Big Game Hunting: The Imricor Story (ASX: IMR)

Good morning Armchair Army,

Welcome to today's edition of The Armchair Analyst, a 5-minute daily update on the ASX life-sciences sector.

The most fertile ground to find 10-baggers for retail investors is where fund managers can’t play.

The $5M to $50M bet.

(In my opinion)

Managing a fund is all about balancing risk and reward.

Still looking for stocks that go up, but often they hunt bigger targets.

Same game, different leagues.

What fundies are looking for is strategic entry points, asymmetric upside, and avoiding getting stuck in illiquid assets.

Most funds run to a mandate that dictates what they can buy, when they enter, and when they exit.

How the fund's performance is measured shapes how they trade.

So does the redemption policy (how investors get their money back) and the fund's phase (deploy capital, or extract it).

A typical fund ticket is $500,000 or more.

To sell that position, realise a gain, or cut a loss, they need liquidity.

Liquidity = enough daily volume to actually get in or out.

A stock trading ~$10K a day? 

It'd take years to exit.

So funds stay in higher-market-cap names and leave the sub-$100M micros to retail, high-net-worths and family offices.

But a healthcare fund still wants its 10x.

The high-risk, high-reward play.

It just hunts from a much higher base.

Going from $5M to $50M can happen on retail interest alone.

The fundie doesn't get to play there.

Their 10x is more likely to come from the $500M to $5B move.

Same return. Bigger stakes.

A far harder hunt.

I think the journey of Imricor (ASX: IMR), the next company in my Biotech 165 Challenge, best highlights this dynamic.

Once upon a time, Imricor was the perfect tax loss ‘buy’ for retail investors, and now it's a fund manager’s dream.

When I first heard the Imricor story, I said to myself… 

The fundies are going to like this one.

FIRST, it has genuinely industry-shaping technology and is going after a $22 billion opportunity.

(more on this in a bit)

SECOND, the stock is liquid (trades north of $500,000 of stock per day).

THIRD, the technology has been validated through partnerships with top-tier firms (Siemens, Philips, and GE HealthCare) and some of the best hospitals in Europe and the US.

FOURTH, a founder-CEO who's been building this for over 20 years, and a team to match.

FINALLY, a pathway to commercial value in the near-term. US market entry slated for early next year.

But it wasn’t always like that. 

In 2023, Imricor was a $15M market-cap minnow, cash-hungry, and with no friends in fund manager land.

Today, it is a $620M market-cap beast and is looking to become the next great med tech company.

(With a pro-forma cash balance of ~$108 million)

This is the story of a company that is chasing a US$22 billion industry… heart surgery.

But they are not looking to take a fraction out of the market.

Imricor are after the whole pie.

Over the last 20 years, Imricor has developed technology that allows doctors to perform cardiac ablations inside an MRI scanner rather than under an X-ray scanner.

Cardiac ablation = small heart surgery.

It's how doctors fix arrhythmias (dodgy heart rhythms). 

They thread a thin tube called a catheter up through an artery into the heart and burn away the faulty tissue causing the misfire. 

No chest opening, no scalpel.

The catch is that most of the time, the surgeons are flying blind. 

The X-ray shows shadows of bone and catheter, but can't see the soft heart tissue the doctor is actually trying to treat.

An MRI sees everything X-ray can't: soft tissue, blood flow, and crucially, the scar. 

In real time, in 3D. 

X-ray ablation is like trying to defuse a bomb wearing a blindfold, by feel. 

MRI takes the blindfold off.

For the hardest arrhythmia of all, Ventricular Tachycardia, X-ray-guided ablation succeeds only around 48% of the time, because the operator can't see the scar they're aiming at. 

MRI shows it.

The reason no one has done this before is that an MRI is a giant magnet and a catheter is a metal wire.

… and that metal wire would rip through someone's body if they went through the MRI, or get so hot it would melt due to the radiofrequency waves.

(Hopefully not inside someone at the time)

Doing ablations inside an MRI has been the industry dream for years. 

The technology was never there. Until Imricor.

Imricor built the first MRI-safe catheter, as well as all the capital equipment and software required to perform the procedure.

All are uniquely MRI compatible, all Imricor’s.

No metal braiding, no heating, no image artefact, and the hardware and software to run a full ablation inside the scanner.

A genuine industry-shaping technology.

Big tick for the fundies.

Now, if you put in all that effort to change the entire industry (replace X-ray surgeries with MRI surgeries), the prize needs to be big.

… and it is.

The big players are already there. 

Johnson & Johnson. Medtronic. Boston Scientific. Abbott. 

They supply the catheters for X-ray ablations today.

Each catheter is single-use, and reimburses at US$3,500–6,500 pre-procedure.

Big-money recurring revenue, every procedure, forever.

The global cardiac ablation market is valued at around US$16 billion today and is projected to reach US$22 billion by FY2030, growing at roughly 15% annually.

This is the prize that Imricor is going after.

Not a fraction of it…

Imricor is going after the whole thing.

Imricor is changing the way cardiac ablations are done, and aiming to be the only company on the planet that can supply the tools to do it the new way.

The goal is to “upgrade” the X-ray labs to MRI labs, so that it is the only supplier of MRI-safe catheter equipment.

Imricor already has several MRI labs established in Europe, but this was just the pilot rollout.

The real prize is the US Market.

The company expects to have full FDA clearance for its suite of products for atrial flutter available by the end of the year, with market entry in early 2027.

For any investor betting on a medical device on the cusp of commercialisation, one question matters above all others.

Can they sell it?

To answer that for Imricor, you have to understand how they actually go to market. 

It runs in two moves.

FIRST, sell the lab.

Hospitals run their procedures in labs, purpose-built rooms kitted out with everything the operator needs. 

Right now, every single cardiac ablation lab in the US is an X-ray lab. Not one is an MRI lab.

(This is genuinely new technology; the MRI ablation lab didn't exist, so the facilities don't either.)

There are plenty of MRI suites in hospitals, of course… for diagnostic imaging, scanning brains, joints, tumours. 

Just none built to run a cardiac ablation.

Every decade or so, a hospital has to refit these labs. That's Imricor's moment.

Instead of replacing an old X-ray lab with another, Imricor's job is to convince the hospital to install an MRI lab instead.

Once they’re in, they’re in.

THEN, Imricor sells the “picks and shovels”.

These are the single-use catheters used in every procedure performed in that lab. 

Recurring revenues.

The larger the installed footprint, the larger the recurring base.

Imricor is not doing this alone.

It has partnerships with the three largest providers of MRI machines, Philips, Siemens and GE Health.

These partners do the heavy lifting when it comes to convincing the hospitals to change from X-ray machine labs to MRI labs (where they make better margins and better upfront).

I’m always hesitant with distribution as a sales strategy.

There needs to be real synergy between the distributors (Siemens, GE and Phillips) and Imricor’s product.

Otherwise, it will never be sold.

BUT, I think that in this case, the synergies are real. 

Siemens is also a major shareholder of Imricor and sees this opportunity as a way to increase sales of its MRI machines in hospitals.

Once Imricor is in the building, it's all about utilisation. 

More procedures through the MRI lab, more catheter revenue. 

The goal is simple: if there's an ablation to be done in that hospital, make sure it goes through the MRI lab, not the old X-ray one.

That's where Imricor's own sales team earns its keep, training and education on the floor.

But in the end, it comes down to one person: the operator.

The surgeon's preference determines which lab the case goes to.

Lucky for us, I've got a framework for exactly that. 

I’ve enlisted Surgeon Dan again for this section of my Imricor article.

Let's see how it stacks up.

Hi Armchair Army, Surgeon Dan here.

How ablation surgery works is that the surgeon will snake a catheter through your vessels from either your wrist or groin all the way to the heart, and sizzle a bit of tissue and look to see how the heart responds electrically.

The thing with cardiac ablation is that the surgeon can’t really see the burn itself; they only see its effect.

Imricor wants to fix the guesswork involved.

Many surgeons have talked about MRI-based Cath Labs, but they have never existed.

The radiation in X-ray cath labs is real.

We have to wear lead apron shields, which are heavy and uncomfortable. 

(For me, after a full day of lasering stones, I am a sweaty, back-aching mess)

It’s not unbearable (interventionalists have worked in these conditions for decades), but it is not ideal.

What IS unbearable with radiation from X-Ray labs is when it comes to children.

In children's hospitals, radiation is public enemy number one. 

Convincing a parent that an X-ray or CT may be helpful in their child is met by a common response… 

Why not an MRI?

Imricor is changing the script, and no one else is doing this; they have a true first-mover advantage and an intellectual property moat to back it up.

So, let’s see how it stacks up on my Surgeon Scorecard.

Tick.

An MRI-based lab completely eliminates radiation from the equation. 

The amount of radiation administered ranges from about 10 to 20 mSv (millisieverts) and varies with the complexity of the mapping involved. 

One ablation surgery is around 500 to 1000 chest X-rays for a person, or about 5 years of background radiation. 

The reduced recurrence rate hasn’t yet been proven in any head-to-head comparison; it is currently theorised to be due to improved visualisation with the technology used. 

I will be eagerly awaiting the results of the VISABL-AFL trial (and the future VISABL-VT trial) to see what clinical results Imricor can produce.

Imricor states that it will increase case throughput and speed. 

If true, great, another win. 

I think there will be a learning curve. 

However, Imricor’s equipment is designed to look, feel, and function like the tools surgeons already use, and internal trials have shown improved mapping and ablation times.

Even in an emergency during cardiac ablation, the patient would not need to leave the MRI suite because all emergency equipment is MRI-safe (for example, MRI-safe defibrillators).

Adopting the razor-and-razor-blades model (our medical equivalent of picks & shovels) is a tried-and-true approach for medical device companies. 

The 100% revenue from consumables is real and recurring; once you factor in the upfront cost of the machine and software subscription, only a few labs are needed to start generating serious recurring revenue.

The biggest hurdle is fitting out a hospital suite to accommodate interventional cardiac MRI.

This is Imricor’s biggest challenge as it thinks about its commercial launch in the US.

Right now, every cath lab in the US is X-ray-based.

Even if a surgeon WANTED to perform MRI-guided ablation surgeries, they would need the facilities to do so.

How available and accessible these procedures are depends entirely on Imricor’s ability to get hospitals to invest the upfront capital in the infrastructure.

The Bull Case

The main benefit of Imricor’s system is the ability to visualise and process tissue in real time, which improves the experience for surgeons working in the field.

(Particularly when it comes to VT and biopsy, which Imricor has flagged as a potential opportunity).

Also, there is no radiation. 

Which, for cardiologists, is a big health risk mitigated. 

I believe there will be real, meaningful demand within the paediatric space, and it's good to see the company file for consideration of paediatric expansion.

The Bear Case

Shifting the workflow into an MRI suite is a big ask for the hospital, surgeon, and theatre staff.

For the surgeon who has done 1,000 ablation surgeries in an X-ray lab, you’ll need something very convincing to change.

(We like to do things the way we’ve always done)

Surgeon’s Cut

Like any new technology, the question is: Is the juice worth the squeeze?

The answer generally lies in clinical evidence.

While there is a proof-of-concept rollout in Europe right now, I expect that the results of the VISABL-AFL trial (and the future VISABL-VT trial) will have a meaningful impact on answering that question.

A VT ablation can take up to 8 hours, and much of that time is spent mapping (hunting for the targets). 

If Imricor’s VISABL-VT trial can show hours of time savings and lift the success rate from 48% (which is poor), then that would be a meaningful clinical benefit that surgeons would pay attention to.

Alright, Armchair back.

Thanks, Surgeon Dan.

Imricor right now is pre-revenue.

In fact, its current MRI labs, rolled out across several targeted regions in Europe, are being used to gather data for its clinical trial. 

(NOT making money for Imricor… yet)

But the goal is always to leverage Europe to get into the US, because that is where the real prize is.

With each new lab opened in the US, Imricor expects to get between US$500K to US$700K in upfront capital revenue.

Which could lead to US$400,000 in annual recurring revenue (and up to $3M per hospital, depending on utilisation and type of surgeries):

This has always been the blue sky target for the company.

Roll out MRI labs in the US and print cash.

But when Imricor was battling through the European launch during COVID-19, the dream didn’t die, but the liquidity did.

Ceasing to be substantial shareholder notices from Blackrock and Regal… off the back of an exit from the All Ords:

At $15M market cap, with no liquidity and a large burn rate, Imricor was set to dilute itself into oblivion.

After months of grinding and small capital raises without a broker, the company achieved several key milestones and rebuilt market trust.

Just like a Premier League team that gets relegated… and relegated again.

Imricor had to fight its way back with little institutional support.

In the March 2025 S&P DJI quarterly rebalance, Imricor was re-admitted to the All Ordinaries. 

Within a fortnight, the company called a trading halt, went into suspension, and came out the other side having completed an A$70 million capital raise.

The institutions that wouldn't touch it at 11 cents were now writing eight-figure cheques the moment it was index-eligible again.

This is the great irony and opportunity for the retail investor.

Finding those stocks in the lower leagues that have the potential.

… but they are few and far between.

NOW that the stock has liquidity and is cashed up, it’s in a different league altogether.

At $15M, the dream of changing the entire heart surgery industry was outrageous.

They’ll never have enough cash to get there…

But at a $620M market cap with a pro forma cash balance of $108M… that dream seems within reach.

Still, a big moonshot.

But the liquidity, balance sheet and market cap questions that every fund manager asks have now been firmly answered.

A big thank you to Nick Corkill, the VP of Corporate Strategy, for sharing the story with me.

(Honestly, Imricor can be a bit of a complex story to wrap your head around, and Nick has done a great job of streamlining it while also knowing everything inside and out).

See you all tomorrow,

The Armchair Analyst

But first…

Sigma Healthcare (ASX: SIG) has thrown its hat in the ring as a potential buyer of the UK’s Boots. (AFR, SIG)

🪑 This would genuinely be a huge acquisition. If you’ve ever been to London, Boots are everywhere.

Chemist Warehouse is about to launch in the UK. This could be a huge fast track to get there.

Regal Funds Management has sold about half of its shares in the first two trading days of Opthea (ASX: OPT), according to two change-in-substantial-shareholder notices. (OPT, OPT)

🪑 Regal has been a big seller in the market and is price-agnostic (selling for tax-loss reasons). 

I’ve been watching these notices carefully because once Regal is out, that is a big seller off the table.

Looks like there were 166 million shares to go at the end of trading last Thursday (these notices only come out 2 days after the trading). 

Watch this space.

Island Pharmaceuticals (ASX: ILA) will undertake its dose-optimisation study of Galidesivir against Marburg Virus at USAMRIID's BSL-4 containment facilities. (ILA)

Argenica Therapeutics (ASX: AGN) announces the WHO approval of the 'xaranetide' name for its lead neuroprotective drug candidate ARG-007. (AGN)

Micro-X (ASX: MX1) has achieved a $1.6M milestone payment from ARPA-H after completing the critical design review for its Full Body CT program. (MX1)

REPORT: What's behind the rapid rise in virtual menopause care? (Second Opinion) 

🪑 The phrase “pent-up demand” was used about six times in the article. 

A clear sign that the changes to the black box warning on Hormone Replacement Therapy for women last year have improved the outlook for women’s health.

Good signs for Acrux (ACR) (disclosure: I own some as a trading position).

Vitrafy Life Sciences (ASX: VFY) enters a trading halt pending the announcement of an equity capital raising. (VFY)

ImpediMed (ASX: IPD) successfully completed an oversubscribed Share Purchase Plan, raising $2.1M following a $13.2M institutional placement. (IPD)

GSK boosts cancer pipeline with US$11B buyout of Nuvalent Bio. (Biopharma Dive)

AlzeCure Pharma, Eli Lilly partner on Alzheimer's drug, $10M upfront, $1B+ milestones. (Pharma Times)