Boston Scientific entered 2025 with significant momentum. Fresh off a standout first quarter, the company’s leadership has outlined a compelling vision for sustainable long-term growth rooted in high-performing cardiology franchises, operational precision, and disruptive technologies in electrophysiology (EP). Leaders spoke at a recent Bank of America Healthcare Conference. The discussion marked outgoing CFO Dan Brennan’s final investor presentation and underscored Boston Scientific’s transformation into one of medtech’s most durable growth stories.
“Since 2014, Boston Scientific’s stock has returned nearly 21 percent annually, vastly outperforming the healthcare sector and the S&P,” noted the moderator. To that, Brennan noted “That takes the team. We have 55,000 global team members to make that happen.”
Smooth Leadership Transition
Brennan’s successor, John Monson, was chosen not only for his 25-year tenure at the company but for his recent experience in investor relations. Brennan emphasized the seamlessness of the CFO transition. “Everything [John] has ever done, he’s done exceptionally well. He knows the business, he knows the team, and he knows the investors.”
Q1 2025 validated that continuity. The company reported 18.2 percent organic revenue growth, a 28.9 percent adjusted operating margin, 34 percent adjusted EPS growth, and a gross margin of 71.5 percent. “That gross margin number is particularly exciting,” said Brennan. “In 2019, we were at 72.4 percent. To be this close — just a fraction off — shows how focused we are on restoring margin leadership.”
That performance enabled Boston Scientific to raise full-year revenue guidance from 11–13.5 percent in February to 12–14 percent in April. “We couldn’t have asked for a better start to the year,” Brennan added.
The results are even more impressive considering the company faced a $200 million unanticipated tariff impact in April. “You don’t want something like that to slow your momentum,” Brennan said. “We offset half of it with revenue upside and favorable foreign exchange, and the other half through $100 million in smart discretionary spending reductions.”
The company’s long-standing focus on discipline and execution, even in the face of external shocks, reflects a broader cultural commitment. “When confronted with a $200 million hit, we didn’t even consider lowering our margin guidance,” said Brennan. “We said, ‘We’re going to offset it. We’ll still deliver the 50–75 basis points of margin expansion.’ That mindset is embedded in how we operate.”
Margin Expansion Strategy
Boston Scientific’s long-term target remains a 30 percent+ operating margin, and the leadership team sees ample runway ahead to achieve that. “Margin expansion has been a critical part of our success — not just in retrospect, but looking forward,” Brennan said.
Unlike some in industry who use tariffs or macroeconomic volatility as reasons to temper financial performance, Boston Scientific continues to invest with precision. “We do a nice job as a team of looking at ways to reinvest to fuel the top line while maintaining financial discipline,” Brennan noted.
This dual focus — strategic reinvestment and cost control — allows Boston Scientific to weather market shifts while still expanding its operational envelope. “If trade tensions ease and tariff burdens are reduced, we’ll take a balanced approach,” said Brennan. “We’ll consider reinvestment in pipeline assets, but we’re also committed to strengthening margins year over year.”
M&A and Revenue Growth
With Boston Scientific now consistently posting low double-digit revenue growth, the conversation turned to sustainability. “A few years ago, our weighted average market growth rate was 5 percent. Now it’s around 9 percent,” said Brennan. “That shift reflects intentional portfolio moves.”
That deliberate strategy spans several areas: expanding high-growth product lines, targeting adjacent therapy areas, and complementing organic R&D with disciplined M&A. “Go back five years, even 10 years, and you’ll see a clear pattern: slow but steady expansion of our growth base,” he explained.
“People ask, ‘How long can Boston Scientific keep growing at this rate?’ And our answer is: quite a while,” he added. “We’ve delivered three consecutive strong years — 16.4 percent organic growth in 2024, and now we’ve raised 2025 expectations just a few months into the year.”
While specifics for 2026 and beyond will be held until the medtech firm’s September 30 Investor Day, Brennan hinted that the company has a clear line of sight into future catalysts. “Our leadership is focused not just on Q2 or full-year 2025,” he said. “We’re looking at 2026, 2027, 2028 — and even 2030. That’s how you build a business that endures.”
Boston Scientific’s approach to mergers and acquisitions remains steadfast: prioritizing tuck-in deals that complement existing capabilities. “We’ve done nearly 30 acquisitions over the last decade, from $40 million to $4 billion,” Brennan noted. “Every one of them was about fit — strategic, technological, and commercial.”
Rather than targeting transformative acquisitions that could upend operations or culture, Boston Scientific focuses on technology platforms that plug into existing infrastructure. “It’s not about size,” said Joe Fitzgerald, executive vice president and group president, cardiology. “It’s about strategic fit — whether it aligns with our commercial model and R&D expertise.”
Notably, tuck-in acquisitions have played a pivotal role in Boston Scientific’s entry and rise in the electrophysiology market, a segment that’s undergoing a seismic shift thanks to pulsed field ablation (PFA).
Leading in Electrophysiology
The company’s FARAPULSE platform has become the center of gravity in Boston Scientific’s EP growth engine. “We did about a billion dollars in the first 12 months post-FDA approval,” said Fitzgerald. “And this is just the beginning.”
Previously, thermal ablation dominated the U.S. market. But now, with FARAPULSE, PFA is quickly gaining share. “We estimate we’ll move from 40 percent penetration in 2024 to 80 percent over the next several years,” Fitzgerald explained.
Boston Scientific isn’t just betting on one product, however. It’s building an ecosystem. “We’re developing multiple catheter types, building out mapping and imaging capabilities, and layering in software and diagnostic tools,” he said. “This isn’t just about being a strong player in ablation — it’s about owning the EP lab.”
Mapping and imaging are key focus areas. “Mapping can add up to $4,000 per procedure,” Fitzgerald said. “In the U.S., 100 percent of EP procedures are mapped, and we only recently entered that space with FARAVIEW NAV. Now we’re aiming to disrupt.”
The company’s acquisition of Cortex and its strategic work with intracardiac echocardiograph (ICE) guidance are also enabling access to additional untapped markets. “ICE catheters are a billion-dollar market where we currently have no presence,” Fitzgerald said. “We’re fixing that.”
Early physician feedback on the mapping system has been positive. “If you use FARAVIEW NAV with Opal, you can eliminate $2,500 mapping systems in 85 percent of cases and reduce exchanges,” he said. “That’s cost savings, efficiency, and safety.”
International Rollouts
Boston Scientific’s approach to international expansion reflects the same strategic focus. In Japan, FARAPULSE received reimbursement in Q4 2024, leading to rapid adoption. “Penetration in Japan is tracking similarly to the U.S. — fast and deep,” Fitzgerald said.
In contrast, China presents structural challenges. “You have to go province by province with tendering. We’re still early in the game,” he said. “But make no mistake. It’s a billion-dollar opportunity, and we’re building for the long term.”
The Watchman Opportunity
Beyond EP, Boston Scientific’s WATCHMAN left atrial appendage closure (LAAC) system continues to be a major driver of growth. With over 100,000 procedures expected in the United States this year and a growing trend toward concomitant ablation and LAAC procedures, the company sees strong near-term acceleration.
“Fifty percent of ablation cases now include Watchman. That’s tremendous, and it’s happening just months after [Centers for Medicare and Medicaid Services] introduced a [diagnosis-related group] that reimburses for same-setting procedures,” said Fitzgerald. “We also presented Option trial data showing the safety and efficacy of the approach.”
Looking ahead, the Champion trial could be transformative. The 3,000 patient study will provide head-to-head data versus anticoagulants, with endpoints in stroke and bleeding prevention. “We’re 99 percent confident we’ll present Champion in the first half of 2026,” said Fitzgerald.
With a total addressable market of 4 million patients under the current label, Boston Scientific sees Watchman as still early in its life cycle. “We’re proud of how the safety profile has improved across generations,” said Fitzgerald. “Watchman Flex Pro represents our most refined version yet.”
Conclusion
At a time when many medtech firms are grappling with regulatory headwinds, pricing pressures, and geopolitical disruptions, Boston Scientific is focused, aligned, and thriving. The company’s growth in electrophysiology, strength in LAAC, disciplined margin expansion, and pipeline visibility have all contributed to its standing as one of the industry’s top-performing players.
“Our growth strategy is intentional, and our margin journey is very much alive,” said Brennan. “We’re not just executing in 2025. We’re building for 2030.”
Boston Scientific is all-in on platform innovation, procedural efficiency, and durable leadership in high-growth therapy areas. As the company prepares to unveil more of its long-range strategy in September, the medtech industry will be watching closely.
This article was written by Sherrie Trigg, Editor and Director of Medical Content. She can be reached at
