Core points
Taking the breakthrough of key technologies as an opportunity, the localization rate is expected to be further improved in the future. Electrophysiological surgery is divided into two-dimensional and three-dimensional. Three-dimensional surgery has small radiation, expanded indications and short doctor learning curve. The proportion will rapidly increase to 77% in 2020. Electrophysiological surgery is divided into two steps: mapping and ablation. ① Mapping: ordinary four pole, ten pole and ring mapping conduits can be replaced by domestic ones; High density mapping catheter is monopolized by imported manufacturers (improve mapping speed and modeling accuracy). In terms of equipment, the three-dimensional mapping system has entered the era of electromagnetic fusion, and the total installed capacity in China is expected to be nearly 2000 (domestic 200-300). The domestic products in the multi-functional modules such as magnetic positioning modeling accuracy, pressure sensing module and ice intracardiac ultrasound catheter are insufficient and missing, the source closure of magnetic positioning technology, and the engineers providing services are unwilling to use consumables other than the manufacturer, which have become the reasons for limiting the increase of domestic market share. ② Ablation: according to different energy modes, it can be divided into radiofrequency ablation (mainstream mode), cryoablation and pulse ablation (embryonic stage). In terms of product function, cold saline perfusion can reduce thrombosis, improve output power and increase ablation injury. The technical barrier is not high, and domestic products have been listed. Pressure sensing can ensure the effective adhesion between catheter and myocardial tissue, which is the key to the treatment of atrial fibrillation. Domestic pressure catheter is still under development and is expected to be on the market in 2023. In addition, cryoballoon treatment of atrial fibrillation does not need the help of three-dimensional system and pressure sensing. The proportion of surgery will increase to 12% year by year in 2020. Domestic manufacturers are expected to find another way to treat atrial fibrillation. In the future, breakthroughs in key technologies and product listing may become the driving force for the rapid increase of domestic share.
The high value and high proportion of atrial fibrillation have become an indisputable place, and the power of domestic products still needs to be further improved. In terms of indications, supraventricular tachycardia, atrial fibrillation and ventricular tachycardia are the main types of surgery for arrhythmias. In 2020, the number of operations for atrial fibrillation is 82000, supraventricular tachycardia is 99000 and ventricular tachycardia is expected to be 45000. From the perspective of hospital operation cost, atrial fibrillation is 80000-100000, supraventricular tachycardia is 35000, and ventricular tachycardia is 45000. The high cost of atrial fibrillation comes from the use of high-value products (high-density mapping and magnetic localization pressure induction ablation). Atrial fibrillation accounts for more than half of the electrophysiological market, and because the incidence of atrial fibrillation is positively correlated with aging, the proportion will be further expanded in the future. Due to the immature 3D system technology and the lack of pressure sensing products, China cannot enter the atrial fibrillation market at present. After the technical breakthrough in the next 2-3 years, the localization rate is expected to be further improved. Supraventricular tachycardia is more dependent on doctors’ electrophysiological knowledge, and the number of domestic operations is relatively high. Due to the high radical cure rate, the growth of operation volume is relatively gentle. The introduction of three-dimensional system is of great benefit to ventricular early mapping, with high growth rate of surgical volume and simple surgical consumables. The electrophysiological permeability is low. Considering centralized mining, the long-term market space can reach 18.5 billion yuan. In 2020, the market scale of electrophysiology will be 5.2 billion yuan, with a compound growth rate of 28%. We expect that there will be no centralized purchase in the short term. Centralized purchase may be carried out by category in 3-6 years. With reference to similar pacemakers, the price reduction range is 40-60%. In terms of penetration rate, the penetration rate of electrophysiological surgery in China is less than 1%, which is 1 / 7 of that in the United States. Considering centralized mining, the long-term market space is expected to reach 18.5 billion yuan.
Apt Medical Inc(688617) featuring mapping catheter, minimally invasive electrophysiology focuses on the sales of a full set of self owned products. Imported manufacturers include Johnson & Johnson, Abbott, Medtronic and Boston science, while domestic manufacturers include Apt Medical Inc(688617) , minimally invasive electrophysiology, xinnuop (puncture needle and sheath), Jinjiang Electronics (equipment), etc. ① Apt Medical Inc(688617) : mapping catheters account for a high proportion of revenue. Decapolar coronary sinus mapping catheters have high recognition and market share in the market. The three-dimensional system was launched in 2021. Previously, there was no own system, and consumables were mainly sold together with equipment and consumables of other manufacturers. ② Minimally invasive electrophysiology: the three-dimensional system has been on the market for 5 years, focusing on the sales of a full set of self owned products (three-dimensional system, mapping catheter and ablation catheter). The total sales volume of minimally invasive catheter is half of that of huitai; The price of mapping catheter and two-dimensional ablation catheter is close to that of huitai, and the added value of three-dimensional ablation catheter is high. The revenue of the two domestic companies in the field of electrophysiology is close, about 150 million yuan in 2020.
Risk warning: the research and development of pressure conduit is not as expected; Foreign companies in China are not fully comparable, and the relevant materials and data of benchmarking are only for reference; Risk of excessive price reduction of centralized purchase; The research and development of electromagnetic fusion technology is less than expected; The survey data are not representative of the industry, and the relevant data are only for reference; Uncertainty of long-term permeability; Focus on the company’s performance less than expected.
