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Electrophysiology and the Pulsed Field TurnNarrow moat

Abbott Laboratories (ABT) — moat facet

Abbott's electrophysiology sales doubled to $2.8 billion from 2017 to 2025 and grew 13.4% in Q2 2026, with its first US pulsed field system approved in December 2025.

Electrophysiology is where Abbott's heart business is growing fastest, and the technology underneath it is changing. Electrophysiology sales were $1,353 million in 20171 and $2,764 million in 20252, 2.04 times as much3. In the second quarter of 2026 they grew 13.4% on a comparable basis, the fastest of the device lines4.

Abbott electrophysiology sales ($M)1,35320171,72120191,90720212,19520232,7642025Abbott Forms 10-K FY2019, FY2021, FY2023 and FY2025, product-line sales
Doubled in eight years.

The products are mapping systems, catheters and the consumables that go with every procedure. A hospital that has trained its staff on one mapping system and stocked its catheters tends to keep both, which is the switching cost. Each ablation then uses new catheters, so the installed system becomes a stream of disposable sales.

The change is pulsed field ablation, which uses electrical pulses rather than heat or cold. In December 2025 Abbott won FDA approval for its Volt pulsed field ablation system, its first pulsed field offering for patients in the United States5. At the Heart Rhythm Society meeting in April 2026 it presented late-breaking data from four trials across its pulsed field and conduction system pacing portfolios6.

From 1 January 2026 the Amulet left atrial appendage device moved into Electrophysiology from Structural Heart, with $101 million of first-half 2025 sales moved with it7. Part of the line's 2026 growth is therefore a reclassification, and the comparable figure is the one to read.

The line has grown in most years. It sold $1,578 million in the pandemic year of 2020, below the $1,721 million of 20198, and then $2,195 million in 2023 and $2,467 million in 20249. In the first half of 2026 it sold $1,649 million, up 13.0% on a comparable basis10.

The growth is broad across regions. US electrophysiology sales were $420 million in the second quarter of 2026, up 15.9%, and international sales $441 million, up 12.3% reported11. A technology shift that only one market adopted would show up as a gap between those two numbers; so far there is none.

This sub-aspect lives or dies on pulsed field adoption. Electrophysiology growth falling below the device segment's own comparable growth, 8.4% in the second quarter12, would suggest the new catheter is not winning the procedures the old installed base used to capture.

Moat trajectory: Widening

EP +13.4% comparable in Q2 2026; Volt PFA approved December 2025.

The number that tests this moat
Reported
Electrophysiology comparable sales growth, latest quarter
+13.4% (Q2 2026: $861M)

Whether the pulsed field transition is going Abbott's way; growth below the device segment's average would mean it is not.

Source: Abbott Q2 2026 earnings release ↗
⚠ Threats to the moat
⚠ THREAT 01
When the Catheter Changes, the Base Resets
Pulsed field ablation resets hospital choices, and Abbott's Volt is its first US offering in the technology.
References
  1. ReportedElectrophysiology sales were $1,353 million in 2017 and $2,764 million in 2025, 2.04 times as much.
    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 ↗
  2. ReportedElectrophysiology sales were $1,353 million in 2017 and $2,764 million in 2025, 2.04 times as much.
    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 ↗
  3. Moat Explorer calcElectrophysiology sales were $1,353 million in 2017 and $2,764 million in 2025, 2.04 times as much.
    Moat Explorer calculation from Abbott Laboratories reported figures ($ 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.
  4. ReportedIn the second quarter of 2026 they grew 13.4% on a comparable basis, the fastest of the device lines.
    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 ↗
  5. ReportedIn December 2025 Abbott won FDA approval for its Volt pulsed field ablation system, its first pulsed field offering for patients in the United States.
    Abbott Laboratories fourth-quarter and full-year 2025 earnings release, Form 8-K exhibit 99.1 - fourth-quarter sales by segment, the Nutrition decline and strategic price actions, continuous glucose monitor sales growth, adjusted EPS of $5.15, the Volt PFA approval and 2026 guidance. — FY2025 · publ. 22 January 2026 · source ↗
  6. ReportedAt the Heart Rhythm Society meeting in April 2026 it presented late-breaking data from four trials across its pulsed field and conduction system pacing portfolios.
    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 ↗
  7. ReportedFrom 1 January 2026 the Amulet left atrial appendage device moved into Electrophysiology from Structural Heart, with $101 million of first-half 2025 sales moved 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 ↗
  8. ReportedIt sold $1,578 million in the pandemic year of 2020, below the $1,721 million of 2019, and then $2,195 million in 2023 and $2,467 million in 2024.
    Abbott Laboratories Form 10-K for 2021 - product-line sales for 2019-2021 including Rapid Diagnostics, Molecular and Diabetes Care, and the balance sheet at 31 December 2021. — FY2021 · publ. February 2022 · source ↗
  9. ReportedIt sold $1,578 million in the pandemic year of 2020, below the $1,721 million of 2019, and then $2,195 million in 2023 and $2,467 million in 2024.
    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 ↗
  10. ReportedIn the first half of 2026 it sold $1,649 million, up 13.0% on a comparable basis.
    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 ↗
  11. ReportedUS electrophysiology sales were $420 million in the second quarter of 2026, up 15.9%, and international sales $441 million, up 12.3% reported.
    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. ReportedElectrophysiology growth falling below the device segment's own comparable growth, 8.4% in the second quarter, would suggest the new catheter is not winning the procedures the old installed base used to capture.
    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 ↗
Sources
Generated October 6, 2026