and Q3 is typically our lowest quarter for generating COGS efficiency savings given the holidays. However, we do expect Q4 margins to increase year-over-year and show strong sequential improvement.

我們預計第三季利潤率將下降數百個基點，因為該季度包含了關稅全年影響的一半。此外，CAS 和糖尿病業務的預期成長加速將繼續影響業務組合，而由於假期原因，第三季度通常是我們實現 COGS 效率節約最低的季度。不過，我們預期第四季利潤率將年增，並呈現強勁的環比成長。

Looking ahead to next year, we continue to expect high single-digit EPS growth in fiscal year '27, driven by accelerating revenue growth, a lesser impact of business mix from CAS and Diabetes on the gross margin line, and leverage on SG&A while we continue to drive higher investments in R&D and sales and marketing. Look, we remain committed to driving both revenue and earnings growth and believe strongly that our financial algorithm will flow from our current focus on building sustained top line momentum.

展望明年，我們繼續預期 2027 財年每股收益將實現高個位數成長，這主要得益於營收成長加速、CAS 和糖尿病業務組合對毛利率的影響減小，以及對銷售、一般及行政費用的槓桿作用，同時我們將繼續加大對研發、銷售和營銷的投資。我們始終致力於推動營收和獲利成長，並堅信，我們目前的財務策略將源自於我們對持續營收成長動能的關注。

Geoff, back to you.

傑夫，把機會交還給你。

Okay. Thank you, Thierry. Before we go to Q&A, let me share a few quick thoughts. So when you look at our top line, you can really see the focus we've had on allocating capital, and executing on our pipeline is all now coming together to drive meaningful acceleration in our growth. We're on an incredible trajectory with PFA, and we're just getting started with some big new opportunities with Symplicity and Altaviva.

好的。謝謝你，蒂埃里。在進入問答環節之前，我想先簡單分享幾點想法。所以，當你查看我們的營收數據時，你就能真正看出我們一直專注於資本配置，並且正在推進我們的項目，所有這些現在都匯聚在一起，推動我們實現有意義的加速成長。我們與 PFA 的合作正處於令人難以置信的發展階段，而與 Symplicity 和 Altaviva 的合作也才剛開始，我們將迎來一些新的重大機會。

At the same time, our newly formed Board committees are helping as we act decisively and with increased speed. We're executing on margin enhancement programs to fuel our enterprise growth drivers, the future pipeline and earnings leverage. We continue to evaluate the overall portfolio at every level as well as tuck-in M&A, and we are committed to growing above our WAMGR, while also raising the WAMGR of the company over time. And I'm looking forward to diving deeper into all of this with you at our Investor Day next year.

同時，我們新成立的董事會委員會也在幫助我們果斷行動，加快腳步。我們正在執行利潤率提升計劃，以推動企業成長、未來業務拓展和提高獲利能力。我們將繼續評估各個層面的整體投資組合以及補充併購，我們致力於實現高於我們 WAMGR 的成長，同時隨著時間的推移提高公司的 WAMGR。我期待明年在我們的投資者日上與大家深入探討所有這些問題。

So bottom line, we're executing on our commitments. You can see it in our numbers. And with every quarter, we're picking up more momentum. We're pleased with the progress, but eager to continue proving Medtronic has turned the page and entered a new period of greater revenue and earnings growth.

總之，我們正在履行我們的承諾。從我們的數據中就能看出這一點。每個季度，我們都在積蓄更多力量。我們對所取得的進展感到滿意，但渴望繼續證明美敦力已經翻開了新的一頁，進入了營收和利潤成長更加強勁的新時期。

Finally, I want to thank our employees who are watching today around the world. Thank you. Thank you for your steadfast commitment to the Medtronic mission and to the patients that you and our customers serve every day. I also appreciate your continued execution, which allows us to collectively deliver on our total company performance. So thank you.

最後，我要感謝今天在全球各地觀看比賽的各位員工。謝謝。感謝您對美敦力使命的堅定承諾，以及對您和我們的客戶每天服務的患者的承諾。我也很欣賞你們的持續執行力，這使我們能夠共同實現公司的整體表現。所以，謝謝你。

Okay. Now it's time to move on to Q&A where we're going to try to get to as many analysts as possible. We ask that you limit yourself to just one question and, only if needed, a related follow-up. If you have additional questions, you can reach out to Ryan and the Investor Relations team after the call. So Ryan, can you please give the Q&A instructions and queue up the analysts?

好的。現在進入問答環節，我們將盡可能多地採訪分析師。我們要求您只提一個問題，並且只有在必要時才可以提出相關後續問題。如果您還有其他問題，可以在通話結束後聯絡 Ryan 和投資者關係團隊。Ryan，你能給出問答環節的說明並安排分析師的發言順序嗎？

Sure, Geoff. (Event Instructions) Finally, please be advised that this Q&A session is being recorded.

當然可以，傑夫。（活動須知）最後，請注意，本次問答環節將會錄製。

Patrick Wood, Morgan Stanley.

派崔克‧伍德，摩根士丹利。

I'll keep it to one, of course. I'd love to start with Symplicity. You mentioned the commercial discussions happening faster than kind of expected. Obviously, without diving into any individual payer, how are those reflective relative to the NCD? Like are there restrictions being put on? What is the sort of tone of the conversation? And how are the commercial payers looking to introduce this within their patient pool?

當然，我只會選一個。我很樂意從Symplicity開始。你提到商業洽談的進展速度比預期的還要快。顯然，在不深入探討任何具體支付者的情況下，這些支付方與非傳染性疾病相比有何不同？例如，是否有任何限制措施？談話的語氣如何？商業保險公司打算如何將這項技術引入他們的患者群體？

Yes. Thanks for the question, Patrick. The commercial payers, like you I mentioned in the commentary, they are coming online faster than I believe we anticipated. They're getting a lot of push from patients as well. In terms of restrictions, first of all, I'd say, look, the Medicare NCD is broad, and it's better than we anticipated. It's better than the proposal. So we're comparing it to that.

是的。謝謝你的提問，派崔克。正如我在評論中提到的，商業支付方上線的速度比我們預期的要快得多。他們也得到了患者的大力支持。就限製而言，首先我想說，你看，Medicare NCD 覆蓋範圍很廣，比我們預期的要好。這比提案好。所以我們要把它和那個比較。

The one area that I've heard, in addition, on NCD, they've incorporated physician -- for lack of a better word, physician discretion, patient discretion on, hey, as a patient, can I tolerate these meds? Or does the physician feel like the patient cannot tolerate the meds. That gives them that avenue to move to Ardian, to Symplicity.

此外，我還聽說，在 NCD 方面，他們已經納入了醫生（暫且這麼說吧）的自由裁量權，以及患者的自由裁量權，例如，作為患者，我是否可以耐受這些藥物？或醫生認為病人無法耐受這些藥物？這為他們提供了前往阿爾迪安、前往辛普利西蒂的途徑。

In the commercial payers, we're seeing where there is one difference that I know of is around the medication, so more of an emphasis on being on a few medications for a while. So that's the one area that I'm aware of, Patrick, and we'll keep everyone posted as we get more commercial payers online.

在商業支付方方面，據我所知，有一個區別，那就是藥物方面，他們更注重一段時間內服用幾種藥物。派崔克，這是我目前了解的情況，一旦有更多商業支付方上線，我們會及時向大家通報最新進展。

Travis Steed, BofA Global Securities.

Travis Steed，美國銀行全球證券。

Congrats on a good quarter. I guess, first of all, the implied second half guide around 6%, and kind of think about it in two buckets, the pipeline and then kind of the base business. And maybe talk about kind of what you're assuming on RDN in the second half, and then also the base business, why confident in the slight rebound in MedSurg and kind of the confidence to keep the base business humming?

恭喜你本季業績出色。首先，我猜想下半年的預期成長約為 6%，可以把它分成兩部分來考慮：一是專案儲備，二是基礎業務。或許可以談談您對下半年 RDN 業務的預期，以及基礎業務，為什麼您對 MedSurg 業務的小幅反彈充滿信心，以及為什麼有信心保持基礎業務的良好發展？

And then on the margins in the second half, this quarter, we didn't see quite as much margin flow through. Just assuming that changes in the second half, the revenue upside leads to more margin upside in the second half?

而在下半年的這個季度，我們在利潤率方面並沒有看到太多的提升。假設下半年情況有所變化，那麼營收成長是否會帶來下半年利潤率的更大提升？

Do you want to take that one?

你想選那個嗎？

So maybe I'll start with the margin. Travis, thanks for the question. Look, we described the momentum that we had from a commercial perspective in the second quarter. And pretty early on in the quarter, we saw the order intake being pretty strong. We also saw that we were going to have a little bit of upside from a tax perspective, even though that's timing, but we did see it coming early on in the quarter.

那我或許應該先從邊際效益入手。崔維斯，謝謝你的提問。你看，我們已經描述了我們在第二季度從商業角度取得的良好勢頭。本季開始，我們就看到訂單量非常強勁。我們也看到，從稅收角度來看，我們會有一些好處，儘管這取決於時機，但我們確實在本季度初就看到了這一點。

And so we just made a decision to go invest in the places that are going to drive the growth going forward. So we made some significant investments in the mappers structure, for example, in Cardiac Ablation. We started to build up the capability from a direct marketing on the Symplicity side. So we took the opportunity that we were going to see upside on revenue and a little bit on the tax line just to lean into the investment to make sure we fully capture the opportunities that are ahead of us.

因此，我們決定投資那些將在未來推動成長的地方。因此，我們對映射器結構進行了一些重大投資，例如在心臟消融方面。我們從 Symplicity 方面的直接行銷開始，逐步建立這種能力。因此，我們抓住了收入增長和稅收方面略有增長的機會，加大了投資力度，以確保我們充分把握擺在我們面前的機會。

And so you saw that in R&D. It's the second quarter where we have R&D growth that's pretty significantly higher than the revenue growth. And this quarter, specifically, you saw it on the SG&A line, where we put, as I said, quite a bit of investment, especially in sales and marketing, while keeping the G&A line pretty constrained. So going forward into the rest of the year, we'll keep investing in these growth areas. You'll see R&D continue to ramp up.

所以你在研發領域也看到了這一點。第二季度，我們的研發成長明顯高於營收成長。具體來說，本季在銷售、一般及行政費用（SG&A）方面，正如我所說，我們投入了相當多的資金，尤其是在銷售和市場營銷方面，同時將一般及行政費用控制在相當嚴格的範圍內。因此，在今年餘下的時間裡，我們將繼續投資這些成長領域。你會看到研發投入持續加大。

As you know, we're targeting to get over time to roughly about 10% of our revenue on the R&D line. On SG&A, though, you should expect to see leverage in the second half. So SG&A together. So we'll start seeing a lift there. And so ex tariffs, we'll have gross margin and operating margin leverage in the second half. But we'll have to contend with the tariff impact.

如您所知，我們的目標是隨著時間的推移，研發投入佔總收入的10%左右。不過，在銷售、一般及行政費用方面，預計下半年會出現槓桿效應。所以，銷售、一般及行政費用合併在一起。所以我們將會看到那裡的升降機開始升溫。因此，剔除關稅因素後，下半年我們將擁有毛利率和營業利潤率槓桿效應。但我們必須應對關稅的影響。

So all in all, on a full year basis, you'll see gross margin slightly up before tariffs, down about 50 basis points post tariffs. And at the operating margin level, you'll see operating margin roughly flat year-over-year ex tariffs and slightly down with the impact of tariffs. So look, it's all about capitalizing on the opportunities that we've got ahead of us, and that's what we'll keep doing. But again, second half leverage on both those lines.

綜上所述，從全年來看，在徵收關稅之前，毛利率會略有上升；徵收關稅之後，毛利率會下降約 50 個基點。從營業利潤率來看，不計關稅，營業利潤率與去年同期基本持平；而計入關稅後，營業利潤率略有下降。所以你看，關鍵在於抓住我們面前的機遇，而我們也會繼續這樣做。但同樣，下半場這兩條線都有提升空間。

So on the revenue, as you see from the guidance, we're looking at a back half ramp here that will extend into '27. And the way I'd break it down, I mean, a big piece of that is these growth drivers that are kicking in, these multibillion-dollar opportunities. In terms of the back half, though, most of that is really coming from PFA. So -- in terms of the new big ones, right? When you think about PFA, Symplicity, Altaviva and we have Hugo coming, those are, we would say, are big multibillion-dollar upmarket opportunities. In the back half, the contribution will be more from PMA in that category. PFA, I mean, is cranking right now. We've got a lot of momentum there.

因此，就收入而言，正如您從指導意見中看到的那樣，我們正在考慮下半年的成長，這將持續到 2027 年。我的分析是，這其中很大一部分原因是這些正在發揮作用的成長動力，這些價值數十億美元的機會。不過，就後半部而言，大部分其實都來自 PFA。所以——就新的大型專案而言，對吧？想想 PFA、Symplicity、Altaviva，還有即將推出的 Hugo，我們認為這些都是價值數十億美元的高階市場機會。後半程，PMA 在該類別的貢獻將更大。PFA，我的意思是，現在正在全力運作。我們在這方面勢頭很強勁。

When it comes to Symplicity -- obviously, Symplicity and Altaviva are approved in the US. On Symplicity, I'd say we're going to see it start to tick up in the back half of the year and then ramp in the quarters following that. Like I said, between the NCD and the commercial payers coming online, this market is really a best case scenario. It's as big as what we said it is. It's not about if or even how big, like it's as big as we said, it's really how fast. And we're measuring that speed of adoption in quarters, not years.

至於 Symplicity——顯然，Symplicity 和 Altaviva 都已在美國獲得批准。關於 Symplicity，我認為我們將在今年下半年看到它開始緩慢成長，然後在接下來的幾個季度加速成長。正如我所說，隨著 NCD 和商業支付方的上線，這個市場真的是最好的情況。它和我們說的一樣大。關鍵不在於它是否很大，甚至不在於它有多大（就像我們說的），而是它的速度有多快。我們以季度而不是年來衡量這種普及速度。

Altaviva, again, just approved, a lot of great leading indicators. Physician training is over-booked, and we can talk more about that if I get questions on why we're so excited. Again, it will start to contribute in the back half a little bit. And then Hugo, we don't have too much on, but we do still expect the approval in the back half of our year.

Altaviva 再次獲得批准，它有許多優秀的領先指標。醫生訓練名額已滿，如果有人問起我們為什麼如此興奮，我們可以詳細談談這個問題。再說，它在後半程會開始做出一些貢獻。至於 Hugo，我們目前沒有太多工作，但我們仍然預計在今年下半年獲得批准。

Then there's another -- getting to the base business, Diabetes pops back up as our new sensors are available. Neuromodulation continues to be strong. CST will continue to be strong. CRM had a really good Q2. I don't know if we're going to have that same level of growth there, but still a strong growth there.

然後還有另一個問題——回到基本業務，隨著我們新的傳感器上市，糖尿病問題再次浮現。神經調控技術依然強勁。CST將持續保持強勁勢頭。CRM第二季度表現非常出色。我不知道那裡的成長速度是否會和其他地方一樣快，但肯定還會保持強勁成長。

And then you've got two other businesses that will, I'll call it, tick up, or incrementally increase their growth rate, Peripheral Vascular with the carotid stent, mechanical thrombectomy coming. And then Neurovascular, again, it's also selling that carotid stent, got some hemorrhagic products coming. And they're just lapping some issues, a recall and then lapping VVP here. So the base business is a big contributor. PFA is a big contributor. And then you're going to start to see Symplicity, Altaviva and a little bit of Hugo.

此外，還有兩個業務將會，我稱之為，小幅增長，或者說逐步提高增長率，分別是外周血管業務（頸動脈支架）和即將推出的機械血栓切除術。還有神經血管公司，它也在銷售頸動脈支架，還有一些止血產品即將上市。他們只是在處理一些問題，例如召回，然後在這裡處理 VVP。因此，基礎業務貢獻巨大。PFA貢獻大。然後你會開始看到 Symplicity、Altaviva 和一點 Hugo 的影子。

Vijay Kumar, Evercore ISI.

Vijay Kumar，Evercore ISI。

Congrats on a nice sprint here. I had maybe a new product question, a two-parter, if you will. One on Affera, Geoff, do you feel like we have enough mappers now? And is supply in a place enough where you can hit the $2 billion? How are you thinking about supply and mapping? And then on tibial, we've got some good feedback on cannibalization of -- whether tibial could cannibalize BOTOX procedures. Could tibial be a $1 billion product for you guys down the road?

恭喜你這次衝刺跑得很好。我可能有一個關於新產品的問題，這個問題可以分成兩個部分。Affera 的 Geoff，你覺得我們現在的地圖繪製人員夠多嗎？某個地方的供應量是否足以達到 20 億美元的目標？你們是如何考慮物資供應和地圖繪製的？然後，關於脛骨，我們收到了一些關於脛骨是否會蠶食肉毒素注射手術的良好回饋。脛骨平台未來有可能成為你們價值 10 億美元的產品嗎？

So I'll start with the PFA questions. On the supply, that's not holding us back. So supply is in a good spot. And then on the mappers, the mapper hiring is going well, right? We're staying ahead, but I wish the buffer a little bit more, because the growth is tremendous. But we are staying ahead on the mappers and the supply is not an issue. And like I said, our PFA business is really humming.

那我就先從 PFA 的問題開始。供應方面，這並沒有阻礙我們。所以供應狀況良好。至於地圖繪製人員，地圖繪製人員的招募工作進展順利，對吧？我們保持領先地位，但我希望緩衝空間能再大一些，因為成長速度非常驚人。但我們在地圖繪製方面保持領先，供應不成問題。正如我所說，我們的 PFA 業務發展勢頭非常強勁。

I was just with a big customer yesterday. They've got two systems. They laid out three more that they're going to buy. And just talking about once they put -- especially Affera, once they put that in one of their hospitals, how it kind of takes all the market share or the majority of the market share there for all types of cases. There's just all these benefits there. So feeling really good about that. And again, this mapper hiring has been a Medtronic, not just our Cardiac Ablation business, but a Medtronic effort, and our HR team is doing a hell of a job there.

我昨天剛接待了一位大客戶。他們有兩個系統。他們還拿出了另外三件準備要買的東西。說到他們一旦投入使用——特別是 Affera，一旦他們把那套系統安裝到他們的一家醫院裡，它就幾乎佔據了所有或大部分市場份額，涵蓋所有類型的病例。那裡有太多好處了。所以感覺真的很好。再次強調，這次地圖繪製員的招募是美敦力公司整體的努力，不僅僅是我們心臟消融業務部門的努力，我們的人力資源團隊在這方面做得非常出色。

And then on tibial. Look, tibial is something I think everyone needs to invest a little bit of time in here. It's a huge market, 46 million people in the US with overactive bladder and of that 16 million with urinary urge incontinence, where this really shines. And it takes the therapy versus sacral, which works really well.

然後是脛骨。我認為每個人都需要花點時間了解脛骨的情況。這是一個巨大的市場，美國有 4,600 萬人患有膀胱過動症，其中 1,600 萬人患有尿急性尿失禁，而這正是該產品大放異彩的領域。而且這種療法與骶骨療法相比，效果非常好。

It's been a great market for us. There's been some channel disruption in the market lately, but it's still a great market and works really well for patients. But it does take weeks or months to get that therapy to a patient from when they start versus tibial is less than a day. So what you're seeing here is, with tibial, right, you have to do -- I mean, with the sacral nerve, you have to do a trial, then you have to go in for the implant, then the patient leaves without the therapy turned on, has to come back to get it activated, versus tibial, this all happens in a day and the procedure is easier.

對我們來說，這是一個非常好的市場。最近市場通路出現了一些混亂，但這仍然是一個很棒的市場，對患者來說也非常好。但是，從患者開始接受治療到接受脛骨治療，需要數週或數月的時間，而脛骨治療則不到一天。所以你在這裡看到的是，對於脛神經，對吧？我的意思是，對於骶神經，你必須先進行試驗，然後進行植入，之後患者離開時治療功能尚未開啟，必須回來激活；而對於脛神經，所有這些都可以在一天內完成，而且手術也更簡單。

And when patients, to get to the core of your question, when they're presented with options, all of their options, sacral nerve, tibial, BOTOX, they tend to choose the tibial. So we do think it will take share from BOTOX. And I would emphasize that this, we believe -- look, there's a very strong place for sacral nerve. This is an incremental opportunity on top of our sacral business. And so sacral combined with tibial, given that it's going to be incremental, this is going to make that business, that pelvic health business, a growth driver for the company. That's what I'll say about that. It's going to meaningfully improve the growth rate of that business.

而當患者面對各種選擇時，例如骶神經、脛骨、肉毒桿菌注射等，他們往往會選擇脛骨。所以我們認為它會從肉毒桿菌手中奪取市場份額。我想強調的是，我們認為──你看，骶神經在其中扮演著非常重要的角色。這是在我們核心業務之外的另一個成長機會。因此，骶骨與脛骨相結合，考慮到這將是一個漸進的過程，這將使骨盆底健康業務成為公司的成長動力。關於這件事，我就說這麼多。這將顯著提高該業務的成長率。

Robbie Marcus, JPMorgan.

羅比馬庫斯，摩根大通。

Nice quarter. Thierry, I wanted to ask, you talked about strategically reinvesting into SG&A and over time, materially increasing R&D, I think, up to 200 basis points. How are you thinking about where those dollars are going? How soon should we be thinking about that? And just help us think about the cadence and the ability to still grow operating margin in the face of higher investment.

不錯的街區。蒂埃里，我想問一下，你談到要對銷售、一般及行政費用進行策略性再投資，並且隨著時間的推移，大幅增加研發投入，我認為，最多可以增加 200 個基點。你覺得這些錢會流向哪裡？我們應該多久之後開始考慮這個問題？請幫助我們思考在高投資的情況下，如何保持成長節奏並持續提高營業利潤率。

Yes. Robbie, thanks for the question. So first, where the dollars are going? So there are really two different categories, I would say. One is, as I said, to capitalize to the maximum extent possible on the growth drivers that are ahead of us.

是的。羅比，謝謝你的提問。首先，這些錢都流向哪裡了？所以，我認為實際上可以分為兩大類。正如我所說，其一是要最大限度地利用擺在我們面前的成長動力。

So there's a significant amount of investment that's going to CAS, to Ardian, to Altaviva and, obviously, to Hugo with a profile that's a little bit more long term. There are other growth drivers that we're funding at the same time such as Structural Heart and Neuromodulation, for example.

因此，有大量的投資流向了 CAS、Ardian、Altaviva，當然還有 Hugo，這些投資的重點在於長期發展。我們同時也資助其他成長驅動因素，例如結構性心臟病和神經調控。

The second category of where we're putting investment is to make sure that we keep the leading edge from a technology perspective in the key franchises that are our bread and butter. So there's overinvestment compared to the average of the business in CRM, for example, in next generation of Micra. And there's significant investment going in CST to continue to develop the ecosystem that, that business has created around AiBLE that has enabled us to make the CST business more sticky with the customers from a device perspective and gradually improve the margin. So it's really those two areas, capitalize on the growth drivers on one hand and keep the edge on innovation in the key franchises on the other side.

我們投資的第二大重點是確保我們在賴以生存的關鍵業務領域保持技術領先。因此，與企業平均水平相比，在 CRM 方面存在過度投資，例如在下一代 Micra 上。CST 正在進行大量投資，以繼續發展其圍繞 AiBLE 創建的生態系統，這使我們能夠從設備角度增強 CST 業務與客戶的黏性，並逐步提高利潤率。所以，關鍵在於這兩個面向：一方面要利用成長動力，另一方面要在關鍵特許經營領域保持創新優勢。

From a sequence perspective, look, I would say third quarter, we made a pretty deliberate strong investment because we saw the upside coming. You'll see a bit less of that already in the second half. So as I said, you should see leverage on the SG&A line in the second half of the year already. But maybe going into the longer term, look, we've tried to give as much clarity as possible on the gross margin line so that you see the dynamics. If you look at what happened this quarter, we had about 40 basis points of pricing and about 30 basis points or 40 basis points of cost out.

從順序的角度來看，我認為第三季我們進行了相當有計劃的大力投資，因為我們看到了上漲的趨勢。下半場這種情況就會減少一些。正如我所說，你應該會在今年下半年看到銷售、一般及行政費用的槓桿效應。但從長遠來看，我們已經盡力讓毛利率這條線盡可能清晰明了，以便您能了解其動態變化。如果你看看本季發生的事情，我們定價下降了大約 40 個基點，成本下降了大約 30 到 40 個基點。

That's been sort of a recurring performance over the last quarters, and we expect that to continue over time, right? So we're generating, between those two lines, 70 to 80 basis points of gross margin improvement, right?

過去幾個季度以來，這種情況一直反覆出現，我們預計這種情況會持續下去，對吧？所以，在這兩條線之間，我們實現了 70 到 80 個基點的毛利率提升，對吧？

And this quarter, you had about 80 basis points of negative mix and 20 basis points of tariffs, and that was offset with FX. Going forward, we expect that negative mix to start getting better towards the second half of '27. So for the rest of the year, it's still going to be a pretty significant headwind as CAS and Diabetes continue to accelerate. And in the second half of '27, Diabetes will be deconsolidated.

本季，你們的匯率組合出現了約 80 個基點的負面影響，關稅也增加了約 20 個基點，但這些都被外匯匯率抵銷了。展望未來，我們預期這種負面因素組合將在 2027 年下半年開始改善。因此，在今年餘下的時間裡，隨著 CAS 和糖尿病的持續加速發展，這仍將是一個相當大的不利因素。2027 年下半年，糖尿病將不再合併。

And then on the CAS side, we'll start seeing the shift between the capital equipment and the catheters, which will make that an accretive business as opposed to being dilutive. So what you're going to see there is the 70 to 80 basis points of gross margin improvement operationally start to show up more as the mix becomes a gradually smaller and a positive effect over time.

然後，在 CAS 方面，我們將開始看到資本設備和導管之間的轉變，這將使該業務成為增值業務，而不是稀釋業務。因此，你會看到，隨著產品組合逐漸縮小，營運上 70 到 80 個基點的毛利率改善開始更加明顯，並且隨著時間的推移會產生正面影響。

And then outside of that, we've got some external factors. So we have to contend with the tariffs. So for second half, we've got about 90% of that $185 million of tariffs that's going to show up in the income statement. The bigger portion is in Q3. And then we'll have a carryover of tariffs going into '27. And we expect foreign exchange, which is the last item there to be a slight tailwind going into '27.

除此之外，還有一些外在因素。所以我們必須應付關稅問題。因此，在下半年，我們將看到 1.85 億美元關稅收入的約 90% 出現在損益表中。大部分集中在第三季。然後，我們將面臨關稅結轉至 2027 年的情況。我們預期外匯市場（最後一個因素）將在 2027 年帶來輕微的利好。

So if you go -- it's a long answer, apologies, but I think it's important that you understand the algorithm. Going into '27, we'll keep investing in R&D to get to the 10% over time. But you should expect to see leverage on the SG&A line in '27. So look, we're confident that with the growth with what we're doing from a gross margin performance in a sustainable fashion in COGS and pricing and the leverage on the overhead, we'll have a leverage P&L on the operating profit line in 2027. And that's why we hold on our commitment to have high single-digit EPS growth going into next year.

所以如果你要去——答案很長，抱歉，但我認為你理解演算法很重要。進入 2027 年，我們將繼續加大研發投入，爭取逐步達到 10% 的目標。但預計 2027 年 SG&A 項下會出現槓桿效應。所以，我們有信心，透過我們目前在毛利率方面的可持續成長，透過降低銷售成本和定價，以及對管理費用的槓桿作用，我們將在 2027 年實現營業利潤率的槓桿化。正因如此，我們才堅持明年實現高個位數每股盈餘成長的承諾。

Yes. And just to add to that, there's more oxygen here to create for the investment. It's begun to see the improved pricing. And as we go forward, we're not assuming much incremental pricing, but at least holding the improved position that we have. But there's more oxygen in our cost down. There's opportunities in scrap, obsolescence and, over time, continuing to optimize our network. So these are areas, I think there's incremental opportunity and cost down.

是的。此外，這裡還有更多投資機會。價格已經開始有所改善。展望未來，我們預期價格不會有太大的上漲空間，但至少會維持我們目前所擁有的有利地位。但我們的成本下降幅度更大。廢料、過時產品以及隨著時間的推移不斷優化我們的網路都蘊藏著機會。所以我認為這些領域存在著逐步降低成本和提升的機會。

And Robbie, I've read some of your stuff in the past that you don't think there's much to do for us on SG&A, but there's more. There's more to go on SG&A for the company, and that's where the scale of the company should benefit us here. And it's not going to be easy on the company, but there's opportunities there, and we're committed to doing what it takes to fund these growth drivers, because what we're seeing out there with patients on these different growth drivers and what we're hearing from clinicians, the impact on them and their staff, this is a big opportunity for the company we haven't seen in decades, and we're going to make it happen, right? And so there's still room to go on SG&A as well. And like I said, COGS to make this happen.

羅比，我以前讀過你的一些文章，你認為我們在銷售、一般及行政費用方面沒什麼可做的，但其實還有更多的事情要做。公司還有更多銷售、一般及行政費用需要處理，而公司規模在這方面應該能為我們帶來好處。這對公司來說並不容易，但其中也蘊藏著機遇，我們致力於盡一切努力為這些增長動力提供資金，因為我們從患者身上看到的這些不同的增長動力，以及我們從臨床醫生那裡聽到的，這些動力對他們及其員工的影響，對公司來說是一個幾十年來從未見過的巨大機遇，我們將努力實現它，對吧？因此，銷售、一般及行政費用方面仍有提升空間。正如我所說，我們需要成本來實現這一切。

Great. That was a fantastic answer. Maybe just one quick follow-up. Geoff and Thierry, I know even since the beginning of this year, you've talked more and more about tuck-in M&A. How are you thinking about the environment today? Do you see a lot of opportunities? And any areas you see more interesting than others to help flesh out the portfolio?

偉大的。這是一個絕妙的回答。或許只需要一個簡短的後續問題。Geoff 和 Thierry，我知道從今年年初開始，你們就一直在談論併購。今天對環境有什麼看法？你覺得有很多機會嗎？您認為還有哪些領域比其他領域更有意思，可以幫助完善投資組合？

Yes. No, look, we're very focused on the tuck-in M&A. I don't want to tip our hat in terms of exact segments, but we definitely are prioritizing some of the -- again, it's tuck-in. We're prioritizing these higher-growth segments. A lot of that is in Cardiology, some in Neuroscience as well. We like that affair profile, right, where you're close to market or just you're on the market. Early stage or close to market would be ideal. Not afraid to make the investment that it takes to get those type of companies.

是的。不，你看，我們非常專注於補充性併購。我不想透露具體的細分市場，但我們肯定會優先考慮一些——再說一遍，這是點綴。我們將優先發展這些高成長領域。其中很多都與心臟病學有關，有些也與神經科學有關。我們喜歡這種婚外情對象，對吧？就是那種接近婚外情市場或正在尋找另一半的人。早期階段或接近上市階段是理想選擇。不怕投入必要的資金來收購這類公司。

But as Thierry said on your earlier question on like where is the R&D going, the tuck-in M&A, I wouldn't rule out some of our other key franchises that may need to augment their R&D with a little M&A. But we are more focused on these higher-growth segments. And then the Board committees we've set up help with the speed and enable us to move faster. So we'll see where it goes, but it's definitely a big focus.

但正如 Thierry 在你之前關於研發方向、補充性併購等問題上所說，我不會排除我們其他一些關鍵特許經營業務可能需要透過一些併購來增強其研發能力。但我們更關注這些高成長領域。此外，我們設立的董事會委員會也有助於提高速度，使我們能夠更快地前進。所以我們會看看事情會如何發展，但這絕對是我們關注的重點。

One thing that we don't communicate a lot about it, but we've got a pretty active ventures arm, and that arm has been pretty active. So it's got over 50 companies in which we have a stake right now. And we like to use that arm to make investments in sort of early-stage companies, and it helps with some of the dilution, et cetera. Typically, we always make these venture investments with a view of going higher into the capital over time. So it's never venture for venture. And again, it's been -- the pipeline there is pretty strong, and we'll keep working that angle too, because it's helpful to feed the pipeline for future M&A.

有一件事我們很少公開談論，但我們有一個非常活躍的創投部門，而且這個部門一直非常活躍。所以，目前我們持有其投資的50多家公司的股份。我們喜歡利用這個部門對早期公司進行投資，這有助於減少股權稀釋等等。通常情況下，我們進行這些創投的目的都是為了隨著時間的推移逐步增加資本投入。所以，這從來都不是單純為了投資而投資。而且，這方面的儲備相當充足，我們也會繼續從這個角度著手，因為這有助於為未來的併購活動儲備人才。

Yes.

是的。

Thank you, Robbie. Looking at the clock here. I think we've got time for about three more questions.

謝謝你，羅比。看看這鐘。我想我們還有時間再問三個問題。

Larry Biegelsen, Wells Fargo Securities.

Larry Biegelsen，富國證券。

Congrats on a nice sprint here. So Geoff, I wanted to ask about the ramp of Ardian because as you said, it's a question of how fast. So I'm hoping you can add some precision to your earlier comments. I think at our conference in September, I asked if US Ardian sales could replicate the US.

恭喜你這次衝刺跑得很好。所以傑夫，我想問關於阿爾迪安斜坡的問題，因為正如你所說，這是一個速度的問題。所以，我希望您能對先前的評論補充一些細節。我想在九月的會議上，我曾問過美國 Ardian 的銷售情況能否複製美國的情況。

WATCHMAN ramp, which was about $400 million in year five. And I believe you said you'd be disappointed if your US Ardian sales didn't achieve $400 million by, I believe, year three. So how does the exclusion of isolated systolic hypertension and the NCD impact how you think about the ramp? And do you still believe you can achieve $400 million US sales by around fiscal 2028, which I think would be year three. And just confirm, Geoff, that the current run rate in the US is about $50 million.

WATCHMAN 坡道，第五年耗資約 4 億美元。我相信你曾說過，如果你的美國 Ardian 產品銷售額在第三年（我記得是這樣）沒有達到 4 億美元，你會感到失望。那麼，排除單純收縮期高血壓和NCD會如何影響你對斜坡的看法？你仍然相信你能在 2028 財年左右（我認為那是第三年）實現 4 億美元的美國銷售額嗎？傑夫，請確認一下，目前美國的年均收入約為 5,000 萬美元。

Well, look, let me start by saying, yes, I would be disappointed if we're at year five or whatever you said, at $400 million. We think it would go faster than that. And the final NCD won't hold us back. And like I said, we believe it's an improvement on the proposed NCD. Maybe this is a good time, because I know there was -- on that NCD, like I said, it's an improvement to the proposed NCD. And if you go back a year, it's better than what we thought a year ago. If you go back five years, and you asked us if we thought we would get this type of NCD, we'd say that's the best case scenario.

好吧，首先我要說，是的，如果到了第五年或你說的某個時候，我們只賺了 4 億美元，我會很失望的。我們認為速度會更快。最終的非傳染性疾病也不會阻礙我們前進。正如我所說，我們認為它比建議的NCD有所改進。也許現在正是時候，因為我知道——就像我之前說的，關於那項 NCD，它比擬議的 NCD 有所改進。如果把時間倒回一年，情況比我們一年前預想的還要好。如果回到五年前，你問我們是否認為我們會患上這種類型的非傳染性疾病，我們會說這是最好的情況。

So this market, like I said, is as big as we said it's going to be. And we believe that this final NCD, as you dig into and really understand how hypertension today is treated, it actually reduces the requirements for patients to get this therapy and it reduces the time. And maybe this is a good time that we have our Chief Scientific and Medical Officer on the line, knowing that there'd be -- Dr. Laura Mauri, who's also an interventional cardiologist, knowing that there'd be maybe some questions on this, on the treatment pathways. Maybe I'll ask Laura to comment since you mentioned that one systolic question -- or diastolic question.

所以，就像我剛才說的，這個市場確實像我們預測的那麼大。我們相信，隨著您深入了解並真正理解當今高血壓的治療方法，最終的NCD實際上降低了患者接受這種治療的要求，並縮短了治療時間。也許現在正是讓我們的首席科學和醫療官接聽電話的好時機，因為我們知道可能會有人——勞拉·毛里博士，她也是一名介入心臟病專家——會就治療方案提出一些問題。既然你提到了那個關於收縮壓（或舒張壓）的問題，或許我可以請蘿拉發表意見。

Laura, can you maybe provide some context here?

勞拉，你能提供一些背景資訊嗎？

Sure. Larry, specific to your question about isolated systolic hypertension, those are patients who don't have an elevation of their diastolic or the lower number of their blood pressure. It's only the top one. And Geoff said, we're continuing to study those patients. But I think the important thing to note is that this population is actually pretty small for us overall.

當然。Larry，關於你提出的單純收縮期高血壓的問題，這類病人舒張壓（血壓的較低數值）沒有升高。只有最上面的那個。傑夫說，我們正在繼續研究這些患者。但我認為需要注意的是，就我們整體而言，這個群體實際上相當小。

If you look at recent studies, people with hypertension over age 60, it's less than 15% of patients who have ISH or this condition. And for patients who are younger than 60, who are half of our patients in trials and then also in practice, it's really very unusual.

如果你查看最近的研究，你會發現，60 歲以上的高血壓患者中，患有 ISH 或這種疾病的患者不到 15%。對於 60 歲以下的患者來說，這種情況非常罕見，而這部分患者占我們試驗和實際治療患者的一半。

So as Geoff said, out the gate with the NCD, if you just look at that topic, we would estimate that it would be less than 10% that would be affected by isolated systolic hypertension or not meet those criteria. And then overall, just to reiterate what Geoff said is that the overall -- the final NCD makes access more practical for patients with less time delays to treatment, less restrictions. And the couple of things that they've talked about screening for are really things that are done in standard practice by general practitioners or internists.

正如傑夫所說，就 NCD 而言，如果你只看這個主題，我們估計受單純收縮期高血壓影響或不符合這些標準的人將不到 10%。最後，重申一下傑夫所說的，總的來說——最終的NCD使患者更容易獲得治療，減少了治療延誤，減少了限制。他們提到的那幾項篩檢項目，其實都是全科醫生或內科醫生在常規診療中會做的。

And I think the other part just to mention is that in their response, CMS really reiterated that quality of life is a really important consideration for patients, because lifestyle changes and being on many medications can be really difficult. And so they specifically said the good faith attempts are reasonable before referral rather than specifying some like mandatory minimum doses or a number of medications. So overall, whether it's ISH or overall, the workflow for patients to get into referral for Symplicity is really not restricted.

我覺得還有一點要提一下，CMS 在他們的回覆中再次強調，生活品質對患者來說是一個非常重要的考慮因素，因為生活方式的改變和服用多種藥物可能會非常困難。因此，他們特意表示，在轉診之前，真誠的嘗試是合理的，而不是具體規定一些要求，例如強制性最低劑量或藥物數量。所以總的來說，無論是 ISH 還是整體而言，患者轉診接受 Symplicity 治療的工作流程實際上並沒有受到限制。

Shagun Singh, RBC Capital Markets.

Shagun Singh，加拿大皇家銀行資本市場。

Great. I wanted to touch on the financial algorithm. A key message was growth acceleration. How should we think about the base business? Is it mid-single digits?

偉大的。我想談談金融演算法。一個關鍵訊息是成長加速。我們該如何看待基礎業務？是幾度嗎？

The $1 billion incremental PFA sales is about 300 basis points. And then RDN, I don't know if you could put a finer point there in terms of the growth contribution. But as you think about growth acceleration, should we think about Medtronic moving towards that high single digit on the top line? And then on portfolio management, I was just wondering how you're thinking about or should we expect portfolio pruning beyond Diabetes?

PFA 新增 10 億美元的銷售額相當於約 300 個基點。至於 RDN，我不知道你能否更細緻地指出它對成長的貢獻。但當我們思考成長加速時，我們是否應該考慮美敦力公司營收成長接近兩位數的目標？關於投資組合管理，我想知道您是如何考慮糖尿病以外的投資組合調整的，或者我們是否應該預期會出現這種情況？

Shagun, thanks for the question. I'll start with the last part of it on the portfolio management. And look, this is an ongoing focus for the company. And it's really making sure that beyond Diabetes, right -- first of all, that deal is tracking and it's on track and going well. But beyond Diabetes, we just want to make sure that the whole portfolio fits together.

Shagun，謝謝你的提問。我先從最後一部分，也就是投資組合管理開始講起。而且，這始終是公司關注的重點。而且，它確實要確保除了糖尿病之外，對吧——首先，這項交易進展順利，一切都在按計劃進行。但除了糖尿病領域，我們只想確保整個產品組合能夠協調一致。

We're getting the right amount of synergies, and we can provide the right amount of focus on these generational enterprise growth drivers like PFA, like Ardian, like Altaviva and Hugo when it comes to the US and others. And so it's still -- it remains a focus, and it remains a focus of like one of the Board committees that we set up, and we're meeting frequently on this and looking at it. And that's what I'll say there. And then I'll have Thierry answer --

我們正在獲得適量的協同效應，並且能夠為這些世代企業成長驅動因素（例如 PFA、Ardian、Altaviva 和 Hugo，尤其是在美國和其他地區）提供適量的關注。所以，這仍然是我們的關注點，也是我們設立的董事會委員會之一的關注點，我們經常就此開會並進行研究。這就是我要說的。然後我會讓蒂埃里回答。--

Yes. Look, overall, if you think about the guidance that we just gave, 5.5% on the full year, we were at 5.2% at the end of the first half, we're guiding at 5.5% in the third quarter. So you can do the math for what fourth quarter looks like, and we don't want to slow down from there. And look, what I would say is it's pretty clear that CAS represents a sizable opportunity. We reiterate the incremental $1 billion coming shortly, probably in the beginning of fiscal year '27 for us.

是的。總的來說，如果你看看我們剛剛給出的全年預期，5.5%，上半年末我們達到了5.2%，我們預計第三季將達到5.5%。所以你可以算算第四季的情況，我們不想就此放慢腳步。而且，我認為很明顯，CAS 代表著一個巨大的機會。我們重申，即將到位的10億美元增加資金可能要到2027財年年初才能到位。

And Ardian, we have all these discussions about the speed, et cetera, but I think it's important to keep in mind that 1% of market share in that population is sort of almost $3 billion of revenue for us. So it's a pretty significant opportunity. And we talked about the size of the Altaviva opportunity as well. It's 20 million patients overall. So those come in increment to the rest of the business, and the rest of the business is not standing still. So Specialty Therapies is getting better. You saw first sign in this quarter, and it's going to keep going with the product activity that we've got in Neurovascular with Altaviva and Pelvic.

Ardian，我們一直在討論速度等等問題，但我認為重要的是要記住，在該人群中 1% 的市場份額對我們來說就意味著近 30 億美元的收入。所以這是一個相當重要的機會。我們也討論了 Altaviva 的巨大發展機會。總共有2000萬患者。因此，這些業務會逐步發展，而其他業務也不會停滯不前。所以專科治療方面正在好轉。本季已經出現了初步跡象，隨著我們在神經血管領域推出 Altaviva 和骨盆腔產品，這種勢頭還將繼續下去。

And the key franchises, look, CRM had a great quarter. It's going to continue to perform for the rest of the year and beyond. We're investing in that business to keep the technology lead. So we don't intend to go backwards. CST has been improving on the back of the AiBLE ecosystem that the team has created. So look, we're positive about the opportunities of the company going forward, and we'll keep you posted when we give next year's guidance at the end of Q4.

而關鍵特許經營業務方面，CRM 表現非常出色。它在今年剩餘時間和未來幾年都將繼續保持良好的表現。我們正在投資這項業務，以保持技術領先地位。所以我們並不打算走回頭路。CST 一直以來都依賴團隊所創造的 AiBLE 生態系統而不斷改進。所以，我們對公司未來的發展機會持樂觀態度，我們將在第四季末發布明年的業績指引時及時通知大家。

Okay. Thank you, Shagun. We've got time for one more question, and I apologize to the analysts that we weren't able to get to. If you've got additional questions, feel free to reach out to me during the day.

好的。謝謝你，莎貢。我們還有時間回答最後一個問題，對於未能採訪到的分析師們，我深感抱歉。如果您還有其他問題，歡迎隨時在白天與我聯繫。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

I have sort of two product questions, so I'll ask them upfront. The first one is, as AF ablations move into the ASC setting, can you talk about how you are positioned in ASC in terms of mappers and fair placements? And on TAVR, can you talk about what you saw in the US, Europe and Japan, and how market share is looking in those markets?

我有兩個關於產品的問題，所以我會先問清楚。第一個問題是，隨著心房顫動消融術進入 ASC 環境，您能否談談您在 ASC 中，在映射和公平定位方面所處的位置？關於經導管主動脈瓣置換術（TAVR），您能否談談您在美國、歐洲和日本的觀察情況，以及這些市場的市佔率現況？

Well, thanks, Pito. Look, for PFA and ASCs, over time, we do see that as an incremental opportunity for market expansion there. There will be a bit of a shift outside of the tertiary centers to the ASCs over time, but it will also be a market expansion opportunity for us. It is a focus for us. We have been hiring across the company, quite frankly, particularly in Neuroscience and in Cardiovascular, folks that are specifically focused on market development in the ASCs for us and what our strategy is and how our product portfolio fits there and the resources we need, including mappers. So this definitely is in the calculus for Medtronic, not just our Cardiac Ablation business. Like I said, I think this will represent an incremental growth opportunity for us there.

謝謝你，皮托。對於 PFA 和 ASC 來說，隨著時間的推移，我們確實認為這是一個逐步擴大市場的機會。隨著時間的推移，患者會逐漸從三級醫療中心轉移到門診手術中心，但這對我們來說也是一個市場擴張的機會。這是我們的關注重點。坦白說，我們一直在全公司範圍內招聘，尤其是在神經科學和心血管領域，我們招聘的人員專門負責我們在 ASC 的市場開發，以及我們的戰略是什麼，我們的產品組合如何融入其中，以及我們需要哪些資源，包括繪圖員。所以這絕對是美敦力公司考量因素之一，而不僅僅是我們的心臟消融業務。正如我所說，我認為這將為我們在那裡帶來逐步成長的機會。

And then on TAVR, what I'll say is we had a decent Q2 here, growing high single digits on a global basis. Internationally, we're executing particularly well and getting more than our fair share of that Boston exit. As we move forward in PFA, I think Q3, we may see a deceleration there.

至於TAVR，我想說的是，我們第二季的表現不錯，全球範圍內實現了接近兩位數的成長。在國際市場上，我們的表現尤其出色，在波士頓的出口市場中獲得了遠超過我們應得的份額。隨著 PFA 的推進，我認為第三季可能會出現成長放緩。

In TAVR.

在經導管主動脈瓣置換術（TAVR）中。

TAVR. What did I say?

經導管主動脈瓣置換術（TAVR）。我說什麼了？

PFA.

PFA。

PFA, I'm sorry. In TAVR, a little bit of a deceleration in Q3, but then it will pop back up in Q4. Due to a phasing, we've seen this in prior quarters as well. I don't know if you want to add anything to that?

請查閱附件，抱歉。TAVR 在第三季略有放緩，但第四季將會回升。由於分階段實施，我們在之前的幾個季度也遇到過這種情況。我不知道你是否還有什麼要補充的？

No, that's right. We saw the Q4, Q1 effect and Q2, Q3 looks kind of similar, a little bit slower in Q3, but with a pickup in the fourth quarter.

沒錯。我們看到了第四季和第一季之間的變化，第二季和第三季的情況也有些類似，第三季增速稍慢，但第四季有所回升。

And just for clarity, PFA, will continue to grow off the 71% and it will accelerate in Q3 and beyond.

為了更清楚地說明，PFA 將繼續保持 71% 的成長勢頭，並在第三季及以後加速成長。

Thank you, Pito. Geoff, if you want to go ahead with your closing remarks?

謝謝你，皮托。傑夫，你想繼續做總結發言嗎？

Sure. So thank you for joining and all your thoughtful questions this morning. And like Ryan said, I apologize to the analysts we didn't get to. We certainly appreciate your support and your interest in Medtronic. Please join us again for our Q3 earnings broadcast for more updates, and there'll be more on our continued progress and on the long-term strategies.

當然。感謝各位的參與，也感謝大家今天早上提出的所有深思熟慮的問題。正如瑞安所說，我向那些我們沒能採訪到的分析師們表示歉意。我們非常感謝您對美敦力的支持與關注。請再次收看我們的第三季財報直播，了解更多最新信息，屆時我們將詳細介紹我們持續取得的進展和長期戰略。

And we expect to hold this on Tuesday, February 17. And for those of you in the US, I wish you and your families a very happy Thanksgiving next week. I can't believe Thanksgiving is next week. With that, enjoy the rest of your day. Thank you.

我們預計將於2月17日星期二舉行此次會議。對於身在美國的各位，我祝福你們和你們的家人下週感恩節快樂。真不敢相信感恩節下週就到了。祝您今天餘下的時間愉快。謝謝。