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✦ Lithotripsy and Amulet 360: The Next Device ApprovalsNarrow moat

Abbott Laboratories (ABT) — the future bets

Abbott is trying to restart its flat Vascular line with coronary lithotripsy and extend Electrophysiology with Amulet 360, both now before the FDA or in trials.

Abbott's device business needs new products to keep its growth rate, and two are moving toward the FDA. In April 2026 it completed enrollment in its TECTONIC US pivotal trial of a coronary intravascular lithotripsy system, "for treating severe calcification in coronary arteries prior to stent implantation"1. In May 2026 it completed its FDA submission for the Amulet 360 left atrial appendage device2.

Abbott sales of the lines the new devices join, first half 2026 ($M)1,649Electrophysiology1,580VascularAbbott Q2 2026 earnings release, Medical Devices sales table
One line to restart, one to extend.

Lithotripsy would go into Vascular, the slowest of Abbott's device lines. Vascular sold $2,995 million in 2025 against $2,892 million in 201734. A device that cracks calcium before a stent is placed would give Abbott something new to sell into the same procedures.

Amulet 360 would go into Electrophysiology, where Abbott moved the Amulet device on 1 January 20265. Left atrial appendage closure is used for patients with atrial fibrillation, so it sits beside the ablation business.

Both depend on trial results and FDA decisions that Abbott does not control, and neither has a disclosed approval date.

Abbott's research budget pays for these programs. R&D was $892 million in the second quarter of 2026, up 22.9%6, and $2,942 million in 20257.

The budget behind these programs is rising. Research and development was $1,659 million in the first half of 2026, up 15.1%8. The two lines they would join are large enough to notice the difference: Electrophysiology sold $1,649 million and Vascular $1,580 million in the first half9. Vascular grew only 3.6% from 2017 to 202510, so even a modest new device would change its trend. At the Heart Rhythm Society meeting in April 2026 Abbott presented late-breaking data from four trials in pulsed field ablation and conduction system pacing11, the evidence base its electrophysiology products are sold on. Amulet's move took $55 million of second-quarter 2025 sales with it12. Vascular sold $2,995 million in 202513.

The devices will be judged by the lines they join. Within two years of a lithotripsy approval, Vascular comparable growth should clear 7%. Still near 5%, and the new device has not lifted a flat business.

Moat trajectory: Holding steady

TECTONIC enrollment complete April 2026; Amulet 360 submitted May 2026.

The number that tests this moat
Reported
Vascular comparable sales growth, latest quarter
+5.1% (Q2 2026: $803M)

The line lithotripsy would join; above 7% after approval would show the new device working.

Source: Abbott Q2 2026 earnings release ↗
References
  1. ReportedIn April 2026 it completed enrollment in its TECTONIC US pivotal trial of a coronary intravascular lithotripsy system, "for treating severe calcification in coronary arteries prior to stent implantation".
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  2. ReportedIn May 2026 it completed its FDA submission for the Amulet 360 left atrial appendage device.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  3. ReportedVascular sold $2,995 million in 2025 against $2,892 million in 2017.
    Abbott Laboratories Form 10-K for 2025 (year ended 31 December 2025) - Item 1 and MD&A for Medical Devices: Diabetes Care, continuous glucose monitors and the cardiovascular and neuromodulation businesses. — FY2025 · publ. 20 February 2026 · source ↗
  4. ReportedVascular sold $2,995 million in 2025 against $2,892 million in 2017.
    Abbott Laboratories Form 10-K for 2019 - the four reportable segments with Diabetes Care folded into Medical Devices from the fourth quarter of 2019 and 2017-2018 recast, product-line sales for 2017-2019, net earnings and EPS for 2017-2019 including the 2017 tax reform charge, and the balance sheet at 31 December 2019. — FY2019 · publ. February 2020 · source ↗
  5. ReportedAmulet 360 would go into Electrophysiology, where Abbott moved the Amulet device on 1 January 2026.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  6. ReportedR&D was $892 million in the second quarter of 2026, up 22.9%, and $2,942 million in 2025.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - total sales, income statement, specified items, tax rate, guidance and the dividend. — Q2 2026 · publ. 16 July 2026 · source ↗
  7. ReportedR&D was $892 million in the second quarter of 2026, up 22.9%, and $2,942 million in 2025.
    Abbott Laboratories Form 10-K for 2025 (year ended 31 December 2025) - Item 1 business and the segment note: the four segments, sales and operating earnings, employees, manufacturing sites, customers and geography. — FY2025 · publ. 20 February 2026 · source ↗
  8. ReportedResearch and development was $1,659 million in the first half of 2026, up 15.1%.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - total sales, income statement, specified items, tax rate, guidance and the dividend. — Q2 2026 · publ. 16 July 2026 · source ↗
  9. ReportedThe two lines they would join are large enough to notice the difference: Electrophysiology sold $1,649 million and Vascular $1,580 million in the first half.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  10. Moat Explorer calcVascular grew only 3.6% from 2017 to 2025, so even a modest new device would change its trend.
    Moat Explorer calculation from Abbott Laboratories reported figures ($ millions unless stated; calendar years). Medical Devices: share of total reportable segment operating earnings 3,011 / 6,916 = 43.5% (2017), 4,533 / 13,422 = 33.8% (2021), 7,212 / 11,800 = 61.1% (2025); first half 2026 3,862 / 6,122 = 63.1%. Share of segment sales 21,387 / 44,311 = 48.3% (2025); first half 2026 11,392 / 23,750 = 48.0%. Segment margin 3,011 / 10,325 = 29.2% (2017), 3,038 / 11,787 = 25.8% (2020), 4,533 / 14,485 = 31.3% (2021), 7,212 / 21,387 = 33.7% (2025); Q2 2026 1,969 / 5,853 = 33.6%, Q2 2025 1,796 / 5,369 = 33.5%. Sales growth 2017-2025 (21,387 / 10,325)^(1/8) - 1 = 9.5% a year; operating earnings 2025 7,212 / 6,153 - 1 = +17.2%; sales 2025 21,387 / 18,986 - 1 = +12.6%. Diabetes Care 7,998 / 1,414 = 5.66 times (2017 to 2025); share of Medical Devices 1,414 / 10,325 = 13.7% (2017), 2,524 / 12,239 = 20.6% (2019), 4,328 / 14,485 = 29.9% (2021), 5,761 / 16,887 = 34.1% (2023), 7,998 / 21,387 = 37.4% (2025); share of company 7,998 / 44,328 = 18.0%; CGM share of Diabetes Care 7.6bn / 7.998bn = 95%. CGM growth 2019-2025 (7.6 / 1.842)^(1/6) - 1 = 26.6% a year. Abbott CGM sales over DexCom revenue 7,600 / 4,662.0 = 1.63 times. DexCom distributor share 3,959.0 / 4,662.0 = 84.9%. Product lines 2017 to 2025: Electrophysiology 2,764 / 1,353 = 2.04 times; Structural Heart 2,523 / 1,083 = 2.33 times; Heart Failure 1,448 / 643 = 2.25 times; Rhythm Management 2,649 / 2,132 - 1 = +24.2%; Neuromodulation 1,010 / 808 - 1 = +25.0%; Vascular 2,995 / 2,892 - 1 = +3.6%. Rhythm Management, Heart Failure, Vascular and Neuromodulation together 2,649 + 1,448 + 2,995 + 1,010 = 8,102 (2025) against 2,390 + 1,279 + 2,837 + 962 = 7,468 (2024), +8.5%. Diagnostics: margin 1,912 / 7,713 = 24.8% (2019), 6,237 / 15,526 = 40.2% (2021), 6,640 / 16,469 = 40.3% (2022), 2,433 / 9,988 = 24.4% (2023), 1,740 / 8,937 = 19.5% (2025); Q2 2026 499 / 3,092 = 16.1%, Q2 2025 372 / 2,173 = 17.1%. Share of segment operating earnings 6,640 / 12,831 = 51.7% (2022), 1,740 / 11,800 = 14.7% (2025). Sales 2025 8,937 / 9,341 - 1 = -4.3%. COVID testing share of Diagnostics sales 2022 8.4bn / 16.469bn = 51%, about half. Core Laboratory 5,360 / 4,063 - 1 = +31.9%. Rapid Diagnostics 2,454 / 10,061 - 1 = -75.6% (2022 to 2025). Point of Care 606 / 550 - 1 = +10.2%. Molecular 2020 peak 1,438 / 463 = 3.11 times 2017. Cancer Diagnostics share of Diagnostics Q2 2026 919 / 3,092 = 29.7%. Exact Sciences US share of 2025 sales 3,145 / 3,247 = 96.9%; purchase price over 2025 sales 20.6bn / 3.247bn = 6.3 times. China net sales 1,907 / 2,253 - 1 = -15.4% (2023 to 2025); China share of company 2,253 / 40,109 = 5.6% (2023), 1,907 / 44,328 = 4.3% (2025). Nutrition: margin 1,741 / 6,975 = 25.0% (2015), 1,705 / 7,409 = 23.0% (2019), 1,763 / 8,294 = 21.3% (2021), 706 / 7,459 = 9.5% (2022), 1,333 / 8,154 = 16.3% (2023), 1,558 / 8,451 = 18.4% (2025); Q2 2026 368 / 2,144 = 17.2%, Q2 2025 418 / 2,212 = 18.9%. Q2 operating earnings 368 / 418 - 1 = -12.0%. Sales 2021 to 2025 8,451 / 8,294 - 1 = +1.9%. Share of company sales 6,925 / 27,390 = 25.3% (2017), 7,409 / 31,904 = 23.2% (2019), 8,294 / 43,075 = 19.3% (2021), 8,154 / 40,109 = 20.3% (2023), 8,451 / 44,328 = 19.1% (2025). US Pediatric 2022 1,562 / 2,192 - 1 = -28.7%. International Adult 3,029 / 1,782 - 1 = +70.0% (2017 to 2025); share of Nutrition 3,029 / 8,451 = 35.8%. International Pediatric 1,816 / 2,112 - 1 = -14.0%. Sturgis: recalled brands 479 / 1,200 - 1 = -60%; Nutrition operating earnings 706 / 1,763 - 1 = -60%. Established Pharmaceuticals: margin 658 / 3,720 = 17.7% (2015), 848 / 4,287 = 19.8% (2017), 904 / 4,486 = 20.2% (2019), 889 / 4,718 = 18.8% (2021), 1,206 / 5,066 = 23.8% (2023), 1,290 / 5,536 = 23.3% (2025); Q2 2026 382 / 1,499 = 25.5%. Sales 5,536 / 3,720 - 1 = +48.8% (2015 to 2025); (5,536 / 4,287)^(1/8) - 1 = 3.2% a year (2017 to 2025). Key Emerging Markets share 4,167 / 5,536 = 75.3%. Segment sales growth 2025: Medical Devices +12.6%, Established Pharmaceuticals 5,536 / 5,194 - 1 = +6.6%, Nutrition 8,451 / 8,413 - 1 = +0.5%, Diagnostics -4.3%; net sales 44,328 / 41,950 - 1 = +5.7%. US share of 2025 net sales 17,126 / 44,328 = 38.6%; international share Q2 2026 7,377 / 12,593 = 58.6%. Further: Structural Heart compensation payments 89 / 2,523 = 3.5% of 2025 line sales. Diabetes Care added 7,998 - 6,805 = 1,193 in 2025. One point of CGM growth on 7.6bn = about 76. Medical Devices share of segment assets 10,689 / (3,540 + 4,791 + 8,273 + 10,689 = 27,293) = 39.2%. Total debt over total assets 32,608 / 109,215 = 29.9% (30 June 2026), 12,929 / 86,713 = 14.9% (end 2025). Net debt over Abbott shareholders' investment 27,005 / 51,110 = 0.53. Market value 173.21 / 217.86 - 1 = -20.5% (end 2025 to 5 October 2026). Second pass: US Structural Heart first half 2026 449 / 1,175 = 38.2%. Rapid Diagnostics 2,454 / 4,376 = 56% of 2020. Diagnostics Q2 2026 operating earnings 499 / 372 - 1 = +34.1%. Nutrition sales (8,451 / 6,925)^(1/8) - 1 = 2.5% a year (2017 to 2025); 8,451 / 7,409 - 1 = +14.1% (2019 to 2025). US Adult Nutrition 1,448 / 1,254 - 1 = +15.5% (2017 to 2025). Adult nutrition 3,029 + 1,448 = 4,477; pediatric 2,158 + 1,816 = 3,974 (2025). Total segment operating earnings 11,800 / 13,422 - 1 = -12.1% (2021 to 2025); Medical Devices 7,212 / 4,533 - 1 = +59.1%. First half 2026 dividends over operating cash flow 2,200 / 3,803 = 57.9%. DexCom revenue 2023 3,095.6 + 526.7 = 3,622.3; 4,662.0 / 3,622.3 - 1 = +28.7%; Abbott CGM 7.6 / 5.3 - 1 = +43.4% (2023 to 2025). US share of first half 2026 sales 9,490 / 23,757 = 39.9%. Diagnostics RPO 6,200 / 8,937 = 69% of 2025 Diagnostics sales; 6,200 / 5,360 = 1.16 times Core Laboratory sales. Libre 7.6 / 1.128 = 6.7 times (2018 to 2025). Medical Devices and Established Pharmaceuticals RPO 455 + 243 = 698, / 6,898 = 10.1%. Cash, debt and dividends: free cash flow 9,566 - 2,171 = 7,395 (2025), 8,558 - 2,207 = 6,351 (2024), 7,261 - 2,202 = 5,059 (2023); after dividends 7,395 - 4,116 = 3,279, about $3.3 billion. Dividends paid over free cash flow 4,116 / 7,395 = 55.7%; over net earnings 4,116 / 6,524 = 63.1%; 2025 dividend per share over adjusted EPS 2.40 / 5.15 = 46.6%; annual dividend 4 x 0.63 = 2.52 over trailing EPS 3.09 = 81.6%. Dividend per share 2.40 / 0.98 = 2.45 times, (2.45)^(1/10) - 1 = 9.4% a year (2015 to 2025). Total debt 3,033 + 9,896 = 12,929 (end 2025), 3,005 + 29,603 = 32,608 (30 June 2026); net debt 12,929 - 8,522 - 417 = 3,990 (end 2025), 32,608 - 5,104 - 499 = 27,005 (30 June 2026), 14,679 - 7,279 = 7,400 (end 2023), 14,125 - 7,967 = 6,158 (end 2024); 27,005 / 3,990 = 6.8 times. Remaining performance obligations 6,200 + 455 + 243 = 6,898, about $6.9 billion; Diagnostics share 6,200 / 6,898 = 90%; beyond 36 months 100% - 52% - 18% = 30%; over trailing twelve-month sales 6,898 / 46,585 = 14.8%, about 15%. Trailing twelve months to June 2026: net sales 44,328 - 21,500 + 23,757 = 46,585; net earnings 6,524 - 3,104 + 2,005 = 5,425; diluted EPS 3.72 - 1.77 + 1.14 = 3.09. Expected amortization 1.5bn (2030) / 2.6bn (2026) - 1 = -42%. Analyst target 120.26 / 100.10 - 1 = +20.1%. 2026 adjusted EPS guidance midpoints (5.55 + 5.80) / 2 = 5.675 (January), (5.38 + 5.58) / 2 = 5.48 (April), (5.45 + 5.60) / 2 = 5.525 (July). Year-end market value (stockanalysis) over net earnings and net sales: 2015 66.99bn / 4,423 = 15.15, / 20,405 = 3.283; 2016 56.55 / 1,400 = 40.39, / 20,853 = 2.712; 2017 99.34 / 477 = 208.26, / 27,390 = 3.627; 2018 127.04 / 2,368 = 53.65, / 30,578 = 4.155; 2019 153.61 / 3,687 = 41.66, / 31,904 = 4.815; 2020 194.06 / 4,495 = 43.17, / 34,608 = 5.607; 2021 248.87 / 7,071 = 35.20, / 43,075 = 5.778; 2022 191.43 / 6,933 = 27.61, / 43,653 = 4.385; 2023 191.09 / 5,723 = 33.39, / 40,109 = 4.764; 2024 196.18 / 13,402 = 14.64, / 41,950 = 4.677; 2025 217.86 / 6,524 = 33.39, / 44,328 = 4.915; 5 October 2026 173.21bn / 5,425 = 31.93, / 46,585 = 3.718 - Medical Devices, Diabetes Care and the device lines. — FY2015-Q2 2026 · publ. October 2026 · source ↗
    Method: Arithmetic on figures reported in Abbott Laboratories Forms 10-K and 10-Q and earnings releases, the DexCom Form 10-K, and stockanalysis.com market values; each operand is stated in the source line.
  11. ReportedAt the Heart Rhythm Society meeting in April 2026 Abbott presented late-breaking data from four trials in pulsed field ablation and conduction system pacing, the evidence base its electrophysiology products are sold on.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  12. ReportedAmulet's move took $55 million of second-quarter 2025 sales with it.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  13. ReportedVascular sold $2,995 million in 2025.
    Abbott Laboratories Form 10-K for 2025 (year ended 31 December 2025) - Item 1 and MD&A for Medical Devices: Diabetes Care, continuous glucose monitors and the cardiovascular and neuromodulation businesses. — FY2025 · publ. 20 February 2026 · source ↗
Sources
Generated October 6, 2026