iRhythm Holdings, Inc. (IRTC) · Nov 5, 2026 · Earnings

iRhythm earnings miss revenue but lifts 2026 guidance sharply

Beat — Adjusted EPS $0.82 vs ~$0.02 consensus; FY revenue guide $890M-$895M

iRhythm earnings narrowly missed revenue expectations, but adjusted profitability surged and 2026 guidance rose with VitalConnect included.

iRhythm is scaling its Zio ambulatory cardiac-monitoring platform while expanding into broader inpatient and hospital-to-home monitoring through the newly closed VitalConnect acquisition. The market was looking for roughly $222.23 million of third-quarter revenue and adjusted EPS near $0.02.

The core business was slightly softer than the top-line bar, but not materially so. Revenue reached $221.6 million, up 14.9% year over year, just below published consensus; however, gross profit grew faster than sales and gross margin expanded to 74.2%, helped by operating efficiencies, mix, and a one-time $3.1 million tariff refund.

Q3 2026Q3 2025Consensus / prior guide
Revenue (Financial Statements)$221.6M (+14.9%)$192.9M~$222.2M
Gross margin (Financial Highlights)74.2% (+310 bps)71.1%
Adjusted EBITDA (EBITDA reconciliation)$51.2M (+137.4%)$21.6M
Adjusted diluted EPS (EPS reconciliation)$0.82$(0.06)~$0.02
FY2026 revenue guidance (Guidance)$890M-$895M$870M-$880M prior
FY2026 adjusted EBITDA margin (Guidance)15.5%-16.0%11.5%-12.5% prior

Profitability was the real upside. Adjusted EBITDA more than doubled to $51.2 million, while adjusted operating expenses fell year over year despite continued investment. The adjusted EPS beat is unusually large because the quarter excludes a $49.8 million litigation settlement and other special costs, so it is not equivalent to a clean GAAP earnings breakout; still, the underlying gross-margin and cost-control improvement is genuine.

The guidance raise matters more than the tiny revenue miss. Management lifted full-year revenue guidance to $890 million-$895 million from $870 million-$880 million and raised the adjusted EBITDA-margin outlook to 15.5%-16.0% from 11.5%-12.5%. The increase partly reflects the October 5 VitalConnect acquisition and its expected $16 million contribution, so it is not entirely an organic acceleration; nevertheless, the margin reset indicates materially better operating leverage than investors had been modeling.

The main qualification is cash conversion and integration execution. Free cash flow was negative $11.5 million in the quarter, versus positive $20.1 million a year earlier, and the VitalConnect deal had already been announced and closed before this release, making the acquisition itself partly known rather than a fresh surprise. The next proof point is whether iRhythm can integrate the acquired MCT platform without giving back the newly improved margin profile.

Bottom line: This was a strong operational beat beneath a barely missed revenue headline. The higher full-year margin and revenue outlook meaningfully strengthen iRhythm’s execution story, though the EPS upside is inflated by one-time exclusions and VitalConnect still has to integrate cleanly.

What to watch next

VitalConnect integration and 2027 growth update

Original filing on SEC EDGAR

More iRhythm Holdings, Inc. news

iRhythm earnings miss revenue but lifts 2026 guidance sharply | IRTC Stock News
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