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LivaNova

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FY2023 Annual Report · LivaNova
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2023 UK Annual Report 

2023 UK Annual Report 

DEFINITIONS
In  this  LivaNova  PLC  2023  UK  Annual  Report,  the  following  terms  and  abbreviations  have  the  meanings  listed  below. 
“LivaNova,” the “Company,” and “Group,” “we,” “us” and “our” refer to LivaNova PLC and its consolidated subsidiaries. 

Abbreviation
2015 Plan
2021 First Lien Credit 
Agreement

Definition
LivaNova PLC 2015 Incentive Award Plan
First  Lien  Credit  Agreement  for  $125  million  between  LivaNova  PLC  and  its  wholly-owned 
subsidiary, Borrower, and Goldman Sachs Bank USA, as First Lien Administrative Agent and First 
Lien Collateral Agent, entered into on 13 August 2021
The year ended 31 December 2022
LivaNova PLC 2022 Incentive Award Plan
The year ended 31 December 2023
2023 Long-Term Incentive Plan
2023 Short-Term Incentive Plan
2024 Annual General Meeting
2024 Long-Term Incentive Plan

2022
2022 Plan
2023
2023 LTIP
2023 STIP
2024 AGM
2024 LTIP
2024 Restructuring Plan A  plan,  initiated  in  2024,  to  enhance  LivaNova’s  focus  on  its  core  Cardiopulmonary  and 

2025 Capped Calls

2025 Indenture
2025 Notes

2029 Capped Calls

2029 Indenture
2029 Notes

A&R 2022 Plan
ACS
Aggressive Climate 
Action
AGM
ALung
Annual Report
AOCI
APAC
ASMs
Audit Committee
Auditor
Barclays
BEPS
Board
Borrower
Bridge Loan Facility

Capped Call 
Transactions
CARES Act
CCPA
CE Mark
CECs
CED
CEO
CFD
CFO

Neuromodulation segments
Privately negotiated capped call transactions entered into with certain of the initial purchasers of the 
2025 Notes or their respective affiliates
The indenture governing the 2025 Notes
$287.5  million  aggregate  principal  amount  of  3.00%  senior  notes  due  December  2025,  issued  June 
17, 2020
Privately negotiated capped call transactions entered into with certain of the initial purchasers of the 
2029 Notes and another financial institution, or their respective affiliates
The indenture governing the 2029 Notes
$345  million  aggregate  principal  amount  of  2.50%  senior  notes  due  March  2029,  issued  March  8, 
2024
Amended and Restated LivaNova PLC 2022 Incentive Award Plan
Advanced Circulatory Support
Scenario with a 1.5°C increase in global average temperatures above pre-industrial levels

Annual General Meeting
ALung Technologies, Inc.
2023 UK Annual Report
Accumulated other comprehensive income
Asia-Pacific
Anti-seizure medications
LivaNova’s Audit and Compliance Committee
Statutory Auditor
Barclays Bank Ireland PLC
Base Erosion and Profit Shifting
LivaNova Board of Directors
LivaNova USA, Inc.
Incremental Facility Amendment No. 1 to the 2021 First Lien Credit Agreement, relating to a €200 
million bridge loan facility, dated 24 February 2022, and repaid on 6 July 2022
The 2025 Capped Calls and the 2029 Capped Calls

Coronavirus Aid, Relief and Economic Security Act
California Consumer Privacy Act
Conformité Européenne, French for “European Conformity”
Comprehensive Epilepsy Centers
Coverage with Evidence Development
Chief Executive Officer
UK Climate-related Finance Disclosure
Chief Financial Officer

2023 UK Annual Report 

Abbreviation
CGU
CHCM Committee
CISO
CLO
CMS
CO2e

Code of Conduct
CODM
Companies Act 2006
Convertible Notes 
Measurement Period
Court of Appeal
CPAP
CPB
CRO
Current Climate Action
Cyberonics
D.S.O.
D23 study

DEFRA
Delayed Draw Term 
Facility
DRE
DSMC
DTC
DTD
E&I
EBT
ECJ
ECMO
EIR
ELT
EPA
EPS
ESG
ESPP
EtO
EU
False Claims Act
FCF
FCPA
FDA
FIFO
FX
GAAP
GDPR
GHG
Hemolung RAS
HHS
HIPAA

Definition
Cash generating unit
Compensation and Human Capital Management Committee
Chief Information Security Officer
Chief Legal Officer
The US Centers for Medicare & Medicaid Services
The number of metric tons of carbon dioxide emissions with the same global warming potential as 
one metric ton of another greenhouse gas
LivaNova PLC’s Code of Ethics and Business Conduct
Chief Operating Decision Maker
Companies Act 2006 of England and Wales
The five business day period after any ten consecutive trading day period

Court of Appeal in Milan
Continuous positive airway pressure
Cardiopulmonary bypass
Chief Risk Officer
“Business-as-usual” scenario indicating a continuation of current warming trends
Cyberonics, Inc.
Days of sales outstanding
The longest and largest naturalistic study on treatments for patients experiencing chronic and severe 
DTD, published by the American Journal of Psychiatry in 2017
UK Department for Environment, Food and Rural Affairs
$50 million delayed draw term facility under the 2021 First Lien Credit Agreement resulting from the 
Incremental Facility Amendment No. 2
Drug-resistant epilepsy
Data and Safety Monitoring Committee
Depository Trust Company
Difficult-to-treat depression
Ethics and Integrity
Employee Benefit Trust
European Court of Justice
Extracorporeal membrane oxygenation
Effective interest rate
Executive Leadership Team
US Environmental Protection Agency
Earnings per share
Environmental, Social and Governance
Global Employee Share Purchase Plan
Ethylene oxide
European Union
US False Claims Act
Free Cash Flow
US Foreign Corrupt Practices Act of 1977
US Food and Drug Administration
First-in-first-out
Foreign currency exchange rate
Generally Accepted Accounting Principles
General Data Protection Regulation
Greenhouse Gas
Hemolung Respiratory Assist System
The US Department of Health & Human Services
Health Insurance Portability and Accountability Act of 1996

2023 UK Annual Report 

Abbreviation
HITECH
HLM
HSE
IBR
IEA
IFRS
ILBM
ImThera

Incremental Facility 
Amendment No. 2
Incremental Facility 
Amendment No. 3
Incremental Revolving 
Facility

Indentures
Initial Term Facility

IPCC
IPR&D
IS
ISDA
ISIN

ISMS
ISO
IT
KPIs
LivaNova PLC
LivaNova USA
LSM
MDD
MDR
Merger
Mitral
MRI
Nasdaq
NCD
NCG
NED
NIST
NOLs
NOPAT
Note Repurchases

Notes
OCI
OECD
Option Counterparties

Definition
Health Information Technology and Clinical Health Act
Heart-lung machine
Health, Safety and Environment
Incremental borrowing rate
International Energy Agency
UK-adopted International Accounting Standards
In-line blood monitor
ImThera  Medical,  Inc.,  acquired  by  LivaNova  in  2018,  a  company  developing  an  implantable 
neurostimulation device system for the treatment of obstructive sleep apnea
An incremental facility amendment to the 2021 First Lien Credit Agreement, dated 6 July 2022

An incremental facility amendment to the 2021 First Lien Credit Agreement, dated 8 March 2024

The Incremental Facility Amendment No. 3 provides for LivaNova USA, Inc. to, among other things, 
obtain commitments for a new revolving facility from a syndicate of lenders in an aggregate principal 
amount of $225 million
The 2025 Indenture and the 2029 Indenture
$225  million  revolving  facility  under  the  2021  First  Lien  Credit  Agreement  resulting  from  the 
Incremental Facility Amendment No. 3
Intergovernmental Panel on Climate Change
In-Process Research and Development
Information security
International Swaps and Derivatives Association, Inc.
National Inspectorate for Nuclear Safety and Radiation Protection, a sub-body of the Italian Ministry 
of Economic Development
Information Security Management System
International Organization for Standardization
Information technology
Key performance indicators
A public limited company organized under the laws of England and Wales on 20 February 2015
LivaNova USA, Inc.
LivaNova Site Management S.r.l.
Medical Device Directive
EU Medical Device Regulation
Business combination of Cyberonics and Sorin
Mitral Holdco S.à r.l.
Magnetic resonance imaging
Nasdaq Global Market
Non-coverage determination
Nominating and Corporate Governance

Non-executive director
National Institute of Standards and Technology
Net operating loss carryforwards
Net operating profit after taxes
The  transaction  by  which  LivaNova  USA,  Inc.,  entered  into  separate  and  individually  negotiated 
transactions with certain holders of LivaNova USA, Inc.’s existing Cash Exchangeable Senior Notes, 
issued  by  LivaNova  USA,  Inc.  and  guaranteed  by  LivaNova,  to  repurchase  $230  million  aggregate 
principal  amount  of  the  Cash  Exchangeable  Senior  Notes  for  an  aggregate  cash  amount  of 
approximately $270.5 million (including accrued and unpaid interest)
The 2025 Notes and the 2029 Notes
Other comprehensive income
Organization for Economic Co-operation and Development
Certain financial institutions with whom LivaNova USA or LivaNova PLC, as applicable, has entered 
into the 2025 Capped Calls and 2029 Capped Calls

2023 UK Annual Report 

Definition
Administrative order from the Italian Ministry of the Environment received by LivaNova in 2021
Obstructive sleep apnea
LivaNova’s  clinical  trial,  “Treating  Obstructive  Sleep  Apnea  using  Targeted  Hypoglossal 
Neurostimulation”
Pearl Meyer & Partners, LLC
OECD BEPS Pillar Two
Qualified Plan Committee
Pre-market approval
Property, plant and equipment
Performance stock units
The Italian Ministry of the Environment and other Italian government agencies
Research and Development
LivaNova’s  clinical  study  “A  Prospective,  Multi-center,  Randomized  Controlled  Blinded  Trial 
Demonstrating the Safety and Effectiveness of VNS Therapy System as Adjunctive Therapy Versus a 
No Stimulation Control in Subjects With Treatment-Resistant Depression”
UK remuneration policy
Return on Invested Capital
Right-of-use
Restricted share
Service-based restricted share units
Relative Total Shareholder Return
Standard & Poor’s
Service-based stock appreciation rights
UK Stamp Duty Reserve Tax
US Securities and Exchange Commission
Streamlined Energy and Carbon Reporting
US Securities Act of 1933, as amended
Settlement agreement between LivaNova and Mr. Damien McDonald, dated 14 April 2023
Selling, general and administrative expenses
SNIA S.p.A.
A first demand bank guarantee of €270.0 million in connection with the SNIA litigation

Secured Overnight Financing Rate
Sorin S.p.A.
The spin-off of Sorin from SNIA in 2004
ESG Steering Committee
The Initial Term Facility, together with the Delayed Draw Term Facility
Trattamento di Fine Rapporto
Third Party Code of Ethics and Business Conduct

LivaNova PLC Employee Benefit Trust
Total Shareholder Return
United Kingdom
Finance (No.2) Act 2023
UK Bribery Act of 2010
United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards, 
comprising FRS 101 “Reduced Disclosure Framework”)

United States of America
Accounting principles generally accepted in the US
Generally Accepted Accounting Principles in the US
US dollar
Undertaxed profits rule

Abbreviation
Order
OSA
OSPREY clinical trial

Pearl Meyer
Pillar Two
Plan Committee
PMA
PP&E
PSUs
Public Administrations
R&D
RECOVER clinical 
study

Remuneration Policy
ROIC
ROU
RS
RSUs
rTSR
S&P
SARs
SDRT
SEC
SECR
Securities Act
Settlement Agreement
SG&A
SNIA
SNIA Litigation 
Guarantee
SOFR
Sorin
Sorin spin-off
SteerCo
Term Facilities
TFR
Third Party Code of 
Conduct
Trust
TSR
UK
UK Act
UK Bribery Act
United Kingdom 
Accounting Standards, 
comprising FRS 101
US
US GAAP
US GAAP
USD
UTPR

2023 UK Annual Report 

Abbreviation
VNS
VNS Therapy
VP LL
WACC

Definition
Vagus nerve stimulation
LivaNova Vagus Nerve Stimulation Therapy
Vice President, Legal Leader, Corporate & Securities
Weighted average cost of capital

This Annual Report of LivaNova PLC comprises the Strategic Report, Directors’ Report, Remuneration Report, and the 
LivaNova  PLC  consolidated  Financial  Statements  prepared  in  accordance  with  UK-adopted  international  accounting 
standards and the Company financial statements in accordance with United Kingdom Accounting Standards, comprising 
FRS 101 and applicable law), in respect of the year ended 31 December 2023 contained herein.

This Annual Report has been prepared to satisfy the reporting requirements of the Companies Act 2006 and will be included in the 
2024 AGM materials made available to shareholders.

Cautionary Statement

Certain statements made in this Annual Report are forward looking. Such statements are based on current expectations and are 
subject to a number of risks and uncertainties that could cause actual results to differ materially from any expected future events or 
results  referred  to  in  the  forward-looking  statements.  Unless  otherwise  required  by  applicable  laws,  regulations  or  accounting 
standards, LivaNova does not undertake any obligation to update or revise any forward-looking statements, whether as a result of 
new information, future developments or otherwise. Nothing in this Annual Report should be regarded as a profit forecast.

Trademarks

These trademarks and trade names are the property of LivaNova or the property of its consolidated subsidiaries and are protected 
under applicable intellectual property laws. Solely for convenience, the Company’s trademarks and tradenames referred to in this 
Annual Report may appear without the ™ symbol, but such references are not intended to indicate in any way that the Company 
will not assert, to the fullest extent under applicable law, the Company’s rights to these trademarks and tradenames.

• Trademarks  for  the  Company’s  Neuromodulation  systems,  the  VNS  Therapy™  System,  the  VITARIA™  System  and  our 
proprietary pulse generator products: Model 102 (Pulse™), Model 102R (Pulse Duo™), Model 103 (Demipulse™), Model 104 
(Demipulse  Duo™),  Model  106  (AspireSR™),  Model  1000  (SenTiva™),  Model  1000-D  (SenTiva™  Duo),  Model  7103 
(VITARIA™ and TitrationAssist™) and Model 8103 (Symmetry™).

• Trademarks  for  our  Cardiopulmonary  product  systems:  Essenz™,  S5™,  S3™,  S5  Pro™,  B-Capta™,  Inspire™,  Heartlink™, 

XTRA™, 3T Heater-Cooler™, Connect™ and Revolution™.

• Trademarks  for  our  advanced  circulatory  support  systems:  TandemLife™,  TandemHeart™,  TandemLung™,  ProtekDuo™, 

LifeSPARC™, ALung™, Hemolung™, Respiratory Dialysis™ and ActivMix™.
• Trademarks for our obstructive sleep apnea system: ImThera™ and aura6000™.

STRATEGIC REPORT

TABLE OF CONTENTS

Introduction      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Business Overview      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Our Global Business Model       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Neuromodulation     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cardiopulmonary     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Advanced Circulatory Support      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Our Strategy: Overview of 2023 and Looking to 2024     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Human Capital Management    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Non-Financial Reporting Measures    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ethics and Integrity       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sustainability    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2023 Greenhouse Gas Report    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Government Regulation and Other Considerations   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Industry Affiliations       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Business Review      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Introduction       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Key Performance Indicators     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Results of Operations      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Liquidity and Capital Resources    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Debt and Capital     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contractual Obligations     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Market Risk      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Risks and Uncertainties    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Our Approach to Stakeholders      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DIRECTORS' REPORT
REMUNERATION REPORT

Statement from the Chair of the Compensation Committee       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How We Establish Executive Compensation Levels      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2023 Remuneration Report    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FINANCIAL STATEMENTS

Independent Auditor’s Report on Group Financial Statements     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Table of Contents: Consolidated Financial Statements    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Consolidated Statement of (Loss)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Consolidated Statement of Comprehensive Income     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Consolidated Balance Sheet     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Consolidated Statement of Changes in Equity     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Consolidated Statement of Cash Flows   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Notes to the Consolidated Financial Statements       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Table of Contents: Parent Company     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Company Statement of Income     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Company Statement of Comprehensive Income       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Company Balance Sheet        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Company Statement of Changes in Equity      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Notes to the Company Financial Statements   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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STRATEGIC REPORT
Business Overview

STRATEGIC REPORT

Business Overview

Our Global Business Model

LivaNova PLC is a market-leading global medical technology company. The Company designs, develops, manufactures, markets 
and  sells  products  and  therapies  that  are  consistent  with  LivaNova’s  mission  to  provide  hope  for  patients  and  their  families 
through  innovative  medical  technologies  that  deliver  life-changing  improvements.  LivaNova  is  a  public  limited  company 
organized under the laws of England and Wales and is headquartered in London, England. LivaNova’s ordinary shares are listed 
for trading on the Nasdaq under the symbol “LIVN.”

For the periods presented herein, LivaNova was comprised of three reportable segments: Cardiopulmonary, Neuromodulation and 
ACS. “Other” includes non-allocated corporate expenses for the years ended 31 December 2022 and 31 December 2023. For the 
year ended 31 December 2021, “Other” also includes the results of LivaNova’s Heart Valve business, which was divested on 1 
June 2021.

During  the  first  quarter  of  2024,  the  Company  reorganised  its  operating  and  reporting  structure  upon  initiating  the  2024 
Restructuring Plan as further described below. In 2024, LivaNova’s ACS segment will be included within “Other,” excluding the 
ACS standalone cannulae and accessories business, which will be included within the Cardiopulmonary reportable segment.

Neuromodulation 

LivaNova’s Neuromodulation segment is engaged in the design, development, manufacture, marketing and selling of devices that 
deliver neuromodulation therapy for treating DRE and DTD. LivaNova’s principal Neuromodulation product, the VNS Therapy 
System,  consists  of  an  implantable  pulse  generator  and  connective  lead  that  stimulates  the  vagus  nerve;  surgical  equipment  to 
assist  with  the  implant  procedure;  equipment  and  instruction  manuals  enabling  a  treating  physician  to  set  parameters  for  a 
patient’s pulse generator; and for epilepsy, magnets to manually suspend or induce nerve stimulation. The lead does not need to be 
removed to replace a generator with a depleted battery.

The Neuromodulation segment is also engaged in the development and management of clinical testing for LivaNova’s aura6000 
System  for  treating  OSA.  The  aura6000  device  stimulates  the  hypoglossal  nerve,  which  engages  specific  tongue  and  palate 
muscles to open the airway while a patient sleeps.

LivaNova’s Neuromodulation segment also includes costs associated with the Company’s former Heart Failure program, which 
the Company began winding down during the first quarter of 2023.

Epilepsy

There are several broad types of treatment available to patients with epilepsy: multiple ASMs; various forms of the ketogenic diet; 
VNS; resective and ablative brain surgery; and intracranial neurostimulation. ASMs typically serve as a first-line treatment and 
are  prescribed  for  virtually  all  patients  diagnosed  with  epilepsy.  After  two  ASMs  fail  to  deliver  seizure  control,  the  epilepsy  is 
characterized as drug-resistant. At this point, adjunctive non-drug options are considered, including VNS therapy, ketogenic diet, 
resective or ablative surgery and other neuromodulation therapies.

In 1997, LivaNova’s VNS Therapy System was the first medical device treatment approved by the FDA for the treatment of DRE, 
and  today  is  the  only  neuromodulation  device  approved  for  use  in  the  US  in  DRE  patients  as  young  as  four  years  of  age  with 
partial  onset,  or  focal,  seizures.  Other  worldwide  regulatory  bodies  have  also  approved  the  VNS  Therapy  System  for  treating 
patients with DRE, many without age or seizure-type restrictions. In 2020, CMS expanded reimbursement for VNS Therapy use 
in  the  treatment  of  Dravet  Syndrome  and,  in  January  2022,  expanded  reimbursement  for  VNS  Therapy  use  in  the  treatment  of 
Lennox-Gastaut Syndrome.

LivaNova distributes multiple VNS Therapy Systems for the treatment of epilepsy, including Model 103 (Demipulse), Model 104 
(Demipulse Duo), Model 106 (AspireSR), Model 1000 (SenTiva) and Model 1000D (SenTiva Duo) pulse generators. LivaNova’s 
AspireSR and SenTiva generators provide the traditional benefits of VNS Therapy but add an additional stimulation capability: 
closed loop stimulation (AutoStim) which responds to detection of changes in heart rate potentially indicative of a seizure. The 
SenTiva generator is the smallest and lightest VNS device capable of delivering responsive therapy for epilepsy and includes the 
additional flexibility of LivaNova’s Scheduled Programming and Day & Night Programming capabilities. In 2017, the SenTiva, 
AspireHC  and  AspireSR  VNS  Therapy  devices  were  approved  by  the  FDA  for  expanded  MRI  access  and  similar  CE  Mark 
approval followed shortly thereafter.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________1

STRATEGIC REPORT
Business Overview

Depression

In 2005, the FDA approved the VNS Therapy System for the adjunctive treatment of chronic or recurrent depression for patients 
18  years  or  older  who  are  experiencing  a  major  depressive  episode  and  have  not  had  an  adequate  response  to  four  or  more 
antidepressant treatments. In 2007, CMS issued a non-coverage determination with respect to reimbursement of the VNS Therapy 
System  for  patients  with  DTD,  significantly  limiting  access  for  most  patients.  In  2020,  LivaNova’s  VNS  Therapy  System, 
Symmetry received CE mark approval for the treatment of DTD.

In 2017, the American Journal of Psychiatry published the results of the longest and largest naturalistic study on treatments for 
patients experiencing chronic and severe DTD. The findings showed that the addition of the VNS Therapy System to traditional 
treatment was effective in significantly reducing symptoms of depression and well-tolerated compared with traditional treatment 
alone. Following publication of the D23 study, LivaNova requested that CMS reconsider its previous NCD, and in 2018, CMS 
published a tracking sheet to reconsider.

In  2019,  CMS  produced  a  final  decision  providing  coverage  for  the  VNS  Therapy  System  for  Medicare  beneficiaries  through 
CED when offered in a CMS-approved, double-blind, randomized, placebo-controlled trial with a follow-up duration of at least 
one year, as well as coverage of VNS Therapy System device replacement. The CED also includes the possibility to extend the 
study to a prospective longitudinal registry.

In  2019,  CMS  accepted  the  protocol  for  LivaNova’s  RECOVER  clinical  study  and  the  first  patient  was  enrolled.  RECOVER 
includes 500 unipolar and up to 500 bipolar patients at a maximum of 100 sites in the US in the randomized part of the trial and 
may include up to an additional 5,800 patients in an open label registry.

In March 2023, LivaNova randomized the 500th unipolar depression patient into the RECOVER clinical study and subsequently 
completed all unipolar implants in May. Upon receipt of the 12-month follow-up data for all 500 patients, the Company expects to 
conduct a final analysis for the unipolar cohort, potentially culminating in publication of the study results for that cohort.

In  June  2023,  LivaNova  randomized  the  150th  bipolar  depression  patient  into  the  RECOVER  clinical  study.  The  RECOVER 
clinical study’s protocol allows for a minimum of 150 and a maximum of 500 bipolar depression patients to be randomized into 
the study. Upon randomizing the 150th bipolar patient, a series of interim analyses are being conducted every 25 patients by an 
independent Statistical Analysis Committee to assess if predictive probability of success has been reached for the bipolar cohort of 
the study. If any analysis reveals that the predictive probability of success has been reached, recruitment into the bipolar arm of 
the study will cease and LivaNova will notify CMS and initiate the prospective open-label longitudinal study for future bipolar 
Medicare patients. After the last patient enrolled into the RECOVER clinical study has completed 12 months of follow- up, a final 
analysis will be conducted on the complete bipolar dataset.

The RECOVER clinical study, if successful, may potentially be used to support a peer-reviewed publication and reconsideration 
of  reimbursement  for  the  VNS  Therapy  System  by  CMS  for  the  treatment  of  DTD.  The  reconsideration  process  will  happen 
independently for the unipolar and bipolar cohorts.

Obstructive Sleep Apnea

In 2018, LivaNova acquired full ownership of ImThera, a company developing an implantable neurostimulation device system for 
the treatment of obstructive sleep apnea. The device stimulates the hypoglossal nerve, which engages specific tongue and palate 
muscles to open the airway while a patient sleeps.

In  2021,  LivaNova  received  approval  from  the  FDA  to  proceed  with  its  investigational  device  exemption  clinical  study,  the 
OSPREY clinical trial, and the first patient was implanted in March 2022. The OSPREY clinical trial seeks to confirm the safety 
and effectiveness of the aura6000 System. In March 2024, the Company announced that the OSPREY clinical study had achieved 
a  positive  predictive  outcome  and  would  conclude  enrollment  sooner  than  expected.  This  means  there  is  a  greater  than  97.5% 
probability that the OSPREY trial will successfully meet its primary endpoint. 

Heart Failure

The VITARIA System was intended to treat heart failure through VNS. In 2018, after completion of pilot studies outside the US, 
the  Company  announced  the  first  successful  implantation  of  the  VITARIA  System  in  a  patient  randomized  in  the  ANTHEM-
HFrEF clinical trial, an international, multi-center, randomized trial (adaptive sample size) to evaluate the VITARIA System for 
the treatment of advanced heart failure. During the fourth quarter of 2022, the Company randomized the 500th patient in the trial 
which triggered the second interim analysis. The independent DSMC evaluated safety, a trend toward the primary endpoint and 
success  in  three  functional  endpoints.  This  analysis  determined  that  the  US  FDA  early  filing  conditions  were  not  met,  and  the 
DSMC recommended that enrollment continue in accordance with the current study protocol. However, the Company conducted 
further  evaluation  of  the  study  data  and  concluded  that  such  data  did  not  demonstrate  a  sufficiently  strong  positive  impact  on 
functional or mortality endpoints and that it was unlikely that the continuation of the study would demonstrate such an impact. As 
a result, on 22 February 2023, LivaNova announced that the Company is stopping enrollment in the ANTHEM-HFrEF clinical 
trial, beginning the process to close the clinical study and winding down the heart failure programme.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________2

STRATEGIC REPORT
Business Overview

Cardiopulmonary

LivaNova’s  Cardiopulmonary  segment  is  engaged  in  the  design,  development,  manufacture,  marketing  and  selling  of 
cardiopulmonary products, including HLMs, oxygenators, autotransfusion systems, perfusion tubing systems, cannulae and other 
related  accessories.  It  includes  the  Essenz  Perfusion  System,  the  Company’s  next-generation  HLM  with  an  embedded  patient 
monitor for tailored patient care strategies and sensing technology for data-driven decision making during CPB procedures.

CPB  is  commonly  used  in  many  operations  involving  the  heart.  This  technique  enables  the  surgical  team  to  oxygenate  and 
circulate  the  patient’s  blood,  thus  enabling  the  surgeon  to  operate  on  the  heart.  The  most  commonly  performed  procedures 
requiring  CPB  are  conventional  coronary  artery  bypass  grafting  and  valve  surgeries.  LivaNova’s  products  enable  CPB  for 
neonatal, pediatric, and adult patients.

Heart-lung Machines

The  HLM  product  group  includes  HLMs,  heater-coolers,  related  cardiac  surgery  equipment  and  maintenance,  and  technical 
services. HLMs temporarily take over the work of the heart and/or lungs, providing blood and oxygen to the body. HLMs are most 
often  used  during  procedures  that  require  the  heart  to  be  stopped.  Heater-coolers  are  used  during  surgeries  to  warm  or  cool 
patients as part of their care. They are especially important during surgeries involving the heart and lungs.

In March 2023, LivaNova announced it had received FDA 510(k) clearance for its Essenz HLM, which enabled the commercial 
launch of Essenz in the US. In the same month, LivaNova also initiated a broad commercial release of Essenz in Europe following 
a  successful  limited  commercial  release  that  supported  more  than  200  adult,  pediatric  and  neonatal  patients  in  that  region. 
Approvals in various other countries have followed.

In August 2023, LivaNova announced it had received FDA 510(k) clearance and CE Mark for its Essenz ILBM, which provides 
continuous measurement of essential blood parameters to perfusionists throughout CPB procedures. The ILBM is integrated into 
the Essenz Perfusion System, which enables perfusionists to access and manage reliable blood parameters without the need for 
additional monitors or holders.

Oxygenators and Perfusion Tubing Systems

The oxygenators product group is comprised of disposable devices for extracorporeal circulation, including the Inspire systems. 
The Inspire range of products is comprised of 12 models that provide perfusionists with a customizable approach for the benefit of 
patients. Oxygenators exchange oxygen and carbon dioxide in the blood of patients during surgical procedures and are utilized by 
perfusionists during cardiac surgery in conjunction with a HLM and can also be utilized in ECMO.

Autotransfusion Systems

One of the key elements for a complete blood management strategy is autologous blood transfusion. The autotransfusion product 
group facilitates the collection, processing and reinfusion of the patient’s own blood lost at the surgical site.

Cannulae

The cannulae product group in the Cardiopulmonary segment is used to connect the extracorporeal circulation system to the heart 
of  the  patient  during  cardiac  surgery.  During  the  first  quarter  of  2024,  as  a  result  of  the  2024  Restructuring  Plan  as  further 
described below, the Company will transition all ACS standalone cannulae and accessories, including ProtekDuo and transseptal 
(TandemHeart) cannulae, into its Cardiopulmonary segment. The ACS cannulae are designed and used for temporary unloading of 
the right ventricle, for supporting the left ventricle and for connecting ECMO systems.

Advanced Circulatory Support 

LivaNova’s ACS segment was engaged in the design, development, manufacture, marketing and selling of temporary life support 
products.  ACS’s  products,  which  comprise  the  LifeSPARC  and  Hemolung  systems,  and  standalone  cannulae  and  accessories, 
including  ProtekDuo  and  transseptal  (TandemHeart)  cannulae,  simplify  temporary  extracorporeal  cardiopulmonary  life  support 
solutions for critically ill patients.

On 5 January 2024, the Board of Directors of LivaNova PLC approved the 2024 Restructuring Plan to enhance the Company’s 
focus on its core Cardiopulmonary and Neuromodulation segments. The main component of this plan is to wind down the ACS 
segment, which the Company anticipates will be substantially complete by the end of 2024. During the first quarter of 2024, the 
Company reorganized its operating and reporting structure upon initiating the 2024 Restructuring Plan and transitioned all ACS 
standalone  cannulae  and  accessories,  including  ProtekDuo  and  transseptal  (TandemHeart)  cannulae,  into  its  Cardiopulmonary 
segment. Operations for other ACS products, including LifeSPARC and Hemolung systems, will be discontinued by the end of 
2024. For additional information, please refer to “Note 8. Restructuring” in LivaNova’s consolidated financial statements included 
in this Report.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________3

STRATEGIC REPORT
Business Overview

Our Strategy: Overview of 2023 and Looking Forward to 2024

In  2023,  the  Company  achieved  double-digit  growth  in  both  revenue  and  adjusted  operating  income.  This  performance  was 
achieved while investing in critical capabilities for the Company including manufacturing infrastructure and IT modernization as 
well as managing the impact to business operations as a result of the cybersecurity incident. The Company also took actions to 
conclude  the  heart  failure  clinical  program  and  the  wind  down  of  the  ACS  segment.  Both  actions  will  result  in  a  positive 
contribution  to  adjusted  operating  income  in  2024  and  allow  the  Company  to  dedicate  additional  focus  to  the  core 
Cardiopulmonary segment and Epilepsy business.

Core Businesses

LivaNova’s  core  businesses  include  Epilepsy,  the  primary  driver  of  the  Neuromodulation  segment,  as  well  as  the 
Cardiopulmonary segment. The markets for these segments are significant and growing, and the Company has strong leadership 
positions in both. To drive value in 2023, the Company focused on advancing its leadership positions and generating consistent, 
profitable revenue growth in Epilepsy and Cardiopulmonary.

Epilepsy

In the U.S., the Company has made progress on its goal to build VNS Therapy treatment pathways in both CECs and community 
health  systems  to  improve  patient  access  to  care,  drive  physician  advocacy  and  cultivate  networks  of  health  systems  to  deliver 
VNS Therapy. In 2023, this progress resulted in revenue and total patient implant growth.

The Company’s distinct focus on CECs forms the core of the Company’s commercial strategy, whereby the Company utilizes a 
multidisciplinary  team  approach  to  meet  the  varied  needs  of  these  large  customer  segments.  This  approach  involves  utilizing 
dedicated teams who deliver improved outcomes by bringing expertise in the areas of clinical research, education and training, 
and community outreach.

The Company’s mission for this business is to drive greater awareness of all surgical interventions, including VNS Therapy, as a 
treatment option for DRE, versus cycling through drugs. To achieve its mission, the Company is expanding its partnerships with 
its physician base, including its first scientific advisory meeting in February 2024. The Company believes that it can build upon its 
leadership position to deliver sustainable profitable growth.

Cardiopulmonary

In 2023, LivaNova’s Cardiopulmonary segment delivered strong revenue growth, reflecting the post-pandemic recovery of cardiac 
procedures and increased capital placements. The Company also gained market share in its disposable products, benefiting from 
competitor  quality  and  supply  challenges.  Notably,  in  2023,  the  Company  launched  its  next  generation  HLM,  the  Essenz 
Perfusion System, in the U.S. and in Europe. Capitalising on its user-centric design approach, the Essenz system was developed to 
modernize  the  practice  of  perfusion.  The  new  device  enables  users  to  more  easily  tailor  patient  care  strategies  and  supports 
continuous improvement of clinical practice. The system is based on a near 50-year legacy of proven safety and reliability. The 
Essenz Perfusion System comprises the next generation HLM, a comprehensive range of sensing technology, the intuitive Essenz 
patient monitor, and a service offering. The launch of Essenz meaningfully contributed to revenue growth in the Cardiopulmonary 
segment in 2023.

In 2024, LivaNova will continue the roll-out of Essenz to drive growth for the Cardiopulmonary segment. The Company estimates 
that approximately one-third of its installed base of 7,000 units are past their average lifetime use of approximately 10 years. The 
Company  is  initially  targeting  these  older  systems  in  the  U.S.  and  in  Europe  with  particular  emphasis  on  large  accounts.  The 
Company  is  encouraged  by  the  Essenz  launch  so  far  and  has  been  successful  in  both  evaluations  and  placements  including 
shipments to highly prestigious hospital systems. 

Strategic Portfolio Initiatives

The foundation of the Company’s profit-generating core businesses supports investments into the Company’s two SPIs: DTD and 
OSA. The respective RECOVER Study and OSPREY Trial both target medical conditions with high unmet needs.

Depression

The current VNS Therapy System is being leveraged to treat Difficult-to-Treat Depression, a condition where patients experience 
chronic or recurrent depression and have not had an adequate response to four or more antidepressant treatments. The safety and 
efficacy of VNS Therapy is well understood with over 125,000 patients implanted to date. 

The  RECOVER  clinical  study  aims  to  further  demonstrate  the  safety  and  efficacy  of  VNS  treatment  for  DTD  beyond  existing 
studies. RECOVER will include up to 500 unipolar and up to 500 bipolar patients at a maximum of 100 sites in the U.S.. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________4

STRATEGIC REPORT
Business Overview

The RECOVER clinical study continues to steadily progress. On 23 March 2023, LivaNova randomized the 500th unipolar patient 
into  the  study.  After  the  last  patient  enrolled  into  the  RCT  has  completed  12  months  of  follow-up,  a  final  analysis  will  be 
conducted on the complete dataset for that respective cohort. Recruitment for the bipolar cohort is ongoing, and the first interim 
analysis was initiated upon the 150th bipolar patient being randomized in June 2023. The study is currently under way as part of a 
Coverage  with  Evidence  Development  framework  per  the  CMS  National  Coverage  Determination  process.  The  study,  if 
successful, may potentially be used to support a peer-reviewed article and reconsideration of reimbursement for VNS Therapy by 
the U.S. Centers for Medicare & Medicaid Services for the treatment of depression that is difficult to treat.

Obstructive Sleep Apnea

LivaNova continues to make progress with its IDE clinical trial, OSPREY, Treating Obstructive Sleep APnea Using TaRgEted 
HYpoglossal Neurostimulation. OSPREY is the first randomized control trial to confirm efficacy of hypoglossal nerve stimulation 
for OSA. Specifically, the clinical trial will determine if the apnea-hypopnea index responder rate of patients stimulated via the 
device  is  statistically  higher  than  the  rate  of  those  without  stimulation.  The  patient  population  is  comprised  of  adults  with 
moderate to severe OSA who do not achieve results from a traditional CPAP machine or have declined its use. In March 2024, the 
Company announced that the OSPREY clinical trial had achieved a positive predictive outcome and would conclude enrollment 
sooner  than  expected.  This  means  there  is  a  greater  than  97.5%  probability  that  the  OSPREY  trial  will  successfully  meet  its 
primary endpoint.

Focused on 2024

In 2023, the Company positioned itself for success through maintaining investment in its pipeline initiatives, investing in critical 
capabilities for the Company, including manufacturing infrastructure and IT modernization, and taking actions related to portfolio 
optimization. 2024 is a critical inflection point for LivaNova due to significant data milestones for each SPI that will occur during 
the  course  of  the  year.  The  core  Cardiopulmonary  segment  and  Epilepsy  business  are  well  positioned  for  targeted  innovation, 
sustained  growth  and  value  creation.  LivaNova  is  focused  on  maintaining  the  Company’s  momentum  and  achieving  the 
Company’s commitments to serving patients while creating shareholder value.

Human Capital Management

LivaNova  has  approximately  2,900  employees  worldwide,  representing  75  nationalities  and  located  in  32  countries.  These 
employees are crucial in achieving the Company’s mission to provide hope to its patients and their families. LivaNova encourages 
its employees to live by LivaNova’s five core values: patients first, meaningful innovation, act with agility, commitment to quality 
and integrity, and collaborative culture. LivaNova evaluates itself against these values and, ultimately, achieves success through 
them as an organization.

Compensation and Benefits

To meet the needs of LivaNova’s patients and customers, the Company strives to attract, retain, develop and reward exceptional 
talent.  LivaNova’s  proactive  talent  acquisition  strategies,  competitive  compensation  and  benefits,  collaborative  and  rewarding 
work environment, leadership development programs, and professional training opportunities have been a significant driver of the 
Company’s success. In addition to base pay, LivaNova’s rewards, compensation, and benefits programs may include, depending 
on jurisdiction, annual performance bonuses, stock awards, pensions, health and wellbeing programs, paid time off and parental 
leave, financial assistance for education-related purposes, flexible working schedules, hybrid and remote working, employee stock 
purchase plans, and employee rewards programs, among others.

Culture

LivaNova  seeks  to  foster  a  culture  of  continuous  learning,  where  open  and  direct  communication  is  valued.  Accordingly, 
LivaNova regularly conducts employee engagement surveys, called LivaNova4You, to measure overall employment engagement 
and satisfaction and to provide the Company with actionable data for potential opportunities for improvement.

The 2023 LivaNova4You survey results saw an increase in overall employee engagement since the last survey in 2021. With over 
90% of employees completing the survey, the results indicate an increase in employee satisfaction and motivation. In response to 
feedback from the survey results, the executive leadership team has committed to improving, among other things, the digitization 
of work systems and the Company’s branding.

Performance Management, Leadership Development and Professional Training

LivaNova’s annual performance management process is designed to build employee skills and capabilities and develop and retain 
enterprise  leaders  for  the  future.  It  includes  training  to  increase  the  quality  of  employee/manager  talent  review  discussions  and 
employee  performance  calibrations  among  leaders  to  drive  consistency.  All  employees,  which  include  full-time  and  part-time 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________5

STRATEGIC REPORT
Business Overview

employees, start the year creating performance-aligned goals which are reviewed with their managers at both mid-year and year-
end performance evaluation reviews.

Employees have access to an extensive training library called LivaNova University, which contains modules covering different 
aspects of the business. In addition, LivaNova has a range of tailored programs in place to develop and enhance employees’ career 
paths.  The  LivaNova  Leadership  Academy  is  a  program  that  promotes  development  through  three  different  learning  forums, 
Manager Fundamentals, Emerging Leaders and Advanced Leadership, to accelerate the development and succession readiness for 
employees chosen for the program.

LivaNova also supports the continuing education of its employees externally. In the US and internationally, eligible employees 
can  access  financial  aid  through  education  reimbursement  programs  for  approved  courses  and  certifications  completed 
independently. Additionally, the Company sponsors professional growth opportunities.

Finally, LivaNova offers internships and apprenticeships across functions around the globe, in partnership with universities and 
institutions, which regularly lead to full-time employment at the Company.

Diversity, Equity and Inclusion

LivaNova  recognizes  the  value  in  fostering  a  diverse,  equitable  and  inclusive  work  environment  and  strives  to  provide  a 
workplace free of harassment or discrimination. Accordingly, the Company closely monitors its gender metrics on a regular basis. 
As of 31 December 2023, LivaNova had nine Directors on its Board, of whom three (33%) are female and six (67%) are male. 
The executive leadership team at the end of 2023 consisted of twelve individuals, of whom two (17%) are female and ten (83%) 
are  male.  Of  the  Company’s  senior  leadership  team,  which  includes  the  executive  team,  vice  presidents  and  directors,  as  of  31 
December  2023,  approximately  30%  are  female  and  approximately  70%  are  male.  Finally,  as  of  31  December  2023,  of 
LivaNova’s approximately 2,900 employees, 51% are female and 49% are male.

LivaNova’s  strategy  for  accelerating  diversity  begins  with  creating  new  ways  to  find  extraordinary  talent.  Examples  of  the 
Company’s  efforts  include  networking  with  historically  black  colleges  and  universities,  posting  job  listings  on  diverse  sites, 
ensuring diversity-focused interview panels, and training interviewers on how to conduct a fair, unbiased interview process. 

In  addition,  LivaNova  supports  internal  diversity  affinity  initiatives,  including  the  Global  Women’s  Network  which  consists  of 
female  employees  across  the  globe  that  convene  to  discuss  topics  that  unite  and  celebrate  the  strength  of  diversity  in  the 
workplace.  Similarly,  the  LivaNova  Women’s  Network,  a  mentorship  program  created  by  women  and  for  women,  facilitates 
pairings  between  mentors  and  mentees  in  the  US  and  Latin  America.  Topics  range  from  career  and  financial  advice  to 
performance management and connection to the Company’s strategy. These programs provide members with new perspectives, 
more personalized development, and an opportunity to network with other women across the organization.

Non-Financial & Sustainability Information Statement

LivaNova  recognizes  the  increasing  risk  that  climate  change  can  pose  to  its  business.  LivaNova  has  utilized  climate  scenario 
modelling,  consistent  with  guidance  from  the  Department  of  Business,  Energy,  and  Industrial  Strategy  on  mandatory  climate-
related  financial  disclosures,  to  assess  its  exposure  to  climate-related  (both  physical  and  transition)  risks  and  opportunities, 
including likelihood and impacts, to evaluate the resilience of LivaNova’s business model and strategy to these risks. This initial 
2023  exercise  starts  what  will  be  a  multi-year  process  to  assess  the  potential  impact  of  climate  risks  and  opportunities  and  the 
associated climate risk management process. 

Based  on  its  2023  qualitative  climate  scenario  analysis,  LivaNova  has  identified  the  principal  climate-related  physical  and 
transition risks, as well as opportunities, to its business. Over the next two years, LivaNova plans to expand its understanding of 
the principal climate-related risks and opportunities, as well as any impacts by completing a quantitative climate scenario analysis. 

Governance

At  LivaNova,  the  oversight  and  management  of  climate-related  risks  and  opportunities  occurs  at  different  levels  of  the 
organization and includes: the Board, the Executive Leadership Team (ELT), the SteerCo, the VP Legal, Corporate, and Securities 
(VP  LCS),  the  Senior  Director  of  Sustainability,  and  the  ESG  Task  Force.  As  an  example,  the  identification  of  climate-related 
physical risks and opportunities to LivaNova in 2023 was led by the Senior Director of Sustainability in collaboration with the 
ESG Taskforce which includes the VP LCS. It was subsequently shared and discussed with the Board and ELT, and guided by 
consideration of all of LivaNova’s stakeholders, including patients, employees, regulators, investors and third-party frameworks 
such as the TCFD All-Sector Guidance, among others.

LivaNova’s  governance  of  sustainability  and  climate-related  risks  and  opportunities  is  evolving  and  is  an  area  that  LivaNova 
expects to continue refining over the course of 2024 and beyond as the organization matures and climate risk is embedded into its 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________6

STRATEGIC REPORT
Business Overview

ways 

of  working 

(e.g., 

integration 

of 

climate 

risks 

into 

its 

planning 

and 

risk 

governance).

Board-Level 

The NCG Committee of LivaNova’s Board oversees the Company’s ESG matters, as codified in its charter. The NCG Committee 
receives a report on the ESG Task Force’s activities at each of its quarterly meetings along with a verbal discussion led by the VP 
LCS. The quarterly update includes progress on the Company’s climate-related risks and opportunities. The full Board receives 
the  same  report  in  their  meeting  materials  as  well.  In  April  2023,  at  the  recommendation  of  the  NCG  Committee,  the  Board 
reviewed and approved LivaNova’s Carbon Reduction Plan, which included the Company’s carbon reduction initiatives and 2050 
Net Zero target. In December 2023 and February 2024, the results of LivaNova’s first climate scenario analysis were shared and 
discussed with the NCG Committee and subsequently, full Board. In April 2024, at the recommendation of the NCG Committee, 
the  Board  reviewed  and  approved  the  updated  Carbon  Reduction  Plan,  which  is  available  on  the  Company’s  Sustainability 
webpage. 

ELT

The ELT is involved in defining LivaNova’s sustainability vision and strategy, monitoring progress on LivaNova’s sustainability 
journey,  and  periodically  discussing  LivaNova’s  principal  climate  risks.  The  ELT  receives  regular  updates  on  LivaNova’s 
sustainability activities and moving into 2024, includes progress on LivaNova’s principal climate-related risks and opportunities. 
For  example,  the  ELT  was  updated  throughout  the  process  of  the  climate  scenario  analysis  exercise  and  was  involved  in  a 
discussion of potential next steps.

ESG Task Force & Senior Director of Sustainability

LivaNova’s ESG Task Force consists of leaders and executives from: Human Resources, Legal (including the VP LCS and Senior 
Director  of  Sustainability),  IT  (including  Information  Security),  Corporate  Communications,  Investor  Relations,  Corporate 
Finance,  HSE,  Internal  Audit,  Operations,  Packaging,  Product  Safety  and  Quality,  Research  and  Development,  and  Strategic 
Procurement.  The  ESG  Task  Force  defines  and  executes  upon  LivaNova’s  Sustainability  strategy,  vetting  and  executing  the 
Company’s  sustainability  goals  and  overarching  strategy,  including  the  management  of  principal  climate-related  risks  and 
opportunities. 

Members  of  the  Task  Force  engage  directly  with  ELT  stakeholders  to  support  execution  of  ESG  tasks  and  to  ensure  timely 
reporting on relevant compliance updates, such as reporting on climate risks and opportunities. In addition, the Senior Director of 
Sustainability  leads  monthly  meetings  with  the  ESG  Steering  Committee  (which  includes  key  members  of  the  ELT)  to  ensure 
alignment on vision and purpose and to confer regarding progress in LivaNova’s Sustainability and ESG journey. 

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Business Overview

Risk Management

As  LivaNova  embarks  on  its  sustainability  and  climate  risk  management  journey,  the  approach  to  climate-related  risk  and 
opportunity identification and management is expected to evolve in phases. The approach followed in 2023 focused on completing 
a qualitative climate scenario analysis and leveraging cross-functional collaboration from key members of the ESG Task Force. 
The  climate  scenario  analysis,  which  identified  and  assessed  LivaNova’s  climate-related  risks,  was  consistent  with,  but  not 
integrated into, LivaNova’s existing enterprise risk management framework. Starting in 2024, LivaNova intends to embark upon a 
quantitative climate scenario analysis and align climate risk with its enterprise risk management process. 

In  2023  the  Senior  Director  of  Sustainability  and  the  ESG  Task  Force  participated  in  a  qualitative  climate  scenario  analysis 
comprised of the following five main steps: 

1. Developing  an  extensive  list  of  potential  climate-related  risks  and  opportunities  based  on  industry  research  and 
stakeholder engagement (including interviewing and surveying over 100 LivaNova cross-functional stakeholders across 
geographies) to identify a holistic view of the perceived and potential climate risks and opportunities to LivaNova across 
the globe.

2. Mapping the list of potential climate risks and opportunities to LivaNova’s global value chain, to surface dependencies 
and critical nodes at risk across LivaNova’s global operations. This allows LivaNova to better assess its exposure to each 
of these risks and the potential vulnerability of the business to them.

3. Conducting  a  qualitative  climate  scenario  analysis  on  the  climate-related  risks  and  opportunities  (see  “Approach  to 
climate-related  scenario  analysis”  below),  leveraging  reports  produced  by  the  IPCC  and  the  IEA  to  assess  the  level  of 
impact of each climate-related risk and opportunity.

4. Prioritizing  the  identified  climate-related  risks  and  opportunities,  leveraging  LivaNova’s  enterprise  risk  management 
framework  to  identify  principal  climate  risks  and  opportunities  based  on  the  probability  of  occurrence  and  potential 
consequences of each climate risk and opportunity.

5. Evaluating  potential  mitigation  strategies  for  principal  risks  and  strategies  to  leverage  principal  opportunities.  Once 
aligned on the path forward and resource requirement, the Senior Director of Sustainability presented the risk mitigation 
strategy and resource requirements to the ELT for approval. 

Within the approach of 2023, climate-related risks were mitigated on a case-by-case basis. LivaNova, by way of the ESG Task 
Force, plans on reviewing its risk governance approach in 2024, including the incorporation of climate-related risks into the risk 
taxonomy, risk management process, and enterprise risk management tools. 

Strategy

Principal Climate Risks and Opportunities 

Based on the qualitative climate scenario analysis conducted in 2023, the following have been identified as the principal climate 
risks and opportunities to LivaNova’s business:

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STRATEGIC REPORT
Business Overview

The  analysis  defined  the  short-term  as  being  up  to  3  years  (in  line  with  the  planned  refresh  frequency  of  LivaNova’s  climate 
scenario  analysis  and  the  short/medium  time  risk  management  time  horizons  used  by  LivaNova’s  Risk  team),  medium-term  as 

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STRATEGIC REPORT
Business Overview

being  between  3-10  years  (encompassing  two  risk  management  planning  cycles  –  each  5  years),  and  long-term  as  being  10-30 
years (aligning with the overall life of LivaNova’s assets).

Given  the  medium  to  long  term  onset  of  the  identified  principal  risks  to  LivaNova  and  the  additional  insulation  afforded  to 
companies  in  the  medical  space,  the  impact  of  the  identified  principal  risks  on  LivaNova’s  business  model  and  strategy  are 
negligible in the short term. Nonetheless, LivaNova is starting to take action due to the long lead time associated with some of the 
mitigation actions and LivaNova’s evolving sustainability strategy. 

Approach to Climate-Related Scenario Analysis 

The above risks and opportunities were identified by leveraging two climate scenarios, which were informed by internationally 
recognized  data  sets  and  models  developed  by  the  IPCC  and  the  IEA,  and  were  guided  by  the  non-binding  guidance  of  the 
Department for Business, Energy & Industrial Strategy for CFD and scenarios that peers in have used in their climate scenario 
analysis.  The  two  scenarios  are  varied  and  align  with  the  guidance  of  including  an  Aggressive  Climate  Action  scenario  and  a 
Current Climate Action scenario.

a. Aggressive Climate Action scenario: 1.5°C warming by 21001

i.

Emission  reductions  in  line  with  Paris  Agreement,  marked  by  global  collaboration  among  governments, 
industry, and society, leading to steep decarbonization.

ii. Global collaboration to start reducing emissions now in an aggressive way to meet Paris Agreement goals

b. Current Climate Action scenario: ~4°C warming by 2100 

i.

Emissions  continue  to  increase  with  no  changes  to  current  policies,  doing  very  little,  if  anything  to  avert  the 
physical risks

ii. Baseline of how global emissions would evolve if governments made no changes to their existing policies.2

Metrics and Targets

As  noted  above,  LivaNova  is  in  the  early  stages  of  this  exercise.  This  Non-Financial  and  Sustainability  Information  Statement 
commences a multi-year process to assess the potential impact of climate risks and opportunities and the associated climate risk 
management process. The Company maintains its commitment to achieving Net Zero GHG emissions by 2050, while recognizing 
the  data  collection  and  diligence  required  to  fully  implement  that  plan.  To  track  initial  progress,  LivaNova  has  adopted  the 
following near-term targets:

•

•

Scope 1 and Scope 2: 55% reduction by 2033, relative to 2022 GHG emissions baseline 

Scope 3: 28% reduction by 2033, relative to 2022 GHG emissions baseline

LivaNova is in the process of completing the baseline of its Scope 3 emissions and automating the carbon accounting process over 
the coming 12 months. 

In addition, LivaNova is examining metrics and targets to further support its sustainability strategy and monitor its exposure to 
climate risks. These metrics include but are not limited to: 

•
•
•
•
•

Energy intensity 
Energy from renewable sources 
Days of unplanned downtime due to climate-related events
Number of workday equivalents lost due to climate-event related absenteeism
Reduction in waste to landfill

Ethics and Integrity

Code of Conduct & Related Policies

LivaNova’s  commitment  to  integrity  starts  with  the  Company’s  Code  of  Conduct,  which  sets  the  tone  of  the  Company’s 
organisational culture and outlines the key expectations of behavior for LivaNova employees, officers and directors. 

Relatedly, the Company believes that LivaNova’s business can only succeed where the rights of all workers involved in the value 
chain of LivaNova’s business are protected and respected, and the Company aims to conduct business with third parties who share 
the Company’s commitment to operating in a responsible and ethical manner. To that end, LivaNova also maintains a Third Party 
Code of Conduct outlining the minimum standards in a variety of areas in which LivaNova requires the Company’s partners to 

1 IPCC1 SSP1-2.6 (Physical risk) and IEA2 Sustainable Development Scenario (SDS) and Net Zero Emissions by 2050 (NZE2050) (Transition risk)
2
 IPCC1 SSP5-8.5 (Physical) and IEA2 Current Policies Scenarios (CPS) (Transition)

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STRATEGIC REPORT
Business Overview

comply when doing business with or for LivaNova – including the areas of human rights & labour conditions, conflict minerals, 
environment  &  sustainability,  anti-bribery  &  anti-corruption,  anti-trust  &  fair  competition,  trade  compliance,  confidentiality  & 
data privacy, and intellectual property - in addition to all applicable laws, regulations and industry standards.

The E&I Committee, which consists of the CEO, CFO, Chief Legal Officer, Chief E&I Officer, Chief HR Officer and Head of 
Internal Audit, oversees the Company’s global ethics and compliance program. 

The Speak Up global ethics and compliance program is the Company’s ensemble of all policies, procedures, systems, awareness/
educational  initiatives  and  monitoring  activities  that  relate  to  LivaNova’s  efforts  to  allow  and  encourage  employees  and  third 
parties to report / speak up about alleged misconduct, as well as the investigative procedures & corrective measures in place to 
resolve and remediate any confirmed issues. In managing Speak Up matters, investigations, LivaNova is committed to putting the 
protection  of  bona  fide  reporters  and  victims  at  the  forefront,  while  maintaining  confidentiality  and  anonymity  as  required  and 
allowed by local laws. 

Furthermore,  LivaNova  endeavours  to  positively  impact  the  community  in  which  it  operates,  and  the  Company’s  Third  Party 
Code  of  Ethics  and  Business  Conduct  promotes  and  advocates  on  behalf  of  the  principles  of  human  rights,  among  others. 
LivaNova respects the human rights of all LivaNova employees and those in the Company’s value chain, demanding a safe, clean 
working environment; freedom from discrimination and coercion; a prohibition on the use of child or forced labour; and respect 
for the rights of privacy and protection of access to personal information. The Company’s Modern Slavery Statement, which is 
available on the LivaNova homepage, is updated annually and clearly defines the Company’s commitment to eradicating slavery 
and human trafficking from LivaNova’s business activities and supply chains.

Training and Awareness

The E&I function is committed to dedicating significant efforts to training and education. In 2023, the Company conducted more 
than 80 compliance-related educational initiatives or update sessions with the business, including face-to-face or virtual instructor-
led sessions, online attestations, system-based procedure trainings, newsletters and email communications/announcements. 

The Company’s 2023 Annual Certification process was offered both online and offline, depending on the resources available to 
the employees. With oversight and support from all levels of executive leadership, the Company recorded a one hundred percent 
completion rate amongst eligible online employees. The assignment required each employee to (1) reiterate their commitment to 
the principles of the Company’s Code of Conduct, (2) attest to the Company’s Business Integrity Policy, and (3) the Speak Up and 
Non-Retaliation Policy and, in addition to the policy attestations, employees completed a scenario-based survey to self-assess their 
knowledge and understanding of company policies and how they apply to real-life situations.

Ethics Line and Investigations

The  Company  has  multiple  reporting  channels  for  employees  as  well  as  business  partners  to  report  concerns  about  potential 
violations of the Company’s Code of Conduct, Company policies and procedures, or applicable laws and regulations. LivaNova’s 
Ethics Line is available 24/7 across multiple time-zones and languages, and employees are encouraged to speak up in good faith 
over alleged misconduct. Every claim received is addressed per the Company’s internal investigation procedure and remediated 
where  substantiated.  In  2023,  the  Company  investigated  reports  of  alleged  misconduct  across  different  countries,  resulting  in 
several  follow-up  corrective  actions  including,  but  not  limited  to,  process  reviews  and  improvements,  additional  training  and 
coaching, or disciplinary measures for some of the involved parties. On a quarterly basis, the Chief E&I Officer reports all Serious 
Reportable Matters to the Audit Committee. Immediate escalations and referrals directly to the Chair of the Audit Committee are 
handled in accordance with the Company’s internal investigation procedure.

Information Security

Cyber Risk Management and Strategy

LivaNova’s  enterprise  risk  management  process  consists  of  risk  identification,  evaluation,  control  and  monitoring,  and 
documentation.  The  LivaNova  Board  oversees  risk  management  within  the  Company,  and  the  CRO  provides  the  framework  to 
identify and reduce risks that may materially impact the Company’s business. As part of the CRO’s enterprise risk management 
process,  regular  inquiries  and  discussions  are  held  with  the  CISO,  Chief  Information  Officer,  Chief  Privacy  Officer,  and  their 
respective teams to review the cybersecurity risk landscape. 

LivaNova’s CISO has a Master of Science in Accountancy with a specialization in risk management, in addition to over 15 years 
of experience in the IT Risk Advisory sector. The CISO leads the Company’s information security team, identifies cybersecurity 
threats,  and  implements  countermeasures  in  the  cybersecurity  realm,  considering  both  internal  operations  and  the  external 
landscape. As part of his duties, the CISO provides relevant information to the CRO in their regular discussions. The CISO also 
manages  the  Company’s  ISMS  program.  Guided  by  the  principles  of  various  industry-leading  standards,  such  as  the  NIST 
cybersecurity  framework  and  ISO  27001,  the  objective  of  the  ISMS  program  is  to  continue  to  strengthen  LivaNova’s  cyber 
resiliency in connection with its information systems.

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As part of LivaNova’s cyber resiliency strategy and in an effort to mitigate potential cybersecurity risks, the Company employs 
various  measures,  including  employee  training,  systems  monitoring,  testing  and  maintenance  of  protective  systems,  and 
contingency  plans.  In  addition,  the  CISO  manages  a  structured  cyber  incident  response  program  where  periodic  simulation 
exercises  are  performed  to  prepare  and  train  the  Company’s  cybersecurity  incident  responders.  The  Company  deploys  security 
tools  to  help  bolster  its  defense  detection  capabilities,  such  as  endpoint  detection  and  response  tools,  security  information  and 
event management tools, and 24/7 monitoring. LivaNova regularly evaluates itself for appropriate business continuity and disaster 
recovery planning, with test scenarios that include simulations and penetration tests.

In addition, LivaNova routinely engages with third-party service providers to conduct evaluations of its security controls, whether 
through penetration testing or consulting on best practices to address new challenges. The Company receives threat intelligence 
from  industry  peers,  government  agencies,  industry-specific  information  sharing  and  analysis  centers,  and  cybersecurity 
associations. The Company relies heavily on its supply chain to deliver products and services to its customers, and a cybersecurity 
incident at a supplier, subcontractor, or service provider could materially adversely impact the Company. The Company assesses 
third-party  cybersecurity  controls  through  its  information  security  program  and  includes  security  and  privacy  addendums  to  its 
contracts where applicable.

Historically, risks from cybersecurity threats have not materially affected the Company’s business strategy, results of operations 
or financial condition. As previously reported, in November 2023, the Company initiated its cyber response protocol in response 
to a cybersecurity incident that resulted in a disruption of portions of its information technology systems. Promptly after detecting 
the  issue  and  per  LivaNova’s  cyber  response  protocol,  the  Company  began  an  investigation  with  assistance  from  external 
cybersecurity consultants and coordinated with law enforcement. The Company continues to assess the nature and scope of the 
affected  data  and  analyse  its  legal  notification  obligations,  and  the  Company  is  notifying  affected  individuals  and  regulators  as 
required  by  applicable  law.  As  of  31  March  2024,  LivaNova  had  incurred  direct  costs  totalling  approximately  $5.4  million  in 
connection  with  this  cybersecurity  incident.  While  the  Company  has  taken  and  will  continue  to  take  actions  to  enhance  its 
information  security  framework,  LivaNova  cannot  fully  determine  at  this  time  the  extent  of  the  impact  from  this  event  on  its 
business,  results  of  operations,  cash  flows,  or  financial  condition.  For  further  information,  please  refer  to  section  entitled 
“Business Review” of this Report.

Cyber Governance

On  a  quarterly  basis,  the  CISO  presents  key  security  metrics  to  the  Company’s  IT  Advisory  Council,  which  is  composed  of 
functional  leaders  across  the  Company  and  is  responsible  for  IT  governance  oversight  in  the  Company.  Specifically,  this  IT 
Advisory Council is responsible for establishing program strategies in alignment with LivaNova’s business objectives, as well as 
providing  guidance  on  the  implementation  of  appropriate  and  necessary  security  controls  in  alignment  with  the  Information 
Security  Policy.  Among  other  things,  the  IT  Advisory  Council  reviews  summaries  of  information  security  incidents,  audit 
findings, or other test reports, and ensures appropriate root-cause analyses are performed and corrective actions are taken. It also 
establishes year-over-year goals, security objectives, and priorities for the information security program. On an annual basis, the 
CISO reviews the information security program achievements and reports to the Company’s IS Executive Committee, which is a 
cross-functional  group  composed  of  the  CEO,  the  CFO,  the  CLO,  and  other  executive  leaders  of  the  Company.  Among  other 
things,  the  IS  Executive  Committee  approves  the  information  security  policy  and  the  allocation  of  budget  and  resources  to 
information security program initiatives, performs the annual management review of the security program, and reviews corrective 
action to improve the program.

As codified in its charter, the Audit & Compliance Committee is responsible for reviewing the processes by which cybersecurity 
risks are managed and reporting any issues that arise out of such reviews to the Board. The CISO provides key security metrics to 
the Audit Committee on a quarterly basis, and directly to the chair of the Audit Committee on a case-by-case basis, as needed, at 
any  time  during  the  quarter.  The  Audit  Committee  reviews  these  reports,  which  include,  among  other  things,  external  events 
impacting the Company, security incidents, user training statistics, and evaluations of user readiness to address cyber incidents. 
Notwithstanding the Company’s approach to cybersecurity, the Company may not be successful in preventing or mitigating future 
cybersecurity  incidents  that  could  have  a  material  adverse  effect  on  the  Company.  While  LivaNova  maintains  cybersecurity 
insurance, the costs related to cybersecurity threats or disruptions may not be fully insured. For more information on risks related 
to cybersecurity and data security, please refer to the “Risk and Uncertainties” section under the heading entitled Risks Relating to 
the Company’s Business and Operations in this Strategic Report.

Sustainability

LivaNova  has  always  focused  on  delivering  strong  financial  results  and  is  committed  to  doing  so  in  a  way  that  respects  the 
communities and environments in which the Company operates.

LivaNova  has  established  a  Sustainability  strategy  delivery  program  with  global  coordination  to  respond  to  regulatory 
requirements  and  commercial  needs.  In  2023  and  in  coordination  with  the  Company’s  executive  team,  LivaNova’s  cross-
functional  ESG  Task  Force  developed  the  Company’s  Sustainability  commitment  and  associated  actions  (see  Figure  1: 

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STRATEGIC REPORT
Business Overview

LivaNova's Sustainability Commitment). The Sustainability commitment encompasses the Company’s Sustainability Focus Areas 
– People, Products, and Planet.

Sustainability Governance

Through  the  Nominating  and  Corporate  Governance  Committee  of  the  LivaNova  Board  of  Directors,  the  Board  oversees  the 
Company’s  Sustainability  efforts.  Within  the  organization,  the  Company’s  sustainability  efforts  are  managed  by  the  Head  of 
Sustainability.  The  Sustainability  governance  structure  includes  a  quarterly  executive  team  partnership  for  vision  and  purpose 
calibration, a monthly engagement with a Steering Committee body (sponsored by the CFO) to drive corporate strategy awareness 
and goal setting alignment, and the cross-functional ESG Task Force for unified execution of priorities. The ESG Task Force is 
comprised of senior leaders and other key stakeholders across the Company who lead ESG focus areas or whose work is impacted 
by ESG. 

Embedding Sustainability within LivaNova’s Ways of Working

The Senior Director of Sustainability drives the governance structure and is accountable for successful prioritization and execution 
of the strategy and associated initiatives noted above, including regular and transparent education and awareness of Sustainability 
progress  among  the  Company’s  stakeholders,  both  internally  and  externally;  monitoring  relevant  regulations  in  markets 
worldwide  to  enable  LivaNova  to  meet  ESG  and  Sustainability  performance  expectations  and  requirements;  and  embedding 
sustainability impact, risks and opportunity analysis into the Company’s strategic plan. 

During 2023, sustainability strategy highlights included:

•

•

•

•

Onboarding a Senior Director of Sustainability.

Conducted  the  Company’s  LivaNova4You  employee  engagement  survey  to  measure  overall  employment  engagement 
and satisfaction and to provide the Company with actionable data for potential opportunities for improvement. The 2023 
LivaNova4You survey results saw an increase in overall employee engagement since the last survey in 2021. With over 
90% of employees completing the survey, the results indicated an increase in employee satisfaction and motivation. In 
response to feedback from the survey results, the executive leadership team has committed to improving, among other 
things, the digitization of work systems and the Company’s branding.

Publication  of  its  Board-approved  Carbon  Reduction  Plan,  which  includes  the  Company’s  carbon  reduction  initiatives 
and  net  zero  targets,  based  on  the  absolute  contraction  approach  of  science-based  target  setting.  LivaNova  continues 
implementing  energy  and  resource  optimization  initiatives  to  reduce  greenhouse  gas  emissions  and  waste.  LivaNova’s 
Carbon Reduction Plan is published on the LivaNova Sustainability webpage, Planet. 

Updating the LivaNova Sustainability webpage, Products, to include quality, safety and performance statistics relating to 
Warning Letters and recalls. The LivaNova Sustainability webpage, Products, provides details of the Company’s quality 
commitment and global impact.

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Business Overview

•

Retaining  a  third-party  consultant  to  assist  in  preparing  the  Company’s  CFD,  which  involved  a  qualitative  climate 
scenario analysis to identify principle climate risks and opportunities. For more information on LivaNova’s CFD, please 
refer to the section entitled “ Non-Financial & Sustainability Statement” in this Strategic Report. 

2023 Greenhouse Gas Report

LivaNova  is  committed  to  conducting  business  in  a  manner  that  is  respectful  of  the  environment  and  the  Company’s  natural 
resources. Throughout the Company’s operations, LivaNova utilizes environmental management systems and safety programs to 
protect the environment and employees. Some of the regulations and governmental agencies with which LivaNova comply are as 
follows: the EPA; the European Union Registration, Evaluation, Authorisation and Restriction of Chemicals; the DEFRA; the UK 
Environment Agency; Companies Act 2006, Regulations 2013 and the Companies and Limited Liability Partnerships (Energy and 
Carbon Report) Regulations 2018; the UK Energy Savings Opportunity Scheme; and Italian regulations under the IEA. 

LivaNova  believes  that  sound  environmental,  health  and  safety  performance  contribute  to  the  Company’s  competitive  strength 
while  benefiting  the  Company’s  customers,  employees  and  shareholders.  LivaNova  is  focused  on  continuous  improvement  in 
these  areas  by  working  to  reduce  pollution,  depletion  of  natural  resources  and  the  Company’s  overall  environmental  footprint. 
Specifically, the Company works to optimize energy and resource usage, ultimately reducing greenhouse gas emissions and waste. 
Whether in response to ESG Task Force projects, LBS ideas or employee initiative, the Company is supportive of projects, big 
and small, that move us towards being a “greener” Company.

In  compliance  with  the  Companies  Act  2006  (Strategic  Report  and  Directors’  Report)  Regulations  2013  and  the  Companies 
(Directors’ Report) and Limited Liability Partnerships (Energy and Carbon Report) Regulations 2018, LivaNova reports on the 
Company’s  Scope  1  and  2  emissions  from  seven  manufacturing  sites,  LivaNova  site  management  operations  in  Saluggia,  the 
global vehicle fleet, the global commercial offices, and the UK-specific emissions in line with the SECR requirements. Scopes 1, 
2 and 3 are broken down as follows: 

•

•

•

scope 1 (direct emissions): Activities owned by the organisation that release emissions directly into the atmosphere, for 
example the combustion of fuels in company owned equipment, employees leveraging fuel cards and fugitive emissions.

scope  2  (indirect  emissions):  Emissions  released  into  the  atmosphere  associated  with  the  consumption  of  purchased 
electricity, heat, and steam used at LivaNova manufacturing sites and commercial offices. 

scope 3 (other indirect emissions): These include emissions relating to travel for business purposes in assets not owned or 
directly operated by LivaNova and mileage for business purposes in cars owned by employees. 

Methodology and Approach

In reporting the emissions data as shown in the table herein, LivaNova and its third party consultant used the operational control 
approach, covering the reporting period from 1 January 2023 to 31 December 2023, in line with the Company’s financial year.

Emissions  were  calculated  in  compliance  with  the  revised  World  Resources  Institute  GHG  Protocol  Corporate  Accounting  and 
Reporting  Standard  (GHG  Protocol  Corporate  Standard),  the  GHG  Protocol  Scope  2  Guidance  and  the  Corporate  Value  Chain 
(Scope 3) Accounting and Reporting Standard.

The  Company  has  applied  the  emission  factors  most  relevant  to  the  source  data,  including  DEFRA  -  UK  Government  GHG 
Conversion Factors for Company Reporting 2022 for UK locations, all gas, oil, heat, fugitive emissions and transport, Emissions 
& Generation Resource Integrated Database 2021 published by the EPA for US locations, and the IEA electricity emission factors 
2023 for all other locations.

Building  and  manufacturing  site  related  GHG  emissions  were  calculated  from  the  utility  provider  invoices  or  landlord  energy 
statements, and transport related emissions were calculated from fuel expenses and mileage, and where this data was not available, 
estimates have been used.

Within the organisational and operational boundaries, LivaNova quantifies and reports on emissions of the following greenhouse 
gases:

carbon dioxide (CO2),

a.
b. methane (CH4),
c.
d.
e.
f.

nitrous oxide (N2O),
hydrofluorocarbons (HFCs),
perfluorocarbons (PFCs), and
sulphur hexafluoride (SF6).

LivaNova does not use any nitrogen trifluoride (NF3).

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Business Overview

Energy Efficiency Measures 

In LivaNova’s efforts to reduce the Company’s carbon footprint, LivaNova continues to implement energy efficiency and low-
carbon  energy  measures  as  they  relate  to  Scope  1  and  Scope  2  emissions,  for  example,  in  LivaNova’s  Munich  and  Houston 
facilities,  LivaNova’s  electricity  contract  requires  the  use  of  100%  clean  energy  sources.  In  addition,  we  continue  to  retrofit 
lighting systems to LED lighting.

Also,  while  not  reflected  in  the  total  emission  numbers,  LivaNova  allows  certain  non-essential  office  employees  to  continue 
working in a hybrid remote environment, directly decreasing the energy required for employees to commute to and from work. 
LivaNova’s  leased  vehicle  program  includes  both  hybrid  cars  and  electric  vehicles,  with  the  Company  looking  to  add  electric 
vehicles  in  the  years  to  come.  Lastly,  LivaNova  maintains  and  continues  to  install  EV  charging  stations  at  multiple  sites, 
supporting those employees and visitors who want to commute using electric vehicles.

Future  efforts  include  (1)  reviewing  and  updating  key  business  policies  and  procedures  to  ensure  that  business  practices  are 
aligned  and  supportive  of  LivaNova’s  Net  Zero  commitment,  (2)  increasing  awareness  around  carbon  emissions  data  in 
connection with booking business travel; and (3) developing a supplier engagement program to reduce Scope 3 emissions from the 
Company’s supply chain.

Changes in Emissions 

In  compliance  with  the  Companies  Act  2006  (Strategic  Report  and  Directors’  Report)  Regulations  2013  and  the  Companies 
(Directors’ Report) and Limited Liability Partnerships (Energy and Carbon Report) Regulations 2018, which implement the UK 
Governments policy on SECR, LivaNova reports on its direct and indirect emissions as follows:

•

•

•

Scope  1  –  Direct  GHG  emissions  from  sources  that  are  owned  or  controlled  by  the  Company  such  as  combustion  in 
boilers, company cars, and fugitive emissions.

Scope 2 – Energy indirect emissions from the consumption of purchased electricity, heat and steam at the Company’s 
owned or controlled sites.

Scope 3 – Other indirect emissions relating to employee business travel in leased or private cars where LivaNova is not 
responsible  for  paying  the  fuel  in  addition  to  a  sub-set  of  6  out  of  the  15  categories  for  LivaNova  UK  Limited,  as 
indicated below.

◦
◦
◦
◦
◦
◦

3: UK grid electricity transmission and distribution
4: Upstream transportation and distribution
5: Waste generated in operations
6: Business travel
7: Employee commuting
9: Downstream transportation and distribution

This  report  focuses  on  the  areas  of  largest  environmental  impact,  which  includes  the  Company’s  global  manufacturing  sites, 
commercial offices, the global vehicle fleet, and the Company’s UK offices. While the majority of manufacturing sites increased 
output  to  support  increased  sales  of  approximately  12.9%  in  2023  as  compared  to  2022,  the  tonnes  CO2e  per  sales  revenue 
(US$M) decreased by 10.7%. See the illustration below for detailed information on the carbon emissions tonnes Co2e and total 
energy used in 2023 and 2022. 

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STRATEGIC REPORT
Business Overview

* As the Company has made strides in improving its data collection efforts in 2023, certain figures in 2022 have been restated to 
reflect corrections and refinements in the Company’s data collection process. 

Government Regulation and Other Considerations

LivaNova’s medical devices are subject to extensive government regulation by numerous government agencies, both within and 
outside the US To varying degrees, each of these agencies requires the Company to comply with laws and regulations governing 
the research, development, testing, manufacturing, labeling, pre-market clearance or approval, marketing, distribution, advertising, 
promotion, record keeping, reporting, tracking, and importing and exporting of the Company’s products. LivaNova’s business is 
also  affected  by  patient  privacy  and  security  laws,  cost  containment  initiatives,  and  environmental  health  and  safety  laws  and 
regulations worldwide.

The  laws  applicable  to  LivaNova  are  subject  to  changing  and  evolving  interpretations,  and  the  Company  continues  to  monitor 
such shifts. The Company believes it is in compliance with such laws and regulations, and while the impact of regulatory changes 
cannot  be  predicted  with  certainty,  the  Company  does  not  expect  compliance  to  have  a  material  adverse  effect  upon  the 
Company’s  earnings,  competitive  position  or  estimated  capital  expenditures.  However,  if  a  governmental  authority  were  to 
conclude  that  LivaNova  was  not  in  compliance  with  applicable  laws  and  regulations,  LivaNova  and  its  officers  and  employees 
could be subject to severe civil and criminal penalties, including substantial fines and damages, and exclusion from participation 
as a supplier of products to beneficiaries covered by government programs, among other potential enforcement actions.

Product Approval and Monitoring

Many countries in which LivaNova sells its products subject the Company’s medical devices to their own product approval and 
requirements  regarding  performance,  safety  and  quality.  For  example,  each  medical  device  that  LivaNova  seeks  to  distribute 
commercially in the US must receive 510(k) clearance or PMA from the FDA, unless specifically exempted by the agency. The 
510(k)  process,  also  known  as  pre-market  notification,  requires  LivaNova  to  demonstrate  that  its  new  medical  device  is 
substantially  equivalent  to  a  legally  marketed  medical  device.  The  PMA  process,  which  is  more  costly  and  rigorous  than  the 
510(k) process, requires LivaNova to demonstrate independently that a medical device is safe and effective for its intended use. 
One or more clinical studies may be required to support a 510(k) application and are almost always required to support a PMA 
application.

The EU has established a single regulatory product approval process, pursuant to which a CE Mark certifies conformity with all of 
the  legal  requirements  of  the  regulatory  process.  To  obtain  a  CE  Mark,  defined  products  must  meet  minimum  standards  of 
performance,  safety  and  quality  based  on,  among  other  things,  the  evaluation  of  clinical  data  supporting  the  safety  and 
performance of the products during normal conditions of use. The competent authorities of the EU countries separately regulate 
the clinical research for medical devices and the market surveillance of products placed on the market, and manufacturers with CE 
marked devices are subject to regular inspections to monitor compliance with the applicable directives and essential requirements. 
In 2017, for example, the EU published its MDR, which has resulted in significant additional pre- and post- market requirements. 
Certifications to EU MDR must be achieved by December 2027 or December 2028, based on the risk classification of the device. 
Penalties  for  regulatory  non-compliance  can  be  severe,  including  fines  and  revocation  or  suspension  of  a  company’s  business 
license, mandatory price reductions and criminal sanctions.

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STRATEGIC REPORT
Business Overview

LivaNova  is  also  required  to  comply  with  the  regulations  of  every  other  country  where  it  commercializes  products  before  the 
Company can launch or maintain new products in the market. To be sold in Japan, for example, LivaNova’s medical devices must 
undergo thorough safety examinations and demonstrate medical efficacy from the Japanese government through the Ministry of 
Health,  Labour  and  Welfare  before  they  are  granted  approval.  In  China,  regulatory  requirements  are  becoming  more  stringent. 
Many  countries  also  require  that  product  approvals  be  recertified  on  a  regular  basis,  generally  every  four  to  five  years.  The 
recertification process requires LivaNova to evaluate any device change and any new regulation or standard relevant to the device 
and, where required, conduct appropriate testing to document continued compliance.

The global regulatory environment is becoming increasingly more stringent and unpredictable. Several countries that did not have 
regulatory  requirements  for  medical  devices  have  established  such  requirements  in  recent  years,  and  other  countries  have 
expanded,  or  plan  to  expand,  their  existing  regulations.  While  some  regulatory  bodies  have  pursued  harmonization  of  global 
regulations, requirements continue to differ significantly among countries. LivaNova expects this global regulatory environment 
will  continue  to  evolve,  which  could  impact  the  Company’s  cost,  approval  lead  time,  or  ability  to  maintain  existing  or  obtain 
future product approvals.

Product and Promotional Restrictions

Both before and after LivaNova releases a product for commercial distribution, the Company has ongoing responsibilities under 
various laws and regulations governing medical devices. The FDA and other regulatory agencies in and outside the US review 
LivaNova’s design and manufacturing practices, labeling, record keeping, and required reports of adverse experiences and other 
information  to  identify  potential  problems  with  marketed  medical  devices.  LivaNova  is  also  subject  to  periodic  inspections  for 
compliance with applicable quality system regulations, which govern the methods used in, and the facilities and controls used for, 
the design, manufacture, packaging, and servicing of finished medical devices intended for human use. In addition, the FDA and 
other US regulatory bodies monitor the manner in which LivaNova promotes and advertises its products. Although physicians are 
permitted to use their medical judgment to prescribe medical devices for indications other than those cleared or approved by the 
FDA, LivaNova is prohibited from promoting products for such “off-label” uses and can only market the Company’s products for 
cleared or approved uses.

Any  adverse  regulatory  action,  depending  on  its  magnitude,  may  limit  LivaNova’s  ability  to  market  and  sell  its  products 
effectively,  limit  its  ability  to  obtain  future  premarket  approvals  or  result  in  a  substantial  modification  to  LivaNova’s  business 
practices and operations. For additional information, please refer to the “Risk and Uncertainties” section under the heading title 
“LivaNova’s  products  are  subject  to  complex  laws  and  regulations,  and  failure  to  obtain  product  approvals,  clearance  or 
reimbursement may materially adversely affect LivaNova’s business, results of operations, cash flows and financial condition.” in 
this Strategic Report.

Governmental Trade Regulations

The sale and shipment of LivaNova’s products and services across international borders, as well as the purchase of components 
and products from international sources, subject LivaNova to extensive governmental trade regulations. Many countries control 
the export and re-export of goods, technology and services for public health, national security, regional stability, antiterrorism and 
other  reasons.  Some  governments  may  also  impose  economic  sanctions  against  certain  countries,  persons  or  entities.  In  certain 
circumstances,  governmental  authorities  may  require  LivaNova  to  obtain  approval  before  LivaNova  may  export  or  re-  export 
goods, technology or services to certain destinations, to certain end-users and for certain end-uses. Because LivaNova is subject to 
extensive  regulations  in  the  countries  in  which  it  operates,  the  Company  is  subject  to  the  risk  that  laws  and  regulations  could 
change in a way that would expose LivaNova to additional costs, penalties or liabilities.

LivaNova also sells and provides goods, technology and services to agents, representatives and distributors who may export such 
items  to  customers  and  end-users,  and  if  these  third  parties  violate  applicable  export  control  or  economic  sanctions  laws  or 
regulations  when  engaging  in  transactions  involving  the  Company’s  products,  LivaNova  may  be  subject  to  varying  degrees  of 
liability depending on the extent of its participation in the transaction. The activities of these third parties may cause disruption or 
delays in the distribution and sale of LivaNova’s products or result in restrictions being placed on the Company’s international 
distribution and sales of products, which may materially impact LivaNova’s business activities.

Data Privacy and Security Laws

As a global medical device technology company, LivaNova may be subject to various laws worldwide that protect the privacy, 
security  and  confidentiality  of  certain  data,  including  employee  data  and  patient  health  information  and  restrict  the  use  and 
unauthorized disclosure of such information. Privacy standards are often strict. Enforcement actions and financial penalties related 
to privacy issues in the EU continue to grow, and new privacy and data localization laws and restrictions are being passed in other 
countries including the US. The management of cross-border transfers of personal information outside of EU member countries is 
becoming more complex, which may complicate LivaNova’s business and clinical research activities, as well as product offerings 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________17

STRATEGIC REPORT
Business Overview

that involve transmission or use of patient health information. LivaNova continues to adapt its business processes to comply with 
those standards and requirements applicable to it.

In  the  US,  HIPAA,  as  amended  by  the  HITECH  Act  and  their  respective  implementing  regulations,  imposes  specified 
requirements  relating  to  the  privacy  and  security  of  certain  individually  identifiable  health  information.  Among  other  things, 
HITECH  makes  certain  of  HIPAA’s  privacy  and  security  standards  directly  applicable  to  “business  associates,”  essentially 
defined  as  service  providers  of  covered  entities  that  create,  receive,  maintain  or  transmit  protected  health  information  in 
connection  with  providing  a  service  for  or  on  behalf  of  a  covered  entity.  In  certain  instances,  LivaNova  may  be  considered  a 
business associate. In such instances, the patient data that LivaNova receives may include protected health information, as defined 
under  HIPAA.  Related  enforcement  actions  can  be  costly  and  may  also  interrupt  LivaNova’s  regular  business  operations.  In 
addition, state laws, such as the CCPA, govern the privacy and security of health information in certain circumstances, many of 
which differ from each other in significant ways, thus complicating compliance and data protection efforts. Since the CCPA was 
enacted, other US states have enacted privacy laws. The effects of the CCPA and other recently adopted laws include an increased 
ability  of  individuals  to  control  the  use  of  their  personal  data,  heightened  transparency  obligations,  increased  obligations  of 
companies  to  maintain  the  security  of  data,  and  increased  exposure  to  fines  or  damages  for  companies  that  violate  these  laws, 
including by not providing individuals their specified privacy rights or, not maintaining data security safeguards at specified levels 
of quality, or that experience data breaches. For additional information, please refer to the “Risk and Uncertainties” section under 
the  heading  titled  “Cyber-attacks  or  other  disruptions  to  LivaNova’s  information  technology  systems  could  lead  to  reduced 
revenue, increased costs, liability claims, fines, harm to LivaNova’s competitive position and loss of reputation" in this Strategic 
Report. 

In  the  EU,  the  processing  of  certain  data,  including  employee  and  patient  information,  is  subject  to  the  privacy,  security  and 
confidentiality provisions set forth in Regulation 2016/679. Under the GDPR, data concerning health constitutes sensitive data. 
The processing of sensitive data is subject to, among other obligations, appropriate notice and consent requirements. Additional 
requirements  apply  with  respect  to  issues  such  as  data  sharing,  cross-border  data  transfers,  data  security,  and  data  breach 
notification. The GDPR also requires LivaNova to implement a number of accountability measures in relation to the processing of 
sensitive  data,  including  carrying  out  Data  Protection  Impact  Assessments  and  appointing  a  Data  Protection  Officer. 
Administrative fines may be levied for non-compliance with the GDPR’s requirements and can reach the higher of €20 million 
(approximately $22.1 million) or up to 4% of LivaNova’s total worldwide annual net revenue for the preceding financial year.

Cost Containment Initiatives

Government and private sector initiatives to limit the growth of healthcare costs, including price regulation, competitive pricing, 
bidding  and  tender  mechanics,  coverage  and  payment  policies,  comparative  effectiveness  of  therapies,  technology  assessments 
and  managed-care  arrangements  are  continuing  in  many  countries  where  LivaNova  does  business.  These  changes  are  driving 
customers  to  place  increased  emphasis  on  the  delivery  of  more  cost-effective  medical  devices  and  therapies.  Government 
programs, private healthcare insurance and managed-care plans have attempted to control costs by limiting the extent of coverage 
or  amount  of  reimbursement  available  for  particular  procedures  or  treatments,  by  connecting  reimbursement  to  outcomes,  by 
shifting  to  population  health  management  and  through  other  mechanisms  designed  to  constrain  utilization  and  contain  costs. 
Hospitals are also seeking to reduce costs through a variety of mechanisms, for example, creating centralized purchasing functions 
that set pricing and, in some cases, limit the number of vendors that can participate in a given purchasing program. Hospitals are 
also aligning their interests with those of physicians through employment and other arrangements, such as gainsharing, whereby a 
hospital agrees with physicians to share certain realized cost savings resulting from the physicians’ collective change in practice 
patterns, such as standardization of devices where medically appropriate, and participation in affordable care organizations. Such 
alignment has created increased levels of price sensitivity among customers for LivaNova’s products.

Some  third-party  payers  must  also  approve  coverage  and  set  reimbursement  levels  for  new  or  innovative  devices  or  therapies 
before they reimburse healthcare providers that use the medical devices or therapies. Even though a new medical device may be 
cleared  for  commercial  distribution,  LivaNova  may  find  limited  demand  for  the  device  until  coverage  and  sufficient 
reimbursement levels have been obtained from governmental and private third-party payers. In addition, some private third- party 
payers require that certain procedures or the use of certain products be authorized in advance as a condition of coverage.

As a result of LivaNova’s manufacturing efficiencies, cost controls and other cost-savings initiatives, the Company believes it is 
well-positioned to respond to changes resulting from this worldwide trend toward cost containment. However, uncertainty remains 
as to the nature of any future legislation or other reforms, making it difficult for LivaNova to predict the potential impact of cost-
containment trends on future operating results.

Applicability of Anti-Corruption Laws and Regulations

LivaNova’s  worldwide  business  is  subject  to  the  FCPA,  the  UK  Bribery  Act  and  other  anti-corruption  laws  and  regulations 
applicable  in  the  jurisdictions  where  LivaNova  operates.  The  FCPA  can  be  used  to  prosecute  companies  in  the  US  for 
arrangements with physicians or other parties outside the US if the physician or party is a government official of another country 

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STRATEGIC REPORT
Business Overview

and  prohibited  payments  are  made  to  obtain  or  retain  business.  The  UK  Bribery  Act  prohibits  both  domestic  and  international 
bribery, as well as bribery across both public and private sectors. There are similar laws and regulations applicable to LivaNova 
outside  the  US  and  the  UK,  all  of  which  are  subject  to  evolving  interpretations.  For  additional  information,  please  refer  to  the 
“Risk  and  Uncertainties”  section  under  the  heading  titled  “Risks  Relating  to  the  Company’s  Business  and  Operations”  in  this 
Strategic Report.

Environmental Regulation and Management

LivaNova is subject to various environmental laws, directives and regulations both in the US and abroad that have resulted in, and 
could  lead  to,  increased  environmental  compliance  expenditures  and  reporting.  LivaNova’s  ongoing  manufacturing  and  other 
operations involve the use, storage and transportation of hazardous and non-hazardous substances regulated under environmental 
health  and  safety  laws.  In  addition,  governmental  authorities  may  seek  to  hold  LivaNova  liable  for  successor  environmental 
liability  violations  committed  by  any  companies  in  which  LivaNova  invests  or  acquires  or  may  require  LivaNova  to  clean  and 
remove hazardous substances at its sites that were produced by the operations of prior owners and are unrelated to the Company’s 
current  operations.  For  additional  information,  please  refer  to  “Note  24.  Commitments  and  Contingencies”  in  LivaNova’s 
consolidated  financial  statements  under  the  sections  entitled  “Saluggia  Site  Hazardous  Substances”  and  “SNIA  Environmental 
Liability”  and  the  “Risk  and  Uncertainties”  section  under  the  heading  titled  “LivaNova  is  subject  to  environmental  laws  and 
regulations and the risk of environmental liabilities, violations, protest voting and litigation in multiple jurisdictions, any of which 
could have a material impact on LivaNova’s business, results of operations, cash flows, financial condition and liquidity.”  in this 
Strategic Report.

Health Care Fraud and Abuse and Related Laws

The delivery of LivaNova’s products is subject to regulation by HHS and comparable state and non-US agencies responsible for 
reimbursement  and  regulation  of  healthcare  products  and  services.  LivaNova  is  subject  to  US  federal  and  state  government 
healthcare  regulations  and  enforcement  imposed  primarily  in  connection  with  government  healthcare  programs,  such  as  the 
Medicare and Medicaid programs, as well as healthcare regulations and enforcement imposed by governments in other countries 
in which LivaNova conducts business.

US  federal  healthcare  laws  apply  when  LivaNova  or  customers  submit  claims  for  items  or  services  that  are  reimbursed  under 
government  healthcare  programs,  including  laws  related  to  kickbacks,  false  claims,  self-referrals  or  other  healthcare  fraud. 
Specifically,  the  federal  healthcare  Anti-Kickback  Statute  prohibits  persons  from,  among  other  things,  knowingly  and  willfully 
offering or paying remuneration, directly or indirectly, to a person to induce them to order, purchase, lease, or recommend a good 
or service for which payment may be made in whole or in part under a federal healthcare program such as Medicare or Medicaid, 
unless the arrangement fits within one of several statutory exemptions or regulatory “safe harbors.” Violations of the federal Anti-
Kickback Statute may result in civil monetary penalties up to $100,000 for each violation, plus up to three times the remuneration 
involved. Violations can also result in criminal penalties, including criminal fines of up to $50,000 and imprisonment for up to 10 
years. Finally, violations can result in exclusion from participation in government healthcare programs, including Medicare and 
Medicaid.

Additionally, violations of the False Claims Act can result in significant monetary penalties and treble damages. The US federal 
government  utilizes  the  False  Claims  Act,  the  Anti-Kickback  Statute  and  similar  laws  to  investigate  and  prosecute  device, 
pharmaceutical and biotechnology companies in connection with the promotion of products for unapproved uses, the provision of 
patient  and  provider  support  (e.g.,  reimbursement  support),  and  other  prohibited  sales  and  marketing  practices.  The  US 
government has obtained multi-million and multi-billion-dollar settlements under the False Claims Act, in addition to individual 
criminal convictions under applicable criminal statutes. Given the US government’s success in prosecuting claims under the False 
Claims Act, LivaNova anticipates that the US government will continue to devote substantial resources to investigating healthcare 
providers’ and manufacturers’ compliance with applicable fraud and abuse laws.

In addition to the Anti-Kickback Statute and False Claims Act, many states have their own laws related to kickbacks, false claims, 
self-referrals  or  other  healthcare  fraud.  These  laws  do  not  always  have  the  same  exceptions  or  safe  harbors  as  their  federal 
corollaries and, in some states, apply with respect to all payers, including commercial health insurance companies.

HIPAA includes federal criminal statutes that prohibit, among other actions, knowingly and willfully executing, or attempting to 
execute,  a  scheme  to  defraud  any  healthcare  benefit  program,  including  private  third-party  payors;  knowingly  and  willfully 
embezzling or stealing from a healthcare benefit program; willfully obstructing a criminal investigation of a healthcare offense; or 
knowingly  and  willfully  falsifying,  concealing  or  covering  up  a  material  fact  or  making  any  materially  false,  fictitious  or 
fraudulent  statement  in  connection  with  the  delivery  of  or  payment  for  healthcare  benefits,  products  or  services.  Similar  to  the 
federal Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to violate 
it in order to have committed a violation.

There is also federal and state regulation of, and transparency with respect to, payments made to physicians and other healthcare 
providers.  LivaNova  is  subject  to,  for  example,  the  Physician  Payments  Sunshine  Act,  which  requires  the  Company  to  report 

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STRATEGIC REPORT
Business Overview

annually  certain  payments  and  other  transfers  of  value  it  makes  to  US  licensed  physicians,  nurse  practitioners,  physician 
assistants, or teaching hospitals. Any failure to comply with such laws and regulations may result in civil financial penalties.

In addition, as discussed above, the US and foreign government regulators enforce the FCPA and other anti-bribery laws. These 
laws and regulations are broad in scope and are subject to evolving interpretation. As a result, LivaNova has been, and will likely 
continue  to  be,  required  to  incur  substantial  costs  to  investigate  allegations,  audit  and  monitor  compliance,  and/or  alter  the 
Company’s  practices  with  respect  to  these  laws.  Violations  or  alleged  violations  of  these  laws  could  result  in  litigation,  and 
LivaNova  may  be  subject  to  criminal  or  civil  penalties  and  sanctions,  including  substantial  fines,  imprisonment  of  current  or 
former employees and exclusion from participation in governmental healthcare programs.

The evolving commercial compliance environment and the resulting need to build and maintain robust systems to comply with 
different  compliance  and/or  reporting  requirements  in  multiple  jurisdictions  increases  the  possibility  that  a  healthcare  company 
may  violate  one  or  more  of  these  requirements  and  be  required  to  allocate  significant  resources  to  its  compliance  program.  If 
LivaNova’s  operations  are  found  to  be  in  violation  of  any  such  laws  or  any  other  governmental  regulations  that  apply  to  the 
Company, LivaNova may be subject to penalties, including, without limitation, civil and criminal penalties, damages, fines, entry 
into corporate integrity agreements or other monitoring agreements with governmental agencies, the curtailment or restructuring 
of its operations, and exclusion from participation in federal and state healthcare programs, any of which could adversely affect 
LivaNova’s financial results and the Company’s ability to operate its business.

Industry Affiliations 

To  help  navigate  the  complex  compliance  environment  in  which  the  Company  operates,  LivaNova  has  adopted  the  AdvaMed 
Code of Ethics on Interactions with Health Care Professionals, the APACMed Code of Ethical Conduct, the MecoMed Code of 
Ethical Business Practice and the MedTech Europe Code of Ethical Business Practice. 

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STRATEGIC REPORT
Business Review

Business Review

LivaNova is reporting in its consolidated financial statements in this Annual Report the results from operations for the years ended 
31  December  2023  and  31  December  2022.  The  basis  of  presentation,  critical  accounting  estimates  and  significant  accounting 
policies are set forth in "Note 2. Basis of Preparation, Use of Accounting Estimates and Material Accounting Policies" and “Note 
3. Revenue Recognition” to the IFRS and with the requirements of the Companies Act 2006 as applicable to companies reporting 
under those standards consolidated financial statements contained in this Annual Report. Additionally, LivaNova reported the US 
GAAP consolidated financial statements for the years ended 31 December 2023 and 31 December 2022 in the Annual Report on 
Form 10-K filed with the SEC on 29 February 2024.

LivaNova reported an operating loss of $69.8 million on net revenue of $1,153.5 million for the year ended 31 December 2023 
and an operating loss of $86.4 million on net revenue of $1,021.8 million for the year ended 31 December 2022. 

During the year ended 31 December 2023, LivaNova recorded $90.0 million as impairment of long-lived assets and $40.9 million 
as  litigation  provision.  During  the  year  ended  31  December  2022,  LivaNova  recorded  $145.0  million  as  an  impairment  of 
goodwill, $21.7 million as litigation provision, net and $0.1 million from loss on sale of the Company’s Heart Valve business. 
These items totalled $130.9 million and $166.8 million for the years ended 31 December 2023 and 2022, respectively, and are 
included in exceptional items in the consolidated statement of (loss). Refer to “Note 30. Exceptional Items” for more details.

Key Performance Indicators

The  directors  of  LivaNova  consider  that  the  most  important  KPIs  for  2023  are  those  set  out  below,  which  can  be  found  in  the 
Company’s press release dated 21 February 2024, and which are reported under the basis of US GAAP.

•

Net revenue growth (on a constant currency basis, or adjusted net revenue)

Due to the number of currencies in which LivaNova’s sales are invoiced to customers, the directors believe that constant currency 
sales growth is a more appropriate way to measure operational performance. Constant currency growth measures the change in 
sales between any particular year and the immediate prior year using average foreign exchange rates during the immediate prior 
year.  Net  revenue  includes  revenue  earned  from  customers  from  sales  of  products  and  services  net  of  customer  discounts  and 
estimated sales returns.

•

Adjusted operating income

Income from operations, as measured under US GAAP and adjusted for non-cash transactions and non-recurring costs, measures 
LivaNova’s sales and management of normalised operating expenses.

•

Adjusted net income

Adjusted  net  income  represents  the  Company’s  measure  of  the  totality  of  LivaNova's  consolidated  statement  of  (loss).  It  is 
calculated as US GAAP net income adjusted for non-cash transactions and non-recurring costs and certain finance costs, and the 
related tax effects. 

•

Adjusted earnings per share

US GAAP EPS, as adjusted for the items referred to above, is a measure often used by investors to arrive at a value for each share 
issued by a company, including the dilutive effect of incentive shares issued to management. 

•

Share price

An important KPI to be evaluated over a period longer than one year is the share price, which reflects not only LivaNova’s current 
financial results, but also management’s ability to articulate medium and longer term strategy and communicate both of these to 
investors.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________21

STRATEGIC REPORT
Business Review

Results of Operations

In this Annual Report, LivaNova and its consolidated subsidiaries report results for the years ended 31 December 2023, and 31 
December 2022 as follows (in thousands, except per share amounts):

Net revenue      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Costs and expenses:

Cost of sales      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Selling, general and administrative     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Research and development       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other operating expense     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exceptional items      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating loss     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance expenses      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net gain on embedded exchange feature and capped call derivatives      . . . . . . . . . . . . . . . . . . . . . .
Net foreign exchange and other income/(expense)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Share of loss from equity accounted investments     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss before tax     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income tax expense       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss attributable to owners of the parent     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023
1,153,545  $ 

2022
1,021,805 

381,730 
514,267 
193,193 
3,308 
130,895 
(69,848)   
(60,450)   
24,209 
21,598 

(104)   
(84,595)   
(15,787)   
(100,382)  $ 

314,206 
463,829 
155,650 
7,737 
166,789 
(86,406) 
(49,709) 
43,789 
8,273 
(53) 
(84,106) 
(2,188) 
(86,294) 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________22

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
STRATEGIC REPORT
Business Review

Net Revenue

The following table presents net revenue by operating segment and geographic region for the years ended 31 December 2023 and 
2022 (in thousands):

Cardiopulmonary

United States      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Europe (1)
      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Neuromodulation

United States     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Europe (1)
      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Advanced Circulatory Support

United States     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Europe (1)
      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other Revenue (2)
Totals

      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2023

2022

188,299  $ 
156,606 
244,072 
588,977 

407,493 
57,435 
54,782 
519,710 

39,252 
751 
319 
40,322 
4,536 

159,489 
127,064 
213,761 
500,314 

374,542 
50,291 
52,160 
476,993 

37,527 
1,447 
327 
39,301 
5,197 

United States     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Europe (1)
      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

635,044 
214,792 
303,709 
1,153,545  $ 

571,558 
178,802 
271,445 
1,021,805 

(1) Includes  countries  in  Europe  where  the  Company  has  a  direct  sales  presence.  Countries  where  sales  are  made  through 

distributors are included in “Rest of World.”

(2) Other revenue primarily includes rental income not allocated to segments.

Cardiopulmonary

Cardiopulmonary  net  revenue  for  the  year  ended  31  December  2023  increased  17.7%  to  $589.0  million  compared  to  the  year 
ended 31 December 2022 with growth across all regions, driven by increased HLM sales, including from Essenz Perfusion System 
installations, and strong oxygenator demand.

Neuromodulation

Neuromodulation net revenue for the year ended 31 December 2023 increased 9.0% to $519.7 million compared to the year ended 
31 December 2022 with growth across all regions, including new and replacement implants in the US region.

Advanced Circulatory Support

ACS net revenue for the year ended 31 December 2023 increased 2.6% to $40.3 million compared to the year ended 31 December 
2022  driven  by  an  increase  in  case  volumes.  On  5  January  2024,  the  Board  of  Directors  of  LivaNova  PLC  approved  the  2024 
Restructuring Plan. The main component of this plan is to wind down the ACS segment, which the Company anticipates will be 
substantially complete by the end of 2024. For additional information refer to “Note 8. Restructuring” and “Note 33. Subsequent 
Events” in the consolidated financial statements in this Annual Report.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________23

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
STRATEGIC REPORT
Business Review

Cost of Sales and Expenses

The following table presents cost of sales and major expenses as a percentage of net revenue for the years ended 31 December 
2023 and 2022:

Cost of sales      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Selling, general and administrative       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Research and development      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other operating expense     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 33.1 %
 44.6 %
 16.7 %
 0.3 %

 30.8 %
 45.4 %
 15.2 %
 0.8 %

2023

2022

Cost of Sales

Cost of sales consists primarily of direct labor, allocated manufacturing overhead, and the acquisition cost of raw materials, and 
components.

Cost of sales as a percentage of net revenue was 33.1% for the year ended 31 December 2023, an increase of 2.3 percentage points 
compared to the year ended 31 December 2022. The increase was primarily due to the net impact of the change in fair value of 
sales-based  contingent  consideration  arrangements  totalling  $14.2  million  as  well  as  an  inventory  obsolescence  adjustment  of 
$12.6 million during the year ended 31 December 2023 associated with the wind down of LivaNova’s ACS segment.

Selling General and Administrative

SG&A expenses are comprised of sales, marketing, and general and administrative activities. 

SG&A expenses as a percentage of net revenue was 44.6% for the year ended 31 December 2023, a decrease of 0.8 percentage 
points compared to the year ended 31 December 2022, primarily due to lower share-based compensation expense of $6.2 million 
in 2023, driven by the forfeiture of share-based awards associated with the departure of the Company’s former CEO, as well as 
recovery of legal costs associated with the Caisson litigation of $3.0 million in 2023. These decreases were partially offset by the 
$2.6 million increase in costs associated with the previously mentioned November 2023 cybersecurity incident.

Research and Development

R&D expenses consist of product design and development efforts, clinical study programs and regulatory activities.

R&D expenses as a percentage of net revenue was 16.7% for the year ended 31 December 2023, an increase of 1.5 percentage 
points compared to the year ended 31 December 2022. The increase was primarily due to the net unfavourable change in the fair 
value of milestone-based contingent consideration arrangements totalling $27.8 million, as well as increased expenses associated 
with the Company’s RECOVER clinical study and OSPREY clinical trial totalling $12.4 million.

Other Operating Expense

The following table presents the components of other operating expense for the years ended 31 December 2023 and 2022:

Saluggia site remediation provision (1)
Restructuring expense (2)
Merger and integration expense (3)
Other operating expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

2,269  $ 
956 
83 
3,308  $ 

— 
6,611 
1,126 
7,737 

(1) For additional information refer to “Note 24. Commitments and Contingencies” in the consolidated financial statements in 

this Annual Report.

(2) For additional information refer to “Note 8. Restructuring” in the consolidated financial statements in this Annual Report.
(3) LivaNova does not expect to incur any further merger and integration expense.

Exceptional Items

Items that are material, either by size or incidence, and non-recurring in nature are classified as exceptional items. Further details 
on these items are included below.

Impairment of Long-lived Assets

During the year ended 31 December 2023, LivaNova recorded an impairment of long-lived assets of $90.0 million. For additional 
information refer to “Note 8. Restructuring” in the consolidated financial statements in this Annual Report. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________24

 
 
 
 
STRATEGIC REPORT
Business Review

Litigation Provision

During  the  years  ended  31  December  2023  and  2022,  LivaNova  recorded  additional  litigation  provisions  of  $40.9  million  and 
$21.7 million, respectively, due to new information received about the nature of certain claims. Refer to “Note 24. Commitments 
and Contingencies” in the consolidated financial statements in this Annual Report. 

Impairment of Goodwill 

Goodwill is tested for impairment annually as of 31 December and when circumstances indicate that the carrying value may be 
impaired.  As  part  of  LivaNova’s  2022  goodwill  impairment  assessment,  the  Company  considered  that  revenue  for  LivaNova’s 
ACS  CGU  had  declined  compared  to  the  prior  year  period,  primarily  as  a  result  of  a  reduction  in  severe  COVID-19  cases, 
hospital-related challenges and product mix. Furthermore, future revenue projections were reduced. Based on these circumstances, 
the  Company  concluded  that  the  goodwill  of  LivaNova’s  ACS  CGU  was  impaired,  and  the  Company  performed  a  quantitative 
assessment  of  the  goodwill  using  management’s  current  estimate  of  future  cash  flows.  Based  on  the  valuation  performed, 
LivaNova determined that the recoverable amount of the ACS CGU was less than the carrying value and recognised a goodwill 
impairment of $145.0 million in the Company’s consolidated statement of (loss) during the year ended 31 December 2022. Refer 
to “Note 10. Goodwill and Intangible Assets” in the consolidated financial statements in this Annual Report.

Finance Expenses

LivaNova  incurred  finance  expenses  of  $60.5  million  for  the  year  ended  31  December  2023,  as  compared  to  $49.7  million  for 
2022. The increase for the year ended 31 December 2023, compared to the year ended 31 December 2022, was primarily due to an 
increase  in  interest  rates  and  average  borrowings,  partially  offset  by  reduced  amortisation  of  debt  issuance  costs.  For  further 
information on LivaNova’s debt refer to “Note 17. Financial Liabilities” in the consolidated financial statements in this Annual 
Report.

Net Gain on Embedded Exchange Feature and Capped Call Derivatives

Net gain associated with the Company’s embedded exchange feature and capped call derivatives was a gain of $24.2 million for 
the year ended 31 December 2023, compared to a gain of $43.8 million for the year ended 31 December 2022. The net gains on 
the embedded exchange feature and capped call derivatives were primarily due to a decline in the LivaNova share price during the 
years ended 31 December 2023 and 2022. For further information on LivaNova’s debt refer to “Note 17. Financial Liabilities” in 
the consolidated financial statements in this Annual Report.

Net Foreign Exchange and Other Income/(Expense)

LivaNova  incurred  FX  and  other  income  of  $21.6  million  for  the  year  ended  31  December  2023,  compared  to  FX  and  other 
income  of  $8.3  million  for  2022.  For  further  details,  refer  to  “Note  28.  Consolidated  Statement  of  (Loss)  by  Nature”  in  the 
consolidated financial statements in this Annual Report.

Income Taxes

LivaNova PLC is resident in the UK. The Company’s subsidiaries conduct operations and earn income in numerous countries and 
are subject to the varying laws and income tax rates of the taxing jurisdictions within those countries. As a result of changes in the 
overall  level  of  the  Company’s  taxable  income,  the  mix  of  taxable  income  in  various  jurisdictions,  changes  in  unrecognised 
deferred tax assets, and changes in tax laws, LivaNova’s consolidated effective income tax rate may vary substantially from one 
reporting period to another.

LivaNova  continues  to  monitor  the  adoption  of  the  OECD  BEPS  Pillar  Two  by  the  taxing  jurisdictions  in  which  the  Company 
operates. The UK has enacted legislation providing for a minimum effective tax rate of 15% through a “multinational top-up tax” 
and a “domestic top-up tax” for accounting periods beginning on or after 31 December 2023. Draft UK legislation has also been 
published  for  an  “undertaxed  profits  rule”  to  be  introduced,  although  not  before  accounting  periods  beginning  on  or  after  31 
December  2024.  A  UTPR  would  be  a  backstop  rule  intended  to  ensure  that  amounts  of  multinational  top-up  tax  that  are  not 
collected under foreign global minimum tax rules can in certain circumstances be collected instead in the UK.

LivaNova’s  effective  income  tax  rate  for  the  year  ended  31  December  2023  was  (18.7%)  on  loss  before  tax  of  $84.6  million 
compared  with  (2.6%)  on  loss  before  tax  of  $84.1  million  for  2022.  Compared  with  the  year  ended  31  December  2022,  the 
increase  in  the  effective  tax  rate  for  2023  was  primarily  attributable  to  changes  in  pre-tax  income  in  countries  with  varying 
statutory tax rates and changes in unrecognised deferred tax assets.

Liquidity and Capital Resources

Based on LivaNova’s current business plan, the Company believes that LivaNova’s sources of liquidity, which primarily consist 
of cash and cash equivalents, future cash generated from operations and available borrowings under its current debt facilities, will 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________25

STRATEGIC REPORT
Business Review

be sufficient to fund LivaNova’s uses of liquidity, primarily consisting of purchase obligations for expected operating, working 
capital,  capital  expenditures,  and  debt  service  requirements  over  the  twelve-month  period  beginning  from  the  issuance  date  of 
these consolidated financial statements. From time to time, LivaNova may decide to access debt and/or equity markets to optimize 
the Company’s capital structure, raise additional capital or increase liquidity as necessary. Refer to “Note 24. Commitments and 
Contingencies” in the consolidated financial statements in this Annual Report.

LivaNova’s liquidity could be adversely affected by the factors affecting future operating results, including those referred to in 
“Risks  and  Uncertainties”  below  and  by  the  contingencies  referred  to  in  “Note  24.  Commitments  and  Contingencies”  in  the 
consolidated financial statements in this Annual Report.

Our operating and working capital obligations primarily consist of liabilities arising from the normal course of business including 
inventory  supply  contracts,  the  future  settlement  of  derivative  instruments,  and  future  lease  payments,  as  well  as  contingent 
consideration arrangements resulting from acquisitions, and obligations associated with legal and other accruals.

Cash Flows

Net  cash  and  cash  equivalents  provided  by  (used  in)  operating,  investing  and  financing  activities  and  the  net  increase  in  the 
balance  of  cash,  cash  equivalents  and  restricted  cash  were  as  follows  during  the  years  ended  31  December  2023  and  2022  (in 
thousands):

Operating activities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Investing activities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financing activities       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Effect of exchange rate changes on cash, cash equivalents and restricted cash      . . . . . . . .
Net increase in cash, cash equivalents and restricted cash       . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

85,028  $ 
(40,331)   
11,370 
6,187 

62,254  $ 

80,900 
(38,414) 
269,150 
(4,011) 
307,625 

Operating Activities

Cash  provided  by  operating  activities  for  the  year  ended  31  December  2023  increased  $4.1  million  compared  to  the  prior  year 
primarily  resulting  from  improvements  in  working  capital  and  an  increase  in  net  income  adjusted  for  non-cash  items,  partially 
offset by an increase in 3T Heater-Cooler litigation payments of $24.8 million.

Investing Activities

Cash  used  in  investing  activities  during  the  year  ended  31  December  2023  increased  $1.9  million  compared  to  the  prior  year 
largely  due  to  increases  in  purchases  of  property,  plant  and  equipment  and  investments  of  $8.5  million  and  $3.6  million, 
respectively,  partially  offset  by  $8.9  million  paid  during  the  year  ended  31  December  2022  associated  with  the  acquisition  of 
ALung.

Financing Activities

Cash provided by financing activities during the year ended 31 December 2023 decreased $257.8 million compared to the prior 
year. The decrease was primarily due to a year on year reduction in proceeds from net long and short-term debt borrowings and 
repayments of $257.5 million.

Debt and Capital

LivaNova’s capital structure consists of debt and equity. As of 31 December 2023, the Company had total debt of $586.6 million 
which was 62.9% of total equity of $933.0 million.

Debt

During the year ended 31 December 2023, LivaNova received $50.0 million in proceeds from the issuance of long-term debt and 
repaid $21.6 million in long-term debt.

During the year ended 31 December 2022, LivaNova received $507.5 million in proceeds from the issuance of long-term debt and 
repaid $223.5 million in long-term debt.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________26

 
 
 
 
 
STRATEGIC REPORT
Business Review

On 17 June 2020, LivaNova’s wholly-owned subsidiary, LivaNova USA, issued the 2025 Notes. Holders of the 2025 Notes are 
entitled to exchange the 2025 Notes at any time during specified periods, at their option. This includes the right to exchange the 
2025  Notes  during  any  calendar  quarter,  if  the  last  reported  sale  price  of  LivaNova’s  ordinary  shares,  with  a  nominal  value  of 
£1.00 per share, is greater than or equal to 130% of the exchange price, or $79.27 per share for at least 20 trading days (whether or 
not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately 
preceding calendar quarter. The exchange condition was not satisfied on 31 December 2023. As a result, LivaNova has included 
its  obligations  from  the  2025  Notes  and  the  associated  embedded  exchange  feature  derivative  as  a  long-term  liability  on  the 
consolidated  balance  sheets  as  of  31  December  2023  and  2022.  The  2025  Notes  are  exchangeable  solely  into  cash  and  are  not 
exchangeable into ordinary shares of LivaNova or any other security under any circumstances. The initial exchange rate for the 
Notes  is  16.3980  ordinary  shares  per  $1,000  principal  amount  of  2025  Notes  (equivalent  to  an  initial  exchange  price  of 
approximately  $60.98  per  share).  The  exchange  rate  is  subject  to  adjustment  in  certain  circumstances,  as  set  forth  in  the  2025 
Indenture.  If  holders  elect  to  exchange  their  2025  Notes  during  any  future  periods  in  the  event  an  exchange  condition  is  met, 
LivaNova  would  be  required  to  settle  its  exchange  obligation  through  the  payment  of  cash,  which  could  adversely  affect  the 
Company’s liquidity.

The  Company  (through  its  wholly-owned  subsidiary,  LivaNova  USA)  has  also  entered  into  the  2025  Capped  Calls  with  terms 
substantially  similar  to  those  applicable  to  the  2025  Notes.  The  2025  Capped  Calls  over,  subject  to  anti-dilution  adjustments 
substantially similar to those applicable to the 2025 Notes, the number of LivaNova’s ordinary shares underlying the 2025 Notes 
and are expected generally to offset any cash payments the Company is required to make upon exchange of the 2025 Notes in 
excess of the principal amount thereof in the event that the market value per ordinary share, as measured under the 2025 Capped 
Calls, is greater than the strike price of the 2025 Capped Calls, with such offset being subject to an initial cap price of $100.00 per 
share. If the Company’s share price exceeds the cap price, the proceeds under the 2025 Capped Calls would not fully offset the 
excess principal amount due to the holders of the 2025 Notes. The 2025 Capped Calls expire on 15 December 2025 and must be 
settled in cash. If the 2025 Capped Calls are converted or redeemed early, settlement occurs at their termination value, which is 
equal to their fair value at the time of the conversion or redemption. The 2025 Capped Calls are included at their estimated fair 
value as of 31 December 2023 within long-term derivative assets on the consolidated balance sheets. 

On 13 August 2021, LivaNova PLC and its wholly-owned subsidiary, the Borrower, entered into a First Lien Credit Agreement 
with the lenders and issuing banks party thereto and Goldman Sachs Bank USA, as First Lien Administrative Agent and First Lien 
Collateral  Agent,  relating  to  a  $125  million  senior  secured  multi-currency  revolving  credit  facility  to  be  made  available  to  the 
Borrower.  The  2021  First  Lien  Credit  Agreement  is  available  for  working  capital  and  other  general  corporate  purposes  and,  if 
drawn, can be repaid at any time without premium or penalty. There were no outstanding borrowings under the 2021 First Lien 
Credit Agreement as of 31 December 2023.

On 21 February 2022, the Court of Appeal notified the Company that it granted the Company a suspension with respect to the 
payment of damages in the amount of €453.6 million (approximately $502.0 million at 31 December 2023) in the SNIA (a former 
parent company of Sorin) litigation until a decision has been reached on LivaNova’s appeal to the Italian Supreme Court. This 
suspension was subject to LivaNova providing a first demand bank guarantee of €270.0 million (approximately $298.8 million at 
31 December 2023) within 30 calendar days. 

On 24 February 2022, LivaNova PLC and its wholly-owned subsidiary, LivaNova USA, entered into the Bridge Loan Facility. On 
16 March 2022, LivaNova entered into Amendment No. 2 to the 2021 First Lien Credit Agreement, which converted the available 
borrowings under the Bridge Loan Facility from €200 million to $220 million and converted the EURIBOR rate in the 2021 First 
Lien Credit Agreement to SOFR. LivaNova delivered a borrowing notice for $220 million in connection with the Bridge Loan 
Facility, which was funded on 17 March 2022. LivaNova used the proceeds of the Bridge Loan Facility to post a portion of the 
cash collateral supporting the SNIA Litigation Guarantee.

On  18  March  2022,  LivaNova  PLC,  acting  through  its  Italian  branch,  entered  into  an  Indemnity  Letter  and  an  Account  Pledge 
Agreement  with  Barclays,  further  to  which  Barclays  issued  the  €270.0  million  SNIA  Litigation  Guarantee.  As  security  for  the 
SNIA  Litigation  Guarantee,  LivaNova  is  required  to  grant  cash  collateral  to  Barclays  in  USD  in  an  amount  equal  to  the  USD 
equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. On 31 December 2023 and 
2022,  the  cash  collateral  classified  as  restricted  cash  on  the  consolidated  balance  sheet  was  $311.4  million  and  $301.4  million, 
respectively.

On 21 March 2022, LivaNova delivered the SNIA Litigation Guarantee as required by the Court of Appeal, thereby satisfying the 
condition  to  obtain  the  suspension  for  the  payment  of  damages  in  connection  with  the  SNIA  litigation  until  review  of  such 
judgment by the Italian Supreme Court.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________27

STRATEGIC REPORT
Business Review

On 6 July 2022, LivaNova and its wholly-owned subsidiary, LivaNova USA, entered into a new incremental facility amendment 
to its 2021 First Lien Credit Agreement. The Incremental Facility Amendment No. 2 provides for LivaNova USA to, among other 
things, obtain commitments for term loan facilities from a syndicate of lenders in an aggregate principal amount of $350 million 
consisting of (i) an initial term loan facility in an aggregate principal amount of $300 million and (ii) a delayed draw term loan 
facility  in  an  additional  aggregate  principal  amount  of  $50  million.  On  6  April  2023,  LivaNova  drew  $50  million  under  the 
Delayed Draw Term Facility for general corporate purposes.

Proceeds from the Initial Term Facility were used to repay in full the Bridge Loan Facility on 6 July 2022, with the remainder 
used for general corporate purposes of the Company. The Term Facilities have a maturity of the earlier of (i) five years or (ii) 91 
days  prior  to  15  December  2025,  the  maturity  date  of  the  2025  Notes,  unless  by  that  date  LivaNova  USA  will  have  either 
redeemed or refinanced the 2025 Notes, or set aside an amount of cash equal to the then-outstanding principal amount of the 2025 
Notes. 

For  additional  information  on  LivaNova’s  debt  and  debt  transactions,  please  refer  to  “Note  17.  Financial  Liabilities”  in  the 
consolidated financial statements in this Annual report.

Restructuring

Subsequent Events

On 5 January 2024, the Board of Directors of LivaNova PLC approved the 2024 Restructuring Plan to enhance the Company’s 
focus on its core Cardiopulmonary and Neuromodulation segments. The main component of this plan is to wind down the ACS 
segment, which the Company anticipates will be substantially complete by the end of 2024. LivaNova reorganised its operating 
and reporting structure upon initiating the 2024 Restructuring Plan and transitioned all ACS standalone cannulae and accessories, 
including  ProtekDuo  and  transseptal  (TandemHeart)  cannulae,  into  its  Cardiopulmonary  segment.  Operations  for  other  ACS 
products, including LifeSPARC and Hemolung systems, will be discontinued by the end of 2024. 

In  connection  with  the  2024  Restructuring  Plan,  LivaNova  expects  to  incur  pre-tax  restructuring  charges  in  the  range  of 
approximately $15 million to $20 million. The anticipated charges are comprised of approximately $10 million to $12 million in 
severance  expenses  and  retention  bonuses  and  approximately  $5  million  to  $8  million  in  other  expenses,  including  lease 
termination, facilities remediation, and asset disposal expenses. LivaNova expects the majority of the severance expenses to be 
incurred in the first half of 2024. Retention bonuses will be earned over the period of service, which is expected to be over the full 
year  of  2024.  All  future  cash  payments  related  to  these  restructuring  charges  are  expected  to  be  paid  out  during  2024.  These 
estimates  are  subject  to  change.  During  the  three  months  ended  31  March  2024,  LivaNova  recorded  restructuring  expense  of 
$9.2 million associated with the 2024 Restructuring Plan. 

Effective in 2024, LivaNova changed its reportable segments corresponding to the above-mentioned restructuring and changes in 
how  the  Company’s  CODM  regularly  reviews  information,  allocates  resources  and  assesses  performance.  The  Company’s 
changes to its reportable segments are summarised as follows:

•

•

LivaNova’s  ACS  segment  will  be  included  within  “Other,”  excluding  the  ACS  standalone  cannulae  and  accessories 
business.
LivaNova’s  ACS  standalone  cannulae  and  accessories  business  will  be  included  within  the  Cardiopulmonary  reportable 
segment.

Financial Liabilities

Indenture and Notes

On 8 March 2024, LivaNova issued $345 million aggregate principal amount of its 2.50% convertible senior notes due 2029. The 
2029 Notes were issued pursuant to an indenture, dated as of 8 March 2024, between LivaNova and Citibank, N.A., as trustee. 
Additionally,  on  8  March  2024,  LivaNova’s  wholly-owned  subsidiary,  LivaNova  USA,  Inc.,  entered  into  separate  and 
individually  negotiated  transactions  with  certain  holders  of  LivaNova  USA,  Inc.’s  existing  Cash  Exchangeable  Senior  Notes, 
issued by LivaNova USA, Inc. and guaranteed by LivaNova, to repurchase $230 million aggregate principal amount of the Cash 
Exchangeable  Senior  Notes  for  an  aggregate  cash  amount  of  approximately  $270.5  million  (including  accrued  and  unpaid 
interest), and unwound a corresponding portion of the 2025 Capped Calls.

LivaNova  received  net  proceeds  from  the  offering  of  approximately  $333.0  million,  after  deducting  the  initial  purchasers’ 
discount  and  estimated  offering  expenses  payable  by  LivaNova.  LivaNova  used  (1)  approximately  $31.6  million  of  the  net 
proceeds of the offering to pay the cost of entering into 2029 Capped Calls described below, (2) approximately $270.5 million of 
the net proceeds of the offering to pay the purchase price for the Note Repurchases and (3) the remaining proceeds for general 
corporate purposes.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________28

STRATEGIC REPORT
Business Review

The 2029 Notes are general senior unsecured obligations of LivaNova. The 2029 Notes will bear interest at a rate of 2.50% per 
year, payable semiannually in arrears on March 15 and September 15 of each year, beginning on 15 September 2024. The 2029 
Notes will mature on 15 March 2029, unless earlier repurchased, redeemed or converted in accordance with their terms.

The initial conversion rate of the 2029 Notes is 14.4085 of LivaNova’s ordinary shares, with a nominal value of £1.00 per share, 
per  $1,000  principal  amount  of  the  2029  Notes  (equivalent  to  an  initial  conversion  price  of  approximately  $69.40  per  ordinary 
share). Upon conversion of the 2029 Notes, LivaNova will pay cash up to the aggregate principal amount of the 2029 Notes to be 
converted  and  pay  or  deliver,  as  the  case  may  be,  cash,  LivaNova’s  ordinary  shares,  or  a  combination  of  cash  and  LivaNova’s 
ordinary shares, at LivaNova’s election, in respect of the remainder, if any, of LivaNova’s conversion obligation in excess of the 
aggregate principal amount of the 2029 Notes being converted.

Holders may convert their 2029 Notes at their option at any time prior to the close of business on the business day immediately 
preceding  15  December  2028  only  under  the  following  circumstances:  (1)  during  any  calendar  quarter  commencing  after  the 
calendar  quarter  ending  on  30  June  2024  (and  only  during  such  calendar  quarter),  if  the  last  reported  sale  price  of  LivaNova’s 
ordinary shares for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, 
and  including,  the  last  trading  day  of  the  immediately  preceding  calendar  quarter  is  greater  than  or  equal  to  130%  of  the 
conversion  price  on  each  applicable  trading  day;  (2)  during  the  five  business  day  period  after  any  ten  consecutive  trading  day 
period  in  which  the  trading  price  per  $1,000  principal  amount  of  2029  Notes  for  each  trading  day  of  the  Convertible  Notes 
Measurement  Period  was  less  than  98%  of  the  product  of  the  last  reported  sale  price  of  LivaNova’s  ordinary  shares  and  the 
conversion rate on each such trading day; (3) if LivaNova calls such 2029 Notes for redemption, at any time prior to the close of 
business on the second scheduled trading day immediately preceding the redemption date, but only with respect to the 2029 Notes 
called (or deemed called) for redemption; or (4) upon the occurrence of specified corporate events. On or after 15 December 2028 
until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert their 
2029 Notes at any time, regardless of the foregoing circumstances.

The conversion rate will be subject to adjustment in some events but will not be adjusted for any accrued and unpaid interest. In 
addition, following certain corporate events that occur prior to the maturity date or if LivaNova delivers a notice of redemption, 
LivaNova  will,  in  certain  circumstances,  increase  the  conversion  rate  for  a  holder  who  elects  to  convert  its  2029  Notes  in 
connection  with  such  a  corporate  event  or  convert  its  2029  Notes  called  (or  deemed  called)  for  redemption  in  connection  with 
such notice of redemption, as the case may be.

On or after 22 March 2027, LivaNova may redeem for cash all or part of the 2029 Notes, at LivaNova’s option, if the last reported 
sale price of LivaNova’s ordinary shares has been at least 130% of the conversion price then in effect for at least 20 trading days 
(whether or not consecutive) during any 30 consecutive trading day period (including the last trading day of such period) ending 
on,  and  including,  the  trading  day  immediately  preceding  the  date  on  which  LivaNova  provides  notice  of  redemption.  The 
redemption  price  will  be  equal  to  100%  of  the  principal  amount  of  the  2029  Notes  to  be  redeemed,  plus  accrued  and  unpaid 
interest to, but excluding, the redemption date (unless the redemption date falls after a regular record date but on or prior to the 
immediately succeeding interest payment date, in which case LivaNova will pay the full amount of accrued and unpaid interest to 
the holder of record as of the close of business on such regular record date, and the redemption price will be equal to 100% of the 
principal amount of the 2029 Notes to be redeemed). No sinking fund is provided for the 2029 Notes. LivaNova may also redeem 
the 2029 Notes at its option, at any time, in whole but not in part, only upon the occurrence of certain tax related events.

If  LivaNova  undergoes  a  fundamental  change,  holders  may  require  LivaNova  to  repurchase  for  cash  all  or  any  portion  of  the 
holders’  2029Notes  at  a  fundamental  change  repurchase  price  equal  to  100%  of  the  principal  amount  of  the  2029  Notes  to  be 
repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date.

2029 Capped Calls

In connection with the pricing of the 2029 Notes, LivaNova entered into privately negotiated capped call transactions with certain 
of  the  initial  purchasers  or  their  respective  affiliates  and  another  financial  institution,  as  option  counterparties.  LivaNova 
subsequently  entered  into  additional  capped  call  transactions  with  the  option  counterparties  in  connection  with  the  initial 
purchasers’  exercise  in  full  of  their  option  to  purchase  additional  2029  Notes.  The  2029  Capped  Calls  cover,  subject  to  anti-
dilution  adjustments  substantially  similar  to  those  applicable  to  the  2029  Notes,  the  number  of  LivaNova’s  ordinary  shares 
initially underlying the 2029 Notes.

The 2029 Capped Calls are expected generally to compensate (through the payment of cash to LivaNova) for potential dilution to 
LivaNova’s ordinary shares upon conversion of any 2029 Notes and to offset any cash payments made in excess of the principal 
amount of converted 2029 Notes, as the case may be, in the event that the market price of ordinary shares, as measured under the 
terms of the 2029 Capped Calls, exceeds the strike price of the 2029 Capped Calls, which initially corresponds to the conversion 
price  of  the  2029  Notes  and  is  subject  to  customary  anti-dilution  adjustments  substantially  similar  to  those  applicable  to  the 
conversion  rate  of  the  2029  Notes.  If,  however,  the  market  price  per  ordinary  share,  as  measured  under  the  terms  of  the  2029 
Capped Calls, exceeds the cap price of the 2029 Capped Calls, there would nevertheless be dilution the effect of which would not 
be compensated for and/or there would not be an offset of such cash payments, in each case, to the extent that such market price 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________29

STRATEGIC REPORT
Business Review

exceeds such cap price of the 2029 Capped Calls. The cap price of the 2029 Capped Calls is initially $94.2840 per share, which 
represents a premium of 80% over the last reported sale price of LivaNova’s ordinary shares on 5 March 2024 and is subject to 
certain adjustments under the terms of the 2029 Capped Calls.

Incremental Amendment No. 3 to the 2021 First Lien Credit Agreement

In connection with the offering  of  the  2029  Notes,  LivaNova, along with LivaNova USA, Inc., entered into a new incremental 
facility amendment to its First Lien Credit Agreement dated 13 August 2021 with the lenders and issuing banks party thereto and 
Goldman Sachs Bank USA, as First Lien Administrative Agent and First Lien Collateral Agent, as from time to time amended.

The  Incremental  Amendment  No.  3  provides  for  LivaNova  USA,  Inc.  to,  among  other  things,  obtain  commitments  for  a  new 
revolving  facility  from  a  syndicate  of  lenders  in  an  aggregate  principal  amount  of  $225  million.  The  Incremental  Revolving 
Facility will be available to be drawn by LivaNova USA, Inc. until the fifth anniversary of the entering into of the Incremental 
Amendment  No.  3  and  entirely  replaced  the  $125  million  revolving  facility  previously  provided  for  under  the  2021  First  Lien 
Credit Agreement. Additionally, the Incremental Facility Amendment No. 3 lowered the Interest Coverage Ratio to 2.00 to 1.00. 
Proceeds of the Incremental Revolving Facility will be used for general corporate purposes.

Contractual Obligations
LivaNova has various contractual commitments that the Company expects to fund from existing cash, future operating cash flows 
and borrowings under LivaNova’s credit facilities. 

The  following  table  summarizes  the  Company’s  significant  contractual  obligations  as  of  31  December  2023  and  the  periods  in 
which such obligations are due (in thousands):

Less Than 
One Year

One to Three 
Years

Three to Five 
Years

Thereafter

Total 
Contractual 
Obligations

Principal payments on debt obligations     $ 
Interest payments on long-term debt    . .
3T litigation settlements    . . . . . . . . . . . .
Lease obligations       . . . . . . . . . . . . . . . . .
Inventory supply contract obligations     .
Derivative instruments      . . . . . . . . . . . . .
Probability-weighted contingent 
consideration arrangements      . . . . . . . . .

Total contractual obligations      . . . . . . . $ 

18,084  $ 
33,094 
100 
10,938 
40,724 
3,883 

341,654  $ 

265,313  $ 

55,147 
— 
16,405 
25,707 
45,569 

12,454 
— 
11,136 
— 
— 

312  $ 
— 
— 
32,167 
— 
— 

625,363 
100,695 
100 
70,646 
66,431 
49,452 

13,750 
120,573  $ 

44,337 

528,819  $ 

36,565 
325,468  $ 

— 
32,479  $ 

94,652 
1,007,339 

LivaNova  has  other  commitments  that  the  Company  is  contractually  obligated  to  fulfil  with  cash  under  certain  circumstances. 
Obligations  under  these  guarantees  are  not  normally  called,  as  LivaNova  typically  comply  with  underlying  performance 
requirements.  As  of  31  December  2023,  no  liability  has  been  recorded  in  the  consolidated  financial  statements  associated  with 
these obligations.

The following table summarizes the Company’s guarantees as of 31 December 2023 (in thousands):

Less Than 
One Year

One to Three 
Years

Three to Five 
Years

Thereafter

Total 
Guarantees

      . . . . . . $ 

Guarantees on government bids (1)
Guarantees - commercial (2)    . . . . . . . . . . .
Guarantees to tax authorities (3)       . . . . . . . .
Guarantees to third-parties       . . . . . . . . . . . .
Total guarantees       . . . . . . . . . . . . . . . . . . . . $ 

3,322  $ 
553 
4,318 
268 
8,461  $ 

1,835  $ 
344 
1,197 
410 
3,786  $ 

520  $ 

— 
— 
— 

520  $ 

1,326  $ 
1,710 
— 
553 
3,589  $ 

7,003 
2,607 
5,515 
1,231 
16,356 

(1) Government bid guarantees include such items as unconditional bank guarantees, irrevocable letters of credit and bid bonds.

(2) Commercial guarantees include the Company’s lease and tenancy guarantees.

(3) Guarantees to tax authorities consist of guarantees issued to the Italian Revenue Agency.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________30

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
STRATEGIC REPORT
Business Review

Market Risk

LivaNova  is  exposed  to  certain  market  risks  as  part  of  its  ongoing  business  operations,  including  risks  from  foreign  currency 
exchange rates, interest rate risks and concentration of procurement suppliers, that could adversely affect LivaNova’s consolidated 
financial  position,  results  of  operations  or  cash  flows.  LivaNova  manages  these  risks  through  regular  operating  and  financing 
activities and, at certain times, derivative financial instruments.

Foreign Currency Exchange Rate Risk

Due  to  the  global  nature  of  LivaNova’s  operations,  the  Company  is  exposed  to  FX  fluctuations.  Historically,  LivaNova  has 
maintained  a  foreign  currency  exchange  rate  risk  management  strategy  that  utilizes  cash  flow  hedges  and  freestanding  foreign 
currency  derivatives  to  reduce  the  Company’s  exposure  to  unanticipated  fluctuations  in  forecasted  revenue  and  costs,  inter-
company debt, bank deposits, accounts receivable, and accounts payable caused by changes in foreign currency exchange rates. 
Upon  the  settlement  of  LivaNova’s  foreign  currency  cash  flow  hedges  in  the  fourth  quarter  of  2022  and  following  an  in-depth 
analysis  of  the  utility  of  the  Company’s  cash  flow  hedging  program,  LivaNova  discontinued  its  foreign  currency  cash  flow 
hedging program. LivaNova continues to use freestanding derivative forward contracts to offset exposure to the variability of the 
value associated with assets and liabilities denominated in a foreign currency.

LivaNova mitigates its credit risk relating to counterparties of its derivatives through a variety of techniques, including transacting 
with  multiple,  high-quality  financial  institutions,  thereby  limiting  the  Company’s  exposure  to  individual  counterparties  and  by 
entering into ISDA Master Agreements, which include provisions for a legally enforceable master netting agreement, with almost 
all  of  LivaNova’s  derivative  counterparties.  The  terms  of  the  ISDA  agreements  may  also  include  credit  support  requirements, 
cross default provisions, termination events, and set-off provisions. Legally enforceable master netting agreements reduce credit 
risk  by  providing  protection  in  bankruptcy  in  certain  circumstances  and  generally  permitting  the  closeout  and  netting  of 
transactions with the same counterparty upon the occurrence of certain events.

If LivaNova was to incur a hypothetical 10% adverse change in foreign currency exchange rates, net unrealised losses associated 
with  LivaNova’s  foreign  currency  denominated  assets  and  liabilities  as  of  31  December  2023  would  be  approximately  $4.5 
million.  Any  gains  and  losses  on  the  fair  value  of  derivative  contracts  would  generally  be  offset  by  gains  and  losses  on  the 
underlying transactions. These offsetting gains and losses are not reflected in the above analysis.

Interest Rate Risk

LivaNova is subject to interest rate risk on its investments and debt. Historically, LivaNova has entered into interest rate derivative 
instruments designated as cash flow hedges to manage the exposure to interest rate movements and to reduce the risk of increased 
borrowing costs by converting floating-rate debt into fixed-rate debt. Under these agreements, LivaNova agrees to exchange, at 
specified  intervals,  the  difference  between  fixed  and  floating  interest  amounts  calculated  by  reference  to  agreed-upon  notional 
principal amounts. These interest rate swaps are structured to mirror the payment terms of the underlying loan. The Company’s 
outstanding interest rate swaps expired on 6 April 2023. LivaNova elected not to renew the interest rate swaps as finance expenses 
associated  with  the  Initial  Term  Facility  is  principally  offset  by  holding  a  significant  portion  of  the  Initial  Term  Facility  in  a 
depository account, which earns a floating rate of interest. 

If  interest  rates  associated  with  LivaNova’s  variable-rate  financing  arrangements  as  of  31  December  2023  were  to  increase/
(decrease)  by  100  basis  points,  the  effect  on  finance  expenses  within  LivaNova’s  consolidated  statement  of  (loss)  would  be  an 
increase/(decrease)  of  approximately  $3.5  million,  respectively.  Conversely,  if  the  interest  rate  associated  with  LivaNova’s 
variable-rate depository account as of 31 December 2023 were to increase/(decrease) by 100 basis points, the effect on net foreign 
exchange  and  other  income/(expense)  within  LivaNova’s  consolidated  statements  of  income  (loss)  would  be  an  increase/
(decrease) of approximately $3.5 million, respectively.

Concentration of Credit Risk

LivaNova’s trade accounts receivable represent potential concentrations of credit risk. This risk is limited due to the large number 
of customers and their dispersion across a number of geographic areas, as well as LivaNova’s efforts to control its exposure to 
credit risk by monitoring its receivables and the use of credit approvals and credit limits. In addition, LivaNova has historically 
had strong collections and minimal write-offs. While LivaNova believes that its reserves for credit losses are adequate, essentially 
all  of  the  Company’s  trade  receivables  are  concentrated  in  the  hospital  and  healthcare  sectors  worldwide,  and  accordingly, 
LivaNova is exposed to their respective business, economic and country-specific variables. Although LivaNova does not currently 
foresee  a  concentrated  credit  risk  associated  with  these  receivables,  repayment  is  dependent  on  the  financial  stability  of  these 
industry sectors and the respective countries’ national economies and healthcare systems. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________31

STRATEGIC REPORT
Risk and Uncertainties

Risks and Uncertainties

Risks Relating to the Company’s Business and Operations

LivaNova is subject to the risks of conducting business internationally.

LivaNova designs, develops, manufactures, markets, and sells products globally, and the Company intends to continue to pursue 
growth opportunities worldwide. LivaNova’s international operations are subject to risks that are inherent in conducting business 
globally  and  under  non-US  laws,  regulations  and  customs.  These  risks,  many  of  which  LivaNova  has  experienced  first-hand, 
include: higher danger of terrorist activity, war or civil unrest; greater exposure to inflation; volatility in freight and labor costs; 
fluctuating  interest  and  exchange  rates;  evolving  sanctions;  increased  exposure  to  cyber-attacks  and  supply  chain  challenges; 
changing  energy  prices;  local  product  changes  and  compliance  requirements;  longer  payments  terms  and  collection  times  for 
receivables  in  local  jurisdictions;  difficulty  enforcing  agreements;  greater  exposure  to  creditworthiness  of  customers  and 
inconsistent  local  law  enforcement  of  obligations;  trade  protection  measures  and  import  and  export  licensing  requirements; 
ensuring  compliance  with  anti-bribery  laws;  different  labor  regulations  and  workforce  instability;  selling  its  products  through 
distributors and agents; and political and economic instability.

Conflicts, for example, including those in Ukraine and the Middle East, have caused the Company to assess its ability to source 
materials, sell product, collect payment, and comply with international sanctions in the aforementioned markets. These conflicts 
have increased economic and regulatory uncertainties, and a significant escalation or continuation of these conflicts could have a 
material impact on the Company’s operating results.

Certain of LivaNova’s subsidiaries have engaged in business dealings in countries subject to comprehensive sanctions, including 
Iran, Sudan and Syria in addition to Russia and Belarus. These business dealings represent an insignificant amount of LivaNova’s 
consolidated  revenues  and  income  but  expose  the  Company  to  a  heightened  risk  of  violating  applicable  sanctions  regulations. 
Violations  of  these  regulations  are  punishable  by  civil  and  criminal  penalties  including  fines,  denial  of  export  privileges, 
injunctions,  asset  seizures,  debarment  from  government  contracts  and  revocations  or  restriction  of  licenses,  as  well  as  criminal 
fines and imprisonment. Despite best efforts to comply, there can be no assurance that LivaNova’s policies and procedures will 
prevent the Company from violating these regulations in every transaction in which LivaNova may engage, and such a violation 
could adversely affect its reputation, business, results of operations, cash flows and financial condition.

LivaNova’s global operations result in revenues and expenses that are denominated in currencies other than LivaNova’s reporting 
currency, the USD. Fluctuations in exchange rates may impact, and have impacted, LivaNova’s results of operations and financial 
condition. Although LivaNova has in the past elected, and may in the future elect, to hedge certain foreign currency exposures, it 
is unlikely that any hedging strategy would eliminate its currency risk entirely.

In  many  of  the  countries  where  LivaNova  operates,  employees  are  covered  by  various  laws  and/or  collective  bargaining 
agreements that endow them, through their local or national representatives, with the right to be consulted in relation to specific 
issues,  including  reorganizations  and  staff  reductions.  The  laws  and/or  collective  bargaining  agreements  that  are  applicable  to 
these  agreements  could  have  an  impact  on  LivaNova’s  flexibility,  as  they  apply  to  programs  to  redefine  and/or  strategically 
reposition the Company’s activities. LivaNova’s ability to implement staff reduction programs or even temporary interruptions of 
employment  relationships  is  predicated  on  the  approval  of  government  entities  and  the  consent  of  labor  unions.  A  negative 
response  from  a  works  council  or  union-organized  work  stoppages  by  employees  could  have  a  negative  impact  on  LivaNova’s 
business.

Any  of  the  aforementioned  risks  could  adversely  affect  LivaNova’s  business,  results  of  operations,  cash  flows  and  financial 
condition.

Cyber-attacks  or  other  disruptions  to  LivaNova’s  information  technology  systems  could  lead  to  reduced  revenue,  increased 
costs, liability claims, fines, harm to LivaNova’s competitive position and loss of reputation.

LivaNova is increasingly dependent on its information technology systems and those of third parties to operate its business, and 
certain  products  of  the  Company  include  integrated  software  and  information  technology.  Such  dependencies  have  been 
exacerbated  by  remote  working  practices.  LivaNova  relies  on  information  technology  systems  to  collect  and  process  customer 
orders, manage product manufacturing and shipping, and support regulatory compliance. The Company routinely processes, stores 
and transmits large amounts of data, including sensitive personal information, patient health information and confidential business 
information.  The  secure  processing,  maintenance  and  transmission  of  this  information  is  critical  to  LivaNova’s  operations.  The 
quantity and complexity of the Company’s products and information technology systems make such systems vulnerable to cyber-
attacks,  breakdown,  interruptions,  destruction,  loss  or  compromise  of  data,  obsolescence  or  incompatibility  among  systems  or 
other significant disruptions. The Company has experienced, and is continually at risk of being subject to cyber-attacks and other 
disruptions. Programs and systems may require frequent updates or may no longer be supported, which may impact the ability of 
the Company’s information technology systems to operate properly or without disruption. Unauthorized persons routinely attempt 
to access LivaNova’s systems to disrupt, disable or degrade services, obtain proprietary or confidential information, make ransom 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________32

STRATEGIC REPORT
Risk and Uncertainties

demands,  and/or  remotely  disrupt  or  access  the  systems  of  large  health  care  providers  by  exploiting  the  Company’s  systems. 
Furthermore,  LivaNova’s  security  assessments  of  third-party  vendors  may  be  inadequate  to  determine  whether  their  security 
protocols are sufficient to withstand a cyber-attack or other security breach. LivaNova also cannot be certain that the Company 
will receive timely notification of such cyber-attacks or other security breaches. Cyber- attacks or other security breaches could 
remain  undetected  for  an  extended  period,  which  could  potentially  result  in  significant  harm  to  the  Company’s  information 
technology systems, as well as unauthorized access to the information stored on and transmitted by the Company’s information 
technology systems. In addition, to access LivaNova’s products and services, its clients may use computers and other devices that 
are beyond the Company’s security control safeguards.

Unauthorized  disclosure  or  use  of,  denial  of  access  to,  or  other  incidents  involving  sensitive  or  confidential  customer,  patient, 
employee,  vendor  or  Company  data,  whether  through  systems  failure,  employee  negligence,  fraud,  misappropriation,  or 
cybersecurity, ransomware or malware attacks, or other intentional or unintentional acts, could expose the Company to liability 
under  various  laws  and  regulations  across  jurisdictions  and  increase  the  risk  of  litigation  and  governmental  or  regulatory 
investigation,  damage  LivaNova’s  reputation  and  its  competitive  positioning  in  the  marketplace,  disrupt  its,  or  the  Company’s 
customers’  businesses,  or  cause  LivaNova  to  lose  customers,  resulting  in  significant  financial  exposure  and  legal  liability. 
Similarly,  unauthorized  access  to  or  through,  denial  of  access  to,  or  other  incidents  involving  LivaNova  or  its  vendors’ 
information  systems,  whether  by  the  Company’s  employees  or  third  parties,  including  a  cyber-attack  by  criminal  hackers, 
members of organized crime groups or state-sponsored organizations, who continuously develop and deploy viruses, ransomware, 
malware or other malicious software programs or social engineering attacks, has resulted and could in the future result in negative 
publicity,  significant  remediation  costs,  legal  liability,  notification  requirements,  and  damage  to  LivaNova’s  reputation,  which 
could  have  a  material  adverse  effect  on  the  Company’s  business,  results  of  operations,  cash  flows  and  financial  condition. 
Cybersecurity  threats  are  constantly  expanding  and  evolving,  becoming  increasingly  sophisticated  and  complex,  increasing  the 
difficulty of detecting and defending against them and maintaining effective security measures and protocols. Even when a cyber-
attack or other security incident is detected, the full extent of the incident may not be determined immediately. The costs to the 
Company to mitigate cyber-attacks and security incidents could be significant and, while the Company has implemented security 
measures to protect its information technology systems, its efforts to address these problems may not be successful. LivaNova’s 
cyber risk insurance may be insufficient to cover all losses, such as litigation costs or financial losses that exceed the Company’s 
policy limits or are not covered under any of its current insurance policies. Cyber risk insurance has also become more difficult 
and expensive to obtain, and LivaNova cannot be certain that the Company’s current levels of insurance will be available in the 
future on economically reasonable terms.

As previously disclosed, in November 2023, LivaNova detected a cybersecurity incident that resulted in a disruption of portions of 
the  Company’s  information  technology  systems.  Promptly  after  detecting  the  issue,  LivaNova  began  an  investigation  with 
assistance from external cybersecurity experts and notified law enforcement. LivaNova continues to assess the full impact of the 
cybersecurity  event  on  its  business,  and  these  impacts  may  materially  affect  its  results  of  operations,  cash  flows  and  financial 
condition.

The  costs  of  complying  with  the  requirements  of  federal,  state,  and  foreign  laws  pertaining  to  the  privacy  and  security  of 
personal  information,  including  health-related  information  and  the  potential  liability  associated  with  failure  to  do  so,  could 
materially adversely affect LivaNova’s business and results of operations.

There is significant regulatory and enforcement focus on data protection in the US (at both the federal and state level) and abroad, 
and  an  actual  or  alleged  failure  to  comply  with  applicable  US  or  foreign  data  protection  regulations  or  other  data  protection 
standards  may  expose  LivaNova  to  litigation,  including  class  action  litigation,  fines,  sanctions  or  other  penalties,  which  could 
harm  the  Company’s  reputation  and  adversely  impact  LivaNova’s  business,  results  of  operations,  cash  flows  and  financial 
condition. The Company collects, stores, and handles employee and patient data, including sensitive patient health information, 
which may present material obligations and risks to LivaNova’s business, including significantly expanded compliance burdens, 
costs and enforcement risks. If LivaNova does not lawfully collect, store, handle or otherwise process personal information and 
does not prevent data breaches, particularly given the increased risks associated with sensitive health information, LivaNova may 
suffer  legal  and  regulatory  consequences  in  addition  to  business  consequences.  As  a  result  of  its  worldwide  operations,  the 
Company  may  be  subject  to  various  data  protection  and  cyber-security  laws  and  regulations  in  many  jurisdictions,  including 
HIPAA, the CCPA and similar state laws, and the GDPR. Other governments have enacted, amended, or are enacting similar data 
protection laws, including data localization laws that require data to stay within their borders and other technical and operational 
adaptions  that  may  be  required  given  the  rapid  changes  in  data  protection  regulation  where  LivaNova  conducts  business.  The 
enactment  of  such  laws  could  have  potentially  conflicting  requirements  that  would  make  compliance  challenging.  LivaNova’s 
efforts to comply with applicable laws and regulations may be inadequate, and the Company may be unable to avoid enforcement 
actions  by  governmental  bodies.  Enforcement  actions  may  be  costly  and  could  interrupt  regular  operations  of  LivaNova’s 
business. Moreover, LivaNova’s insurance coverage may be insufficient to cover all losses. In addition, there is a trend of civil 
lawsuits and class actions relating to compromises of personal data or other cyber- attacks pursuant to laws such as the CCPA. 
While LivaNova has not been named in any such lawsuits, the Company could become a target of civil litigation or government 
enforcement actions as a result of a compromise to or loss of data.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________33

STRATEGIC REPORT
Risk and Uncertainties

Reductions and interruptions in LivaNova’s supply chain have had, and may continue to have, adverse effects on LivaNova’s 
business, results of operations, cash flows and financial condition.

LivaNova purchases many of the components and raw materials used in manufacturing its products from numerous suppliers in 
various countries. In some cases, LivaNova purchases specific components and raw materials from primary or main suppliers (or 
in some cases, a single or sole supplier) for reasons related to quality assurance, cost-effectiveness and availability. Any problem 
affecting a supplier (whether due to external or internal causes) could have a negative impact on LivaNova. Difficulties and delays 
in  manufacturing,  internally,  externally  or  otherwise  within  the  supply  chain,  may  lead  to  voluntary  or  involuntary  business 
interruptions or shutdowns, product shortages, withdrawals or suspensions of products from the market, and potential regulatory 
action.

While LivaNova works closely with its suppliers to ensure supply continuity and minimize the instances in which LivaNova relies 
on a sole supplier, the Company cannot guarantee that its efforts will always be successful. Moreover, due to strict standards and 
regulations governing the manufacture and marketing of LivaNova’s products, the Company may not be able to locate new supply 
sources quickly or at all in response to a supply reduction or interruption, resulting in negative effects on its ability to manufacture 
products effectively and timely. To date, the Company’s supply of raw materials and the production and distribution of finished 
products have not been materially affected, but to the extent the Company is unsuccessful in managing its supply chain, any such 
issues could have a material adverse effect on LivaNova’s business, results of operations, cash flows and financial condition.

The global medical device industry is highly competitive, and LivaNova may be unable to compete effectively.

LivaNova operates in a highly competitive market characterized by increasingly complex products that are expensive and time- 
consuming  to  develop  and  manufacture.  In  the  product  lines  in  which  LivaNova  competes,  the  Company  faces  a  mixture  of 
competitors ranging from large manufacturers with multiple business lines to small manufacturers that offer a limited selection of 
specialized  products.  Development  by  other  companies  of  new  or  improved  products,  processes,  or  technologies  may  make 
LivaNova’s products or proposed products less competitive. In addition, LivaNova faces competition from providers of alternative 
medical  therapies,  pharmaceuticals,  and  surgical  interventions,  among  others.  Competitive  factors  include:  product  quality, 
reliability and performance; product technology and innovation; breadth of product lines and product services; ability to identify 
new market trends; changes to the regulatory environment; cost-effectiveness and price; customer support and training; capacity to 
recruit engineers, scientists and other qualified employees; ability to navigate the regulatory approval process in the markets in 
which LivaNova operates; reimbursement approval; and effectiveness of systems and processes. Difficulties in any of these areas 
may have a material adverse effect on LivaNova’s business, results of operations, cash flows and financial condition.

The rapid pace of technological development in the medical industry and the specialized expertise required in different areas of 
medicine make it difficult for one company alone to develop a broad portfolio of technological solutions. As a result, LivaNova 
also relies on investments and investment collaborations to provide the Company access to new technologies. If LivaNova fails to 
develop new and enhanced products and services on a timely basis, the Company’s offerings will become obsolete over time, and 
its  business  and  financial  results  would  be  negatively  impacted.  LivaNova’s  success  depends  on  several  factors,  including  its 
ability to appropriately allocate the Company’s R&D funding to products and services with higher growth prospects, for example, 
further incorporation of software; hiring and retaining the necessary R&D talent; stimulating customer demand for and convincing 
customers to adopt new technologies; innovating and developing new technologies and applications; and acquiring or obtaining 
third-party technologies that may have valuable applications in the markets that LivaNova serves.

LivaNova  expects  to  make  investments  where  it  believes  that  the  Company  can  develop,  or  acquire,  new  technologies  and 
products  to  further  LivaNova’s  strategic  objectives  and  strengthen  LivaNova’s  existing  businesses.  Investments  and  investment 
collaborations  in  and  with  medical  technology  companies  are  inherently  risky,  and  LivaNova  cannot  guarantee  that  any  of  its 
previous or future acquisitions, investments or investment collaborations will be successful or will not materially adversely affect 
LivaNova’s business, results of operations, cash flows and financial condition.

The success and continuing development of LivaNova’s products depend on maintaining strong relationships with physicians and 
healthcare  professionals.  If  LivaNova  fails  to  maintain  its  working  relationships  with  physicians  and  other  healthcare 
professionals,  the  Company’s  products  may  not  be  developed  and  marketed  in  line  with  the  needs  and  expectations  of  the 
professionals  who  use  and  support  LivaNova’s  products.  Physicians  assist  LivaNova  as  researchers,  marketing  consultants, 
product  consultants,  inventors  and  public  speakers,  and  LivaNova  relies  on  these  professionals  to  provide  the  Company  with 
considerable  knowledge  and  experience.  If  LivaNova  is  unable  to  maintain  these  strong  relationships,  the  development  and 
marketing of the Company’s products could suffer, which could have a material adverse effect on LivaNova’s business, results of 
operations, cash flows and financial condition.

LivaNova’s  products  are  subject  to  complex  laws  and  regulations,  and  failure  to  obtain  product  approvals,  clearance  or 
reimbursement may materially adversely affect LivaNova’s business, results of operations, cash flows and financial condition.

LivaNova’s medical devices and technologies, as well as its business activities, are subject to a complex set of regulations and 
rigorous  enforcement,  including  by  the  FDA,  US  Department  of  Justice,  HHS,  and  numerous  other  federal,  state,  and  non-US 
governmental authorities. The time required to obtain approvals from foreign countries may be longer or shorter than that required 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________34

STRATEGIC REPORT
Risk and Uncertainties

for FDA clearance, and requirements for such approvals may differ from FDA requirements. To varying degrees, each of these 
agencies  requires  LivaNova  to  comply  with  laws  and  regulations  governing  the  development,  testing,  manufacturing,  labelling, 
reimbursement,  marketing,  and  distribution  of  LivaNova’s  products.  As  a  part  of  the  approval,  marketing  clearance  or 
reimbursement  process  for  new  products  and  new  indications  for  existing  products,  LivaNova  may  conduct  clinical  trials  and 
studies. Unfavourable or inconsistent clinical data from existing or future clinical trials, or the interpretation of such clinical data 
by  customers  and/or  regulatory  authorities,  may  adversely  impact  LivaNova’s  ability  to  obtain  product  approvals  and  receive 
reimbursement.

LivaNova, for example, is currently conducting clinical studies, and any delays or news regarding unfavourable or inconsistent 
data could have a material adverse effect on LivaNova’s business. Success in pre-clinical testing and early clinical studies does 
not  always  ensure  that  later  clinical  studies  will  be  successful,  as  LivaNova  experienced  and  announced,  for  instance,  in 
connection with stopping enrollment of the ANTHEM-HFrEF clinical trial, and LivaNova cannot be sure that later studies will 
replicate the results of prior studies. Any delay or termination of LivaNova’s clinical studies will delay or preclude the filing of 
regulatory  submissions  or  requests  for  coverage  determinations  and,  ultimately,  LivaNova’s  ability  to  commercialize  new 
products or product modifications and obtain reimbursement for the Company’s products. It is also possible that patients enrolled 
in  clinical  studies  will  experience  adverse  side  effects  that  are  not  currently  part  of  the  product’s  profile,  which  could  inhibit 
further marketing and development of such products.

Even if LivaNova is able to obtain approval, marketing clearance and reimbursement, it may take a significant amount of time, 
require  the  expenditure  of  substantial  resources,  involve  stringent  clinical  and  pre-clinical  testing  and  increased  post-market 
surveillance, and/or involve modifications, repairs or replacements of LivaNova’s products or limitations on the proposed uses of 
its products. Ultimately, LivaNova cannot guarantee that its clinical trials will be successful or that the Company will be able to 
obtain or maintain marketing clearance and/or reimbursement for new products or modifications to existing products. Any such 
issues, whether in relation to trials, approvals, clearances or reimbursement, could have a material adverse effect on LivaNova’s 
business, results of operations, cash flows and financial condition.

Failure to comply with product-related government regulations may materially adversely affect LivaNova’s business, results of 
operations, cash flows and financial condition.

Both before and after a product is commercially released, LivaNova has ongoing responsibilities under FDA and other applicable 
non-US government agency regulations. For instance, many of LivaNova’s facilities and procedures and those of its suppliers are 
subject  to  periodic  inspections  by  the  FDA,  which  can  result,  and  in  the  past  has  resulted,  in  inspectional  observations  on  the 
FDA’s Form-483, warning letters, or other forms of enforcement. If the FDA were to conclude that LivaNova is not in compliance 
with applicable laws or regulations, or that any of the Company’s medical products are ineffective or pose an unreasonable health 
risk, the FDA could ban such medical products, detain or seize adulterated or misbranded medical products, order a recall, repair, 
replacement  or  refund  of  such  products,  refuse  to  grant  pending  PMA  applications,  and/or  require  LivaNova  to  notify  health 
professionals and others that the devices present unreasonable risks of substantial harm to the public health. Similar consequences 
could follow, such as audits by non-US regulators and notified bodies.

The FDA and other non-US government agencies could also assess civil or criminal penalties against LivaNova, the Company’s 
officers,  or  other  employees  and/or  impose  operating  restrictions  on  a  company-wide  basis.  The  FDA  could  also  recommend 
prosecution to the US Department of Justice. An adverse regulatory action could restrict LivaNova from effectively marketing and 
selling  its  products,  limit  its  ability  to  obtain  future  pre-market  clearances  or  PMAs,  and  result  in  a  substantial  modification  to 
LivaNova’s business practices and operations. These potential consequences, as well as any adverse outcome from government 
investigations,  could  have  a  material  adverse  effect  on  LivaNova’s  business,  results  of  operations,  cash  flows  and  financial 
condition.

In addition, device manufacturers are prohibited from promoting their products for uses and indications that are not set forth in the 
approved product labeling (so called “off-label uses”). While physicians may exercise their discretion in prescribing a device off-
label, a device manufacturer’s failure to comply with the related applicable regulations could subject LivaNova to significant civil 
or criminal exposure, administrative obligations and costs, and/or other potential penalties. The EU MDR, for example, prohibits 
manufacturers from misleading users and patients by suggesting uses for the device other than those stated as part of the intended 
purpose for which the conformity assessment was carried out.

Governmental  regulations  outside  the  US  have,  and  may  continue  to,  become  increasingly  stringent  and  common  as  well.  For 
example, the EU MDR has resulted in significant additional premarket and post-market requirements. Certifications to EU MDR 
must  be  achieved  by  December  2027  or  December  2028,  based  on  the  risk  classification  of  the  device.  In  the  interim,  the 
European  Commission  is  allowing  companies  to  use  their  MDD  certifications.  LivaNova  is  working  to  obtain  all  appropriate 
approvals as required, as penalties for regulatory non-compliance can be severe, including fines and revocation or suspension of a 
company’s  business  license.  The  development  and  implementation  of  future  laws  and  regulations  may  also  have  a  material 
adverse effect on LivaNova.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________35

STRATEGIC REPORT
Risk and Uncertainties

Global  healthcare  policy  changes  and  reduction  in  reimbursement  for  products  may  have  a  material  adverse  effect  on 
LivaNova.

In response to increases in healthcare costs, there have been and continue to be proposals by governments, regulators and third- 
party payers to control these costs. These proposals have resulted in efforts to enact healthcare system reforms that may lead to 
pricing restrictions, payback requirements, limits on the amounts of reimbursement available for LivaNova’s products and limits 
on the acceptance and use of LivaNova’s products. For example, in 2015, the Italian Parliament introduced rules for entities that 
supply goods and services to the Italian National Healthcare System, impacting the business and financial reporting of medical 
technology sector companies that sell devices in Italy. A key provision of the law is a “payback” measure, requiring companies 
selling medical devices in  Italy  to  repay  a  percentage of the healthcare expenditures exceeding the regional maximum caps for 
medical devices. While LivaNova is appealing the imposition of the guidelines and requests for payment pursuant to the rule as 
well  as  waiting  on  the  Constitutional  Court  in  Italy  to  determine  the  constitutionality  of  the  rule,  the  Company  may  not  be 
successful.  See  “Note  24.  Commitments  and  Contingencies”  in  LivaNova’s  consolidated  financial  statements  included  in  this 
Report for additional information.

LivaNova’s ability to profitably commercialize the Company’s products is dependent, in large part, on whether third-party payers, 
including  private  healthcare  insurers,  managed  care  plans,  governmental  programs  and  others,  agree  to  cover  the  costs  and 
services associated with LivaNova’s products and related medical procedures in the US and internationally. Third-party payers, 
including  private  and  government  insurers,  are  increasingly  requiring  evidence  that  medical  devices  are  cost-effective.  If 
LivaNova is unable to demonstrate that the Company’s devices are cost-effective, third-party payers may not reimburse the use of 
LivaNova’s products or provide sufficient reimbursement for LivaNova’s products, which could reduce sales of the Company’s 
products to healthcare providers that depend upon reimbursement for payment for their services. Similarly, periodic changes to 
reimbursement methodologies could have an adverse impact on LivaNova’s business. Adoption of some or all of such healthcare 
policy  and  reimbursement  proposals  could  have  a  material  adverse  effect  on  LivaNova’s  business,  results  of  operations,  cash 
flows and financial position.

Failure  to  comply  with  rules  relating  to  reimbursement  of  healthcare  goods  and  services,  healthcare  fraud  and  abuse,  false 
claims  and  other  applicable  laws  or  regulations  may  subject  LivaNova  to  penalties  and  limit  patient  access  to  its  devices, 
thereby adversely impacting the Company’s reputation and business operations.

LivaNova’s devices and therapies are subject to regulation by various governmental agencies worldwide that are responsible for 
regulating  healthcare  goods  and  services,  including  laws  and  regulations  related  to  kickbacks,  false  claims,  self-referrals  and 
healthcare  fraud.  Because  LivaNova’s  marketing  practices  involve  direct  promotion  to  patients  in  certain  jurisdictions,  the 
Company is subject to additional laws and regulations intended to prevent misleading of patients and consumers through unethical 
promotional activities and related data collection practices. Any failure to comply with these laws and regulations could subject 
the Company or its officers and employees to criminal and civil financial penalties.

The risk of being found in violation of these laws is increased by the fact that many of them have not been fully interpreted by 
regulatory authorities or the courts and their provisions are open to a variety of interpretations. Because of the breadth of these 
laws  and  the  narrowness  of  the  statutory  exceptions  and  safe  harbors  available  under  such  laws,  it  is  possible  that  some  of 
LivaNova’s  business  activities,  including  the  Company’s  relationships  with  surgeons  and  other  healthcare  providers,  some  of 
whom recommend, purchase and/or prescribe LivaNova’s devices, group purchasing organizations and LivaNova’s independent 
sales agents and distributors, could be subject to challenge under one or more of such laws. Even an unsubstantiated allegation of 
impropriety could adversely impact LivaNova’s reputation and/or business operations.

Furthermore, LivaNova’s devices, products and therapies are purchased principally by hospitals or physicians that typically bill 
various  third-party  payers,  such  as  governmental  healthcare  programs  (e.g.,  Medicare,  Medicaid  and  comparable  non-US 
programs), private insurance plans and managed care plans for the healthcare services provided to their patients. The ability of 
LivaNova’s customers to obtain appropriate reimbursement for products and services from third-party payers is critical because it 
affects which products customers purchase and the prices they are willing to pay. LivaNova’s devices, products and therapies are 
subject  to  regulation  regarding  quality  and  cost  by  HHS,  including  CMS,  as  well  as  comparable  state  and  non-US  agencies 
responsible  for  reimbursement  and  regulation  of  healthcare  goods  and  services,  including  laws  and  regulations  related  to 
kickbacks,  false  claims,  self-referrals  and  healthcare  fraud.  In  addition,  as  a  manufacturer  of  US  FDA-approved  devices 
reimbursable  by  federal  healthcare  programs,  LivaNova  is  subject  to  the  Physician  Payments  Sunshine  Act,  which  requires  the 
Company  to  annually  report  certain  payments  and  other  transfers  of  value  LivaNova  makes  to  US-licensed  physicians,  US 
teaching hospitals or other covered recipients. Any failure to comply with these laws and regulations could subject the Company 
or its officers and employees to criminal and civil financial penalties.

Finally, LivaNova is subject to risks relating to changes in government and private medical reimbursement programs and policies 
and  changes  in  legal  regulatory  requirements  in  the  US  and  around  the  world.  Implementation  of  further  legislative  or 
administrative  reforms  to  these  reimbursement  systems,  or  adverse  decisions  relating  to  coverage  of  or  reimbursement  for 
LivaNova’s products by administrators of these systems, could have a material adverse impact on the acceptance of and demand 
for the Company’s products and the prices that LivaNova’s customers are willing to pay for them.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________36

STRATEGIC REPORT
Risk and Uncertainties

If  LivaNova’s  marketed  medical  devices  are  defective  or  otherwise  pose  safety  risks,  the  FDA  and  similar  non-US 
governmental authorities could require their recall or initiate an enforcement action, or LivaNova may initiate a recall of the 
Company’s products voluntarily.

The FDA and similar non-US governmental authorities may require the recall of commercialized products in the event of material 
deficiencies or defects in design, software or manufacture, or in the event that a product poses an unacceptable risk to patients’ 
health.  Manufacturers,  on  their  own  initiative,  may  recall  a  product  with  a  material  deficiency,  and  the  Company  has  initiated 
voluntary product recalls in the past. Any recall announcement could harm LivaNova’s reputation with customers and negatively 
affect  LivaNova’s  reputation,  business,  results  of  operations,  cash  flows  and  financial  position.  A  recall  could  also  impair 
LivaNova’s ability to produce its products in a cost-effective and timely manner. In the future, LivaNova may initiate voluntary 
withdrawal, removal or repair actions that the Company determines do not require notification as a recall. If a regulating authority 
were to disagree with LivaNova’s determinations, it could require the Company to report those actions as recalls.

In  addition,  depending  on  the  corrective  action  taken  to  redress  a  device’s  deficiencies  or  defects,  regulators  may  require,  or 
LivaNova may decide, that the Company needs to obtain new approvals or clearances before it markets or distributes the corrected 
device. Seeking such approvals or clearances may delay LivaNova’s ability to replace the recalled device in a timely manner. Any 
corrective  action,  whether  voluntary  or  involuntary,  or  related  litigation  will  require  investment  of  the  Company’s  time  and 
capital, distract management from operating the business, and may harm LivaNova’s reputation and financial results. Moreover, if 
LivaNova  does  not  adequately  address  problems  associated  with  its  devices,  the  Company  may  face  additional  regulatory 
enforcement  action,  including  FDA  warning  letters,  product  seizure,  injunctions,  administrative  penalties,  or  civil  or  criminal 
fines, any of which could have a material adverse effect on LivaNova’s business.

Failure  to  comply  with  anti-bribery  laws  could  materially  adversely  affect  LivaNova’s  business  and  result  in  civil  and/or 
criminal sanctions.

LivaNova’s operations are subject to anti-corruption laws, including the UK Bribery Act, the FCPA and other anti-corruption laws 
that  apply  in  countries  where  the  Company  does  business.  These  laws  generally  prohibit  LivaNova  and  its  employees  and 
intermediaries from bribing, being bribed or making other prohibited payments to government officials or other persons to obtain 
or retain business or gain some other business advantage. Because of the predominance of government-administered healthcare 
systems  in  many  parts  of  the  world  outside  the  US,  many  of  LivaNova’s  customer  relationships  are  potentially  subject  to  such 
laws.

LivaNova  is,  therefore,  exposed  to  the  risk  that  its  employees,  independent  contractors,  principal  investigators,  consultants, 
vendors, independent sales agents, and distributors may engage in fraudulent or other illegal activity in violation of these laws and 
LivaNova’s  Code  of  Conduct.  LivaNova  maintains  policies  and  programs  to  educate  its  employees  and  agents  on  these  legal 
requirements, and to prevent and prohibit improper practices. However, existing safeguards and any future improvements may not 
always  be  effective,  and  LivaNova’s  employees,  consultants,  sales  agents,  or  distributors  may  engage  in  conduct  for  which 
LivaNova  could  be  held  responsible.  In  addition,  regulators  could  seek  to  hold  LivaNova  liable  for  conduct  committed  by 
companies  in  which  LivaNova  invests  or  acquires.  The  FCPA  can  pose  unique  challenges  for  manufacturers  who  operate  in 
foreign  cultures  where  conduct  prohibited  by  the  FCPA  may  not  be  viewed  as  illegal  in  local  jurisdictions.  It  is  not  always 
possible  to  identify  and  deter  misconduct  by  LivaNova’s  employees  and  other  third  parties,  and  the  precautions  the  Company 
takes to detect and prevent this activity may not be effective in controlling unknown or unmanaged risks or losses or in protecting 
LivaNova  from  governmental  investigations  or  other  actions  or  lawsuits  stemming  from  a  failure  to  comply  with  such  laws  or 
regulations.

Global  enforcement  of  anti-corruption  laws  has  increased  substantially  in  recent  years,  with  more  frequent  voluntary  self- 
disclosures by companies, aggressive investigations and enforcement proceedings by governmental agencies, and assessment of 
significant fines and penalties against companies and individuals. LivaNova cannot predict the nature, scope or effect of future 
regulatory requirements to which the Company’s international operations might be subject or the manner in which existing laws 
might  be  administered  or  interpreted.  Any  alleged  or  actual  violations  of  these  laws  and  regulations  may  subject  LivaNova  to 
government scrutiny, severe criminal or civil sanctions and other liabilities, including exclusion from government contracting or 
government healthcare programs, and could negatively affect LivaNova’s reputation, business, results of operations, cash flows 
and financial condition.

Quality concerns with LivaNova’s processes, products, and services could harm the Company’s reputation for producing high-
quality products and erode LivaNova’s competitive advantage, revenue, and market share.

Quality  is  extremely  important  to  LivaNova  and  its  customers  due  to  the  serious  and  costly  consequences  of  product  failure. 
LivaNova’s quality certifications are critical to the marketing success of the Company’s products and services. If LivaNova fails 
to meet these standards, the Company’s reputation could be damaged, the Company could lose customers and LivaNova’s revenue 
and  results  of  operations  could  decline.  Aside  from  specific  customer  standards,  LivaNova’s  success  depends  generally  on  the 
Company’s  ability  to  manufacture  precision-engineered  components,  sub-assemblies,  and  finished  products  to  exact  tolerances 
with  certified  materials.  If  LivaNova’s  components  fail  to  meet  these  standards  or  fail  to  adapt  to  evolving  standards,  the 

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STRATEGIC REPORT
Risk and Uncertainties

Company’s reputation as a manufacturer of high-quality components will be harmed, its competitive advantage could be damaged, 
and LivaNova could lose customers and market share.

LivaNova may not successfully execute or achieve the expected benefits of the Company’s 2024 Restructuring Plan and other 
cost  saving  measures  the  Company  may  take  in  the  future  which  may  adversely  affect  the  Company’s  business,  financial 
condition and results of operations.

On 5 January 2024, LivaNova’s Board of Directors approved the 2024 Restructuring Plan to enhance the Company’s focus on its 
core Cardiopulmonary and Neuromodulation segments. As part of the 2024 Restructuring Plan, the Company will wind down the 
ACS segment, which is anticipated to be substantially complete by the end of 2024. The 2024 Restructuring Plan is based on the 
Company’s  current  estimates,  assumptions  and  forecasts,  which  are  subject  to  known  and  unknown  risks  and  uncertainties, 
including assumptions regarding cost savings, cash burn rate, and effectiveness of the Company’s reduced spend. Additionally, 
LivaNova  may  not  fully  achieve  the  expected  cost  savings,  enhanced  liquidity  and  other  benefits  anticipated  from  the  2024 
Restructuring Plan. To the extent that the Company is unsuccessful in implementing the 2024 Restructuring Plan or other, future 
cost saving measures, such issues could have a material adverse effect on LivaNova’s business, reputation, result of operations, 
cash  flows,  and  financial  condition.  For  additional  information  on  the  2024  Restructuring  Plan,  please  refer  to  “Note  8. 
Restructuring ” in LivaNova’s consolidated financial statements included in this Report.

Legal and Intellectual Property Risks

As  a  manufacturer  of  medical  devices,  LivaNova  is  exposed  to  product  liability  claims  that  could  adversely  affect  its 
consolidated financial condition and tarnish the Company’s reputation.

LivaNova  designs,  develops,  manufactures,  markets,  and  sells  medical  devices,  both  equipment  and  implantables,  that  pose 
product  liability  risks.  Component  failures,  manufacturing  defects,  software  errors,  design  flaws  or  inadequate  disclosure  of 
product-related  risks  or  product  or  use-related  information,  or  physician  misuse  with  respect  to  these  or  other  products  the 
Company manufactures or sells could result in an unsafe condition for, injury to, or death of, a patient. Such an event could result 
in product liability claims or a recall of, or safety alert relating to, one or more of LivaNova’s products. For example, as described 
in  “Note  24.  Commitments  and  Contingencies”  in  LivaNova’s  consolidated  financial  statements  included  in  this  Report,  the 
Company is involved in product liability litigation relating to its cardiopulmonary 3T Heater-Cooler product that may adversely 
affect  LivaNova’s  financial  condition  and  may  require  the  Company  to  devote  significant  resources  to  its  defense  and/or 
settlement  of  these  claims.  Although  the  Company  is  defending  these  matters  vigorously,  the  outcome  could  have  a  material 
adverse effect on LivaNova’s business.

LivaNova  holds  global  insurance  policies  to  cover  a  portion  of  future  potential  product  liability  losses  and  has  elected  to  self- 
insure with respect to a significant portion of the Company’s product liability risks. Product liability claims or product recalls in 
the future, regardless of their ultimate outcome, could have a material adverse effect on LivaNova’s business and reputation and 
on  the  Company’s  ability  to  attract  and  retain  customers  for  its  products,  and  future  losses  from  product  liability  claims  could 
exceed  LivaNova’s  product  liability  insurance  coverage  and  lead  to  a  material  adverse  effect  on  the  Company’s  financial 
condition  and  liquidity.  In  addition,  future  unanticipated  large  liability  claims  may  raise  substantial  doubt  about  LivaNova’s 
ability to continue as a going concern.

LivaNova is subject to environmental laws and regulations and the risk of environmental liabilities, violations, and litigation in 
multiple jurisdictions, any of which could have a material impact on LivaNova’s business, results of operations, cash flows, 
financial condition and liquidity.

Certain environmental laws assess liability on current, prior and/or related owners or operators of real property for the costs of 
investigation, removal, or remediation of hazardous substances on their properties or at properties on which they have disposed of 
hazardous  substances.  For  example,  LivaNova’s  Saluggia  campus  contains  hazardous  substances  as  a  result  of  nuclear 
installations  built  in  1960  under  previous  ownership,  and  the  Italian  Government  has  stated  that  LivaNova  will  eventually  be 
responsible  for  dismantling  the  nuclear  installation  on  Company  property,  as  well  as  delivering  the  aforementioned  waste  to  a 
national  repository.  It  is  also  possible  that  a  governmental  authority  may  seek  to  hold  LivaNova  liable  for  successor  liability 
violations committed by any companies in which LivaNova invests or acquires. For example, LivaNova is currently in litigation 
with  the  government  in  Italy  stemming  from  a  civil  action  where  the  Court  of  Appeal  declared  LivaNova  (formed  through  a 
merger with Sorin) liable for environmental liabilities incurred by SNIA’s (a former parent company of Sorin) other subsidiaries. 
See  “Note  24.  Commitments  and  Contingencies”  in  LivaNova’s  consolidated  financial  statements  included  in  this  Report  for 
additional information regarding these two matters. LivaNova’s business, results of operations, cash flows, financial condition and 
liquidity could be materially adversely affected by a negative decision in the case of SNIA and could be adversely affected by an 
increase in anticipated costs relating to disposal of hazardous waste in Saluggia. Private parties could also bring personal injury or 
other claims due to the presence of, or exposure to, hazardous substances.

In addition, LivaNova’s operations involve the use of substances regulated under environmental laws, including for purposes of 
sterilization. Regulations require sterilization of LivaNova’s products, and the Company operates a sterilization facility in

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STRATEGIC REPORT
Risk and Uncertainties

Colorado allowing the Company to sterilize certain of its products in-house. The US Environmental Protection Agency and certain 
states have begun scrutinizing the levels of community exposure to EtO, which is used in the sterilization process. Certain medical 
device operating facilities have been designated as “elevated risk” facilities based on emission levels of EtO. LivaNova is not on 
the “elevated risk” list, nor is it in violation of any current local or federal regulations. However, to the extent LivaNova or its 
contract  sterilizers  are  unable  to  sterilize  LivaNova’s  products,  whether  due  to  regulatory,  legislative,  or  other  constraints, 
including on the use of EtO, LivaNova may be unable to transition to alternative internal or external resources or methods in a 
timely or cost-effective manner or at all, which could have a material impact on LivaNova’s results of operations and financial 
condition.

LivaNova is substantially dependent on patent and other proprietary rights and failing to protect such rights or to be successful 
in litigation related to LivaNova’s rights or the rights of others may result in the Company’s payment of significant monetary 
damages  and/or  royalty  payments,  negatively  impact  LivaNova’s  ability  to  sell  current  or  future  products  or  prohibit  the 
Company from enforcing its patent and other proprietary rights against others.

LivaNova  relies  on  a  combination  of  patents,  trade  secrets,  and  non-disclosure  and  non-competition  agreements  to  protect  the 
Company’s proprietary intellectual property, and LivaNova will continue to do so. While LivaNova intends to defend against any 
threats to the Company’s intellectual property, any litigation to counter the infringement, misappropriation, or unauthorized use of 
LivaNova’s  intellectual  property  may  require  the  expenditure  of  significant  financial  and  managerial  resources,  which  may 
adversely affect LivaNova’s business, results of operations, cash flows and financial condition. Additionally, LivaNova’s patents, 
trade  secrets,  or  other  agreements  may  not  prevent  competitors  from  independently  developing  or  selling  similar  products  and 
services and may not adequately deter misappropriation or improper use of the Company’s technology. Further, pending patent 
applications may not result in patents being issued to LivaNova. Patents issued to or licensed by LivaNova in the past or in the 
future may be challenged or circumvented by competitors and such patents may be found invalid, unenforceable or insufficiently 
broad to protect the Company’s technology, and may limit LivaNova’s competitive advantage. Third parties could obtain patents 
that may require LivaNova to negotiate licenses to conduct business, and the required licenses may not be available on reasonable 
terms or at all.

LivaNova also relies on non-disclosure and non-competition agreements with certain employees, consultants and other parties to 
protect, in part, trade secrets and other proprietary rights. LivaNova cannot be certain that these agreements will not be breached, 
that the Company will have adequate remedies for any breach, that others will not independently develop substantially equivalent 
proprietary information, or that third parties will not otherwise gain access to LivaNova’s trade secrets or proprietary knowledge. 
Further, new proposed regulations in the US would prohibit certain competition agreements, and if final regulations are adopted as 
proposed and enforced, LivaNova may not be able to rely on such agreements with certain of the Company’s employees or other 
parties.

LivaNova operates in an industry characterized by extensive patent litigation and has been, and is, subject to patent claims from 
time to time. While LivaNova intends to defend against any third-party intellectual property threats, intellectual property litigation 
is inherently complex and unpredictable. Such litigation can result in significant damage awards and injunctions that could prevent 
LivaNova’s manufacture and sale of affected products or require the Company to pay significant royalties in order to continue to 
manufacture or sell affected products.

In addition, the laws and intellectual property systems of certain countries in which LivaNova markets some of its products do not 
protect the Company’s intellectual property rights to the same extent as in the US, which may impact its market position in those 
countries.  LivaNova  could  also  face  competition  in  countries  where  the  Company  has  not  invested  in  an  intellectual  property 
portfolio,  or  where  the  Company  has  not  invested  in  the  same  protection  as  in  the  US.  If  the  Company  is  unable  to  protect 
LivaNova’s  intellectual  property in  those  countries, it could have a material adverse effect on LivaNova’s reputation, business, 
results of operations, cash flows and financial condition.

Inadequate  funding  for  US  federal  government  agencies  and  government  shutdowns  could  negatively  affect  LivaNova’s 
business, results of operations, cash flows and financial condition.

The ability of the FDA to review and approve new products can be affected by a variety of factors, including government funding 
levels,  the  ability  to  hire  and  retain  key  personnel,  government  shutdowns,  and  statutory,  regulatory  and  policy  changes.  In 
addition,  a  portion  of  LivaNova’s  revenue  is  dependent  on  US  federal  government  healthcare  program  reimbursement.  Any 
disruption  in  US  federal  government  operations,  including  government  shutdowns,  could  have  a  material  adverse  effect  on 
LivaNova’s business, results of operations, cash flows and financial condition.

Risks Related to LivaNova’s Indebtedness

Paying amounts due with respect to LivaNova’s outstanding Notes on interest payment dates, at maturity and upon exchange 
or conversion thereof, as applicable, will require a cash payment. LivaNova may not have sufficient cash flow from its business 
operations to pay when due or be able to raise the funds necessary to pay when due, amounts owed with respect to the Notes 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________39

 
STRATEGIC REPORT
Risk and Uncertainties

and/or  any  amounts  owed  under  the  Company’s  revolving  credit  facility  and  term  facilities,  which  could  adversely  affect 
LivaNova’s business and results of operations.

On 17 June 2020, LivaNova’s wholly-owned subsidiary, LivaNova USA, issued the 2025 Notes and on 8 March 2024, LivaNova 
issued the 2029 Notes. The ability to make scheduled payments of interest on, and principal of, to satisfy exchanges for cash or 
conversions, as applicable, in respect of, and/or to refinance LivaNova’s outstanding Notes or other indebtedness (including any 
indebtedness under LivaNova’s revolving credit facility or term facilities) depends on the Company’s future performance, which 
is subject to economic, financial, competitive and other factors beyond its control. For further information on LivaNova’s term 
facilities, please refer to the “Business Review” section in this Strategic Report under the section entitled “Liquidity and Capital 
Resources.” If LivaNova is unable to generate enough cash flow to make payments on the Notes or other indebtedness when due, 
the Company may be required to adopt one or more alternatives, such as selling assets or obtaining additional debt financing or 
equity capital on terms that may be onerous or highly dilutive. LivaNova’s ability to refinance the Notes or other indebtedness, 
which  the  Company  may  need  to  do  in  order  to  satisfy  its  obligations  thereunder,  will  depend  on  the  capital  markets  and 
LivaNova’s financial condition at such time. LivaNova may not be able to engage in these activities on desirable terms or at all, 
which could result in a default on the Notes and/or LivaNova’s revolving credit facility and term facilities.

The  holders  of  the  Notes  have  the  right  to  require  LivaNova  to  repurchase  their  Notes  upon  the  occurrence  of  a  fundamental 
change (as defined in the Indentures) at a repurchase price equal to 100% of the principal amount of the Notes to be repurchased, 
plus  accrued  and  unpaid  interest,  if  any.  Upon  repurchase  of  the  Notes,  LivaNova  will  be  required  to  make  cash  payments  as 
required by the Indentures. LivaNova may not have enough available cash or be able to obtain financing at the time the Company 
is  required  to  make  repurchases  of,  or  exchange  or  conversion  of,  as  applicable,  the  Notes  for  cash.  LivaNova’s  failure  to 
repurchase  the  Notes  or  exchange  or  convert  the  Notes,  as  applicable,  for  cash  at  a  time  when  the  repurchase  or  exchange  or 
conversion is required by the Indentures governing the Notes would constitute a default under such Indentures.

In addition, LivaNova’s indebtedness including under the Notes, combined with the Company’s other financial obligations and 
contractual commitments including those under LivaNova’s revolving credit facility or term facilities, could have other important 
consequences. For example, it could:

• Make LivaNova more vulnerable to adverse changes in government regulations and in the global economy, healthcare 

•
•
•

and competitive environment;
Limit the Company’s flexibility in planning for, or reacting to, changes in LivaNova’s business and its markets;
Place the Company at a disadvantage compared to LivaNova’s competitors who have less debt;
Limit  LivaNova’s  ability  to  borrow  additional  amounts  for  working  capital,  to  fund  acquisitions  and  for  other  general 
corporate purposes; and

• Make a sale of the Company less attractive to buyers or more difficult to complete.

Any  of  these  factors  could  harm  LivaNova’s  business,  results  of  operations,  cash  flows  and  financial  condition.  In  addition,  if 
LivaNova  incurs  additional  indebtedness  under  the  revolving  credit  facility  or  term  facilities,  the  risks  related  to  LivaNova’s 
business  and  its  ability  to  repay  the  Company’s  indebtedness,  including  under  the  Notes,  would  increase.  For  additional 
information,  please  refer  to  “Note  17.  Financial  Liabilities  ”in  LivaNova’s  consolidated  financial  statements  included  in  this 
Report.

The  conditional  exchange  or  conversion  features  of  the  Notes,  as  applicable,  if  triggered,  may  adversely  affect  LivaNova’s 
liquidity and operating results.

If the conditional exchange feature of the 2025 Notes is triggered, holders are entitled to exchange the 2025 Notes at any time 
during specified periods, at their option. Holders of the 2025 Notes for example, are entitled to exchange the 2025 Notes during 
the  current  calendar  quarter  if  the  closing  price  of  LivaNova’s  ordinary  shares  for  at  least  20  trading  days  (whether  or  not 
consecutive) during the last 30 consecutive trading days of the immediately preceding calendar quarter is greater than or equal to 
130% of the exchange price – the exchange price being $60.98 per share and the “conversion trigger” (subject to other conditions 
per the 2025 Indenture) being $79.27 per share – on each applicable trading day. The exchange condition was not satisfied on 31 
December 2023, and therefore, exchangeability is not an option from 1 January 2024, through 31 March 2024. If holders elect to 
exchange  their  2025  Notes  during  future  periods  following  the  satisfaction  of  an  exchange  condition  as  laid  out  in  the  2025 
Indenture,  LivaNova  would  be  required  to  settle  its  exchange  obligation  through  the  payment  of  cash,  which  could  adversely 
affect the Company’s liquidity.

Additionally, holders may convert their 2029 Notes at their option at any time prior to the close of business on the business day 
immediately preceding 15 December 2028 only under the following circumstances: (1) during any calendar quarter commencing 
after  the  calendar  quarter  ending  on  30  June  2024  (and  only  during  such  calendar  quarter),  if  the  last  reported  sale  price  of 
LivaNova’s ordinary shares for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading 
days ending on, and including, the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% 
of the conversion price on each applicable trading day; (2) during the five business day period after any ten consecutive trading 
day period in which the trading price per $1,000 principal amount of Notes for each trading day of the 2029 Notes Measurement 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________40

STRATEGIC REPORT
Risk and Uncertainties

Period was less than 98% of the product of the last reported sale price of LivaNova’s ordinary shares and the conversion rate on 
each such trading day; (3) if LivaNova calls such 2029 Notes for redemption, at any time prior to the close of business on the 
second  scheduled  trading  day  immediately  preceding  the  redemption  date,  but  only  with  respect  to  the  2029  Notes  called  (or 
deemed called) for redemption; or (4) upon the occurrence of specified corporate events. On or after 15 December 2028 until the 
close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert their Notes at 
any time, regardless of the foregoing circumstances.

The initial conversion rate of the 2029 Notes is 14.4085 of LivaNova’s ordinary shares, with a nominal value of £1.00 per share, 
per  $1,000  principal  amount  of  the  2029  Notes  (equivalent  to  an  initial  conversion  price  of  approximately  $69.40  per  ordinary 
share). Upon conversion of the 2029 Notes, LivaNova will pay cash up to the aggregate principal amount of the 2029 Notes to be 
converted  and  pay  or  deliver,  as  the  case  may  be,  cash,  LivaNova’s  ordinary  shares,  or  a  combination  of  cash  and  LivaNova’s 
ordinary shares, at LivaNova’s election, in respect of the remainder, if any, of LivaNova’s conversion obligation in excess of the 
aggregate  principal  amount  of  the  2029  Notes  being  converted.  Such  payment  of  cash  could  adversely  affect  the  Company’s 
liquidity.

LivaNova’s  debt  instruments  require  LivaNova  to  comply  with  affirmative  covenants  and  specified  financial  covenants  and 
ratios and other obligations.

Certain  restrictions  and  covenants  in  LivaNova’s  debt  instruments,  including  the  Company’s  revolving  credit  facility  or  term 
facilities, could affect its ability to operate and may limit its ability to react to market conditions or to take advantage of potential 
business  opportunities  as  they  arise.  For  example,  such  restrictions  could  adversely  affect  LivaNova’s  ability  to  finance  its 
operations, make strategic investments, alliances or acquisitions, restructure its organization or finance capital needs. Additionally, 
LivaNova’s  ability  to  comply  with  these  covenants  and  restrictions  may  be  affected  by  events  beyond  its  control,  such  as 
prevailing  economic,  financial,  regulatory  and  industry  conditions.  If  any  of  these  restrictions  or  covenants  are  breached, 
LivaNova could be in default under one or more of its debt instruments, which, if not cured or waived, could result in acceleration 
of the indebtedness under such agreements and cross-defaults under its other debt instruments. For more information on these debt 
instruments,  please  refer  to  “Note  17.  Financial  Liabilities”  in  LivaNova’s  consolidated  financial  statements  included  in  this 
Report.

The effective interest rate and related finance expenses reported in LivaNova’s consolidated financial statement of operations 
is significantly greater than the stated interest rate of the Notes and may result in volatility to the Company’s reported financial 
results, which could adversely affect the price at which LivaNova’s ordinary shares trade.

LivaNova will settle exchanges of the 2025 Notes entirely in cash. Additionally, upon conversion of the 2029 Notes, LivaNova 
will pay cash up to the aggregate principal amount of the 2029 Notes to be converted and pay or deliver, as the case may be, cash, 
LivaNova’s ordinary shares, or a combination of cash and LivaNova’s ordinary shares, at LivaNova’s election, in respect of the 
remainder,  if  any,  of  LivaNova’s  conversion  obligation  in  excess  of  the  aggregate  principal  amount  of  the  2029  Notes  being 
converted Accordingly, the exchange or conversion feature, as applicable that is part of the Notes is accounted for as a derivative 
pursuant to accounting standards relating to derivative instruments. This resulted in an initial accounting valuation of the exchange 
or conversion feature, as applicable, which was bifurcated from the debt component of the Notes, resulting in an original issue 
discount. The original issue discount is amortized and recognized as a component of finance expenses over the term of the Notes, 
which  results  in  an  effective  interest  rate  reported  in  LivaNova’s  consolidated  statements  of  operations  in  excess  of  the  stated 
interest rate of the Notes. Although this accounting treatment does not affect the amount of cash interest paid to holders of the 
Notes  or  LivaNova’s  cash  flows,  it  reduces  the  Company’s  earnings  and  could  adversely  affect  the  price  at  which  its  ordinary 
shares trade.

Additionally, for each financial statement period after issuance of the Notes, a derivative gain or loss is and will be reported in 
LivaNova’s consolidated statements of income (loss) to the extent the valuations of the exchange feature and conversion feature,  
as applicable, changes from the previous period. The Capped Call Transactions described below and elsewhere in this Report are 
also  accounted  for  as  derivative  instruments.  The  valuation  of  the  exchange  feature  of  the  2025  Notes  and  2025  Capped  Calls 
utilizes significant observable and unobservable market inputs, including stock price, stock price volatility, risk-free interest rate, 
and  time  to  expiration  of  the  2025  Notes.  The  valuation  of  the  conversion  feature  of  the  2029  Notes  and  2029  Capped  Calls 
similarly  utilizes  significant  observable  and  unobservable  market  inputs,  including  stock  price,  expected  volatility,  risk-free 
interest rate, expected dividend yield, and time to expiration of the 2029 Notes. The change in input values at the current period 
end compared to the previous period end may result in a material change in the respective valuations and the gain or loss resulting 
from  the  exchange  feature  of  the  2025  Notes  and  2025  Capped  Calls  and  the  conversion  feature  of  the  2029  Notes  and  2029 
Capped Calls, as applicable, and may not completely offset each other. As such, there may be a material net impact on LivaNova’s 
consolidated statements of operations, which could adversely affect the price at which its ordinary shares trade.

The  arbitrage  or  hedging  strategy  by  purchasers  of  the  Notes  and  Option  Counterparties  in  connection  with  LivaNova’s 
Capped Call Transactions may affect the value of LivaNova’s ordinary shares.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________41

STRATEGIC REPORT
Risk and Uncertainties

LivaNova  expects  that  many  investors  in,  and  potential  purchasers  of,  the  Notes  will  employ,  or  seek  to  employ,  an  arbitrage 
strategy  with  respect  to  the  Notes.  Investors  would  typically  implement  such  a  strategy  by  selling  short  LivaNova’s  ordinary 
shares underlying the Notes and dynamically adjusting their short position while continuing to hold the Notes. Investors may also 
implement this type of strategy by entering into swaps on LivaNova’s ordinary shares in lieu of or in addition to selling short the 
Company’s ordinary shares. This activity could decrease, or reduce the size of any increase in, the market price of LivaNova’s 
ordinary shares at that time.

In connection with the pricing of the Notes, LivaNova entered into the Capped Call Transactions. The Capped Call Transactions 
are expected generally to offset cash payments due upon exchange of the 2025 Notes and to compensate (through the payment of 
cash to LivaNova) for potential dilution to the Company’s ordinary shares, or to offset cash payments due, upon conversion of the 
2029 Notes in excess of the principal amount thereof in the event that the market price per ordinary share of the Company at the 
time of exchange of the 2025 Notes or conversion of the 2029 Notes, respectively, is greater than the strike price under the 2025 
Capped  Calls  or  2029  Capped  Calls,  respectively,  with  such  offset  subject  to  a  cap  based  on  the  respective  cap  prices.  It  is 
LivaNova’s understanding that the Option Counterparties, or their respective affiliates, in connection with establishing their initial 
hedges of the Capped Call Transactions, purchased LivaNova’s ordinary shares and/or entered into various derivative transactions 
with  respect  to  the  Company’s  ordinary  shares  concurrently  with  or  shortly  after  the  pricing  of  the  Notes.  The  Option 
Counterparties  or  their  respective  affiliates  may  modify  these  initial  hedge  positions  by  entering  into  or  unwinding  various 
derivatives  with  respect  to  LivaNova’s  ordinary  shares  and/or  purchasing  or  selling  its  ordinary  shares  or  other  of  LivaNova’s 
securities  in  secondary  market  transactions  prior  to  the  maturity  of  the  Notes  (and  are  likely  to  do  so  during  any  observation 
period related to an exchange of the 2025 Notes or upon a repurchase or redemption of the 2025 Notes or related to a conversion 
of the 2029 Notes or upon a repurchase of the 2029 Notes by LivaNova, if LivaNova elects to unwind a corresponding portion of 
the 2029 Capped Calls). This activity could cause or avoid an increase or decrease in the market price of LivaNova’s ordinary 
shares at that time.

LivaNova is subject to counterparty risk with respect to the Capped Call Transactions.

The Option Counterparties are financial institutions, and LivaNova is subject to the risk that they might default under the Capped 
Call Transactions. LivaNova’s exposure to the credit risk of the Option Counterparties is not secured by any collateral.

If  an  Option  Counterparty  becomes  subject  to  insolvency  proceedings,  LivaNova  will  become  an  unsecured  creditor  in  those 
proceedings,  with  a  claim  equal  to  the  Company’s  exposure  at  that  time  under  the  Capped  Call  Transactions  with  that  Option 
Counterparty.  LivaNova’s  exposure  will  depend  on  many  factors  but  generally  an  increase  in  the  Company’s  exposure  will  be 
correlated to an increase in the market price and in the volatility of its ordinary shares. In addition, upon a default by an Option 
Counterparty, LivaNova may suffer adverse tax consequences and may, on a net basis, have to pay more cash to settle exchanges 
or conversions of the Notes, as applicable, and may suffer more dilution the effect of which would not be compensated for than 
the Company currently anticipates with respect to the ordinary shares upon conversions of the 2029 Notes. LivaNova can provide 
no assurances as to the financial stability or viability of the Option Counterparties.

Risks Relating to Tax and LivaNova’s Jurisdiction of Incorporation

LivaNova is incorporated in England and Wales and governed by their laws which may afford less protection to shareholders 
than under US laws.

LivaNova  is  a  public  limited  company  incorporated  under  the  laws  of  England  and  Wales,  and  as  such,  the  Company’s 
shareholders  may  have  more  difficulty  protecting  their  interests  than  would  shareholders  of  a  corporation  incorporated  in  a 
jurisdiction of the US. It may be difficult to enforce court judgments obtained in the US and based on the civil liability provisions 
of US federal or state securities laws against LivaNova in the UK. In addition, there is also some uncertainty as to whether the UK 
courts would recognize or enforce judgments of US courts obtained against LivaNova or any of its directors or officers.

Changes  in  tax  laws  or  exposure  to  additional  income  tax  liabilities  could  have  a  material  impact  on  LivaNova’s  results  of 
operations and financial condition.

LivaNova is subject to income taxes as well as non-income-based taxes in the US, the UK, the EU and various other jurisdictions. 
Any  material  change  in  tax  laws,  regulations  or  policies,  or  their  interpretation  and  enforcement,  including  with  respect  to  the 
OECD’s Pillar Two global minimum tax rules applicable to multinational groups with global revenue over €750 million, could 
result in a higher effective tax rate and have a material impact on LivaNova’s consolidated statements of income (loss) or financial 
condition.

LivaNova continues to monitor the adoption of Pillar Two by the taxing jurisdictions in which it operates. The UK has enacted 
legislation providing for a minimum effective tax rate of 15% through a multinational top-up tax and a domestic top-up tax for 
accounting  periods  beginning  on  or  after  31  December  2023.  Draft  UK  legislation  has  also  been  published  for  an  undertaxed 
profits rule to be introduced, although not before accounting periods beginning on or after 31 December 2024. A UTPR would be 
a backstop rule intended to ensure that amounts of multinational top-up tax that are not collected under foreign global minimum 
tax rules can in certain circumstances be collected instead in the UK. LivaNova is assessing the full implication on 2024 financial 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________42

STRATEGIC REPORT
Risk and Uncertainties

results  and  will  continue  to  monitor  legislative  developments  and  related  guidance  in  the  UK  and  other  jurisdictions  that  may 
impact LivaNova’s operations. Any material changes in tax laws, regulations or policies, or their interpretation and enforcement, 
including with respect to Pillar Two, could result in a higher effective tax rate for LivaNova and have a material impact on its 
consolidated statements of income (loss) or financial condition.

LivaNova’s actual effective tax rate may vary from its expectations or from historical trends and that variance may be material. 
LivaNova’s effective tax rates could be affected by changes in the mix of earnings in countries with differing statutory tax rates, 
changes  in  the  valuation  of  deferred  tax  assets  and  liabilities  or  changes  in  tax  laws  or  their  interpretation.  LivaNova  is  also 
subject to ongoing tax audits in various non-US jurisdictions. Tax authorities may disagree with certain positions LivaNova has 
taken  and  assess  additional  taxes.  LivaNova  believes  that  its  accruals  reflect  the  probable  outcome  of  known  contingencies. 
However,  there  can  be  no  assurance  that  LivaNova  will  accurately  predict  the  outcomes  of  ongoing  audits,  and  the  actual 
outcomes  of  these  audits  could  have  a  material  impact  on  LivaNova’s  consolidated  statements  of  income  (loss)  or  financial 
condition.

As  a  public  limited  company  incorporated  under  the  laws  of  England  and  Wales,  certain  of  LivaNova’s  capital  structure 
decisions require shareholder approval, which may limit the Company’s flexibility to manage its capital structure.

LivaNova is a public limited company incorporated under the laws of England and Wales. Under English law, LivaNova’s Board 
of Directors may only allot shares with the prior authorization of shareholders. English law also generally provides shareholders 
with  preemptive  rights  when  new  shares  are  issued  for  cash,  which  rights  may  be  surrendered  by  shareholders.  In  addition, 
English  law  generally  prohibits  a  public  limited  company  from  repurchasing  its  own  shares  without  the  prior  approval  of 
shareholders. As a result, LivaNova’s shareholders must approve these authorities at an annual general meeting of shareholders. If 
LivaNova does not receive shareholder approval of these matters, the Company may not be able to raise any required additional 
capital  in  a  timely  manner  or  at  all.  In  addition,  LivaNova  may  not  be  able  to  continue  to  grant  equity  awards  to  its  directors, 
officers and employees under the relevant incentive plan.

Transfers  of  LivaNova’s  shares,  other  than  those  effected  by  means  of  the  transfer  of  book-entry  interests  in  DTC,  may  be 
subject to UK Stamp Duty or SDRT.

Transfers of LivaNova’s shares effected by means of the transfer of book-entry interests in DTC are not subject to UK stamp duty 
or SDRT. However, if a shareholder holds LivaNova’s shares directly rather than through DTC, any transfer of shares could be 
subject to UK stamp duty or SDRT at a rate of 0.5% of the consideration paid for the transfer. In addition, certain transfers of 
shares to depositories or into clearance services are charged at a rate of 1.5% of the consideration paid for the transfer, or 1.5% of 
the  market  value  of  the  shares  if  there  is  no  consideration.  The  transferee  generally  pays  the  UK  stamp  duty  or  SDRT.  The 
potential for UK stamp duty or SDRT could adversely affect the trading price of LivaNova’s shares.

If  DTC  determines  at  any  time  that  LivaNova’s  shares  are  not  eligible  for  continued  deposit  and  clearance  within  its  facilities, 
LivaNova  believes  that  its  shares  would  not  be  eligible  for  continued  listing  on  a  US  securities  exchange  and  trading  in  the 
Company’s  shares  would  be  disrupted.  While  LivaNova  would  pursue  alternative  arrangements  to  preserve  the  listing  and 
maintain trading, any such disruption could have a material adverse effect on the trading price of LivaNova’s shares.

General Risk Factors

LivaNova’s success depends on its ability to attract and retain key personnel needed to successfully operate its business and to 
plan for future executive transitions.

LivaNova’s  ability  to  compete  effectively  depends  on  its  ability  to  attract  and  retain  key  employees  and  maintain  robust 
succession  planning  for  key  positions.  LivaNova’s  ability  to  recruit  and  retain  key  talent  depends  on  many  factors,  including 
compensation and benefits, work location, work environment, industry-specific and general economic conditions and the hiring 
practices of competitors. If LivaNova fails to attract and retain key personnel in senior management and other positions, or if the 
Company’s succession planning efforts are not effective, it could have a material adverse effect on LivaNova’s business, financial 
condition and results of operations.

Increasing attention on sustainability matters, including environmental, social, and governance matters, may have a material 
impact on LivaNova’s reputation and business operations and consume additional financial and management resources.

There is a heightened focus from stakeholders, including regulators and shareholders, on issues relating to sustainability, including 
environmental stewardship, social responsibility, diversity and inclusion, and corporate governance matters. Increasing attention 
on  sustainability  issues  related  to  LivaNova’s  business  requires  the  continuous  monitoring  of  various  and  evolving  laws, 
regulations,  standards  and  expectations  and  the  associated  reporting  requirements.  A  failure  to  adequately  meet  stakeholder 
expectations  may  result  in  noncompliance,  reputational  harm,  the  loss  of  business  and  access  to  capital,  negative  impact  to  the 
stock price and a diluted market valuation. In addition, the Company’s adoption of certain standards or mandated compliance with 
certain requirements could necessitate additional investments that could impact LivaNova’s profitability.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________43

STRATEGIC REPORT
Risk and Uncertainties

In  addition,  if  LivaNova’s  sustainability  initiatives  fail  to  satisfy  investors,  customers,  or  other  stakeholders,  the  Company’s 
reputation,  its  ability  to  sell  products  and  services  to  customers,  and  its  attractiveness  as  an  investment,  business  partner  or 
acquirer could be negatively impacted. Similarly, LivaNova’s failure, or perceived failure, to fulfill its sustainability goals or to 
satisfy various reporting standards could also have a similar negative impact on the Company’s reputation, business and results of 
operations.  Furthermore,  environmental  regulations  are  continuing  to  become  more  stringent  and  LivaNova  may  experience 
increased compliance burdens and costs to meet its regulatory obligations, as well as adverse impacts on raw material sourcing, 
manufacturing operations and the distribution of LivaNova’s products.

The  impact  of  pending  or  existing  climate  change  resulting  from  increased  concentrations  of  carbon  dioxide  and  other 
greenhouse gases in the atmosphere could present major risks to LivaNova’s future operations.

The  physical  impacts  of  natural  disasters  and  extreme  weather  conditions,  such  as  hurricanes,  tornadoes,  earthquakes,  winter 
storms,  wildfires  or  flooding  could  pose  physical  risks  to  LivaNova’s  facilities,  temporarily  reduce  demand,  reduce  employee 
productivity, increase absenteeism, disrupt the Company’s supply chain operations and its suppliers’ operations, and negatively 
impact operational costs. Additionally, transitional climate risks such as changing customer behaviors and changing dynamics in 
raw materials and utility markets, could lead to lost revenue due to inability to meet changing customer requirements, increasing 
costs associated with product adjustments to meet changing customer preferences, increasing costs of inputs and raw materials and 
increasing cost of utilities. There continues to be a lack of consistent climate legislation, which creates economic and regulatory 
uncertainty. Legal, regulatory and customer requirements and preferences designed to mitigate the effects of climate change on the 
environment are increasing, and they may impose obligations that may increase LivaNova’s compliance burden and cost to meet 
these obligations. Individually or in aggregate, such risks could materially negatively impact LivaNova’s future operations.

Public health crises have had, and may continue to have, an adverse effect on LivaNova’s business, results of operations, cash 
flows and financial condition, the nature and extent of which are uncertain and unpredictable.

LivaNova’s global operations and business interactions with healthcare systems, providers and patients around the world expose 
the  Company  to  risks  associated  with  public  health  crises,  including  epidemics  and  pandemics  such  as  COVID-19.  The 
COVID-19  pandemic  caused  significant  disruption  to  the  business  and  financial  markets.  LivaNova  continues  to  monitor  the 
potential  effects  of  future  health  epidemics  on  the  Company’s  business  and  operations.  While  the  spread  of  COVID-19  has 
stabilized, LivaNova cannot guarantee that a future outbreak of this or any other widespread epidemic will not occur, which could 
have the effect of decreasing demand and/or increasing volatility in demand for LivaNova’s products.

If LivaNova’s business development and restructuring activities are unsuccessful, the Company may not realize the intended 
benefits.

LivaNova has sought, and in the future, may seek, to supplement its organic growth through strategic investments, alliances and 
acquisitions. Moreover, LivaNova has also sought, and in the future may seek, to divest or wind down certain assets deemed non-
core to the Company’s long-term strategic objectives. For example, as part of the 2024 Restructuring Plan, the Company will wind 
down the ACS segment, which is anticipated to be substantially complete by the end of 2024. Such transactions are inherently 
risky and require significant effort and management attention. The success of any investment, alliance, acquisition or divestiture 
may be affected by various factors, including LivaNova’s ability to properly assess, finance, value and obtain relevant approvals 
for a potential business opportunity or to successfully integrate any business LivaNova may acquire. LivaNova cannot be certain 
that its investments, alliances and acquired businesses will achieve the financial projections supporting those investment decisions. 
In addition, if LivaNova’s investments, alliances, divestitures, or acquisitions are not successful, the Company may incur costs in 
excess of what it anticipates, including those resulting from related litigation.

As  a  result  of  acquisitions,  LivaNova  may  face  risks  due  to  the  implementation,  modification,  or  remediation  of  controls, 
procedures  and  policies  relating  to  data  privacy  and  cybersecurity  at  the  acquired  company.  In  addition,  failure  to  manage  and 
coordinate the growth of the combined company successfully could have an adverse impact on LivaNova’s business.

Similarly, LivaNova may divest and has divested portions of its business, resulting in the migration of data and overlapping data 
obligations. As a result of such divestitures, LivaNova may face risks due to the migration or modification of controls, procedures 
and  policies  relating  to  data  privacy  and  cybersecurity  internally  or  enroute  during  migration.  Any  significant  breakdown, 
intrusion,  interruption,  corruption  or  destruction  of  these  systems,  as  well  as  any  data  breaches,  could  have  a  material  adverse 
effect on LivaNova’s business.

LivaNova  may  incur  impairments  of  intangible  assets,  goodwill  and  other  long-lived  assets  that  may  adversely  affect  the 
Company’s financial results.

LivaNova reviews, when circumstances warrant, the carrying amounts of its intangible assets, goodwill and other long-lived assets 
to  determine  whether  those  carrying  amounts  continue  to  be  recoverable  in  accordance  with  US  GAAP.  Significant  negative 
industry  or  economic  trends,  disruptions  to  LivaNova’s  businesses,  significant  unexpected  or  unplanned  changes  in  the  use  of 
assets, divestitures and market capitalization declines, among other events, may result in impairments to LivaNova’s intangible 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________44

STRATEGIC REPORT
Risk and Uncertainties

assets, goodwill and other long-lived assets. Recent impairments have significantly affected LivaNova’s financial results, as could 
future impairments.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________45

STRATEGIC REPORT
LivaNova’s Approach to Stakeholders

LivaNova’s Approach to Stakeholders

Section 172 Statement

In accordance with section 172 of the Companies Act 2006, the Board of Directors considers the Company's key stakeholders and 
takes their views and interests into account when making decisions. Clear communication and proactive engagement to understand 
the issues most relevant to LivaNova’s stakeholders is fundamental to the directors' responsibility to act in good faith to promote 
the success of the Company for the benefit of shareholders. The Board builds trust with those most important to the Company, and 
in doing so, ensures the Board is fully aware of the potential impacts of the decisions it makes for the Company’s stakeholders, the 
environment and the communities in which we operate, in both the short term and the long run. 

Delegation of Authority 

The  Board  believes  governance  of  LivaNova  is  best  achieved  by  delegation  of  its  authority  for  the  executive  management  of 
LivaNova  to  the  CEO,  subject  to  defined  limits  and  monitoring.  The  Board  routinely  monitors  the  delegation  of  authority, 
ensuring  that  it  is  regularly  updated,  while  retaining  ultimate  responsibility.  During  Board  meetings,  the  independent  directors 
review the Company's progress against strategic priorities, and this collaborative approach helps to promote the long-term success 
of LivaNova and its stakeholders. Per the requirements of Section 172, the below articulates LivaNova's principal stakeholders, 
their concerns and the Company’s methods of engagement and impact. 

Connecting with LivaNova’s Stakeholders

Patients 

LivaNova’s mission is to provide hope for patients and their families through innovative medical technologies. The Company is 
driven by its purpose to put patients first to improve the quality of their lives - for every patient, every day. 

Their concerns. LivaNova patients want LivaNova to manufacture safe, quality products that are responsive to their needs and 
protective of their data. They desire information that is fair and balanced, easy to understand, accessible and transparent. Patients 
want LivaNova to take ownership in the face of product complaints and concerns, and they hope to impact and benefit from, next-
generation devices incorporating their feedback. 

How we engage and impact. LivaNova’s Board of Directors is keenly aware of LivaNova's mission and as a result, is focused on 
how  best  to  incorporate  patient  needs  into  the  Company’s  vision.  Marketing  content,  news  stories,  physician  input,  patient 
interviews,  letters,  and  interactions,  and  surveys  are  ways  by  which  the  Board  regularly  receives  feedback  from  our  patients. 
Specifically, working hand in hand with more than 300 perfusionists around the world, the Company designed and developed its 
next-generation heart-lung machine, Essenz, culminating in the successful commercial launch of Essenz in 2023. In addition, the 
Board receives regular updates on relevant topics ranging from cybersecurity to clinical and quality in order to exercise proper 
oversight over those areas that directly impact patient health and safety. Indeed, the full Board was regularly updated during the 
cybersecurity  incident  disclosed  in  November  2023  by  the  Interim  CEO,  Chief  Legal  Officer,  CISO,  Head  of  IT  and  outside 
cybersecurity  counsel  to  ensure  continual  communication  and  appropriate  oversight.  The  Board  continues  to  stay  informed  as 
LivaNova continues to assess the full impact of the cybersecurity event. 

Employees

LivaNova’s workforce is crucial to its mission to provide hope to our patients and their families through delivering life-changing 
medical  innovation.  LivaNova’s  employees  help  the  Company  maintain  its  strong  reputation  for  high  standards  of  business 
conduct  and  are  fundamental  in  delivering  its  purpose.  The  Company,  in  turn,  wants  its  employees  to  be  proud  of  working  at 
LivaNova and safe and supported at work. This can only be done if the Company listens to feedback and takes appropriate action 
to keep its employees incentivized and motivated. 

Their  concerns.  Employees  want  to  know  that  the  Board  is  considering  employee  well-being  and  development  when  making 
strategic  decisions.  They  want  career  opportunities  and  progression,  and  they  want  diversity  and  an  inclusive  workplace. 
Companies  need to  work  hard  to attract  and  retain  talent, keeping in mind that employees want to be valued and appropriately 
incentivized to do their job in an increasingly challenging work environment. 

How we engage and impact. The Board directly engages with the Company's employees by way of discussions during senior 
leadership forums, presentations during regular and ad hoc Board meetings and meet and greets throughout the year. In October 
2023 for example, the Board interacted with members of the Clinical Affairs and Product Manager teams in connection with the 
epilepsy  strategic  review  and  Essenz  product  training,  respectively.  In  addition,  in  response  to  Board  and  Committee  self-
evaluations, the Board committed to more oversight with respect to talent generally by including it as a regularly scheduled topic 
on the Board agenda throughout 2023. Relatedly and in connection with such discussions, the Compensation Committee added 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________46

STRATEGIC REPORT
LivaNova’s Approach to Stakeholders

“human  capital  management”  to  its  charter,  renaming  the  Committee  to  explicitly  recognize  oversight  of  Company  policies, 
strategies, risks, trends, and key metrics as they relate to human capital management within LivaNova. 

Separately, and as noted in the Human Capital Management section of this UK Annual Report, the Company conducted another 
LivaNova4You survey in 2023. The results saw an increase in overall employee engagement since the last survey in 2021. With 
over  90%  of  employees  completing  the  survey,  the  results  indicated  an  increase  in  employee  satisfaction  and  motivation.  In 
response to feedback from the survey results, the executive leadership team has committed to improving, among other things, the 
digitization  of  work  systems  and  the  Company’s  branding. Throughout, the Board has been apprised of the Human Resource’s 
team’s progress in conducting the survey, the results, and implementing initiatives in response to the results. 

Physicians and Healthcare Professionals

LivaNova’s relationships with customers, physicians and healthcare professionals positively influence the business to enhance the 
lives of patients. They are essential partners in clinical research, as advisers, and as study investigators. The Company strives to 
maintain  excellent  relationships  with  these  stakeholders  because  they  provide  a  detailed  understanding  of  therapeutic  and 
diagnostic  developments,  trends,  and  emerging  opportunities,  which  allows  the  Company  to  respond  quickly  to  the  changing 
needs of providers and patients. 

Their concerns. The customers, physicians and healthcare professionals the Company serves want to know that they are in receipt 
of quality, effective products, and they want LivaNova to be held accountable for its products. They want their patients to be heard 
and they want the Company to receive their feedback and respond in an ethical and transparent manner. 

How we engage and impact. The Board is acutely aware of the importance of proper engagement with these key stakeholders. 
LivaNova  engages  by  way  of  scientific  dialogue  to  increase  understanding  of  disease  management,  product  development 
possibilities and patient experience, and the Company ensures it is providing high-quality, balanced information about LivaNova’s 
products and services. The Company designed and developed Essenz for example, building on input from over 300 perfusionists, 
which culminated in the Essenz commercial launch in 2023. Indeed, during the Essenz product training in October 2023, the on-
site Product Manager fielded and responded to a variety of questions from the Board on physician input and response to the new 
machine. The Company wants to support these physicians in doing what is best for each patient and to allow the entire team to 
continuously  improve  their  clinical  practice.  The  Company  also  engages  by  collaborating  on  the  Company’s  clinical  trials  and 
research, and the Board is kept abreast via regular updates during the business and strategic portfolio initiative updates at Board 
meetings.  For  further  information  regarding  the  importance  of  this  relationship,  please  refer  to  the  “Risk  and  Uncertainties” 
section  under  the  heading  entitled:  The  success  and  continuing  development  of  our  products  depend  on  maintaining  strong 
relationships with physicians and healthcare professionals in this Strategic Report. 

Suppliers and Distributors

LivaNova’s suppliers and distributors need to be nurtured in order for the Company’s business to grow and develop. LivaNova 
purchases many of the components and raw materials used in manufacturing the Company’s products from numerous suppliers in 
various countries. In some cases, the Company purchases specific components and raw materials from primary or main suppliers 
(or in some cases, a single or sole supplier) for reasons related to quality assurance, cost-effectiveness and availability. Because 
LivaNova manufactures medical devices, the Company is reliant upon these third parties to provide and distribute safe, quality 
products, to comply with inspection and regulatory review, and importantly, in the face of supply chain delays and disruptions, 
inflationary pressures and logistical issues, to maintain supply and distribution channels, especially in instances of sole suppliers 
for whom we have no alternatives. 

Their concerns. The Company’s suppliers and distributors are also experiencing their own supply chain delays and disruptions. 
They are concerned with maintaining their own business operations and collaborative, fair and ethical partnerships. They desire 
prompt and fair payment and clear communication regarding specifications, needs, and quality and regulatory restrictions. 

How  we  engage  and  impact.  The  Board  receives  regular  updates  from  the  management  team  and  the  Audit  and  Compliance 
Committee on relationships with the Company’s key suppliers and how these relationships and potential risks are evolving as the 
Company  responds  to  different  market  conditions  and  the  macro  environment.  LivaNova  continues  to  experience  supply  chain 
delays  and  interruptions,  labor  shortages,  inflationary  pressures  and  logistical  and  capacity  constraints,  though,  to  date,  the 
Company’s supply of raw materials and the production and distribution of finished products have not been materially affected. 
The Board is actively involved in these risk discussions, drawing on their experiences and insights, to advise the Company as it 
works  with  suppliers  to  ensure  supply  continuity,  minimize  the  instances  in  which  we  rely  on  a  sole  supplier  and  take  other 
countermeasures  -  such  as  closely  managing  the  Company’s  inventory  -  to  reduce  the  Company’s  supply  chain  risk.  For  more 
information regarding the significance of the Company’s supplier relationships, please review the related “Risk and Uncertainties” 
section in the Strategic Report of this Annual Report.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________47

STRATEGIC REPORT
LivaNova’s Approach to Stakeholders

Government and Regulators

Government  policy  can  impact  the  business  operating  environment.  Product  approvals,  reimbursement,  insurance  coverage  and 
clinical trials are all areas in which governmental bodies affect the economic value and availability of LivaNova’s products. In 
many countries, the Company’s principal customers are government-owned hospitals, who purchase the Company’s products for 
their national health systems. It is important that the Company maintains good relationships with governments and regulators so 
that the Company can continue to develop cost efficient and effective solutions for LivaNova’s patients.

Their  concerns.  Governments  and  regulators  are  interested  in  product  safety  and  efficacy  of  LivaNova's  products,  compliance 
with local, legal regulatory requirements, fair competition, and social and economic concerns.

How  we  engage  and  impact.  The  medical  device  industry  is  heavily  regulated,  and  LivaNova’s  worldwide  businesses  are 
overseen by many different authorities in various jurisdictions. The Board relies on the management team to effectively manage 
its relationships with governments and regulators and raise issues of importance as the landscape evolves. In addition, as a matter 
of normal course, the Board receives regular updates on product quality, regulatory matters and complaints. For more information 
regarding the intersection between Government, Regulators and LivaNova, please refer to the "Government Regulation and Other 
Considerations" section of this Strategic Report. 

Investors and Shareholders

Investors  and  shareholders  are  the  ultimate  owners  of  LivaNova’s  business,  and  it  is  important  for  us  to  understand  their 
perspectives on capital allocation and how the Company is managed. 

Their concerns. LivaNova’s investors and shareholders are focused on LivaNova's strategy, performance and leadership. They 
want to know there is a succession plan and that the Company is acting appropriately with respect to remuneration. They desire an 
understanding  of  the  Company’s  pipeline,  business,  culture  and  values,  including  but  not  limited  to  sustainability  matters. 
Ultimately,  LivaNova’s  investors  and  shareholders  want  to  know  that  the  Board  is  representing  all  shareholders'  interests  by 
ensuring the Company is best positioned to create value.

How we engage and impact. Per corporate governance best practices and our Articles of Association, the Board has committed 
to using, doing, and promoting, among other things, the following at LivaNova: annual Board and committee self-evaluations of 
its performance; skills surveys to ensure appropriate refreshment in furtherance of the Company’s strategy; annual elections for 
directors; majority voting for directors in uncontested elections; supermajority voting to change or amend the Company's Articles 
of  Association;  and  a  prohibition  on  repricing  of  grants  in  equity  compensation  plans.  The  Board  is  continually  considering 
corporate governance improvements. In February 2023, for example, the CHCM Committee of the Board approved accelerated 
vesting upon certain terminations of employment in connection with an acquisition of the Company, i.e., a double trigger vesting. 
Furthermore, the Board approved updates to the Company’s Insider Trading Policy in light of the SEC’s new 10b5-1 rules.

The Board and in particular, the NCG Committee, have elevated ESG as a focal point in their agendas. In addition to receiving 
quarterly updates (which are subsequently shared with the full Board), the Board members have had discussions about strategy 
and  shared  experiences  to  further  embed  the  importance  of  Sustainability  and  related  initiatives  into  the  Company  culture. 
LivaNova  has  established  a  Sustainability  strategy  delivery  program  with  global  coordination  to  respond  to  regulatory 
requirements and commercial needs. The Sustainability commitment and associated actions to support the Company focus areas – 
People,  Products,  and  Planet  –  are  integrated  into  the  strategic  plans  for  business  continuity  and  are  foundations  to  grow 
LivaNova’s climate risk resilience, thereby creating long-term stakeholder value. To that end, the Company appointed a Senior 
Director  of  Sustainability,  a  position  that  drives  the  governance  structure  and  is  accountable  for  successful  prioritization  and 
execution of the strategy and associated initiatives, including regular and transparent education and awareness of Sustainability 
progress among the Company’s stakeholders, both internally and externally. Additionally, the Company retained an independent 
consultant firm in 2023 to assist the Company in developing its 2023 UK Climate Related Financial Disclosures, which can be 
found in the “Non-Financial & Sustainability Information Statements” section of this Strategic Report.

In addition and in keeping with the Company’s standard practice, the Board and particularly the Audit and Compliance Committee 
are actively involved in the review of quarterly and full-year results and corresponding press releases that feed into earnings calls 
and  webcasts.  The  Investor  Relations  team  provides  quarterly  updates  to  the  Board  on  shareholder  activity  and  any  significant 
changes  in  holdings,  and  copies  of  analyst  reports  on  the  Company  and  its  peers  are  circulated  regularly  to  the  directors.  The 
AGM  is  perhaps  the  most  important  engagement  mechanism  allowing  (1)  the  directors  to  present  an  annual  report  containing 
information about the Company's strategy and performance, and (2) the shareholders the opportunity to exercise their voting rights 
with respect to important company issues. 

The  Board  is  available  to  meet  and  respond  to  investors  throughout  the  year  to  understand  the  issues  and  factors  that  are 
significant  for  these  stakeholders  and  in  certain  instances,  have  engaged  with  shareholders  on  issues  ranging  from  succession 
planning  to  cyber  security  to  compensation.  The  directors  welcome  the  opportunity  to  engage  in  regular,  fair  and  balanced 
dialogue  with  the  Company’s  investors  to  enable  the  Company’s  investors  to  put  a  fair  value  on  the  Company  and  ensure 
continued access to capital if needed. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________48

STRATEGIC REPORT
LivaNova’s Approach to Stakeholders

CEO Succession

On 5 February 2024, the Company announced that the Board of Directors appointed Vladimir A. Makatsaria as the Company’s 
CEO and a member of the Board of Directors, effective 1 March 2024. In connection with Mr. Makatsaria’s appointment, William 
A. Kozy stepped down from his current position as Interim Chief Executive Officer of the Company on 1 March 2024 but will 
remain the Chair of the Board.

This Strategic Report is approved and signed on behalf of the Board. 

Vladimir Makatsaria

Chief Executive Officer & Director

25 April 2024

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________49

DIRECTORS' REPORT
Directors

DIRECTORS' REPORT

LivaNova’s Directors
The Directors of the Company, who held office in the year ended 31 December 2023 and up to the date of signing the
financial statements, were as follows:

Chair and Executive Director 
Mr. William Kozy*

Executive Director

Mr. Vladimir Makatsaria*

Mr. Damien McDonald**

Non-Executive Directors

Mr. Francesco Bianchi

Mr. Daniel J. Moore

Dr. Sharon O’Kane 

Mr. Todd Schermerhorn

Ms. Stacy Enxing Seng 

Mr. Peter Wilver

Ms. Brooke Story

Mr. James Christopher Barry***

Ms. Andrea Saia****

*Mr. Kozy was an NED and Chair of the board until 14 April 2023 and then was appointed Interim CEO (maintaining his role as Chair of the Board) upon Mr. 
McDonald’s resignation on that same date. Mr. Kozy returned to his NED and Chair of the board role on 1 March 2024 upon Mr. Makatsaria’s appointment as 
Chief Executive Officer and Director of the Company on the same date.

**Mr. McDonald held office as a Director of the Company, and ceased to be Director and Chief Executive Officer of the Company following his resignation on 14 
April 2023. Mr. McDonald assisted with transition activities until his employment ceased on 31 May 2023.

***Mr. Barry was appointed to the Board on 6 October 2023.

****Mrs. Saia retired on 31 December 2023.

Directors' Indemnities 

Each director is covered by appropriate directors' and officers' liability insurance, and there are also Deeds of Indemnity in place 
between the Company and each director. These Deeds of Indemnity provide for the Company to indemnify the directors in respect 
of any proceedings brought by third parties against them personally in their capacity as directors of the Company. The Company 
would also fund on-going costs in defending a legal action as they are incurred rather than after judgement has been given. In the 
event  of  an  unsuccessful  defense  in  an  action  against  them  in  a  criminal  or  civil  action,  individual  directors  would  be  liable  to 
repay  defense  costs  to  the  extent  funded  by  the  Company.  In  respect  of  any  investigations  or  actions  taken  by  a  regulatory 
authority,  individual  directors  would  be  liable  to  repay  defense  costs  to  the  extent  funded  by  the  Company  if  that  regulatory 
authority  has  determined  that  the  relevant  director  has  acted  fraudulently,  been  grossly  negligent,  or  has  engaged  in  wilful 
misconduct in relation to that claim.

There  were  no  qualifying  pension  scheme  indemnity  provisions  in  force  during  the  2023  financial  year  for  the  Company’s 
directors.

Company Details and Branches Outside the UK 

The Company is a public limited company incorporated in England and Wales with registered number 09451374. The Company’s 
registered address is 20 Eastbourne Terrace, London, England W2 6LG, United Kingdom.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________50

DIRECTORS' REPORT
Directors

The Company has one branch outside the UK: LivaNova PLC (Italian Branch) in Italy. The registered address for this branch is 
Via Enrico Cialdini, 16, 20161 Milano, Italy.

Political Donations

The Company has not made any political donations, or incurred any political expenditure, in the period under review. In addition, 
the Company has not made any contributions to a non-UK political party during the period under review. Moreover, we have not 
sought shareholder approval in relation to political donations.

Dividends and Share Buybacks

No dividend has been proposed during, or in respect of, the course of the year under review and the Company has never declared a 
dividend. The Company has no immediate intention to declare and pay dividends. 

The Company has not purchased or acquired any of its own shares pursuant to section 659 of the Companies Act 2006 during the 
course of the year under review. Please see section “Relative importance of spend on pay” in this Annual Report. 

Financial Risk Management Objectives / Policies and Hedging Arrangements 

Please  refer  to  "Note  4.  Financial  Risk  Management"  in  the  consolidated  financial  statements  for  information  on  LivaNova’s 
financial risk management objectives/policies and hedging arrangements.

Post-Balance Sheet Events

Details regarding the Company’s announcement on 8 January 2024 to wind down the ACS business are set out in the following 
section: Consolidated Financial Statements: Note 33. Subsequent Events 

Details  about  the  Company’s  announcement  on  5  February  2024  of  the  CEO  appointment  are  set  out  in  the  following  section: 
Consolidated Financial Statements: Note 33. Subsequent Events 

Details about the Company’s announcement on 4 March 2024 of its 2024 Restructuring Plan are set out in the following section: 
Consolidated Financial Statements: Note 33. Subsequent Events 

Future Developments / Research and Development

Details  of  the  activities  of  the  Company  in  the  field  of  research  and  development,  and  the  likely  future  developments  in  the 
business of the Company are set out in the Business Overview of the Strategic Report.

Greenhouse Gas Reporting

LivaNova reports on the Company’s greenhouse gas emissions in the Company’s Strategic Report: 2023 Greenhouse Gas Report 
of this Annual Report.

Section 172 Statement 

In accordance with section 172 of the Companies Act 2006, the Board considers the Company's key stakeholders and takes their 
views and interests into account when making decisions. Please refer to the section: Strategic Report, LivaNova’s Approach to 
Stakeholders. 

Statement of Disclosure to the UK Auditor

In accordance with section 418 of the Companies Act 2006, the Directors at the date of this Directors’ Report confirm that:

•

•

so far as they are aware, there is no relevant audit information of which the Auditor is unaware; and

they  have  taken  all  the  steps  they  ought  to  have  taken  as  Directors  to  make  themselves  aware  of  any  relevant  audit 
information and to establish that the Auditor is aware of that information.

This confirmation is given and should be interpreted in accordance with the provisions of section 418 of the Companies Act 2006.

Auditors

PricewaterhouseCoopers  LLP,  the  Company's  Auditor,  has  indicated  its  willingness  to  continue  in  office,  and  on  the 
recommendation  of  the  Audit  and  Compliance  Committee  and  in  accordance  with  section  489  of  the  Companies  Act  2006,  a 
resolution to re-appoint it will be proposed at the 2024 AGM.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________51

DIRECTORS' REPORT
Directors

Statement of Directors' Responsibilities in Respect of the Financial Statements

The directors are responsible for preparing the 2023 UK Annual Report and the financial statements in accordance with applicable 
law and regulation.

Company  law  requires  the  directors  to  prepare  financial  statements  for  each  financial  year.  Under  that  law,  the  directors  have 
prepared  the  Group  financial  statements  in  accordance  with  UK-adopted  international  accounting  standards  and  the  Company 
financial statements in accordance with United Kingdom Accounting Standards, comprising FRS 101 and applicable law.

Under  company  law,  directors  must  not  approve  the  financial  statements  unless  they  are  satisfied  that  they  give  a  true  and  fair 
view  of  the  state  of  affairs  of  the  Group  and  Company  and  of  the  profit  or  loss  of  the  Group  and  Company  for  that  period.  In 
preparing the financial statements, the directors are required to:

•

•

•

•

select suitable accounting policies and then apply them consistently;

state  whether  applicable  UK-adopted  international  accounting  standards  have  been  followed  for  the  Group  financial 
statements  and  United  Kingdom  Accounting  Standards,  comprising  FRS  101  have  been  followed  for  Company  financial 
statements, subject to any material departures disclosed and explained in the financial statements;

make judgements and accounting estimates that are reasonable and prudent; and

prepare  the  financial  statements  on  an  going  concern  basis  unless  it  is  inappropriate  to  presume  that  the  Group  and 
Company will continue in business.

The directors are responsible for safeguarding the assets of the Group and Company and hence for taking reasonable steps for the 
prevention and detection of fraud and other irregularities.

The  directors  are  responsible  for  keeping  adequate  accounting  records  that  are  sufficient  to  show  and  explain  the  Group's  and 
Company's transactions and disclose with reasonable accuracy at any time the financial position of the Group and Company and 
enable them to ensure that the financial statements and the Remuneration Report comply with the Companies Act 2006.

The directors are responsible for the maintenance and integrity of the Company’s website. Legislation in the UK governing the 
preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

This Directors’ Report is approved by order of the Board.

Michael Hutchinson
Company Secretary
25 April 2024

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________52

REMUNERATION REPORT
Statement from the Chair of the Compensation and Human Capital Management Committee

Remuneration Report

Dear Shareholder,

LivaNova’s 2023 performance was solid as demonstrated by double-digit revenue growth across all regions, an improvement in 
adjusted operating margin, and a 17% increase in adjusted diluted earnings per share. We realized these results while maintaining 
full investment in our pipeline initiatives, investing in critical capabilities for the Company and taking actions related to portfolio 
optimization.  We  are  pleased  with  these  financial  outcomes  as  well  as  the  progress  made  in  refining  the  business  strategy  and 
portfolio. Moreover, we delivered strong performance despite the previously disclosed cybersecurity incident that occurred in the 
fourth quarter. As noted in prior disclosures, we were able to bring all manufacturing operations back online. For that, we extend a 
sincere  thank  you  to  our  LivaNova  colleagues  around  the  world  who  responded  with  urgency  and  extraordinary  dedication.  In 
2023, the organization embraced change and seized performance opportunities as reflected in these results. We are pleased that 
our 2023 results will allow us to demonstrate our appreciation in a way that recognizes the performance of the Company while 
also taking into account the competitive positions of global pay arrangements.

Separately,  but  also  importantly,  in  2023,  the  CHCM  Committee  modified  its  name  to  include  human  capital  management  and 
updated its charter to reference the CHCM Committee’s oversight of human capital management within the Company, specifically 
overseeing  the  Company’s  policies  and  strategies,  and  periodically  reviewing  risks,  trends  and  key  metrics  relating  to  human 
capital  management.  We  made  this  change  to  emphasize  our  commitment  to  people  within  the  organization  and  to  ensure 
appropriate oversight and continued review.

Review of 2023 Performance 

In 2023, worldwide revenue was $1.15 billion, an increase of 13% on both a reported and constant-currency basis, as compared to 
the prior year. 

For  the  full  year,  Cardiopulmonary  revenue  increased  18%  on  both  a  reported  and  constant-currency  basis  versus  2022,  with 
growth  across  all  regions,  driven  by  increased  heart-lung  machine  sales,  including  Essenz  installations  and  strong  oxygenator 
demand.

For  the  full  year,  Neuromodulation  revenue  increased  9%  on  both  a  reported  and  constant-currency  basis  versus  2022,  with 
growth across all regions, including new and replacement implants in the US region. For the full year, global Epilepsy revenue 
increased  10%  on  a  constant  currency  basis.  Notably,  US  Epilepsy  achieved  3,300  new  patient  implants  in  the  full  year, 
representing 7% growth versus the prior year. Replacement implants reached 7,608 for the full year, also a 7% increase. Epilepsy 
revenue in Europe and the Rest of World grew 10% versus the prior year on a constant currency basis. 

For the full year, ACS revenue increased 3% on both a reported and constant-currency basis versus 2022, driven by an increase in 
case volumes. As previously announced, the ACS standalone cannulae business moved to the CP portfolio in the first quarter of 
2024, and the wind down of the ACS segment is anticipated to be substantially complete by the end of 2024.

We  delivered  strong  performance  despite  the  previously  disclosed  cybersecurity  incident  that  occurred  in  November  2023. 
Importantly,  we  were  pleased  with  our  ability  to  bring  our  manufacturing  operations  and  critical  support  functions  fully  back 
online in a relatively short amount of time. The investigation into the nature and scope of affected data is complex and ongoing, 
and we will continue to comply with our legal notification obligations.

In addition to the above 2023 financial results, management achieved a number of strategic milestones over the past year:

•

•

•

•

•

In  February  2023,  having  received  approval  for  its  PMA  supplement  from  the  FDA,  the  Company  launched  SenTiva 
DUO™,  an  implantable  pulse  generator  with  a  dual-pin  header  to  provide  VNS  Therapy  for  the  treatment  of  drug-
resistant epilepsy. 

Also,  in  February  2023,  the  Company  announced  the  start  of  a  limited  commercial  release  for  the  Essenz  Perfusion 
System in select centers throughout Europe. 

In March 2023, the Company received FDA 510(k) clearance for its Essenz HLM, and with FDA clearance, LivaNova 
initiated  the  commercial  launch  of  Essenz  HLM  in  the  US.  Additionally,  the  Company  initiated  a  broad  commercial 
release in Europe, following a successful limited commercial release. 

In  June  2023,  the  Company  announced  the  150th  bipolar  depression  patient  had  been  randomized  in  the  RECOVER 
clinical  study.  The  trial,  if  successful,  will  be  used  to  support  a  peer-reviewed  article  and  reconsideration  of 
reimbursement for VNS Therapy by CMS for the treatment of depression that is difficult to treat. 

In  August  2023,  the  Company  received  FDA  510(k)  clearance  and  CE  Mark  for  its  Essenz  ILBM,  which  provides 
accurate  and  continuous  measurement  of  essential  blood  parameters  to  perfusionists  throughout  CPB  procedures.  The 
ILBM is integrated into LivaNova’s next-generation CPB platform, the Essenz Perfusion System.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________53

REMUNERATION REPORT
Statement from the Chair of the Compensation and Human Capital Management Committee

2023 Compensation Review 

In February 2023, on the advice of its compensation consultant, Pearl Meyer, the CHCM Committee reviewed the base salary of 
our  then  sole  Executive  Director  and  CEO,  Damien  McDonald,  and  elected  not  to  increase  his  base  salary  for  2023  based  on 
benchmark data and an overall evaluation of the Company’s performance. Mr. McDonald resigned on 14 April 2023.

The 2023 STIP was designed to incentivize the delivery of short-term business targets based on the Company’s business strategy 
and generate a link between performance and reward, thereby driving the creation of further shareholder value. In this vein, the 
2023 STIP included financial objectives - Net Revenue and Adjusted Net Income (as defined below) - and non-financial goals, as 
described  below.  Both  of  the  two  financial  objectives  targets  were  overachieved.  Net  Revenue  was  achieved  at  109.1%  versus 
target, and Adjusted Net Income was overachieved at 110.1% versus target, ultimately leading to a payout percentage of 145.6% 
and 125.2%, respectively. 

The CHCM Committee set a number of non-financial goals with respect to the 2023 STIP that were deemed to be challenging yet 
individually  achievable,  with  the  maximum  scoring  for  each  independent  goal  set  at  100%.  Given  its  determination  that 
achievement  of  all  of  the  non-financial  goals  in  the  year  would  be  especially  difficult,  the  CHCM  Committee  established  a 
modifier to allow for positive modification in the event most, but not all, non-financial goals were achieved. This non-financial 
goal  modifier  was  overachieved  (70%  of  the  non-financial  goals  were  achieved  leading  to  a  110%  modifier),  but  based  on  the 
scoring  of  the  2023  non-financial  goals  as  well  as  an  overall  assessment  of  Company  performance,  the  CHCM  Committee 
determined  to  utilize  negative  discretion  to  cap  the  non-financial  goal  modifier  at  100%.  Accordingly,  the  combination  of  the 
financial and non-financial goals resulted in an overall 137.5% payout of the 2023 STIP.

The  2023  LTIP  for  Mr.  McDonald  consisted  of  grants  of  SARs  with  a  four-year  vesting  schedule  based  on  service  and  a  face 
value of $1.625M, RSUs with a four-year vesting schedule based on service and a face value of $1.625M and PSUs consisting of 
three separate performance metrics (adjusted ROIC, rTSR, and adjusted FCF) with an aggregate face value of $3.250M at target 
payout. Mr. McDonald subsequently forfeited any entitlement to these awards as a result of his resignation on 14 April 2023.

On  19  April  2023,  in  connection  with  Mr.  Kozy  becoming  our  sole  Executive  Director  and  being  appointed  Interim  CEO,  the 
CHCM Committee approved a one-time grant of service-based RSUs with a grant date fair value of $500,000. The RSUs vested 
six months from his start date, i.e., on 14 October 2023. Mr. Kozy did not receive an NED RSU grant in June 2023 due to his role 
as Interim CEO. On 15 December 2023, due to the continuation of his role as Interim CEO, Mr. Kozy received an additional RSU 
award  with  a  grant  date  fair  value  of  $750,000,  which  was  structured  to  vest  upon  the  earlier  of  (i)  the  commencement  of 
employment of a successor CEO and (ii) 13 April 2024, subject to Mr. Kozy’s continued employment through such vesting date. 
As a result of Mr. Makatsaria’s appointment as CEO on 1 March 2024, this RSU award vested on 29 February 2024. Based on the 
advice provided by Pearl Meyer, the CHCM Committee determined that the vesting periods for both of Mr. Kozy’s RSU grants 
were appropriate and necessary to meet the individual circumstances of Mr. Kozy’s interim role. 

Remuneration Report/Say-on-Pay 

We were pleased with the endorsement of LivaNova’s compensation of its named executive officers (otherwise known as US Say-
on-Pay),  which  was  approved  by  92.4%  of  the  votes  cast  by  shareholders  at  our  2023  AGM.  The  advisory  vote  on  the  UK 
Directors’ Remuneration Report regarding executive and NED remuneration also showed strong support with 96.1% approval of 
the votes cast. The CHCM Committee took into account shareholder and other stakeholder feedback along with the results of each 
of these votes and considered all such information when making compensation decisions. The CHCM Committee will continue to 
ensure that performance outcomes and any consequent payments are aligned with business performance.

Review of Non-Executive Director and CHCM Committee Fees

Remuneration for our NEDs includes an annual cash retainer of $110,000 for each of the NEDs, cash amounts paid in addition to 
the basic retainer for the Chair of the Board and for the chairs and members of the three committee of the Board (the Audit and 
Compliance,  Compensation  and  Human  Capital  Management,  and  Nominating  and  Governance  committees  -  see  Single  Total 
Figure of Remuneration - Chair and Non-Executive Directors (Audited) for more details), and annual service-based share awards 
with a grant value of $130,000 for each NED, except the Chair of the Board, for which the grant value of the annual service-based 
share awards is $205,000. 

As noted above, on 14 April 2023, the Company announced that Mr. McDonald had resigned as CEO and Director and that Mr. 
Kozy had been appointed as Interim CEO (alongside his role as Chair of the Board) with immediate effect. On 19 April 2023, in 
connection  with  the  appointment  of  Mr.  Kozy  as  our  Interim  CEO,  the  Board  of  Directors  agreed  to  appoint  the  Chair  of  the 
Nominating  and  Governance  Committee,  Dr.  O’Kane,  as  the  Lead  Director  of  the  Board.  In  recognition  of  the  increased 
responsibilities  and  time  commitment  assumed  by  the  Lead  Director  and  per  market  practice  as  advised  by  the  CHCM 
Committee’s compensation consultant, Pearl Meyer, the CHCM Committee and Board approved an additional annual retainer fee 
of $30,000, which was paid quarterly to the Lead Director from 19 April 2023. With the return of Mr. Kozy to his role of Chair of 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________54

REMUNERATION REPORT
Statement from the Chair of the Compensation and Human Capital Management Committee

the Board, the role of Lead Director was no longer deemed necessary and consequently the additional retainer fee for Dr. O’Kane 
ceased effective 29 February 2024.

In accordance with the Company’s Remuneration Policy for a new non-employee (in this case a returning) Director, the CHCM 
Committee  recommended  that  Mr.  Kozy  be  awarded  a  prorated  $57,849  one-year  RSU  grant  on  30  March  2024  to  cover  his 
service as a NED and Independent Chair from 1 March 2024 through the date of the annual meeting in June 2024.

In addition, on the advice of Pearl Meyer, and based on benchmarking data, in 2024, the CHCM Committee recommended to the 
Board an increase in the grant value of the annual service-based share awards for NEDs of $50,000 (to $180,000 for all NEDs 
other than the Chair of the Board, and to $255,000 for the Chair of the Board) and a consistent decrease of $50,000 to the cash 
Director retainer (to $60,000 for all NEDs other than the Chair of the Board, and to $135,000 for the Chair of the Board). On 15 
February 2024, the Board approved these changes, effective upon the reelection of the NEDs at the 2024 AGM. 

CEO Succession

As noted above, on 5 February 2024, the Company announced the appointment of Mr. Makatsaria as CEO and Director with a 
commencement date of 1 March 2024 and the return of Mr. Kozy to his role as an NED and Chair of the Board. Under the terms 
of  Mr.  Makatsaria’s  employment  agreement,  Mr.  Makatsaria  will  receive  an  initial  annualized  base  salary  of  $930,000  with  a 
target annual bonus equal to 110% of his base salary (pro-rated for 2024). Mr. Makatsaria will also be entitled to receive (i) long-
term equity incentive awards for the Company’s regular 2024 annual grant cycle with a target grant-date value of $5,350,000, (ii) 
special new hire one-time equity grants with an aggregate grant-date value of $1,500,000, vesting in equal annual instalments over 
four years, (iii) a sign-on cash bonus of $200,000 and (iv) certain relocation benefits to assist with Mr. Makatsaria’s relocation 
from New York city to Houston, Texas. His employment agreement also provides for certain severance benefits in the event of 
Mr. Makatsaria’s involuntary termination without cause or termination for good reason and requires Mr. Makatsaria to enter into 
the Company’s standard forms of confidentiality and restrictive covenant agreements as of his start date.

Moving forward, the CHCM Committee will continue to monitor the development of best practices relating to all remuneration. 
We are committed to ensuring that our remuneration is strongly linked to performance and strategy execution, so as to continue 
delivering sustainable value for our shareholders. 

As  Chair  of  the  CHCM  Committee,  I  am  committed  to  ensuring  an  open  dialogue  with  our  shareholders  and  have  joined 
conversations where necessary this past year. If you have any questions about remuneration generally, or the presentation or the 
content of this report, please contact me via mail at c/o Company Secretary, LivaNova PLC, 20 Eastbourne Terrace, London W2 
6LG, United Kingdom or  via  email  at  company.secretariat@livanova.com.  I would like to thank my fellow CHCM Committee 
members for their support throughout the year, and we look forward to your support at our 2024 AGM.

Stacy Enxing Seng 
Chair of the Compensation and Human Capital Management Committee
25 April 2024

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________55

REMUNERATION REPORT

How LivaNova Establishes Executive Compensation Levels 

The  UK  Remuneration  Policy  (“the  “Remuneration  Policy”),  which  aims  to  encourage  directors  to  perform  in  a  consistent, 
responsible  way  with  a  focus  on  long-term  value  creation  for  the  Company’s  shareholders,  became  effective  immediately  after 
approval at the 2022 AGM held on 13 June 2022 and can be found on Investor Relations website (https://investor.livanova.com/
annual-reports).  The  CHCM  Committee  considers  the  Remuneration  Policy  annually  to  ensure  that  it  remains  aligned  with 
business  needs  and  is  appropriately  positioned  relative  to  the  market.  However,  in  the  absence  of  exceptional  or  unexpected 
circumstances that may necessitate a change to the Remuneration Policy, there is no intention to revise it more frequently than 
every three years as required by the Companies Act 2006. 

LivaNova strives to remain competitive in order to retain key talent, which is essential to the Company’s successful operation, and 
the  CHCM  Committee  continues  to  monitor  the  development  of  best  practices  relating  to  remuneration.  In  keeping  with  the 
Remuneration  Policy  in  making  executive  compensation  determinations,  the  Company  relies  on  several  factors  to  set 
compensation  elements  and  compensation  targets  that  are  consistent  with  the  Company’s  executive  compensation  program 
objectives, which include: 

■ Assessment of Company Performance 

The  CHCM  Committee  establishes  specific,  objectively  measurable  company  financial  and  non-financial  performance 
goals  that  the  Board,  the  CHCM  Committee  and  management  believe  will  drive  shareholder  value.  The  relative 
achievement of the performance objectives determines substantially all of the payouts under the Company’s short-term 
incentive plan and its performance-based equity incentive awards. 

■ Assessment of Individual Performance

Individual performance has a strong impact on compensation. 

■ CEO

Following  discussion  with  the  incumbent  CEO,  the  CHCM  Committee  sets  the  CEO's  performance  objectives  for  the 
year.  The  CHCM  Committee  and  the  Chair  of  the  Board  meet  in  executive  session  annually  to  assess  the  incumbent 
CEO’s performance against their performance objectives, their contribution to the Company’s performance, their ethics 
and other leadership attributes. 

■ Benchmarking Analysis

The CHCM Committee reviews peer group data based on benchmark analysis provided by its independent compensation 
consultant,  Pearl  Meyer,  which  compares  individual  pay  to  comparable  roles  among  our  peer  group.  To  perform  the 
benchmark  analysis,  Pearl  Meyer  uses  survey  data  from  Radford  Aon,  which  is  the  compensation  survey  platform 
LivaNova  uses  for  salary  benchmark  data,  as  well  as  data  from  a  pre-established  peer  group  selected  by  the  CHCM 
Committee.

■ Overall Competitiveness

The  CHCM  Committee  uses  aggregated  market  data  and  its  peer  group  as  reference  points  to  ensure  that  executive 
compensation  falls  within  the  broad  middle  range  of  comparable  pay  at  peer  companies  with  which  the  Company 
competes for talent.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________56

REMUNERATION REPORT
2023 Remuneration Report

2023 Remuneration Report

Single Total Figure of Remuneration - Executive Director (Audited)

Basic 
Salary and 
Fees
($’000) (1)

Taxable 
Benefits
($’000) (2)

Pension 
Contributi
ons/
Allowance
($’000) (3)

Total 
Fixed
($'000)

Annual 
Bonus
($’000) (4)

Service-
Based 
Awards
($’000) (5) 
(6)

Performan
ce-Based 
Awards
($’000) (5) 
(7)

Total 
Variable 
($’000)

Recovery 
of Value 
($’000) (8)

Total
($’000)

698   

2   

—   

700   

1,059   

1,250   

—   

2,309   

—   

3,009 

287   

70   

50   

407   

—   

3,250   

—   

3,250    (10,372)  

(6,715) 

967   

92   

277   

1,336   

1,105   

2,750   

1,713   

5,568   

—   

6,904 

William Kozy 
- 2023
Damien 
McDonald - 
2023
Damien 
McDonald - 
2022

*The currency conversion rate used for 2023 is £/$ =1.24305 (average currency rate for the period 1 January 2023 to 31 December 2023) and for 2022 is £/$ = 
1.23186 (average currency rate for the period 1 January 2022 to 31 December 2022).

(1)

(2)

In 2023, Mr. Kozy was paid a prorated base salary of $697,500 as of 14 April 2023- based on an annual salary of $975,000. The amounts Mr. Kozy received 
as an NED in 2023 are reported separately in the “Single Total Figure of Remuneration - Chair and Non-Executive Directors (Audited)” section. In 2023, 
Mr. McDonald was paid a prorated base salary until 14 April 2023 of £230,743 ($286,826), as his annual  salary was £791,117 ($983,402). 
In 2023, the taxable benefits column line: (i) for Mr. Kozy includes tax assistance amounting to £1,500 ($1,865) and (ii) for Mr. McDonald includes (a) a 
prorated car allowance of £5,177 ($6,435) (until 14 April 2023 ) based on an annual allowance of £17,750 ($22,064), (b) health insurance amounting to 
£34,740 ($43,184), (c) tax assistance amounting to £16,089 ($20,000) and (d) London hotel reimbursement, in accordance with the Company’s travel policy, 
amounting to £332 ($414).

(3) Mr. Kozy chose to decline any retirement benefit, despite being eligible for our 401K retirement plan and US Non-Qualified deferred compensation plan. Mr. 
McDonald  was  entitled  to  an  overall  pension  contribution  or  pension  allowance  of  15%  of  salary  and  bonus.As  cash  in  lieu  of  pension  contributions  is 
subject to a UK employer’s National Insurance charge (13.8% from 1 January 2022 to 5 April 2022 and after 6 November 2022, and 15.05% between 6 
April  2022  and  5  November  2022),  any  pension  allowance  paid  as  cash  is  decreased  by  a  corresponding  amount  so  that  the  payment  by  the  Company 
remains  relatively  cost-neutral.  As  no  bonus  was  paid  to  Mr.  McDonald  for  2023,  he  received  a  pension  allowance  in  respect  of  his  salary  until  his 
termination date on 31 May 2023.

(4) The  annual  bonus  payment  for  Mr.  Kozy  is  explained  in  the  "Short-Term  Incentive  Plan  -  Executive  Director  (Audited)''  section  below.  Mr.  McDonald 

forfeited any entitlement to the 2023 short term incentive as a result of his resignation. 

(5) Because  of  LivaNova's  strong  US  nexus  (listing  and  shareholding  base),  the  2023  LTIP  allows  for  the  grant  of  service-based  awards  that  have  no 
performance  requirement,  which  vest  subject  to  continued  service  in  tranches  over  one  or  more  years  or  by  cliff  vesting,  as  well  as  awards  with  a 
performance  requirement.  Due  to  the  difference  in  design  of  the  2023  LTIP  versus  a  typical  long-term  incentive  plan  in  the  UK  and  in  order  to  provide 
optimal  transparency,  LivaNova  has  created  separate  columns  for  such  service-based  awards  and  performance-based  awards.  Amounts  recorded  in  the 
“Service-Based Awards” column are equal to the full grant date value of the equity awards (Award Value) (whether in the form of RSUs or SARs). Because 
a SAR by definition has nil value at the moment of grant, LivaNova has recorded the grant value approved by the CHCM Committee (i.e., the Fair Market 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________57

CEO 2023 Total RemunerationWilliam KozyDamien McDonaldBasic Salary and FeesTaxable BenefitsPension ContributionsAnnual BonusService Based AwardsLong-Term Incentive AwardsRecovery of Value(12,000)(10,000)(8,000)(6,000)(4,000)(2,000)—2,0004,000 
 
 
REMUNERATION REPORT
2023 Remuneration Report

(6)

Value  of  the  SARs  on  the  date  of  grant  calculated  using  the  Black-Scholes  formula).  Meanwhile,  the  “Performance-Based  Awards”  column  refers  to 
performance-based awards. No discretion was exercised as a result of any share price appreciation or depreciation in determining the level of the awards.
In  connection  with  Mr.  Kozy  becoming  the  Company’s  sole  Executive  Director  and  being  appointed  Interim  CEO  in  April  2023,  the  CHCM  Committee 
agreed to a one-time grant of service-based RSUs with a grant date fair value of $500,000, which was granted on 15 June 2023. This grant replaced the 
annual RSU grant that Mr. Kozy would have received in June 2023 had he remained a NED. The RSUs vested on 14 October 2023, six months from his start 
date. The CHCM Committee determined that this vesting period was both appropriate and necessary to meet the individual circumstances of Mr. Kozy’s 
interim role, which was expected to continue until the earlier of the commencement of employment of a successor CEO and the six-month anniversary of his 
start  date.  On  15  December  2023,  the  CHCM  Committee  granted  Mr.  Kozy  a  second  RSU  award  with  a  grant  date  fair  value  of  $750,000,  which  was 
structured  to  vest  upon  the  earlier  of  (i)  the  commencement  of  employment  of  a  successor  CEO  and  (ii)  13  April  2024,  subject  to  Mr.  Kozy’s  continued 
employment through such vesting date. As a result of Mr. Makatsaria’s commencement of employment as CEO on 1 March 2024, these RSUs vested on 29 
February 2024.

(7) As a result of his resignation, Mr. McDonald forfeited any entitlement to any PSUs, RSUs and SARs granted in prior years that would have otherwise vested 
in  2023.  In  addition,  Mr.  McDonald  forfeited  the  rTSR  PSUs  granted  in  March  2021  based  on  the  Company  achieving  a  three-year  (2021-2023)  rTSR 
threshold level of at least the 30th percentile of the 2021 rTSR comparator group. The Company ranked in the 59th percentile of that group, and accordingly, 
115% of the 2021 rTSR PSUs would have vested on 30 March 2024 if Mr. McDonald had been an employee at that time.

(8) This column includes the awards that the Company included in the single figure table as service-based awards or as performance-based awards subject to 

additional service periods that Mr. McDonald forfeited as a result of his resignation. More specifically the amount includes:

a.
b.

c.

d.

e.

f.

$3,250,000 included in this year’s single figure table of RSUs and SARs granted on 30 March 2023 and subsequently forfeited.
$2,062,500 as the difference between the $2,750,000 service-based RSUs and SARs granted on 30 March 2022 and included with the grant value 
in the 2022 single figure table and the $687,500 service-based RSUs and SARs that vested on 30 March 2023 – measured for consistency with the 
same grant value dollar amount.
$1,375,000 as the difference between the $2,750,000 service-based RSUs and SARs granted on 30 March 2021 and included with the grant value 
in  the  2021  single  figure  table  and  the  $1,375,000  service-based  RSUs  and  SARs  that  vested  on  30  March  2023  and  on  30  March  2022  – 
measured for consistency with the same grant value price.
$687,500 as the difference between the $2,750,000 service-based RSUs and SARs granted on 30 March 2020 and included with the grant value in 
the 2020 single figure table and the $2,062,500 service-based RSUs and SARs that vested on 30 March 2023, 30 March 2022 and 30 March 2021 
– measured for consistency with the same grant value price.
$1,290,627  included  in  the  2021  single  figure  table  as  the  fair  market  value  of  the  15,490  ROIC  PSUs  earned  based  on  the  2021  ROIC 
performance condition, which were subject to a further two-year service condition and were forfeited as a result of Mr. McDonald’s resignation. 
The value of these PSUs was calculated using the average stock price in the last quarter of 2021 ($83.32), maintaining consistency with the 2021 
single figure table.
$1,706,060 included in the 2021 single figure table as the fair market value of the 20,476 FCF PSUs earned based on the 2021 FCF performance 
condition, which were subject to a further two-year service condition and were forfeited as a result of Mr. McDonald’s resignation. The value of 
these PSU was calculated using the average stock price in the last quarter of 2021 ($83.32), maintaining consistency with the 2021 single figure 
table.

(9)

See also the “Payments Made for Loss of Office (Audited)” section below.

Short-Term Incentive Plan - Executive Director (Audited)

LivaNova’s  STIP  is  an  annual  cash-based  incentive  bonus  plan,  which  is  an  important  component  of  the  Company’s  total 
compensation program. It provides incentives that compensate the Company’s incumbent CEO for achieving objectives intended 
to enhance shareholder value. 

Under  English  Company  law,  LivaNova  is  required  to  adopt  a  remuneration  policy  for  the  Company’s  directors,  including  the 
Company’s  CEO,  who  is  also  a  director.  Under  that  shareholder-approved  Remuneration  Policy,  the  maximum  short-term 
incentive of the Company’s incumbent CEO cannot exceed 200% of his base salary. In 2023, the CHCM Committee approved a 
lower maximum of 160% for Mr. McDonald and 181.8% for Mr. Kozy. 

The table below shows the minimum and maximum achievement of the target payout under the 2023 STIP:

2023 STIP 
Minimum 
(Percentage of 
Base Salary)
—%
—%

2023 STIP 
Target 
(Percentage of 
Base Salary)
110%
125%

2023 STIP 
Maximum 
(Percentage of 
Target)(1)
181.8%
160%

William Kozy
Damien McDonald

The performance objectives selected by the CHCM Committee for the 2023 STIP were as follows:

(1) Per the Remuneration Policy, the maximum bonus opportunity is 200% of base salary.

Business 
Performance
Factor 

= (

60%

Net Sales 
Payout %

+ 40%

)

X

Adjusted 
Net 
Income 
Payout %

Non-Financial 
Goals
Modifier %

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________58

REMUNERATION REPORT
2023 Remuneration Report

If  the  threshold  for  a  financial  objective  is  achieved,  funding  for  that  objective  is  scaled  down  or  up  for  underachievement  or 
overachievement, respectively, of the objective, as follows:

Net Sales Payout

Achievement %
<90%
90%

Payout % of Target
0%
25%

Linear Interpolation

Linear Interpolation

100%

≥110%

100%

150%

Adjusted Net Income Payout

Achievement %
<80%
80%

Payout % of Target
0%
25%

Linear Interpolation

Linear Interpolation

100%

≥120%

100%

150%

“Net Sales” is defined as the Company’s net sales for 2023 at budgeted currency exchange rates, adjusting for the effects from any 
acquisitions and divestitures in 2023. “Adjusted Net Income” is defined as the Company’s non-GAAP net income at reported 
currency exchange rates, after adjustments for the effects of acquisitions, divestitures, restructuring, integration, product 
remediation, purchase price allocation and intangible amortisation, significant litigation, equity compensation, significant non-
cash adjustments, and other infrequent, unusual or non-recurring items not incurred in the ordinary course of business.

Bonuses are based on the Company’s performance over the calendar year, which is also the Company’s financial year, and are 
generally  paid  in  April  of  the  following  year  after  completion  of  the  audit  of  the  Company’s  annual  financial  statements.  The 
Company’s performance in 2023, as defined by the 2023 STIP, was as follows:

Financial Objectives

Net Sales

Weight (%)
60%

Target ($M)
1,113.70

Achievement 
($M)
1,215.40

Achievement 
(%)
109.1

Adjusted Net Income

40%

138.10

152.00

110.1

Financial 
Payout (% vs 
Target)
145.65%

125.16%

137.5%

Non-Financial Objectives:

LivaNova’s non-financial goal achievement for 2023 resulted in 70% achievement. As these non-financial goals are intended to be 
aspirational goals, this achievement would have resulted in a 110% non-financial modifier of the Company’s STIP payout, based 
on the following table:

Non-Financial Goal Modifier

Achievement %
—%

Payout % of target
75%

Linear Interpolation

Linear Interpolation

50%

100%

100%

125%

However, based on the scoring of the 2023 non-financial objectives as well as an overall assessment of Company performance, 
the CHCM Committee determined to utilize negative discretion to cap the Non-Financial Goal Modifier at 100%. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________59

REMUNERATION REPORT
2023 Remuneration Report

The table below decribes the Company’s Non-Financial Goal achievements:

Business Area

Description

Achievement

Achievement description

DTD

OSA

Epilepsy

CP

ACS

Capability

Total

500th Unipolar patient 
randomized into the study by 
target date, completing 
recruitment for Unipolar cohort
First interim analysis initiated for 
Bipolar cohort in the RECOVER 
study upon randomizing target 
number of bipolar patients by 
target date
Target number of randomized 
patients by target date and 
program assessment completion 
by target date
Target % of NPI growth year over 
year

Two key milestones in 
Regulatory and R&D to be 
completed by target date, each 
weighted 5%
Software release for Europe 
commercialization by target date
One key milestone in Regulatory 
and target number of critical 
product development projects to 
be completed by target date, each 
weighted 5%
Financial system deployed by 
target date

Achieved

500th Unipolar patient randomized 
into the study by target date

Weight 
(%)
15%

Achievement	
(%)
15%

Achieved

Target number of bipolar patients 
achieved on 13 June 2023

10%

10%

Not 
Achieved

Not 
Achieved

Achieved

Target number of patients not 
achieved by the target date, and 
program assessment completed

10%

—%

Achieved high single digit NPI year-
over-year growth, slightly behind 
target %
All milestones achieved by the target 
date

20%

—%

10%

10%

Achieved

Achieved

Software release completed by target 
date
Both regulatory and product 
development goal achieved

15%

10%

15%

10%

Achieved

Financial system – object of this 
goal – went live by the target date 

10%

10%

NFG Modifier
Capped NFG Modifier

100%

70%
110%
100%

Business Performance Factor:

As  a  result  of  achievement  on  Financial  and  Non-Financial  objectives,  the  Business  Performance  Factor  for  2023  resulted  in  a 
payout of 137.5% of the target.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________60

REMUNERATION REPORT
2023 Remuneration Report

Percentage Change in Director Remuneration Compared to Other Employees

The  table  below  shows  the  annual  percentage  change  in  remuneration  in  respect  of  each  of  the  Company’s  directors,  and  the 
average percentage change in remuneration of the Company’s employees (other than any who are also a director, and on a full 
time equivalent basis) between 2023 and 2022, 2022 and 2021, 2021 and 2020, and 2020 and 2019:

Change in 2023 against 2022 (%) Change in 2022 against 2021 (%) Change in 2021 against 2020 (%) Change in 2020 against 2019 (%)

Base 
salary 
change 
%

Benefits 
change 
%

Annual 
Cash 
Bonus 
change 
%

Base 
salary 
change 
%

Benefits 
change 
%

Annual 
Cash 
Bonus 
change 
%

Base 
salary 
change 
%

Benefits 
change 
%

Annual 
Cash 
Bonus 
change 
%

Base 
salary 
change 
%

Benefits 
change 
%

Annual 
Cash 
Bonus 
change 
%

N/A

N/A

N/A

+2.25%

(33)%

(41)%

+1% 

(21)%

N/A

+5%

(11)%

(100)%

N/A

-%

N/A

N/A

N/A

N/A

-%

-%

N/A

N/A

N/A

N/A

-%

-%

N/A

N/A

N/A

N/A

-%

-%

N/A

N/A

N/A

N/A

-%

N/A

N/A

-%

N/A

N/A

-%

N/A

N/A

-%

N/A

N/A

Damien 
McDonald (1)

William Kozy

Stacy Enxing 
Seng

Todd 
Schermerhorn

Francesco Bianchi

-%

N/A

N/A

-%

N/A

N/A

-%

N/A

N/A

-%

N/A

N/A

Dr. Sharon 
O’Kane

Peter Wilver

Brooke Story

Daniel J. Moore

Andrea Saia

Chris Barry

Average for all 
employees

+18%

N/A

N/A

-%

N/A

N/A

-%

N/A

N/A

-%

N/A

N/A

N/A

N/A

-%

-%

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

+4%

+30%

+22%

N/A

N/A

-%

-%

N/A

+3%

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

-%

-%

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

-%

-%

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

+1%

(11)%

+3%

+10%

+223%

+3%

+2%

(16)%

(1) The  base  salary,  benefits  and  bonus  change  calculations  for  Mr.  McDonald  were  made  using  the  original  amounts  in  GBP  to  avoid  any  potential 

misrepresentation resulting from changes in foreign exchange rates.

The  table  above  reflects  a  comparison  of  the  directors’  remuneration  year  over  year.  “N/A”  is  used  if  a  change  is  inapplicable 
because the director started in the current year, if the number was zero in the prior year (as in the case of Mr. McDonald’s bonus 
in 2020) or if the comparison is not meaningful (e.g., comparison between taxable travel expenses year over year or for a prorated 
year with a full year as in the case of the comparison for Mr. McDonald between 2023 and 2022).

By  comparison,  in  2023  versus  2022,  the  remaining  employees  of  LivaNova  PLC,  other  than  the  executive  leadership  team, 
received an average base salary increase of 4% and an average taxable benefit increase of 30%, the latter related to the higher cost 
of  the  employer-provided  private  medical  coverage  in  2023  versus  2022.  Employees  also  received  an  average  annual  bonus 
payout increase of 22% versus 2023. The average annual cash bonus payout was 131% in 2023 versus 107% in 2022.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________61

REMUNERATION REPORT
2023 Remuneration Report

Single Total Figure of Remuneration - Chair and Non-Executive Directors (Audited)

Basic Annual 
Fee
($’000) (1) (4)
2022
2023
110
32
110
110
110
110
110
110
110
110
60
110
32
110
110
110
110
110
—
26

Additional Fee

Benefits

Total Fixed

($’000) (1)

($’000) (2)

($’000)

2023
21
20
30
23
41
23
8
8
23
4

2022
75
20
30
23
18
13
2
7
22
—

2023

0
4
4
8
4
4
3
22
13
0

2022
7
3
3
6
5
3
—
20
18
—

2023
53
134
144
141
155
137
121
140
146
30

2022
192
133
143
139
133
76
34
137
150
0

Service-Based 
Share Awards
($’000) (3)

Total

($’000)

2023
—
130
130
130
130
130
130
130
130
88

2022
205
130
130
130
130
130
96
130
130
—

2023
53
264
274
271
285
267
251
270
276
118

2022
397
263
273
269
263
206
130
267
280
0

William Kozy
Stacy Enxing Seng
Todd Schermerhorn
Francesco Bianchi
Dr. Sharon O’Kane
Peter Wilver
Brooke Story
Daniel J. Moore
Andrea Saia
Chris Barry

 (1)  The following cash amounts are paid in addition to the annual cash retainer: (i) any NED serving as the Chair of the Board shall receive an additional 
annual retainer of $75,000 for such service (ii) any NED serving as the Lead Director shall receive an additional annual retainer of $30,000 for such service 
(iii) any NED serving as Chair of the Audit and Compliance Committee shall receive an additional annual retainer of $30,000 for such service and any NED 
serving as a member of the Audit and Compliance Committee (other than the Chair) shall receive an additional annual retainer of $15,000 for such service. 
(iv) any NED serving as Chair of the CHCM Committee shall receive an additional annual retainer of $20,000 for such service, and any NED serving as a 
member of the CHCM Committee (other than the Chair) shall receive an additional annual retainer of $8,000 for such service. (v) any  NED serving as 
Chair of the NCG Committee shall receive an additional annual retainer of $20,000 for such service ($15,000 until the 2022 AGM) and any NED serving as 
a member of the Nominating and Governance Committee (other than the Chair) shall receive an additional annual retainer of $8,000 ($6,000 until 2022 
AGM) for such service. In the 2022 column, the amounts of the Basic Annual Fee and the Additional Fee for Mr. Wilver reflect the fees earned since the 
2022 AGM and the amounts of the Basic Annual Fee and the Additional Fee for Ms. Story reflect the fees earned since her appointment. In the 2023 column, 
the amounts of the Basic Annual Fee and the Additional Fee for Mr. Barry reflect the fees earned since his appointment.

(2)   The amounts refer to expense reimbursements for the directors to exercise their roles which are considered taxable under UK tax legislation. For non-UK 

resident directors, tax treatment of expenses changes depending on the start of director duties in the UK.

(3)    The figures included for 2023 reflect the annual award of service-based RSUs, which were granted on 15 June 2023, vest on 15 June 2024, and have a grant 
value  of  $130,000.  Mr.  Kozy  was  not  eligible  for  a  Chair  grant  as  he  received  a  grant  for  his  interim  CEO  role  (see  the  “Single  Total  Figure  of 
Remuneration – Executive Directors (Audited)” section above. Ms. Saia’s grant vested on her last day of tenure on 31 December 2023 on a pro-rata basis 
per her award agreement and the Remuneration Policy.

(4)    Payments are made quarterly to directors.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________62

REMUNERATION REPORT
2023 Remuneration Report

2023 Schemes Interests Awarded (Audited) 

Director

Face Value 
of Award 
($)(1)

No. of 
Shares 
Subject to 
the Award 
(2)

Damien McDonald

3,249,994

76,832

Damien McDonald

1,624,997

38,416

Damien McDonald

1,624,997

38,416

Damien McDonald

1,624,997

38,416

Percentage if 
Minimum 
Performance 
is met for 
Performance 
Awards (3)
40%

20%

50%

Closing Share 
Price on Date of 
Grant (for Face 
Value Calculation) 
($) (4)

Date of 
Grant

Expiry of 
Performance
Period

Basis of 
Award

Type of 
Award and 
Performance 
Criteria

rTSR PSUs 
(2) (5)

42.30

42.30

42.30

42.30

30/3/2023

31/12/2025

Fixed value

30/3/2023

31/12/2025

Fixed value FCF PSUs (2) 

(5)

30/3/2023

31/12/2025

Fixed value ROIC PSU 

30/3/2023

Damien McDonald

1,624,997

81,613

19.911

30/3/2023

Damien McDonald
Total Face Value 
2023 Awards
William Kozy

9,749,982

499,980

10,311

William Kozy

749,980

14,512

Daniel J. Moore

129,953

2680

Francesco Bianchi

129,953

2680

Dr. Sharon O'Kane

129,593

2680

Andrea Saia

129,953

2680

Stacy Enxing Seng

129,953

2680

Todd Schermerhorn

129,953

2680

Peter Wilver

129,953

2680

Brooke Story

129,953

2680

Chris Barry

88,321

1709

48.49

51.68

48.49

48.49

48.49

48.49

48.49

48.49

48.49

48.49

51.68

15/6/2023

15/12/2023

15/6/2023

15/6/2023

15/6/2023

15/6/2023

15/6/2023

15/6/2023

15/6/2023

15/6/2023

15/12/23

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

(2) (5)

Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting SARs

Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs
Fixed value Time-Based 
Vesting RSUs

(1) Face value of RSU awards calculated using the most recent closing market price of an ordinary share of the Company’s stock on the Nasdaq on the date of 
grant. face value of PSU awards represents the maximum number of PSUs (200% of target) multiplied by the most recent closing market price of an ordinary 
share of the Company’s stock on the Nasdaq on the date of grant. SARs awarded to Mr. McDonald are calculated by dividing the award value by the Black-
Scholes  value  of  a  SAR  based  on  the  date  of  grant  ($19.911).  With  respect  to  SARs,  because  a  SAR  by  definition  has  nil  value  at  the  moment  of  grant, 
LivaNova has recorded the grant value approved by the CHCM Committee as the face value.

(2) For PSUs, this represents the maximum number of underlying shares (200% of the target). 
(3) PSU details are found in the section entitled, “2023 LTIP (Audited)”.
(4) For SAR awards, this represents the Black-Scholes value of one SAR on the date of grant, rather than the closing market price of an ordinary share of the 

Company’s stock on the Nasdaq on the date of grant.

(5) Mr. McDonald forfeited any entitlement to these awards as a result of his resignation, which was announced by the Company on 14 April 2023.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________63

REMUNERATION REPORT
2023 Remuneration Report

2023 LTIP (Audited)

Mr. Kozy

In connection with Mr. Kozy becoming LivaNova’s sole Executive Director and being appointed Interim CEO in April 2023, the 
CHCM Committee agreed to a one-time grant of service-based RSUs with a grant date fair value of $500,000 which was granted 
on 15 June 2023. This grant replaced the annual RSU grant that Mr. Kozy would have received in June 2023 had he remained an 
NED.  The  RSUs  vested  six  months  from  his  start  date,  i.e.,  on  14  October  2023.  The  CHCM  Committee  determined  that  this 
vesting period was both appropriate and necessary to meet the individual circumstances of Mr. Kozy’s interim role, which was 
expected to continue until the earlier of the commencement of employment of a successor CEO and the six-month anniversary of 
his  start  date.  On  15  December  2023,  the  CHCM  Committee  granted  a  second  RSU  award  with  a  grant  date  fair  value  of 
$750,000, which was structured to vest upon the earlier of (i) the commencement of employment of a successor CEO and (ii) 13 
April  2024,  subject  to  Mr.  Kozy’s  continued  employment  through  such  vesting  date.  As  a  result  of  Mr.  Makatsaria’s 
commencement on 1 March 2024 as CEO, these RSUs vested on 29 February 2024.

Mr. McDonald

The  2023  LTIP  applicable  to  Mr.  McDonald  comprised  both  performance-based  and  service-based  awards.  However,  Mr. 
McDonald forfeited any entitlement to his 2023 LTIP awards as a result of his resignation in 2023.

2023 Service Based Awards

Service-Based Restricted Stock Units

Service-Based Stock Appreciation Rights

Mr. McDonald received 38,416 service-based RSUs, vesting subject 

Mr. McDonald received 81,613 SARs, vesting subject to his 

to  his  continued  employment  in  equal  or  substantially  equal 

continued  employment  in  equal  or  substantially  equal 

amounts  on  each  of  the  first  four  anniversaries  of  the  grant  date. 

amounts on each of the first four anniversaries of the grant 

The CHCM Committee determined the number of RSUs awarded by 

date.  The  CHCM  Committee  determined  the  number  of 

dividing  the  award  value  in  RSUs  ($1,625,000)  by  the  most  recent 

SARs  awarded  to  each  participant  by  dividing  the  award 

closing price ($42.30) of an ordinary share of the Company’s stock 

value in SARs ($1,625,000) by the Black-Scholes value of a 

on  the  Nasdaq  as  of  the  grant  date  and  rounding  down  to  the 

SAR ($19.911) based on the most recent closing price and 

nearest whole unit. 

rounding down to the nearest whole unit. 

2023 Performance Based Awards:

Relative Total Shareholder Return Performance Stock Units

Mr.  McDonald  received  38,416  PSUs  subject  to  a  relative  total  shareholder  return  market  condition.  The  CHCM  Committee 
determined the number of PSUs awarded to each participant by dividing the award value in rTSR PSU ($1,625,000) by the most 
recent  closing  price  ($42.30)  and  rounding  down  to  the  nearest  whole  unit.  At  the  end  of  the  2025  calendar  year,  subject  to 
continued  employment,  the  Company’s  rTSR  for  the  three-year  period  2023  through  2025  will  be  compared  to  the  rTSR  for  a 
comparator group of 27 companies selected by the CHCM Committee on the advice of its compensation consultant, Pearl Meyer, 
and the number of shares of the Company’s stock actually delivered to the participants will be determined by the following chart, 
with linear interpolation applied between specified levels. 

TSR Performance
Percentile Rank
≥90th
80th
50th
30th
<30th

Percent Payout
200%
150%
100%
40%
0%

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________64

REMUNERATION REPORT
2023 Remuneration Report

The 2023 rTSR Peer Group includes:

Avanos Medical, Inc.
Boston Scientific Corporation
CONMED Corporation
DexCom, Inc.
Edwards Lifesciences Corporation
Globus Medical, Inc.
Haemonetics Corporation 
Hologic, Inc.
ICU Medical, Inc.
Insulet Corporation 
Integer Holdings Corporation 
Integra LifeSciences Holdings Corp.
Intuitive Surgical, Inc.
Invacare Corporation 

iRhythm Technologies, Inc.
Masimo Corporation 
Medtronic plc 
Merit Medical Systems, Inc.
Nevro Corp. 
NuVasive, Inc.
Orthofix Medical Inc.
Penumbra Inc.
ResMed Inc.
Smith & Nephew plc
Tandem Diabetes Care, Inc.
Teleflex Incorporated 
Zimmer Biomet Holdings, Inc.

Subject to continued employment, the following parameters will be used to determine rTSR for the three-year period ending 31 
December 2025:

•

•

•

•

Stock Price: 30 trading-day average closing prices as of the beginning and end of the performance period;

Dividend Treatment: Dividend reinvestment approach (using ex-dividend date);

Relative Performance Measurement:

◦

◦

Calculate cumulative TSR for LivaNova and each of the companies in the comparator group; and

Compute  LivaNova’s  discrete  percentile  rank,  which  is  inclusive  of  LivaNova’s  TSR  (using  Excel: 
PERCENTRANK function).

Comparator Group Governance:

◦

◦

Measured against comparator group at the beginning of the performance period; and

Companies acquired or delisted during the performance period are excluded.

Adjusted FCF Performance Stock Units

Mr. McDonald received 19,208 PSUs subject to achievement of a three-year cumulative adjusted FCF target and to his continued 
employment. The CHCM Committee determined the number of PSUs awarded to each participant by dividing the award value in 
adjusted FCF PSUs ($812,500) by the closing price ($42.30) and rounding down to the nearest whole unit. Subject to continued 
employment, the PSUs are scheduled to vest or lapse on 30 March 2026 based on how the Company’s adjusted FCF for fiscal year 
2023-2025  compares  to  target,  and  the  number  of  shares  of  the  Company’s  stock  actually  delivered  to  the  participants  will  be 
determined by the following chart, with linear interpolation applied between specified levels. 

FCF Achievement
Relative to FCF Target
≥150%
125%
100%
60%
<60%

Percent Payout
200%
150%
100%
20%
0%

For purposes of the plan, adjusted FCF is defined as net cash provided by operating activities less cash used for the purchase of 
property, plant and equipment excluding the impact of 3T litigation settlement payments, CARES Act tax stimulus benefits and 
gains  related  to  dividends  received  from  investments,  as  determined  in  accordance  with  the  external  definition  provided  in  the 
LivaNova fourth quarter and full year 2024 performance presentation posted on the Company’s website, and further adjusted as 
needed  for  other  one-time,  non-recurring,  unusual  or  infrequent  charges,  expenses  or  gains,  including  associated  expenses,  that 
may not be indicative of the Company’s core business.

Given that adjusted FCF is a key measure of company value, the Board considers the actual target amounts to be too commercially 
sensitive for disclosure. While the target amounts would typically be disclosed after publication of the Company’s 2025 financial 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________65

REMUNERATION REPORT
2023 Remuneration Report

results, this disclosure is no longer relevant given that Mr. McDonald forfeited any entitlement to these awards as a result of his 
resignation on 14 April 2023.

ROIC Performance Stock Units
Mr.  McDonald  received  19,208  PSUs  subject  to  achievement  of  a  three-year  cumulative  adjusted  ROIC  target  and  to  his 
continued employment. ROIC is defined as the ratio between Net Operating Profits and Invested Capital. The numerator shows 
core operating performance, and the denominator denotes the capital required to achieve that performance. Net Operating Profits 
is defined as the Company’s adjusted operating income less share-based compensation expense and is tax affected by LivaNova’s 
adjusted  tax  rate.  Adjusted  operating  income  and  adjusted  tax  rate  are  non-GAAP  measures,  provided  in  conjunction  with  the 
issuance of the Company’s quarterly earnings press release. Invested Capital is defined as operating working capital plus other net 
operating assets. It excludes restricted cash, derivative assets and liabilities, long-term debt and accrued legal settlements related 
to  LivaNova’s  3T  matter.  The  CHCM  Committee  determined  the  number  of  PSUs  awarded  to  each  participant  by  dividing  the 
award  value  in  ROIC  PSUs  by  the  closing  price  ($42.3)  and  rounding  down  to  the  nearest  whole  unit.  Subject  to  continued 
employment,  the  PSUs  are  scheduled  to  vest  or  lapse  on  30  March  2026  based  on  how  the  Company’s  ROIC  for  the  period 
2023-2025  compares  to  target,  and  the  number  of  shares  of  the  Company’s  stock  actually  delivered  to  the  participants  will  be 
determined by the following chart, with linear interpolation applied between specified levels.

ROIC Achievement
Relative to ROIC Target
Target ≥+ 250 bps
Target + 125 bps
Target
Target - 125 bps
Target ≤-250 bps

Percent Vesting of Award
200%
150%
100%
50%
0%

Given  that  ROIC  is  a  key  measure  of  company  value,  the  Board  considers  the  actual  target  amounts  to  be  too  commercially 
sensitive  for  disclosure.  The  CHCM  Committee  planned  to  disclose  the  target  amounts  after  the  publication  of  the  Company’s 
2025 financial results, but as Mr. McDonald forfeited any entitlement to these awards as a result of his resignation on 14 April 
2023, this disclosure is no longer relevant.

Payments Made to Past Directors (Audited)

The Company did not make any payments in 2023 to past directors, except for providing £1,500 to Mr. Rosenthal and Mr. Novak 
each, for personal income tax return preparation assistance in their capacity as former non-UK resident directors. Such amounts 
were paid directly to such past directors’ tax advisers upon the production of an invoice, pursuant to the Remuneration Policy.

Payments Made for Loss of Office (Audited)

In  connection  with  Mr.  McDonald’s  resignation  as  CEO  and  as  a  director,  the  Company  and  Mr.  McDonald  entered  into  a 
Settlement Agreement, dated 14 April 2023 (the “Settlement Agreement”). Pursuant to the Settlement Agreement, the Company 
elected  to  bring  Mr.  McDonald’s  12-month  notice  period  to  an  end  such  that  his  employment  with  the  Company  ceased  on  31 
May  2023,  prior  to  which  Mr.  McDonald  served  a  period  of  garden  leave.  Mr.  McDonald  received  a  notice  payment  of 
£1,062,138.55 in accordance with the terms of his previously disclosed Service Agreement, representing the 12-month value of 
Mr. McDonald’s salary (£791,117) and certain cash benefits (including his pension allowance of £253,271.55 and car allowance 
(£17,750)). The notice payment was paid to Mr. McDonald during his garden leave period and thereafter in monthly instalments 
between June 2023 and April 2024.

In  accordance  with  the  terms  of  Mr.  McDonald’s  previously  disclosed  Service  Agreement,  he  also  continued  to  receive  certain 
non-cash benefits that would have been received during what would have been his notice period, including health insurance (at a 
value of £14,475), tax return assistance (at a value of $20,000), and the continuation of an existing executive coaching program (at 
a value of £20,000 plus tax). 

In addition, pursuant to the Settlement Agreement, the Company agreed to contribute to the cost of legal advice for Mr. McDonald 
in relation to the Settlement Agreement, up to a maximum amount of £25,000 plus tax. A contribution of £25,000 plus tax was 
ultimately paid by the Company. Finally, pursuant to the Settlement Agreement, the Company paid an amount of £30,681 as cash 
in lieu of accrued and unused holidays.

Any unvested equity awards held by Mr. McDonald were forfeited on 31 May 2023, the last day of his employment. 

Mr.  McDonald  exercised  his  vested,  in-the-money  SARs  within  the  90-days  following  his  termination  date.  See  “Statement  of 
Directors’ Shareholding and Scheme Interest ” section below.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________66

REMUNERATION REPORT
2023 Remuneration Report

Executive and Non-Executive Directors' Shareholdings (Audited)

To align the interests of the Company’s executive and NEDs to those of the Company’s shareholders, the Company established 
Stock  Ownership  Guidelines  detailing  the  minimum  amount  of  equity  expected  to  be  held  by  certain  individuals.  Failure  to 
maintain  the  minimum  amount  of  equity  ownership  once  attained  may  be  a  factor  considered  by  the  CHCM  Committee  in 
recommending and/or approving future awards. The directors believe that meaningful ownership of equity in the Company is an 
essential element in demonstrating the commitment of its leadership to its primary task of creating value for its shareholders. To 
further this belief, equity award programs have been established as part of the overall compensation plans for both officers and 
directors. Until the relevant stock ownership threshold is achieved by the CEO and each NED, each individual should retain 100% 
of  the  net  ordinary  shares  received  (i.e.,  following  tax  withholding)  until  the  relevant  stock  ownership  threshold  has  been 
achieved.  Following  achievement  of  the  relevant  stock  ownership  threshold,  shares  received  in  excess  of  the  stock  ownership 
threshold may be sold, subject to the Company’s insider trading policy then in effect.

Shareholding Requirements 

Level

Executive Director (CEO)
Non-Executive Directors

Stock Ownership Threshold
5 x annual base salary
5 x annual Board cash retainer

The definition of the “qualifying equity ownership” used for purposes of the Company’s stock ownership requirements comprises 
ordinary  shares  owned  by  the  individual  or  held  jointly  with  the  individual’s  spouse  or  children,  and  unvested  time-based 
restricted  stock  units  owned  by  the  individual,  in  each  case  valued  at  the  closing  price  of  an  ordinary  share  of  the  Company’s 
stock on the Nasdaq on the measurement date. 

Stock  Ownership  Thresholds  are  determined  by  using  the  most  current  base  salary  or  annual  cash  retainer  for  the  covered 
individual,  as  applicable,  and  the  closing  price  of  an  ordinary  share  of  the  Company’s  stock  on  the  Nasdaq  on  the  relevant 
measurement date. If there is no closing price on the date in question, Stock Ownership Thresholds will be determined by using 
the  most  recent  closing  price.  Share  Ownership  Thresholds  are  updated  annually  on  1  July  or  when  a  change  in  base  salary  or 
annual cash retainer occurs, with compliance generally measured on 1 July of each year. Once a director or officer has satisfied 
their Stock Ownership Threshold as of a measurement date, the Stock Ownership Threshold will continue to be deemed satisfied 
for  such  director  or  officer,  regardless  of  market  fluctuations,  so  long  as  the  director  or  officer  does  not  sell  or  transfer  any 
ordinary shares (a) where the sale or transfer causes the value of his or her holdings to be less than the Stock Ownership Threshold 
or (b) at a time when the value of his or her holdings is less than the Stock Ownership Threshold.

Furthermore,  it  is  expected  that  any  proposed  sale  of  ordinary  shares  by  a  director  or  officer  subject  to  the  Stock  Ownership 
Thresholds  be  assessed  for  compliance  herewith  at  the  time  of  such  proposed  sale.  In  its  discretion,  at  the  time  of  any  such 
proposed sale, the Company may determine to recalculate the applicable Stock Ownership Threshold.

As of 1 July 2023, based on a stock price of $51.43, four of the Company’s Board members, Mr. Bianchi, Mr. Moore, Ms. Saia, 
and Dr. O’Kane had achieved the Stock Ownership Threshold. 

       Statement of Directors’ Shareholdings and Scheme Interests

Ordinary Shares Held 
as of 31 December 
2023

111,847 

Ordinary Shares 
Underlying Scheme 
Interests Held as of 31 
December 2023 (2)

Damien McDonald (1)
William Kozy
Daniel J. Moore (3)
Francesco Bianchi
Stacy Enxing Seng
Dr. Sharon O’Kane
Todd Schermerhorn
Andrea Saia
Peter Wilver
Christopher Barry
Brooke Story

17,821  
27,534
8,177
6,650
8,074
3,963
10,799
1,637 

—  

1,380 

Vested but 
Unexercised SARs/
Stock Options Held as 
of 31 December 2023
449,338 
—
56,623 
—
—
—
—
—
—
—
—

Stock Options and 
SARs Exercised in the 
Year Ended 31 
December 2023

—
—
—
—
—
—
—
—
—
—
—

—  

14,512 

2,680  
2,680
2,680
2,680
2,680
2,680
2,680
1,709 
2,680

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________67

 
 
 
REMUNERATION REPORT
2023 Remuneration Report

(1) For Mr. McDonald, the amount represents the shareholdings and scheme interests on his termination date of 31 May 2023. Any  RSUs and PSUs that he held 
on his termination date were forfeited and consequently, are not reported in the table. Out of the reported 449,338 vested, but unexercised SARs on his termination 
date, Mr. McDonald exercised his in-the-money SARs within the 90-days following his termination date in two transactions realizing respectively $857,195.20 
from 130,670 SARs granted in 2016, before his appointment to CEO, with an exercise price of $44.79 which were exercised when the stock price was $51.35, and 
$718,433.70 from 58,888 SARs granted in 2020 with an exercise price of $43.57, which were exercised when the stock price was $55.77.
(2) All RSUs held as of 31 December 2023 are service-based awards, which were unvested as of 31 December 2023. 
(3) Mr. Moore was granted 56,623 Stock Options on 15 June 2014 by Cyberonics, Inc. that were converted into LivaNova stock options at the merger date with an 
exercise price of $57.39 and an expiration date of 15 June 2024.

Relative Importance of Spend on Pay 

The following table sets out the total amounts spent in the year ended 31 December 2023 and the year ended 31 December 2022 
on remuneration paid to employees and distributions (comprised of share buybacks and dividends) to shareholders. 

$ thousands

Employee remuneration 
Share buybacks
Dividend

Year Ended 31 
December 2023
480,337
—
—

Year Ended 31 
December 2022
408,698
—
—

% 
change
+18%
N/A
—%

Total Shareholder Return 

Performance Graph

The  graph  below  shows  the  Company’s  performance  measured  through  TSR  on  a  holding  of  $100  in  the  Company’s  shares 
between 31 December 2018 and 31 December 2023, compared to the S&P 500 Index and the S&P Healthcare Equipment Index. 
LivaNova selected these indices as it felt they provided both a broader market benchmark together with a more proximate industry 
benchmark.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________68

REMUNERATION REPORT
2023 Remuneration Report

CEO Total Compensation 

Incumbent
Total Single-Figure Remuneration 
(thousands $)
Annual Bonus Award (as a % of 
Maximum) (1)
Vesting of Long-Term Performance 
Awards (as a % of Maximum) (2)

Year Ended 31 
December 2023

Mr. 
Kozy

Year 
Ended 31 
December 
2022

Year 
Ended 31 
December 
2021

Year 
Ended 31 
December 
2020

Year 
Ended 31 
December 
2019

Year 
Ended 31 
December 
2018 

Year 
Ended 31 
December 
2017

Mr. McDonald

Year Ended 
31 December 
2016 (3)

Mr. 
Ballester

3,009

(6,715)

6,904

9,627

4,594

4,077

9,499

4,065

1,968

76%

—

57%

89%

—

16%

66%

57%

N/A

—%

52%

8%

14%

—

100%

—

53%

25%

(1)

(2)

In  2018,  Mr.  McDonald  received  a  pay-out  of  105%  which  represented  60%  of  the  maximum  payable,  which  was  set  at  160%  of  his  base  salary.  In  2019,  he 
received a payout of 25% which represented 16% of the maximum payable, which was set at 160%. In 2020, Mr. McDonald did not receive a bonus payout. In 
2021, he received a payout of 142.7%, which represented 89% of the maximum payable which was set at 160%. In 2022, he received a payout of 91.4% which 
represented 57% of the maximum payable which was set at 160%. In 2023, Mr. McDonald was not eligible for a bonus payout. The 2023 percentage represents 
the payout received by Mr. Kozy, who received a payout of 137.5% of his bonus at target, representing 76% of the maximum payable, which was set at 181.8% of 
his base salary. 
In  2018,  13,353  performance-based  RSUs  vested  during  the  financial  year  ended  31  December  2018,  which  represents  100%  of  the  maximum  opportunity  for 
vesting  in  the  2018  financial  year.  No  performance  awards  vested  in  2019.  No  performance  awards  vested  in  2020.  In  2021,  7,275  FCF  PSUs  vested.  The 
achievement  percentage  for  the  FCF  PSUs  was  78.58%  which  is  a  payout  percent  of  57.16%  related  to  performance  in  2020.  No  rTSR  PSUs  vested,  which 
together with the FCF PSUs represented 14% of the maximum payable which was set at 400%. In 2022, 5,167 FCF PSUs vested - the achievement percent for the 
FCF  PSUs  was  66.8%  which  is  a  payout  percentage  of  33.5%  related  to  performance  in  2021.  No  rTSR  PSU  vested,  which  together  with  the  FCF  PSUs 
represented  8%  of  the  maximum  payable  which  was  set  at  400%.  In  2022,  25,131  rTSR  PSU  (73%  of  the  target)  and  10,569  FCF  PSU  (30.7%  of  the  target) 
vested, together being 52% of the target PSUs. In 2023, Mr. McDonald did not receive any PSU payout as he forfeited his unvested equity award as a result of his 
resignation. Mr. Kozy’s equity award was time-based only.

(3) The figures relating to the CEO total compensation for the year ended 31 December 2016 reflect the compensation paid to former CEO, Andre-Michel Ballester, 

who resigned effective 31 December 2016.

Because LivaNova has fewer than 250 UK employees, it is exempt from disclosing the CEO pay ratio.

2024 Salary and STIP

Mr. Kozy and Mr. Makatsaria

The following table provides the details of base salary and bonus for Mr. Kozy and Mr. Makatsaria in 2024. Both of them are 
eligible  for  payout  of  our  2024  STIP  on  a  pro-rata  basis  calculated  based  on  the  number  of  days  of  employment  in  2024, 
respectively, Mr. Kozy from 1 January until 29 February and Mr. Makatsaria from 1 March until end of the year.

2024 Annual 
Base Salary 
(USD)
975,000
930,000

2024 STIP at 
Target (% 
base salary)
110%
110%

2024 
prorated 
STIP at 
target
175,820
855,295

Mr. Kozy
Mr. Makatsaria

Payment  of  the  target  bonus  amount  will  be  subject  to  the  achievement  of  certain  financial  and  non-financial  objectives,  as 
described below:

Business
Payout

=

Target Bonus X

Business 
Performance
Factor

The Business Performance Factor will be calculated according to the formula below:

Business 
Performance
Factor

= (

 50 % Net Sales 
Payout %

+

)

X

 50 % Adjusted 
Operating 
Income 
Payout %

Non-Financial 
Goals
Modifier %

e 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________69

 
REMUNERATION REPORT
2023 Remuneration Report

In 2024, the CHCM Committee decided to switch the income metric from Adjusted Net Income to Adjusted Operating Income to 
reward  operating  performance  of  the  organization.  The  CHCM  Committee  also  decided  to  increase  the  weight  of  the  income 
portion from 40% to 50% from the prior year STIP plan.

In addition, as the volatility following the pandemic has progressively decreased, the CHCM Committee changed the threshold 
and maximum levels of performance as compared to the 2023 STIP. If the threshold for a financial objective is achieved, funding 
for that objective is scaled down or up for underachievement or overachievement, respectively, of the objective, as follows:

Net Sales Payout

Achievement %
<93%
93%

Payout %
0%
50%

Linear Interpolation

Linear Interpolation

100%

≥107%

100%

150%

Adjusted Operating Income Payout

Achievement %
<90%
90%

Payout %
0%
50%

Linear Interpolation

Linear Interpolation

100%

≥110%

100%

150%

“Net  Sales”  is  defined  as  the  Company’s  net  sales  for  2024  at  constant  currency  exchange  rates,  excluding  net  sales  from  any 
acquisitions,  divestitures,  restructuring  and  other  strategic  transactions  in  2024.  “Adjusted  Operating  Income”  is  defined  as  the 
Company’s  non-GAAP  operating  income  at  constant  currency  exchange  rates,  after  adjustments  for  the  effects  of  acquisitions, 
divestitures,  restructuring,  integration,  product  remediation,  purchase  price  allocation  and  intangible  amortisation,  significant 
litigation,  equity  compensation,  significant  non-cash  adjustments  and  other  infrequent,  unusual  or  non-recurring  items  not 
incurred in the ordinary course of business.

The  non-financial  objectives  comprise  strategic  milestones  in  commercial,  clinical,  regulatory,  R&D  and  system  capability  that 
will drive revenue generation beyond 2024. The Non-Financial Goal Modifier is determined by the CHCM Committee within a 
range of 75% to 125% based on its evaluation of performance versus a set of pre-determined non-financial goals. 

If the threshold for a Non-Financial Goal Modifier is achieved, then the funding pool is scaled down or up for underachievement 
or overachievement, respectively, as follows:

Non-Financial Goal Modifier

Achievement %
≤75%

Payout %
75%

Linear Interpolation

100%

Linear Interpolation*

 ≥125%

100%

125%

The CHCM Committee considers both quantitative and qualitative results and applies discretion when evaluating performance and 
determining  the  payout  factor.  The  CHCM  Committee  reserves  the  right  to  adjust  an  individual’s  bonus  based  on  an  overall 
assessment of their performance and contributions during the plan year.

Any payout under the 2024 STIP is conditioned on continued employment at the payment date. 

Given that Net Sales and Adjusted Operating Income are key measures of company value, the Board considers the actual target 
amounts of both objectives to be too commercially sensitive for disclosure. The Board also considers the non-financial goals to be 
too  commercially  sensitive  for  disclosure.  Accordingly,  the  CHCM  Committee  will  disclose  these  after  the  publication  of  the 
Company’s 2024 financial results. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________70

REMUNERATION REPORT
2023 Remuneration Report

The table below shows the minimum and maximum achievement of the target payout under the 2024 STIP, subject to continued 
employment.

William Kozy

Vladimir Makatsaria 

.

Minimum
0%

0%

Maximum (1)
181.8%

181.8%

(1) Per the Remuneration Policy, the maximum bonus opportunity is 200% of base salary.

2024 LTIP

Mr. Makatsaria

On  2  February  2024,  the  CHCM  Committee  approved  the  Company’s  equity  award  grant  under  the  2024  LTIP  for  Mr. 
Makatsaria,  the  Company’s  CEO  effective  1  March  2024.  Pursuant  to  the  2024  LTIP,  the  CHCM  Committee  approved  a  total 
equity award in the amount of $5,350,000 comprising of five different award vehicles for Mr. Makatsaria, with an effective date 
of 30 March 2024.

In addition, Mr. Makatsaria was granted special new hire one-time equity grants with an aggregate grant-date value of $1,500,000 
and an effective date of 30 March 2024.

The equity awards are described in more detail below.

2024 LTIP
Special Inducement 
equity award

RSUs ($)
1,337,500
750,000

SARs ($)
1,337,500
750,000

2024 LTIP Service-Based Awards:

RSUs

rTSR PSUs ($)
1,337,500

FCF PSUs ($)
668,750

ROIC PSUs ($)
668,750

Mr. Makatsaria received an award of service-based RSUs in the amount of $1,337,500, vesting subject to continued employment, 
in equal or substantially equal amounts on each of the first four anniversaries of the grant date. The CHCM Committee determined 
the number of RSUs awarded by dividing the award value by the most recent closing price of an ordinary share of the Company’s 
stock on the Nasdaq as of the grant date and rounding down to the nearest whole unit.

SARs
Mr. Makatsaria received an award of SARs in the amount of $1,337,500, vesting subject to continued employment, in equal or 
substantially equal amounts on each of the first four anniversaries of the grant date. The CHCM Committee determined the 
number of SARs awarded by dividing the award value by the Black-Scholes values of a SAR on the grant date and rounding down 
to the nearest whole unit.

2024 LTIP Performance-Based Awards:

rTSR PSUs

Mr.  Makatsaria  received  an  award  of  PSUs  in  the  amount  of  $1,337,500,  subject  to  a  three-year  rTSR  market  condition  and 
continued employment. At the end of 2024, subject to continued employment, the Company’s TSR for the three-year period 2024 
through 2026 will be compared to the TSR of the S&P Healthcare Equipment Select Constituents index, and the number of shares 
of the Company’s stock actually delivered to Mr. Makatsaria will be determined by the following chart, with linear interpolation 
applied between specified levels.

TSR Performance
Percentile Rank
≥90th
80th
50th
30th
<30th

Percent Funding for Objective
200%
150%
100%
40%
0%

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________71

REMUNERATION REPORT
2023 Remuneration Report

In 2024, the CHCM Committee approved a change to the 2023 LTIP, moving from a custom peer group to an index in order to 
facilitate the administration of the comparative group, align performance with broader market trends for more accurate evaluation, 
reduce volatility in benchmarking, and streamline processes.

FCF PSUs

Mr. Makatsaria received an award of PSUs in the amount of $668,750 subject to achievement of a three-year cumulative adjusted 
FCF Target and continued employment. These FCF PSUs were subject to a three-year cliff vesting period. At the end of 2026, 
subject to continued employment, adjusted FCF measurement for the year will be compared to the adjusted FCF Target, and the 
number  of  shares  of  the  Company’s  stock  actually  delivered  to  Mr.  Makatsaria  determined  by  the  following  chart,  with  linear 
interpolation applied between specified levels. 

FCF Achievement
Relative to FCF Target
≥150%
125%
100%
60%
<60%

Percent Funding for Objective
200%
150%
100%
20%
0%

Adjusted  FCF  is  defined  as  net  cash  provided  by  operating  activities  less  cash  used  for  the  purchase  of  property,  plant  and 
equipment excluding the impact of 3T litigation settlement payments, SNIA Financing, 2024 Financing Transactions, CARES Act 
tax  stimulus  benefits  and  gains  related  to  dividends  received  from  investments,  as  determined  in  accordance  with  the  external 
definition  provided  in  the  LivaNova  Q4  and  full  year  2024  performance  presentation  posted  on  the  Company’s  website,  and 
further  adjusted  as  needed  for  other  one-time,  non-recurring,  unusual  or  infrequent  charges,  expenses  or  gains,  including 
associated expenses, that may not be indicative of the Company’s core business. The Board considers the actual target amount to 
be too commercially sensitive for disclosure and will disclose it after the publication of the Company’s 2026 financial results. 

Return on Invested Capital PSUs

Mr. Makatsaria received an award of PSUs in the amount of $668,750, subject to achievement of a three-year average minimum 
threshold ROIC Target and continued employment. At the end of 2026, subject to continued employment, the ROIC measurement 
for the year will be compared to the ROIC Target, and the number of shares of the Company’s stock actually delivered to Mr. 
Makatsaria will be determined by the following chart, with linear interpolation applied between specified levels. 

ROIC Achievement
Relative to ROIC Target
Target ≥ + 250 bps
Target + 125 bps
Target
Target − 125 bps
Target ≤ −250bps

Percent Funding for Objective
200%
150%
100%
50%
0%

ROIC  is  defined  as  the  ratio  between  Net  Operating  Profits  and  Invested  Capital.  The  numerator  shows  core  operating 
performance, and the denominator denotes the capital required to achieve that performance. 
Net Operating Profits is defined as the Company’s adjusted operating income less share-based compensation expense and is tax 
affected by LivaNova’s adjusted tax rate. Adjusted operating income and adjusted tax rate are non-GAAP measures, provided in 
conjunction with the issuance of the Company’s quarterly earnings press release. Invested Capital is defined as operating working 
capital plus other net operating assets. It excludes restricted cash, derivative assets and liabilities, long-term debt and accrued legal 
settlements related to LivaNova’s 3T matter. 

The Board considers the actual target amounts to be too commercially sensitive for disclosure. The CHCM Committee plans to 
disclose the target amounts after the publication of the Company’s 2026 financial results.

2024 LTIP Special Inducement Equity Awards:

RSUs

Mr.  Makatsaria  received  an  award  of  service-based  RSUs,  vesting  subject  to  continued  employment,  in  equal  or  substantially 
equal amounts on each of the first four anniversaries of the grant date. The CHCM Committee determined the number of RSUs 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________72

REMUNERATION REPORT
2023 Remuneration Report

awarded by dividing the award value by the most recent closing price of an ordinary share of the Company’s stock on the Nasdaq 
as of the grant date and rounding down to the nearest whole unit.

SARs

Mr. Makatsaria received an award of SARs, vesting subject to continued employment, in equal or substantially equal amounts on 
each of the first four anniversaries of the grant date. The CHCM Committee determined the number of SARs awarded by dividing 
the award value by the Black-Scholes values of a SAR on the grant date and rounding down to the nearest whole unit.

2024 Service-Based Share Awards and Committee Fees for Non-Executive Directors 

In  line  with  the  Remuneration  Policy  for  a  new  (in  this  case  a  returning)  NED,  the  CHCM  Committee  recommended  that  Mr. 
Kozy  be  awarded  a  prorated  $57,849  one-year  RSU  grant  on  30  March  2024  to  cover  his  service  as  an  NED  and  Chair  of  the 
Board from 1 March 2024 through the date of the annual meeting in June 2024.

In  addition,  on  the  advice  of  Pearl  Meyer  and  based  on  benchmarking,  the  CHCM  Committee  recommended  to  the  Board  an 
increase in the grant value of the annual service-based share awards for NEDs of $50,000 (to $180,000 for all NEDs other than the 
Chair of the Board, and to $255,000 for the Chair of the Board) and a consistent decrease of $50,000 to the cash Director retainer 
(to $60,000 for all NEDs other than the Chair of the Board, and to $135,000 for the Chair of the Board). On 14 February 2024, the 
Board approved this change, which will go into effect after the 2024 AGM. 

Role of the CHCM Committee and Members

The Chair of the CHCM Committee is Stacy Enxing Seng, and the other members of the CHCM Committee are Peter Wilver and 
Francesco Bianchi, all of whom are NEDs that the Company considers to be independent. Ms. Enxing Seng joined the CHCM 
Committee  in  2019  and  became  Chair  in  2021.  Mr.  Bianchi  has  served  on  the  CHCM  Committee  since  2015.  Mr.  Wilver  has 
served on the CHCM Committee upon joining the board in 2022. The CHCM Committee’s charter is available on the Company’s 
website.

The CHCM Committee has authority to determine and approve the corporate goals and objectives applicable to the compensation 
of the Company’s incumbent CEO and to assess the incumbent CEO’s performance annually in light of such goals and objectives 
and then to determine and approve the incumbent CEO’s compensation level based on this evaluation. The incumbent CEO is not 
present  during  discussions  about  their  own  compensation.  The  CHCM  Committee  has  authority  to  determine  and  approve  the 
compensation  of  all  other  executive  officers.  The  CHCM  Committee  is  also  entrusted  with  reviewing  and  approving  incentive 
plans and equity-based plans that apply on a broader basis, including for the incumbent CEO and other executive officers. 

In July 2023, the CHCM Committee modified its name to include human capital management and updated its charter to reference 
the  CHCM  Committee’s  oversight  of  human  capital  management  within  the  Company,  specifically  overseeing  the  Company’s 
policies and strategies, and periodically reviewing risks, trends and key metrics relating to human capital management. 

Role of the Independent Compensation Consultant 

The CHCM Committee has the sole authority to retain (and terminate the retainer of) a compensation consultant to assist with its 
responsibilities,  as  well  as  the  sole  authority  to  approve  the  consultant’s  fees,  which  the  Company  will  then  pay.  Following  a 
yearly review and based on successful prior year collaboration, for 2023, the CHCM Committee directly engaged an independent 
compensation  consultant,  Pearl  Meyer,  to  advise  on  competitive  pay  practices,  recommend  a  peer  group  for  compensation 
purposes,  provide  market  data,  assist  the  CHCM  Committee  in  the  analysis  of  that  data,  and  attend  all  regular  meetings  of  the 
CHCM Committee.

During 2023, Pearl Meyer did not perform any services for the Company, the Company’s executive officers or other employees. 
Based on these factors, the CHCM Committee’s evaluation of Pearl Meyer’s independence pursuant to the requirements approved 
and adopted by the SEC and Nasdaq and information provided by Pearl Meyer, the CHCM Committee determined that the work 
performed by Pearl Meyer did not raise any conflicts of interest and that the advice the CHCM Committee received from Pearl 
Meyer was objective and independent. 

The  Company  paid  Pearl  Meyer  a  total  of  $194,285  for  the  services  indicated  above  for  2023,  computed  on  the  basis  of  Pearl 
Meyer’s  hourly  rates  for  services  rendered,  multiplied  by  the  number  of  hours  required  to  generate  the  reports  and  including 
administrative service fees.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________73

REMUNERATION REPORT
2023 Remuneration Report

Service Contracts 

LivaNova’s NEDs do not have service contracts; they are elected for a one-year term. The Company’s Interim CEO, Mr. Kozy, 
was employed by LivaNova USA Inc., a wholly owned subsidiary of the Company, under an employment letter dated 19 April 
2023, which was in force until the commencement of the employment of his successor CEO, Mr. Makatsaria on 1 March 2024. 

Statement of Voting at Prior Annual General Meetings

At the 2023 AGM held on 12 June 2023, votes on the advisory vote to approve the Remuneration Report were as follows:

To approve, on an advisory basis, the UK Directors' Remuneration Report in the form set out in the 
Company's Annual Report and Accounts for the period ended 31 Dec 2022

Votes

Percentages %

For 
38,942,046
96.05

Against
1,590,167
3.92

Abstentions
13,346
0.03

The Remuneration Policy was last approved by shareholders at the 2022 AGM held on 13 June 2022. The results are below, and 
the approved policy is available on the Investor Relations page of the Company’s website at https://investor.livanova.com/annual-
reports. 

To approve the Directors' Remuneration Policy

Votes

Percentages %

For 
43,264,007
98.48

Against
635,048
1.45

Abstentions
30,723
0.07

Under  English  law,  an  abstention  is  not  a  vote  in  law  and  is  not  counted  in  the  calculation  of  the  proportion  of  votes  “for”  or 
“against” the resolution. 

This Remuneration Report was approved by the Board.

Stacy Enxing Seng

Chair of the Compensation and Human Capital Management Committee

25 April 2024

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________74

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF LIVANOVA PLC

Independent  auditors’  report  to  the 
members of LivaNova PLC 

Report on the audit of the financial statements

Opinion

In our opinion:

● 

● 

● 

● 

LivaNova PLC’s Group financial statements and Company financial statements (the “financial statements”) give a 
true  and  fair  view  of  the  state  of  the  Group’s  and  of  the  Company’s  affairs  as  at  31  December  2023  and  of  the 
Group’s loss, the Company’s profit and the Group’s cash flows for the year then ended;
the  Group  financial  statements  have  been  properly  prepared  in  accordance  with  UK-adopted  international 
accounting standards;
the  Company  financial  statements  have  been  properly  prepared  in  accordance  with  United  Kingdom  Generally 
Accepted Accounting Practice (United Kingdom Accounting Standards, including FRS 101 “Reduced Disclosure 
Framework”, and applicable law); and
the financial statements have been prepared in accordance with the requirements of the Companies Act 2006.

We  have  audited  the  financial  statements,  included  within  the  2023  UK  Annual  Report  (the  “Annual  Report”),  which 
comprise: the Consolidated and Company Balance Sheets as at 31 December 2023; the Consolidated Statement of (Loss), 
the Company Statement of Income, the Consolidated and Company Statements of Comprehensive Income, the Consolidated 
Statement of Cash Flows, and the Consolidated and Company Statements of Changes in Equity for the year then ended; and 
the notes to the financial statements, comprising material accounting policy information and other explanatory information.

Basis for opinion

We  conducted  our  audit  in  accordance  with  International  Standards  on  Auditing  (UK)  (“ISAs  (UK)”)  and  applicable  law. 
Our  responsibilities  under  ISAs  (UK)  are  further  described  in  the  Auditors’  responsibilities  for  the  audit  of  the  financial 
statements section of our report. We believe that the audit evidence we have obtained is sufficient and appropriate to provide 
a basis for our opinion.

Independence

We remained independent of the Group in accordance with the ethical requirements that are relevant to our audit of 
the financial statements in the UK, which includes the FRC’s Ethical Standard, as applicable to listed entities, and we 
have fulfilled our other ethical responsibilities in accordance with these requirements.

Our audit approach

Context

The  Group  operates  in  three  primary  operating  segments  through  a  legal  entity  structure  with  distribution  to  over  100 
countries, which are managed as a number of components. Our audit focuses on five components, over which we performed 
either a full scope audit or audit procedures on certain balances or transactions.

Overview

Audit scope

● 

The components where we conducted audit procedures, together with work performed at corporate functions and 
over  consolidation  adjustments,  accounted  for  approximately  65%  of  the  Group's  net  revenue  and  84%  of  the 
Group's total assets.

Key audit matters

● 
● 

Recoverability of the goodwill carrying values of the Obstructive Sleep Apnea (OSA) cash generating unit (Group)
Recoverability of the carrying value of investments in subsidiaries (Company)

Materiality

● 

● 

● 

Overall Group materiality: $8.5 million (2022: $8.0 million) based on approximately 0.7% of total net revenue.

Overall Company materiality: $41.0 million (2022: $36.0 million) based on approximately 1% of total assets.

Performance  materiality:  $6.3  million  (2022:  $6.0  million)  (Group)  and  $30.0  million  (2022:  $27.0  million) 
(Company).

LivaNova PLC | 2023 UK Annual Report

75

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF LIVANOVA PLC

The scope of our audit

As  part  of  designing  our  audit,  we  determined  materiality  and  assessed  the  risks  of  material  misstatement  in  the  financial 
statements.

Key audit matters

Key audit matters are those matters that, in the auditors’ professional judgement, were of most significance in the audit of 
the  financial  statements  of  the  current  period  and  include  the  most  significant  assessed  risks  of  material  misstatement 
(whether or not due to fraud) identified by the auditors, including those which had the greatest effect on: the overall audit 
strategy; the allocation of resources in the audit; and directing the efforts of the engagement team. These matters, and any 
comments  we  make  on  the  results  of  our  procedures  thereon,  were  addressed  in  the  context  of  our  audit  of  the  financial 
statements as a whole, and in forming our opinion thereon, and we do not provide a separate opinion on these matters.

This is not a complete list of all risks identified by our audit.

The key audit matters below are consistent with last year.

Key audit matter

How our audit addressed the key audit matter

Recoverability of the goodwill carrying value of the 
Obstructive Sleep Apnea (OSA) cash generating unit 
(‘CGU’) (Group)

Refer to Notes 2 and 10 in the Group financial statements

At 31 December 2023, the Group had goodwill of $458.9 
million (2022: $453.8 million).

Goodwill  must  be  tested  for  impairment  on  at  least  an 
annual basis. Goodwill is also tested for impairment between 
annual  assessments  if  an  event  occurs  or  circumstances 
change  that  would  indicate  the  carrying  amount  may  be 
impaired.  An  impairment  charge  is  recognised  when  the 
carrying value of the CGU exceeds its recoverable amount, 
the  recoverable  amount  being  the  higher  of  fair  value  less 
cost of disposal or value in use where the net present value 
of  future  cash  flows  are  estimated  based  on  the  continued 
use  of  the  asset  in  the  business.    There  is  significant 
estimation uncertainty in calculating the recoverable amount 
of  CGUs,  including  the  management'  view  of  future  cash 
flow  forecasts,  external  market  conditions,  such  as  future 
pricing  and  profitability,  useful  economic  life,  timing  and 
probability  of  regulatory  success,  and  the  most  appropriate 
discount  rate.  In  respect  of  the  OSA  CGU  (goodwill  of 
$82.6  million),  this  represented  an  area  requiring  greater 
allocation  of  resources  in  the  audit  and  a  higher  level  of 
audit  effort  and  on  this  basis  is  considered  a  key  audit 
matter.

For the OSA CGU, our audit procedures included evaluating 
and  challenging  the  completeness  and  accuracy  of  the 
impairment  model,  and  assessing  the  reasonableness  of  the 
assumptions  used.  We  evaluated  future  cash  flow  forecasts 
and the process by which they were prepared. This included:

● 

● 

● 

● 

for 

integrity 

understanding  management’s  process 
forecasting cash flows;
comparing the future cash flow forecasts used 
to  the  latest  Board  approved  forecasts  and 
assessed 
the  year  on  year  forecasts  for 
comparison;
testing 
the  mathematical 
management’s impairment models; and
evaluating  and  reperforming  management’s 
sensitivity analysis to understand the impact of 
reasonably 
key 
assumptions.  Additionally,  we  independently 
performed  a  break-even  analysis  to  determine 
the  changes  required  in  key  assumptions  that 
could  result  in  an  impairment,  and  were 
satisfied 
these  were  not  reasonably 
possible.

possible 

changes 

that 

of 

to 

We  tested  key  assumptions  utilised  in  the  impairment 
assessments,  including the short-term revenue growth rate, 
discount  rate  and  the  timing  of  commercialisation.  This 
testing included:

● 

● 

validating the Group’s significant assumptions 
through use of market data, historical financial 
information, and other inputs; and
engaging  with 
valuation 
internal 
specialists  to  assess  the  reasonableness  of  the 
discount rate assumption.

our 

Management  concluded  that  it  was  appropriate  not  to 
recognise  any  impairment  charges  on  the  basis  that  the 
recoverable  value  of  the  OSA  CGU  is  higher  than  its 
carrying value. Based on our procedures, we agree with their 
conclusion. 

We have also assessed management’s disclosures within the 
Group financial statements in Note 2 and 10 and consider 
them to be appropriate. We noted no material exceptions 
through performing our procedures.

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INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF LIVANOVA PLC

Recoverability of the carrying value of investments in 
subsidiaries (Company)

Refer to Notes 2 and 5 in the Company financial statements

Investments in subsidiaries of $2,963 million (2022: $2,938 
million)  are  accounted  for  at  cost  less  impairment  in  the 
Company’s Balance Sheet at 31 December 2023. 

Investments  in  subsidiaries  are  assessed  for  impairment  if 
impairment  indicators  exist.  If  such  indicators  exist,  the 
recoverable  amounts  of  the  investments  in  subsidiaries  are 
estimated in order to determine the extent of the impairment 
loss,  if  any.  Any  such  impairment  loss  is  recognised  in  the 
Company Statement of Income.

impairment 

indicators.  An 

Management  assessed  each  investment  individually  for 
impairment 
indicator  was 
determined  to  be  present  if  the  carrying  value  of  the 
investment  exceeded  the  subsidiary’s  net  assets.  Where  an 
indicator  was  identified,  management  determined  whether 
the carrying value of the  investment  could  be  supported  by 
the  recoverable  amount,  being  the  higher  of  fair  value  less 
cost of disposal or value in use where the net present value 
of  future  cash  flows  are  estimated  based  on  the  continued 
use of the asset in the business.

included 

The  assessment  utilised  the  discounted  cash  flow  analyses 
developed  as  part  of  the  Group  goodwill  impairment 
assessment.  The  key  assumptions 
those 
estimates were short term revenue growth rates and discount 
rates.  As  the  determination  of  the  recoverable  amount 
requires  the  application  of  significant  judgement  and 
estimates, particularly in determining the key assumptions to 
be  applied 
this  
represented an area requiring greater allocation of resources 
in the audit and a higher level of audit effort and accordingly 
on this basis is considered a key audit matter.

in  preparing  cash  flow  projections, 

in 

investment 

For  each 
in  a  subsidiary,  we  evaluated 
management’s  assessment  of  whether  any  indicators  of 
impairment  existed.  Where  an  investment’s  carrying  value 
was greater than the net assets of the subsidiary, which was 
determined  to  be  an  impairment  indicator,  we  audited  the 
detailed assessment prepared by management to support the 
carrying value of the investment held.  

The substantive audit procedures we performed included: 

● 

● 

● 

to 

the 

the  mechanics  and  mathematical 
testing 
integrity of management's impairment models; 
testing  the  allocation  of  the  fair  values  of  the 
CGUs 
in 
respective 
subsidiaries  based  on  their  relative  revenue 
contributions; and
appropriateness  of  key 
the 
evaluating 
assumptions  used  in  the  model,  including  the 
short  term  revenue  growth  rates  and  discount 
rates, 
in  conjunction  with  our  goodwill 
impairment testing.

investments 

Management  concluded  that  it  was  appropriate  not  to 
recognise  any  impairment  charges  on  the  basis  that  the 
carrying values of the investments in subsidiaries held by the 
Company  are  supportable.  Based  on  our  procedures,  we 
agree with its conclusion. 

We have also assessed management’s  disclosures within the 
Company financial statements in Note 2 and 5 and consider 
them to be appropriate. We noted no material exceptions 
through performing our procedures.

How we tailored the audit scope

We tailored the scope of our audit to ensure that we performed enough work to be able to give an opinion on the financial 
statements  as  a  whole,  taking  into  account  the  structure  of  the  Group  and  the  Company,  the  accounting  processes  and 
controls, and the industry in which they operate.

We conducted a full scope audit at two financially significant components: the US and Italy. In addition, in order to achieve 
the required coverage, we performed audit and/or specified procedures over key financial statement line items at four other 
components,  including  cost  of  sales,  selling,  general  and  administrative  expenses,  research  and  development  expenses, 
income tax expense, cash and cash equivalents, restricted cash, inventory, deferred tax assets, tax receivable, tax payable, 
trade  payable  and  other  payables.  In  addition,  audit  procedures  were  performed  centrally  in  relation  to  various  Group 
functions,  including  goodwill  and  in-process  research  &  development  intangible  assets,  share-based  payments,  property, 
plant and equipment, contingent considerations, leases, litigation matters and consolidation.

Our oversight procedures included the issuance of formal written instructions to component auditors setting out the work to 
be  performed  at  each  location  and  regular  communication  throughout  the  audit  cycle  including  regular  component  video 
conferences and calls, annual planning workshop with the US, Italy and Germany component teams, site visits in the US and 
Germany, and review of component auditor work papers for financially significant components.

The  components  where  we  conducted  audit  procedures,  together  with  work  performed  at  corporate  functions  and  over 
consolidation adjustments, accounted for 65% of the Group’s net revenue and 84% of the Group’s total assets.

The Company is incorporated in the UK, with a branch in Italy. We ensured that sufficient coverage was obtained through 
our testing of the UK entity and Italy branch. Certain balances were in scope for the Group audit, including selling, general 
and administrative expenses, research and development expenses, income tax expense, cash and cash equivalents, restricted 
cash, deferred tax assets, tax receivable, tax payable, trade payable and other payables which were audited centrally to Group 
materiality. The remainder of the balances were audited to Company materiality.

The impact of climate risk on our audit

As part of our audit we made enquiries of management to understand the extent of the potential impact of climate risk on the 
Group’s  and  Company’s  financial  statements,  and  we  remained  alert  when  performing  our  audit  procedures  for  any 
indicators of the impact of climate risk. Our procedures did not identify any material impact as a result of climate risk on the 
Group’s and Company’s financial statements.

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77

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF LIVANOVA PLC

Materiality

The  scope  of  our  audit  was  influenced  by  our  application  of  materiality.  We  set  certain  quantitative  thresholds  for 
materiality.  These,  together  with  qualitative  considerations,  helped  us  to  determine  the  scope  of  our  audit  and  the  nature, 
timing and extent of our audit procedures on the individual financial statement line items and disclosures and in evaluating 
the effect of misstatements, both individually and in aggregate on the financial statements as a whole.

Based on our professional judgement, we determined materiality for the financial statements as a whole as follows:

Overall 
materiality
How we 
determined it
Rationale for 
benchmark 
applied

Financial statements – Group
$8.5 million (2022: $8.0 million).

Financial statements - Company
$41.0 million (2022: $36.0 million).

Based on approximately 0.7% of total net revenue

Based on approximately 1% of total assets

As  the  Group  has  been  loss-making  from  a 
statutory  perspective  for  the  past  five  years,  there 
have  been  no  dividends  planned  or  paid  since  the 
merger  date  and  the  most  heavily  weighted  metric 
in  the  determination  of  directors’  remuneration 
being  adjusted  net  revenue,  we  consider  total  net 
revenue to be the appropriate benchmark.

As  the  Company’s  principal  activity  is  to  hold 
investments  in  subsidiaries,  the  Company  is  not 
profit  oriented.  Therefore,  total  assets  are  used  as 
the benchmark.

For each component in the scope of our group audit, we allocated a materiality that is less than our overall Group materiality. 
The range of materiality allocated across components was between $4.5 million and $8.3 million. Certain components were 
audited to a local statutory audit materiality that was also less than our overall Group materiality.

We use performance materiality to reduce to an appropriately low level the probability that the aggregate of uncorrected and 
undetected misstatements exceeds overall materiality. Specifically, we use performance materiality in determining the scope 
of our audit and the nature and extent of our testing of account balances, classes of transactions and disclosures, for example 
in determining sample sizes. Our performance materiality was 75% (2022: 75%) of overall materiality, amounting to $6.3 
million  (2022:  $6.0  million)  for  the  Group  financial  statements  and  $30.0  million  (2022:  $27.0  million)  for  the  Company 
financial statements.

In  determining  the  performance  materiality,  we  considered  a  number  of  factors  -  the  history  of  misstatements,  risk 
assessment and aggregation risk and the effectiveness of controls - and concluded that an amount at the upper end of our 
normal range was appropriate.

We  agreed  with  those  charged  with  governance  that  we  would  report  to  them  misstatements  identified  during  our  audit 
above $0.85 million (Group audit) (2022: $0.8 million) and $4.1 million (Company audit) (2022: $3.6 million) as well as 
misstatements below those amounts that, in our view, warranted reporting for qualitative reasons.

Conclusions relating to going concern

Our evaluation of the directors’ assessment of the Group's and the Company’s ability to continue to adopt the going concern 
basis of accounting included:

● 

● 
● 
● 

● 

agreeing the underlying cash flow projections to the Board approved forecasts, assessing how these forecasts are 
compiled, and evaluating the accuracy of the Board approved forecasts;
evaluating the key assumptions within the Board approved forecasts;
considering liquidity and available financial resources;
considering  the  impact  of  plausible  downside  scenarios  and  performing  a  breakeven  assessment  for  forecast 
revenue, in order to assess the extent of headroom in comparison to the principal risks facing the business; and
reviewing  the  covenants  applicable  to  the  Group’s  borrowings  and  assessing  whether  the  forecasts  supported 
ongoing compliance with the covenants.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, 
individually  or  collectively,  may  cast  significant  doubt  on  the  Group's  and  the  Company’s  ability  to  continue  as  a  going 
concern for a period of at least twelve months from when the financial statements are authorised for issue.

In auditing the financial statements, we have concluded that the directors’ use of the going concern basis of accounting in the 
preparation of the financial statements is appropriate.

However, because not all future events or conditions can be predicted, this conclusion is not a guarantee as to the Group's 
and the Company's ability to continue as a going concern.

Our  responsibilities  and  the  responsibilities  of  the  directors  with  respect  to  going  concern  are  described  in  the  relevant 
sections of this report.

Reporting on other information

The  other  information  comprises  all  of  the  information  in  the  Annual  Report  other  than  the  financial  statements  and  our 
auditors’ report thereon. The directors are responsible for the other information. Our opinion on the financial statements does 

LivaNova PLC | 2023 UK Annual Report

78

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF LIVANOVA PLC

not  cover  the  other  information  and,  accordingly,  we  do  not  express  an  audit  opinion  or,  except  to  the  extent  otherwise 
explicitly stated in this report, any form of assurance thereon.

In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, 
consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in 
the  audit,  or  otherwise  appears  to  be  materially  misstated.  If  we  identify  an  apparent  material  inconsistency  or  material 
misstatement, we are required to perform procedures to conclude whether there is a material misstatement of the financial 
statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that 
there is a material misstatement of this other information, we are required to report that fact. We have nothing to report based 
on these responsibilities.

With respect to the Strategic Report and Directors' Report, we also considered whether the disclosures required by the UK 
Companies Act 2006 have been included.

Based on our work undertaken in the course of the audit, the Companies Act 2006 requires us also to report certain opinions 
and matters as described below.

Strategic Report and Directors’ Report

In our opinion, based on the work undertaken in the course of the audit, the information given in the Strategic Report and 
Directors' Report for the year ended 31 December 2023 is consistent with the financial statements and has been prepared in 
accordance with applicable legal requirements.

In light of the knowledge and understanding of the group and company and their environment obtained in the course of the 
audit, we did not identify any material misstatements in the Strategic report and Directors' Report.

Directors’ Remuneration

In  our  opinion,  the  part  of  the  Remuneration  Report  to  be  audited  has  been  properly  prepared  in  accordance  with  the 
Companies Act 2006.

Responsibilities for the financial statements and the audit

Responsibilities of the directors for the financial statements

As explained more fully in the Statement of Directors' Responsibilities in Respect of the Financial Statements, the directors 
are  responsible  for  the  preparation  of  the  financial  statements  in  accordance  with  the  applicable  framework  and  for  being 
satisfied that they give a true and fair view. The directors are also responsible for such internal control as they determine is 
necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or 
error.

In preparing the financial statements, the directors are responsible for assessing the Group’s and the Company’s ability to 
continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of 
accounting  unless  the  directors  either  intend  to  liquidate  the  Group  or  the  Company  or  to  cease  operations,  or  have  no 
realistic alternative but to do so.

Auditors’ responsibilities for the audit of the financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material 
misstatement, whether due to fraud or error, and to issue an auditors’ report that includes our opinion. Reasonable assurance 
is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a 
material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually 
or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of 
these financial statements.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with 
our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent 
to which our procedures are capable of detecting irregularities, including fraud, is detailed below.

Based on our understanding of the Group and industry, we identified that the principal risks of non-compliance with laws 
and regulations related to product safety (including, but not limited to, environmental laws and regulations and the US Food 
and Drug Administration regulation), and we considered the extent to which non-compliance might have a material effect on 
the financial statements. We also considered those laws and regulations that have a direct impact on the financial statements 
such  as  the  Companies  Act  2006  and  the  Securities  Exchange  Act  of  1934.  We  evaluated  management’s  incentives  and 
opportunities  for  fraudulent  manipulation  of  the  financial  statements  (including  the  risk  of  override  of  controls),  and 
determined that the principal risks were related to posting inappropriate journal entries to manipulate financials results and 
potential  management  bias  in  accounting  estimates.  The  Group  engagement  team  shared  this  risk  assessment  with  the 
component auditors so that they could include appropriate audit procedures in response to such risks in their work. Audit 
procedures performed by the Group engagement team and/or component auditors included:

● 

evaluation  and  testing  of  the  operating  effectiveness  of  management’s  controls  designed  to  prevent  and  detect 
irregularities;

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INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF LIVANOVA PLC

● 

● 

● 

● 

● 

● 

discussions  with  management,  legal  counsel  and  internal  audit,  including  inquiry  regarding  known  or  suspected 
instances of non-compliance with laws and regulations and fraud, and review of the reports made by internal audit;
reviewing  relevant  meeting  minutes,  including  those  of  the  Board  of  directors  and  the  Audit  and  Compliance 
Committee;
challenging assumptions made by management in its significant accounting estimates, in particular in relation to 
the impairment assessments for the Group’s goodwill and Company’s investments in subsidiaries;
identifying and testing the validity of journal entries, in particular any journal entries posted with unusual account 
combinations, journals posted with unusual description, journals posted by senior management and consolidation 
journals;
assessment  of  matters  reported  on  the  Group’s  whistleblowing  helpline  and  the  results  of  the  directors’ 
investigation of such matters; and
performing  incremental  audit  procedures  by  increasing  sample  sizes  of  revenue  transactions  recorded  within  a 
defined  period  before  year-end  to  ensure  cut-off  was  appropriately  achieved  and  performing  risk-based  criteria 
testing of journal entries with certain characteristics which may indicate a risk of fraud due to the Cybersecurity 
incident.

There are inherent limitations in the audit procedures described above. We are less likely to become aware of instances of 
non-compliance  with  laws  and  regulations  that  are  not  closely  related  to  events  and  transactions  reflected  in  the  financial 
statements. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one 
resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, 
or through collusion.

Our  audit  testing  might  include  testing  complete  populations  of  certain  transactions  and  balances,  possibly  using  data 
auditing  techniques.  However,  it  typically  involves  selecting  a  limited  number  of  items  for  testing,  rather  than  testing 
complete populations. We will often seek to target particular items for testing based on their size or risk characteristics. In 
other cases, we will use audit sampling to enable us to draw a conclusion about the population from which the sample is 
selected.

A  further  description  of  our  responsibilities  for  the  audit  of  the  financial  statements  is  located  on  the  FRC’s  website  at: 
www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditors’ report.

Use of this report

This  report,  including  the  opinions,  has  been  prepared  for  and  only  for  the  Company’s  members  as  a  body  in  accordance 
with Chapter 3 of Part 16 of the Companies Act 2006 and for no other purpose. We do not, in giving these opinions, accept 
or assume responsibility for any other purpose or to any other person to whom this report is shown or into whose hands it 
may come save where expressly agreed by our prior consent in writing.

Other required reporting
Companies Act 2006 exception reporting

Under the Companies Act 2006 we are required to report to you if, in our opinion:

● 

● 

● 

● 

we have not obtained all the information and explanations we require for our audit; or

adequate accounting records have not been kept by the Company, or returns adequate for our audit have not been 
received from branches not visited by us; or

certain disclosures of directors’ remuneration specified by law are not made; or

the Company financial statements and the part of the Remuneration Report to be audited are not in agreement with 
the accounting records and returns.

We have no exceptions to report arising from this responsibility.

Nigel Comello 
(Senior Statutory Auditor)
for and on behalf of PricewaterhouseCoopers LLP
Chartered Accountants and Statutory Auditors
London
25 April 2024

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80

LIVANOVA PLC AND SUBSIDIARIES

LIVANOVA PLC AND SUBSIDIARIES
Table of Contents

CONSOLIDATED STATEMENT OF (LOSS)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONSOLIDATED STATEMENT OF COMPREHENSIVE INCOME     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONSOLIDATED BALANCE SHEET      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONSOLIDATED STATEMENT OF CHANGES IN EQUITY      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONSOLIDATED STATEMENT OF CASH FLOWS    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 1. Nature of Operations      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 2. Basis of Preparation, Use of Accounting Estimates and Material Accounting Policies    . . . . . . . . . . . . . . . . . . . . . .

Note 3. Revenue Recognition     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 4. Financial Risk Management    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 5. Fair Value Measurements   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 6. Financial Instruments    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 7. Business Combinations       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 8. Restructuring     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 9. Property, Plant and Equipment   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 10. Goodwill and Intangible Assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 11. Investments in Subsidiaries       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 12. Financial Assets   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 13. Inventories     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 14. Trade Receivables and Other Receivables    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 15. Derivative Financial Instruments       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 16. Shareholders’ Equity     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 17. Financial Liabilities        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 18. Leases      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 19. Other Liabilities   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 20. Contingent Consideration, 3T Litigation Provision Liability and Other Provisions    . . . . . . . . . . . . . . . . . . . . . . . .
Note 21. Share-Based Plans     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 22. Employee Retirement Plans      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 23. Income Taxes Expense   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 24. Commitments and Contingencies    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 25. Earnings Per Share      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 26. Segment and Geographic Information     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 27. Related Parties       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 28. Consolidated Statement of (Loss) by Nature     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 29. Employee Compensation Costs    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 30. Exceptional Items      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 31. Auditors’ Remuneration     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 32. New Accounting Pronouncement    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 33. Subsequent Events         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

82

83

84

86

87

88

88

98

100

105

108

109

110
112
113
115
116
117
118
118
120
121
124
126
126
128
131
135
139
142
142
144
145
146
146
146
146
147

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________81

LIVANOVA PLC AND SUBSIDIARIES
Consolidated Statement of (Loss) Income

LIVANOVA PLC AND SUBSIDIARIES
Consolidated Statement of (Loss)
(In thousands, except per share amounts)

Net revenue       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26

$ 

1,153,545  $ 

1,021,805 

Year Ended 31 December

Note

2023

2022

Costs and expenses:

Cost of sales    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Selling, general and administrative       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

28

28

Research and development    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other operating expense  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Exceptional items      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30

Operating loss     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Finance expenses       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net gain on embedded exchange feature and capped call derivatives     . . . . . . . . .

Net foreign exchange and other income/(expense)  . . . . . . . . . . . . . . . . . . . . . . . .

Share of loss from equity accounted investments    . . . . . . . . . . . . . . . . . . . . . . . . .

4

28

Loss before tax    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Income tax expense     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23

Loss attributable to owners of the parent      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Basic loss per share    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Diluted loss per share   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Shares used in computing basic loss per share    . . . . . . . . . . . . . . . . . . . . . . . . . . .

Shares used in computing diluted loss per share        . . . . . . . . . . . . . . . . . . . . . . . . .

25

25

25

25

381,730 

514,267 

193,193 

3,308 

130,895 

(69,848)   

(60,450)   
24,209 

21,598 

(104)   

(84,595)   

(15,787)   

$ 

$ 

$ 

(100,382)  $ 

(1.86)  $ 

(1.85)  $ 

53,939 

54,212 

314,206 

463,829 

155,650 

7,737 

166,789 

(86,406) 

(49,709) 
43,789 

8,273 

(53) 

(84,106) 

(2,188) 

(86,294) 

(1.61) 

(1.61) 

53,472 

53,472 

See accompanying notes to the consolidated financial statements.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________82

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LIVANOVA PLC AND SUBSIDIARIES
Consolidated Statement of Comprehensive Income

LIVANOVA PLC AND SUBSIDIARIES
Consolidated Statement of Comprehensive Income
(In thousands)

Loss attributable to owners of the parent     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Items of other comprehensive (loss) income that will be subsequently 
reclassified to profit or loss:

Year Ended 31 December

Note

2023

2022

$ 

(100,382)  $ 

(86,294) 

Cash flow hedges for exchange rate fluctuations        . . . . . . . . . . . . . . . . . . . . . .

15

(966)   

Tax impact          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign currency translation differences      . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total items of other comprehensive income (loss) that will be subsequently 
reclassified to profit or loss       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Items of other comprehensive (loss) income that will not be subsequently 
reclassified to profit or loss:

Remeasurement of net assets for defined benefits     . . . . . . . . . . . . . . . . . . . . . .
Tax impact      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total items of other comprehensive (loss) income that will not be subsequently 
reclassified to profit or loss       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total other comprehensive income (loss), net of taxes    . . . . . . . . . . . . . . . . . . . .
Total comprehensive loss, net of taxes attributable to owners of the parent    . . . .

22  

$ 

— 

12,045 

11,079 

(190)   
9 

(181)   

10,898 
(89,484)  $ 

1,911 

— 

(22,170) 

(20,259) 

915 
38 

953 
(19,306) 
(105,600) 

See accompanying notes to the consolidated financial statements.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________83

 
 
 
 
 
 
 
 
 
 
 
 
LIVANOVA PLC AND SUBSIDIARIES
Consolidated Balance Sheet

LIVANOVA PLC AND SUBSIDIARIES
Consolidated Balance Sheet
(In thousands)

31 December

Note

2023

2022

ASSETS
Non-current assets

Property, plant and equipment       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Intangible assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Goodwill        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Right-of-use assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Derivative financial instruments     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total non-current assets        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Current assets

Inventories      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Trade receivables     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other receivables   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial assets        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax receivable      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cash and cash equivalents    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Restricted cash     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total current assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LIABILITIES AND EQUITY
Shareholders’ Equity

Share capital       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Group reconstruction reserve     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Share premium     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Treasury shares       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accumulated other comprehensive loss     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accumulated losses     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total shareholders’ equity      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Non-current liabilities

Financial liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Derivative financial instruments     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contingent consideration     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other liabilities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Provisions     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Long-term lease liabilities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Provision for employee severance indemnities and other employee benefit 
provisions      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred taxes liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total non-current liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9
10
10
18
12
15
23

13
14
14
12

2
2

16
16

16

17
15
20
19
20
18

22
23

$ 

$ 

132,847  $ 
282,459 
458,857 
49,565 
28,380 
38,496 
113,364 
6,527 
1,110,495 

147,887 
215,072 
26,699 
483 
17,571 
266,504 
311,368 
985,584 
2,096,079  $ 

$ 

82,533  $ 

$ 

$ 

2,046,497 
40,058 

(55)   
(13,692)   
(1,222,322)   
933,019  $ 

568,517  $ 
45,569 
80,902 
13,175 
45,945 
45,474 

11,951 
9,086 
820,619 

132,300 
383,370 
453,794 
34,792 
22,431 
54,393 
110,734 
10,065 
1,201,879 

129,379 
183,110 
23,309 
3,012 
30,899 
214,172 
301,446 
885,327 
2,087,206 

82,424 
2,046,497 
37,031 
(375) 
(24,590) 
(1,146,877) 
994,110 

518,044 
85,675 
85,292 
11,695 
42,911 
29,613 

14,055 
7,328 
794,613 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________84

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LIVANOVA PLC AND SUBSIDIARIES
Consolidated Balance Sheet

31 December

Note

2023

2022

Current liabilities

Trade payables    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other liabilities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Current litigation provision liability       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Provisions     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax payable       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total current liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total liabilities and shareholders’ equity       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19
17
20
20

$ 

78,922 
178,249 
18,084 
17,156 
26,690 
23,340 
342,441 
2,096,079  $ 

72,403 
146,746 
23,402 
29,481 
9,946 
16,505 
298,483 
2,087,206 

See accompanying notes to the consolidated financial statements.

The financial statements on pages 81 to 149 were approved by the Board and were signed on its behalf on 25 April 2024 by:

VLADIMIR MAKATSARIA
CHIEF EXECUTIVE OFFICER & DIRECTOR

Company Number: 09451374

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________85

 
 
 
 
 
 
 
 
 
 
 
 
 
 
LIVANOVA PLC AND SUBSIDIARIES
Consolidated Statement of Changes in Equity

LIVANOVA PLC AND SUBSIDIARIES
Consolidated Statement of Changes in Equity
(In thousands)

Ordinary

Note

Number
of Shares

Share
Capital

Group
Reconstruction
Reserve

Share
Premium

Treasury 
Shares

Accumulated 
Other 
Comprehensive 
Loss

Accumulated
Losses

Total
Shareholders’ 
Equity

Balance at 1 January 2022    . . . . . . . . . .

53,762 

$  82,295 

$ 

2,046,497 

$ 

33,257 

$ 

(650)  $ 

(5,284)  $ 

(1,091,312)  $ 

1,064,803 

Share-based compensation plans     . . . . .

21

Total transactions with owners 
recognised directly in shareholders’ 
equity    . . . . . . . . . . . . . . . . . . . . . . . . . .

Net loss  . . . . . . . . . . . . . . . . . . . . . . . . .
Other comprehensive loss    . . . . . . . . . .
Total comprehensive loss for the year   .

16

90 

90 

— 

— 

— 

129 

129 

— 

— 

— 

— 

— 

— 

— 

— 

Balance at 31 December 2022    . . . . . . .

53,852 

82,424 

2,046,497 

Share-based compensation plans     . . . . .

21

Total transactions with owners 
recognised directly in shareholders’ 
equity    . . . . . . . . . . . . . . . . . . . . . . . . . .

Net loss  . . . . . . . . . . . . . . . . . . . . . . . . .
Other comprehensive income      . . . . . . .
Total comprehensive income (loss) for 
the year    . . . . . . . . . . . . . . . . . . . . . . . . .

16

90 

90 

— 

— 

— 

109 

109 

— 

— 

— 

— 

— 

— 

— 

— 

3,774 

275 

3,774 

— 

— 

— 

37,031 

3,027 

3,027 

— 

— 

— 

275 

— 

— 

— 

(375) 

320 

320 

— 

— 

— 

— 

— 

— 

(19,306) 

(19,306) 

(24,590) 

— 

— 

— 

30,729 

34,907 

30,729 

(86,294) 

— 

34,907 

(86,294) 

(19,306) 

(86,294) 

(105,600) 

(1,146,877) 

24,937 

994,110 

28,393 

24,937 

28,393 

(100,382) 

(100,382) 

10,898 

— 

10,898 

10,898 

(100,382) 

(89,484) 

Balance at 31 December 2023    . . . . . . .

53,942 

$  82,533 

$ 

2,046,497 

$ 

40,058 

$ 

(55)  $ 

(13,692)  $ 

(1,222,322)  $ 

933,019 

See accompanying notes to the consolidated financial statements.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________86

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LIVANOVA PLC AND SUBSIDIARIES

Consolidated Statement of Cash Flows

LIVANOVA PLC AND SUBSIDIARIES
Consolidated Statement of Cash Flows 
(In thousands)

Note

8

9, 10
21

8

18

20

10

20

17

17

18

Cash Flows From Operating Activities:

Loss for the year        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Non-cash items included in loss:

Impairment of long-lived assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance expenses       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depreciation and amortisation    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Share-based compensation    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Remeasurement of derivative instruments    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest income    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amortisation of debt issuance costs      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income tax expense     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ACS inventory obsolescence adjustment     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Depreciation of lease assets        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Remeasurement of contingent consideration to fair value     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Impairment of goodwill     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other non-cash items     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Changes in operating assets and liabilities:

Accounts receivable, net        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inventories       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other current and non-current assets       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Litigation provision liability    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax payable        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Current and non-current liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cash provided by operations        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interest paid       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interest received    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Income taxes received/(paid)    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net cash provided by operating activities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cash Flow From Investing Activities:

Purchases of tangible and intangible assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Purchases of investments       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Acquisitions, net of cash acquired     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net cash used in investing activities       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cash Flows From Financing Activities:

Proceeds from long-term debt obligations     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Repayment of long-term debt obligations     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Principal payments of lease liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Shares repurchased from employees for minimum tax withholding      . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Repayments of short-term borrowing (maturities greater than 90 days)       . . . . . . . . . . . . . . . . . . . . . . . . .
Proceeds from deferred consideration from sale of Heart Valves, net of working capital adjustments      . .

Debt issuance costs       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other financial assets and liabilities       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net cash provided by financing activities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Effect of exchange rate changes on cash, cash equivalents, and restricted cash      . . . . . . . . . . . . . . . . . . . . . . . .
Net increase in cash, cash equivalents and restricted cash      . . . . . . . . . . . . . . . . . . . . . . . . . .
Cash, cash equivalents and restricted cash at beginning of year       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cash, cash equivalents and restricted cash at end of year     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Year Ended 31 December
2022
2023

$ 

(100,382)  $ 

(86,294) 

89,974 
60,450 
50,209 
33,184 
(22,911) 
(22,012) 
19,053 
15,787 

12,621 

10,291 

9,360 

— 

1,514 

(28,864) 

(28,478) 

15,302 

(12,731) 

(9,809) 

7,344 

99,902 

(38,506) 

22,012 

1,620 

85,028 

(34,981) 

(6,504) 

— 

1,154 

(40,331) 

50,000 

(21,624) 

(10,114) 

(7,503) 

(1,974) 

— 

— 

2,585 
11,370 

6,187 

62,254 

515,618 

$ 

577,872  $ 

— 
49,709 
47,571 
44,562 
(38,656) 
(4,697) 
21,334 
2,188 

— 

10,603 

(29,881) 

144,990 

(273) 

(4,810) 

(25,679) 

7,486 

(6,558) 

(7,043) 

(26,623) 

97,929 

(20,505) 

4,697 

(1,221) 

80,900 

(26,517) 

(2,952) 

(8,857) 

(88) 

(38,414) 

507,547 

(223,541) 

(10,980) 

(8,671) 

— 

4,596 

(3,292) 

3,491 
269,150 

(4,011) 

307,625 

207,993 

515,618 

See accompanying notes to the consolidated financial statements.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________87

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 1. Nature of Operations

LIVANOVA PLC AND SUBSIDIARIES
Notes to the Consolidated Financial Statements

Note 1. Nature of Operations 

Company information. LivaNova is a public limited company incorporated in the UK under the Companies Act 2006 (Registration 
number  09451374).  The  Company  is  domiciled  in  England  and  Wales  in  the  UK  and  its  registered  address  is  20  Eastbourne 
Terrace, London, W2 6LG, United Kingdom.

Background.  LivaNova  PLC  was  organised  under  the  laws  of  England  and  Wales  on  20  February  2015  for  the  purpose  of 
facilitating the business combination of Cyberonics, a Delaware corporation and Sorin, a joint stock company organised under the 
laws of Italy. As a result of the business combination, LivaNova, headquartered in London, became the holding company of the 
combined businesses of Cyberonics and Sorin. This business combination became effective on 19 October 2015, at which time 
LivaNova’s Ordinary Shares were listed for trading on the Nasdaq and on the LSE as a standard listing under the trading symbol 
“LIVN.”  Upon  the  consummation  of  the  business  combination  of  Cyberonics  and  Sorin,  the  historical  financial  statements  of 
Cyberonics  became  the  Company’s  historical  financial  statements.  On  23  February  2017,  LivaNova  announced  the  voluntary 
cancellation of its standard listing of the Company’s shares with the LSE due to the low trading volume of its shares, and trading 
ceased at the close of business on 4 April 2017. LivaNova continues to serve its shareholders through LivaNova’s listing on the 
Nasdaq.

Description  of  the  business.  LivaNova  PLC  is  a  market-leading  global  medical  technology  company.  The  Company  designs, 
develops, manufactures, markets and sells products and therapies that are consistent with LivaNova’s mission to provide hope for 
patients and their families through innovative medical technologies that deliver life-changing improvements.

Business  segments.  LivaNova  is  comprised  of  three  reportable  segments:  Cardiopulmonary,  Neuromodulation  and  Advanced 
Circulatory Support, corresponding to the Company’s primary business units. 

Note 2. Basis of Preparation, Use of Accounting Estimates and Material Accounting Policies 

Basis  of  Preparation.  The  consolidated  financial  statements  have  been  properly  prepared  in  accordance  with  UK-adopted 
International Accounting Standards and with the requirements of the Companies Act 2006 as applicable to companies reporting 
under those standards and have been prepared on a going concern basis. 

Accounting  policies  have  been  applied  consistently,  other  than  where  new  policies  have  been  adopted,  and  are  presented  on  a 
historical  cost  basis,  except  for  investments  in  equity  instruments  in  privately-held  companies,  derivative  financial  instruments, 
contingent consideration liabilities, pension obligations and share awards that have been measured at fair value. The consolidated 
financial statements are presented in USD and all values are rounded to the nearest thousands, except where otherwise indicated. 

Cybersecurity Incident. In November 2023, LivaNova detected a cybersecurity incident that resulted in a disruption of portions of 
the  Company’s  information  technology  systems.  Promptly  after  detecting  the  issue,  LivaNova  began  an  investigation  with 
assistance  from  external  cybersecurity  experts  and  coordinated  with  law  enforcement.  The  Company  implemented  remediation 
measures to mitigate the impact of the incident. The Company continues to assess the nature and scope of the affected data and 
analyse  its  legal  notification  obligations,  and  the  Company  is  notifying  affected  individuals  and  regulators  as  required  by 
applicable law. The Company believes it has contained the cybersecurity threat, though its investigation and mitigation efforts are 
ongoing. At this time, all of LivaNova’s manufacturing sites worldwide are operating at normal levels. The Company continues to 
assess the full impact of the cybersecurity event on its business, results of operations, cash flows and financial condition.

LivaNova incurred direct costs of approximately $2.6 million during the twelve months ended 31 December 2023, in connection 
with this incident. These costs primarily include external cybersecurity experts, legal counsel, and system restoration costs, and do 
not include business interruption or other non-direct costs. The Company expects to incur additional costs related to this incident 
in  the  future.  LivaNova  maintains  insurance,  including  cyber  insurance,  which  is  subject  to  certain  retentions  and  policy 
limitations that may serve to limit the amount that the insurers may pay the Company when a claim is submitted. LivaNova plans 
to file for reimbursement of covered costs related to this incident, but the Company’s insurance coverage may be insufficient to 
cover all costs and expenses related to this cybersecurity incident, and the insurance carrier may not cover all submitted costs and 
expenses related to this cybersecurity incident.

Reclassifications.  LivaNova  reclassified  certain  prior  period  amounts  on  the  consolidated  balance  sheets  and  consolidated 
statement of (loss) for comparative purposes. These reclassifications had no material impact on LivaNova’s financial condition or 
results of operations.

Going Concern. As of 31 March 2024, the Group had cash and cash equivalents of $309.2 million. Based on LivaNova’s current 
business plan, the Company believes that existing cash and cash equivalents and future cash generated from operations will be 
sufficient to fund its expected operating needs, working capital requirements, R&D opportunities, capital expenditures and debt 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________88

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

service  requirements  for  a  period  of  at  least  12-months  from  the  issuance  of  these  financial  statements.  LivaNova  regularly 
reviews  its  capital  needs  and  considers  various  investing  and  financing  alternatives  to  support  the  Company’s  requirements. 
Additionally, as of 31 March 2024, LivaNova is in compliance with the financial covenants associated with the Company’s debt 
facilities, and the Group’s forecasts support ongoing compliance with the covenants for a period of at least 12-months from the 
issuance of these financial statements. Therefore, it is appropriate to adopt the going concern basis in preparing these consolidated 
financial statements.

The  current  macroeconomic  environment,  including  foreign  exchange  volatility,  inflationary  pressures,  geopolitical  instability, 
and  supply  chain  challenges,  has  impacted  and  may  continue  to  impact  LivaNova’s  business  and  profitability.  Furthermore, 
LivaNova  continues  to  experience  logistical,  capacity,  and  labor  constraints,  though,  to  date,  the  Company’s  supply  of  raw 
materials and the production and distribution of finished products have not been materially affected. The Company continues to 
respond to such challenges, and while LivaNova has business continuity plans in place, the impact of the ongoing challenges the 
Company is navigating, along with their potential escalation, may adversely affect its business.

On 17 June 2020, LivaNova’s wholly-owned subsidiary, LivaNova USA, issued $287.5 million in aggregate principal amount of 
3.00% the 2020 Cash Exchangeable Senior Notes. Holders of the 2025 Notes are entitled to exchange the 2025 Notes at any time 
during specified periods, at their option. This includes the right to exchange the 2025 Notes during any calendar quarter, if the last 
reported sale price of LivaNova’s ordinary shares, with a nominal value of £1.00 per share, is greater than or equal to 130% of the 
exchange price, or $79.27 per share for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive 
trading days ending on, and including, the last trading day of the immediately preceding calendar quarter. The exchange condition 
was not satisfied on 31 December 2023. As a result, LivaNova has included its obligations from the 2025 Notes and the associated 
embedded exchange feature derivative as a long-term liability on the consolidated balance sheets as of 31 December 2023. The 
2025 Notes are exchangeable solely into cash and are not exchangeable into ordinary shares of LivaNova or any other security 
under any circumstances. The initial exchange rate for the 2025 Notes is 16.3980 ordinary shares per $1,000 principal amount of 
Notes (equivalent to an initial exchange price of approximately $60.98 per share). The exchange rate is subject to adjustment in 
certain circumstances, as set forth in the 2024 Indenture. If holders elect to exchange their Notes during any future periods in the 
event an exchange condition is met, LivaNova would be required to settle its exchange obligation through the payment of cash, 
which could adversely affect the Company’s liquidity. Refer to “Note 17. Financial Liabilities” for further information. 

On 21 February 2022, the Court of Appeal notified the Company that it granted the Company a suspension with respect to the 
payment  of  damages  in  the  amount  of  €453.6  million  (approximately  US  $502.0  million  at  31  December  2023)  in  the  SNIA 
litigation until a decision has been reached on LivaNova’s appeal to the Italian Supreme Court. This suspension was subject to 
Livanova  providing  a  first demand  bank guarantee  of €270.0 million (approximately US $298.8 million at 31 December 2023) 
within 30 calendar days.

On 24 February 2022, LivaNova PLC and the Borrower entered into an Incremental Facility Amendment No. 1 to the 2021 First 
Lien Credit Agreement, relating to a €200 million bridge loan facility. On 16 March 2022, LivaNova entered into Amendment No. 
2  to  the  2021  First  Lien  Credit  Agreement,  which  converted  the  available  borrowings  under  the  Bridge  Loan  Facility  from 
€200 million to $220.0 million and converted the EURIBOR rate in the 2021 First Lien Credit Agreement to SOFR. LivaNova 
delivered  a  borrowing  notice  for  $220.0  million  in  connection  with  the  Bridge  Loan  Facility,  which  was  funded  on  17  March 
2022.  LivaNova  used  the  proceeds  of  the  Bridge  Loan  Facility  to  post  a  portion  of  the  cash  collateral  supporting  the  SNIA 
Litigation Guarantee. 

On  18  March  2022,  LivaNova  PLC,  acting  through  its  Italian  branch,  entered  into  an  Indemnity  Letter  and  an  Account  Pledge 
Agreement  with  Barclays,  further  to  which  Barclays  issued  the  €270.0  million  SNIA  Litigation  Guarantee.  As  security  for  the 
SNIA  Litigation  Guarantee,  LivaNova  is  required  to  grant  cash  collateral  to  Barclays  in  US  Dollars  in  an  amount  equal  to  the 
USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. At 31 December 2023, 
the cash collateral classified as restricted cash on the consolidated balance sheet was $311.4 million.

On 21 March 2022, LivaNova delivered the SNIA Litigation Guarantee as required by the Court of Appeal, thereby satisfying the 
condition  to  obtain  the  suspension  for  the  payment  of  damages  in  connection  with  the  SNIA  litigation  until  review  of  such 
judgment by the Italian Supreme Court.

On  6  July  2022,  LivaNova  and  the  Borrower  entered  into  the  Incremental  Facility  Amendment  No.  2,  which  provides  for  the 
Borrower to, among other things, obtain commitments for term loan facilities from a syndicate of lenders in an aggregate principal 
amount of $350 million consisting of (i) the initial term loan facility with an aggregate principal amount of $300 million and (ii) 
the  delayed  draw  term  loan  facility  with  an  additional  aggregate  principal  amount  of  $50  million.  On  6  April  2023,  LivaNova 
drew $50 million under the Delayed Draw Term Facility for general corporate purposes.

For additional information on LivaNova’s debt and debt transactions, please refer to “Note 17. Financial Liabilities” and “Note 33. 
Subsequent Events.”

Fiscal Year-End. LivaNova's fiscal year ends 31 December. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________89

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

Consolidation.  The  accompanying  consolidated  financial  statements  include  LivaNova,  its  wholly  owned  subsidiaries  and 
associates  and  the  LivaNova  PLC  Employee  Benefit  Trust.  All  significant  intercompany  accounts  and  transactions  have  been 
eliminated.

Equity Method. Under the equity method of accounting, the investments in associates and joint ventures are initially recognised at 
cost  and  adjusted  thereafter  to  recognise  the  Company’s  share  of  the  post-acquisition  profits  or  losses  of  the  investee  in  the 
consolidated statement of (loss), and the Company’s share of movements in OCI of the investee in OCI. Dividends received or 
receivable from associates are recognised as a reduction in the carrying amount of the investment.

Unrealised gains on transactions between the Company and its associates are eliminated to the extent of the Company’s interest in 
these  entities.  Unrealised  losses  are  also  eliminated  unless  the  transaction  provides  evidence  of  an  impairment  of  the  asset 
transferred.

Goodwill.  LivaNova  allocates  the  amounts  the  Company  pays  for  an  acquisition  to  the  assets  acquired  and  liabilities  assumed 
based  on  their  fair  values  at  the  date  of  acquisition,  including  property,  plant  and  equipment,  inventories,  accounts  receivable, 
long-term  debt,  and  identifiable  intangible  assets  which  either  arise  from  a  contractual  or  legal  right  or  are  separable  from 
goodwill.  The  Company  bases  the  fair  value  of  identifiable  intangible  assets  acquired  in  a  business  combination,  including  in-
process research and development, on detailed valuations that use information and assumptions provided by management, which 
consider  management’s  best  estimates  of  inputs  and  assumptions  that  a  market  participant  would  use.  LivaNova  allocates  any 
excess purchase price over the fair value of the net tangible and identifiable intangible assets acquired to goodwill. Transaction 
costs  associated  with  these  acquisitions  are  expensed  as  incurred  and  are  reported  as  selling,  general  and  administrative  on  the 
consolidated statement of (loss). LivaNova recognises adjustments to the provisional amounts identified during the measurement 
period with a corresponding adjustment to goodwill in the reporting year in which the adjustment amounts are determined. The 
effect  on  earnings  of  changes  in  depreciation,  amortisation  or  other  income  effects,  if  any,  as  a  result  of  the  change  to  the 
provisional amounts are recorded in the same year’s consolidated financial statements, calculated as if the accounting had been 
completed at the acquisition date.

Intangible  Assets,  Other  than  Goodwill.  Intangible  assets  shown  on  the  consolidated  balance  sheets  consist  of  finite-lived  and 
indefinite-lived  assets  expected  to  generate  future  economic  benefits  and  are  recorded  at  their  respective  fair  values  as  of  their 
acquisition  date.  Finite-lived  intangible  assets  consist  primarily  of  developed  technology  and  technical  capabilities,  including 
patents, related know-how and licensed patent rights, as well as trade names and customer relationships. Customer relationships 
consist of relationships with hospitals and surgeons in the countries where LivaNova operates. Indefinite-lived intangible assets 
other than goodwill are composed of IPR&D assets acquired in acquisitions. LivaNova amortises its finite-lived intangible assets 
over their useful lives using the straight-line method. Estimating the useful lives of intangible assets requires LivaNova to apply 
significant judgment.

LivaNova  evaluates  its  finite-lived  and  indefinite-lived  intangible  assets  each  reporting  year  to  determine  whether  events  and 
circumstances  indicate  either  a  different  useful  life  or  impairment,  respectively.  For  finite-lived  intangible  assets,  if  LivaNova 
changes its estimate of the useful life of an asset, the Company amortises the carrying amount over the revised remaining useful 
life.

Foreign Currency. LivaNova determines the functional currency of its subsidiaries that exist and operate in different economic 
and currency environments based on the primary economic environment in which the subsidiary operates, that is, the currency of 
the environment in which an entity primarily generates and expends cash. LivaNova’s significant foreign subsidiaries are located 
in Europe and the US. The functional currency of LivaNova’s significant European subsidiaries is the Euro, and the functional 
currency of LivaNova’s significant US subsidiaries is the US dollar.

Assets  and  liabilities  of  subsidiaries  whose  functional  currency  is  not  the  US  dollar  are  translated  into  US  dollars  based  on  a 
combination of both current and historical exchange rates, while their revenues earned and expenses incurred are translated into 
US dollars at average period exchange rates. Translation adjustments are included as AOCI on LivaNova’s consolidated balance 
sheets.  Gains  and  losses  arising  from  transactions  denominated  in  a  currency  different  from  an  entity’s  functional  currency  are 
included in net foreign exchange and other income/(expense) on LivaNova’s consolidated statements of income (loss). Taxes are 
not provided on cumulative translation adjustments, as substantially all translation adjustments are related to earnings which are 
intended  to  be  indefinitely  reinvested  in  the  countries  where  earned.  Net  foreign  exchange  and  other  income/(expense)  on  the 
consolidated  statement  of  (loss)  consists  primarily  of  gains  and  losses  arising  from  transactions  denominated  in  a  currency 
different from an entity’s functional currency and foreign currency exchange rate and other derivative gains and losses.

Foreign currency differences arising from translation are recognised in the consolidated statement of (loss).

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________90

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

The Euro and GBP exchange rates to USD used in preparing the consolidated financial statements were as follows:

Year ended 31 December 2023      . . . . . . . . . . . . . . . . . . . . .
Year ended 31 December 2022      . . . . . . . . . . . . . . . . . . . . .

Weighted 
Average Rate 
Euro
0.924732 
0.951016 

Closing Rate 
Euro
0.903590 
0.935410 

Weighted 
Average Rate 
GBP
0.804488 
0.811283 

Closing Rate 
GBP
0.785300 
0.827990 

Financial  Instruments.  A  financial  instrument  is  any  contract  that  gives  rise  to  a  financial  asset  of  one  entity  and  a  financial 
liability or equity instrument of another entity. Financial assets and financial liabilities are offset with the net amount reported in 
the consolidated balance sheet only if there is a current enforceable legal right to offset the recognised amounts and intent to settle 
on a net basis, or to realise the assets and settle the liabilities simultaneously.

(a)

Financial Assets

Initial Recognition and Measurement. Financial assets are classified, at initial recognition, as financial assets at fair value through 
profit or loss, trade receivables and other financial assets, investments, financial assets, or as derivatives designated as hedging 
instruments  in  an  effective  hedge,  as  appropriate.  The  Company  determines  the  classification  of  its  financial  assets  at  initial 
recognition. All financial assets are recognised initially at fair value plus, in the case of assets not at fair value through profit or 
loss,  transaction  costs  that  are  attributable  to  the  acquisition  of  the  financial  asset.  Purchases  or  sales  of  financial  assets  that 
require delivery of assets within a time frame established by regulation or convention in the marketplace (regular way trades) are 
recognised on the trade date, i.e., the date on which the Company commits to purchase or sell the asset.

The subsequent measurement and impairment of financial assets depends on their classification as described below:

Financial Assets at Fair Value Through Profit or Loss. Financial assets at fair value through profit or loss include financial assets 
held for trading  and  financial assets  designated  upon initial recognition at fair value through profit or loss. Financial assets are 
classified  as  held-for  trading  if  they  are  acquired  for  the  purpose  of  selling  or  re-purchasing  in  the  near  term.  This  category 
includes  derivative  financial  instruments  entered  into  by  the  Company  that  are  not  designated  as  hedging  instruments  in  hedge 
relationships as defined by IFRS 9. LivaNova uses freestanding derivative forward contracts to offset exposure to the variability 
of  the  value  associated  with  assets  and  liabilities  denominated  in  a  foreign  currency.  These  derivatives  are  not  designated  as 
hedges,  and  therefore  changes  in  the  value  of  these  forward  contracts  are  recognised  in  the  consolidated  statement  of  (loss), 
thereby offsetting the current net (loss) income effect of the related change in value of foreign currency denominated assets and 
liabilities. 

Changes in the fair value of LivaNova’s investments in equity instruments held at fair value are recognised through profit or loss.

Trade  Receivables  and  Other  Financial  Assets.  Trade  receivables  and  other  financial  assets  are  non-derivative  financial  assets 
with fixed or determinable payments that are not quoted in an active market. After initial measurement, such financial assets are 
subsequently  measured  at  amortised  cost  using  the  EIR  method,  less  impairment.  Amortised  cost  is  calculated  by  taking  into 
account any discount or premium on acquisition and fees or costs that are an integral part of the EIR. The EIR amortisation is 
included in finance income in the consolidated statement of (loss). The receivable balance consists of trade receivables from direct 
customers and distributors and loans issued. LivaNova maintains an expected credit loss provision for expected credit losses based 
on the Company’s estimates of the ability of customers to make required payments, historical credit experience, existing economic 
conditions and expected future trends. The Company’s writes off uncollectable accounts against the provision when all reasonable 
collection  efforts  have  been  exhausted.  Loans,  together  with  the  associated  provision  are  written  off  when  there  is  no  realistic 
prospect of future recovery and all collateral has been realised or has been transferred to the Company. The losses arising from 
impairment are recognised in the consolidated statement of (loss) in cost of sales or other operating expenses for receivables. 

Collection  periods  for  trade  receivables  vary  significantly  due  to  the  nature  of  a  customer  (e.g.  government  or  private)  and  its 
geographic location. LivaNova may utilize non-recourse and with-recourse factoring arrangements as a part of its funding policy; 
however, as of 31 December 2023 and 31 December 2022, there are no factoring arrangements outstanding.

Refer to “Note 14. Trade Receivables and Other Receivables” for further information.

Financial  Asset  Derecognition.  A  financial  asset  (or,  where  applicable,  a  part  of  a  financial  asset  or  part  of  a  group  of  similar 
financial assets) is derecognised when:

•
•

The rights to receive cash flows from the asset have expired, or
The Company has transferred its rights to receive cash flows from the asset or has assumed an obligation to pay the 
received cash flows in full without material delay to a third party under a pass-through arrangement, and either (a) 
the  Company  has  transferred  substantially  all  the  risks  and  rewards  of  the  asset,  or  (b)  the  Company  has  neither 
transferred nor retained substantially all the risks and rewards of the asset, but has transferred control of the asset.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________91

 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

(b)

Financial Liabilities

Initial Recognition and Measurement. Financial liabilities are classified, at initial recognition, as financial liabilities at fair value 
through  profit  or  loss,  loans  and  borrowings  (bank  debt),  payables,  or  as  derivatives  designated  as  hedging  instruments  in  an 
effective hedge, as appropriate. All financial liabilities are recognised initially at fair value and, in the case of loans, borrowings 
and payables, net of directly attributable transaction costs. The Company’s financial liabilities include trade and other payables, 
loans and bank debt including bank overdrafts, and derivative financial instruments.

The measurement of financial liabilities depends on their classification, as follows:

Financial Liabilities at Fair Value Through Profit or Loss. Financial liabilities at fair value through profit or loss include financial 
liabilities held-for-trading and financial liabilities designated upon initial recognition at fair value through profit or loss. Financial 
liabilities are classified as held-for-trading if they are acquired for the purpose of selling in the near term. This category includes 
derivative financial instruments entered into by the Company that are not designated as hedging instruments in hedge relationships 
as defined by IFRS 9, which the Company has elected to apply. Gains or losses on liabilities held-for-trading are recognised in the 
consolidated  statement  of  (loss).  Financial  liabilities  designated  upon  initial  recognition  at  fair  value  through  profit  or  loss  are 
designated  at  the  initial  date  of  recognition,  and  only  if  the  criteria  in  IFRS  9  are  satisfied.  Changes  in  the  fair  value  of  the 
Company’s contingent consideration liability are recognised through profit or loss.

Loans and Borrowings (bank debt). After initial recognition, interest bearing loans and borrowings are subsequently measured at 
amortised cost using the EIR method. Gains and losses are recognised in the consolidated statement of (loss) when the liabilities 
are de-recognised, as well as through the EIR method amortisation process. Amortised cost is calculated by taking into account 
any discount or premium on acquisition and fees or costs that are an integral part of the EIR. The EIR amortisation is included in 
finance costs in the consolidated statement of (loss).

Financial  Liability  Derecognition.  A  financial  liability  is  de-recognised  when  the  obligation  under  the  liability  is  discharged, 
cancelled or expires. When an existing financial liability is replaced by another from the same lender on substantially different 
terms,  or  the  terms  of  an  existing  liability  are  substantially  modified,  such  an  exchange  or  modification  is  treated  as  a  de-
recognition  of  the  original  liability  and  the  recognition  of  a  new  liability.  The  difference  in  the  respective  carrying  amounts  is 
recognised in the consolidated statement of (loss).

Derivative Financial Instruments and Hedge Accounting. LivaNova uses currency exchange rate derivative contracts to manage 
the impact of currency exchange changes on the consolidated statement of (loss) and the consolidated statement of cash flows. 
Derivatives are initially recognised at fair value on the date a derivative contract is entered into and are subsequently re-measured 
at fair value. The method of recognising the resulting gain or loss depends on whether the derivative is designated as a hedging 
instrument,  and  if  so,  the  nature  of  the  item  being  hedged.  The  Company  evaluates  hedge  effectiveness  at  inception  and  on  an 
ongoing basis, based upon a comparison between the actual amounts and the forecasted amounts of the hedged items, for each 
currency included in the hedge accounting model. If a derivative is no longer expected to be highly effective, hedge accounting is 
discontinued.  Hedge  ineffectiveness,  if  any,  is  recorded  in  the  consolidated  statement  of  (loss).  Cash  flows  from  derivative 
contracts are reported as operating activities in the consolidated statement of cash flows.

When a hedging instrument expires, is sold or is terminated, or when a hedge no longer meets the criteria for hedge accounting, 
any  cumulative  gain  or  loss  existing  in  equity  at  that  time  remains  in  equity  and  is  recognised  when  the  forecast  transaction  is 
ultimately  recognised  in  the  consolidated  statement  of  (loss).  When  a  forecast  transaction  is  no  longer  expected  to  occur,  the 
cumulative gain or loss that was reported in equity is immediately reclassified to the consolidated statement of (loss).

In  order  to  minimise  income  statement  and  cash  flow  volatility  resulting  from  currency  exchange  rate  changes,  historically  the 
Company  has  entered  into  derivative  instruments,  principally  forward  currency  exchange  rate  contracts.  These  contracts  are 
designed to hedge anticipated foreign currency transactions and changes in the value of specific assets and liabilities and of some 
revenue. At inception of the forward contract, the derivative is designated as either a freestanding derivative or a cash flow hedge. 
For derivative instruments that are designated and qualify as a cash flow hedge, the effective portion of the gain or loss on the 
derivative  instrument  is  reported  as  a  component  of  AOCI  and  reclassified  to  the  consolidated  statement  of  (loss)  to  offset 
exchange differences originated by the hedged item or to adjust the value of net income (loss). Upon the settlement of LivaNova’s 
foreign currency cash flow hedges in 2022 and following an in-depth analysis of the utility of the Company’s cash flow hedging 
program,  the  Company  discontinued  its  foreign  currency  cash  flow  hedging  program.  LivaNova  does  not  enter  into  currency 
exchange rate derivative contracts for speculative purposes.

LivaNova  uses  interest  rate  derivative  instruments  designated  as  cash  flow  hedges  to  manage  the  exposure  to  interest  rate 
movements and to reduce the risk of increased borrowing costs by converting floating-rate debt into fixed-rate debt. Under these 
agreements, the Company agrees to exchange, at specified intervals, the difference between fixed and floating interest amounts 
calculated by reference to agreed-upon notional principal amounts. The interest rate swaps are structured to mirror the payment 
terms of the underlying loan. The fair value of the interest rate swaps is reported on the consolidated balance sheets as assets or 
liabilities  (current  or  non-current)  depending  upon  the  gain  or  loss  position  of  the  contract  and  the  maturity  of  the  future  cash 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________92

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

flows  of  each  contract.  The  gain  or  loss  on  these  derivatives  is  reported  as  a  component  of  AOCI  and  reclassified  to  finance 
expenses during the period of the respective interest payment.

Cash and Cash Equivalents. LivaNova considers all highly liquid investments with an original maturity of three months or less, 
consisting of demand deposit accounts and money market mutual funds, to be cash equivalents. Cash equivalents are carried on 
the consolidated balance sheet at cost, which approximated their fair value.

Restricted Cash. The Company classifies cash that is not available for use in its operations as restricted cash within current assets 
on the consolidated balance sheets. As of 31 December 2023 and 2022, LivaNova’s restricted cash balance totalled $311.4 million 
and  $301.4  million,  respectively,  and  was  comprised  of  cash  deposits  with  Barclays  held  as  collateral  for  the  SNIA  Litigation 
Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in USD in an 
amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. For 
additional information regarding the SNIA litigation, please refer to “Note 24. Commitments and Contingencies.”

The following  table presents a  reconciliation  of cash, cash equivalents and restricted cash reported on the consolidated balance 
sheets that sum to the total of the amounts shown on the consolidated statement of cash flows as of 31 December 2023 and 2022 
(in thousands):

Cash and cash equivalents      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Restricted cash    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cash, cash equivalents and restricted cash      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

266,504  $ 
311,368 
577,872  $ 

214,172 
301,446 
515,618 

2023

2022

Non-monetary  Assets.  Property,  Plant  and  Equipment.  PP&E  is  carried  at  cost,  less  accumulated  depreciation  and  any 
accumulated  impairment  losses.  Maintenance  and  repairs,  and  minor  replacements  are  charged  to  expense  as  incurred,  while 
significant  renewals  and  improvements  are  capitalised.  LivaNova  computes  depreciation  using  the  straight-line  method  over 
estimated useful lives. Where an item of PP&E comprises several parts with different useful lives, each part is recognised as a 
separate  item  and  depreciated  over  its  useful  life.  Useful  life  and  residual  value  of  PP&E  are  reviewed  at  each  year-end.  As 
necessary,  the  occurrence  of  changes  to  the  useful  life  or  residual  value  is  recognised  prospectively  as  a  change  in  accounting 
estimates.

Leasehold improvements are depreciated over the shorter of the useful life of an asset or the lease term. Capital improvements to 
the building are added as building components and depreciated over the useful life of the improvement or the building, whichever 
is less.

The estimated useful lives for all classes of depreciable PP&E, except for land and capital investment in process which are not 
depreciated, as of 31 December 2023 were as follows:

Building and building improvements       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Equipment, other, furniture, fixtures       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Lives in Years
5 to 36
2 to 20

The estimated useful lives for all classes of depreciable PP&E, except for land and capital investment in process which are not 
depreciated, as of 31 December 2022 were as follows:

Building and building improvements       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Equipment, other, furniture, fixtures       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Lives in Years
5 to 36
2 to 10

Where there are any internal or external indications that the value of an item of PP&E may be impaired, the recoverable amount of 
the group of CGU(s) to which it belongs is calculated. If the recoverable amount is less than the carrying amount of the group of 
CGUs, a provision for impairment is recorded. PP&E is reviewed for impairment annually on 31 December.

Impairment of Goodwill and Long-lived Assets. The Company assesses, at each reporting date, whether there is an indication that 
an  asset  may  be  impaired.  If  any  indication  exists,  or  when  annual  impairment  testing  for  an  asset  is  required,  the  Company 
estimates the asset’s recoverable amount. An asset’s recoverable amount is the higher of an asset’s CGU’s fair value less costs of 
disposal  and  its  value  in  use.  It  is  determined  for  an  individual  asset,  unless  the  asset  does  not  generate  cash  inflows  that  are 
largely  independent  of  those  from  other  assets  or  groups  of  assets.  Where  the  carrying  amount  of  an  asset  or  CGU  exceeds  its 
recoverable amount, the asset is considered impaired and is written down to its recoverable amount.

The methodology applied to LivaNova’s CGUs is fair value less costs of disposal, reflecting past experience and external sources 
of information, includes Board approved five-year budgets based on cash flows which are extended to trend the expected short-
term revenue growth rate at the end of the budgeted period down to the estimated long-term growth rate in a linear manner. The 
methodology applied to the Company’s fair value less cost of disposal calculations is based on projected periods and includes a 
discounted  cash  flow  model  test,  utilising  discount  rates  and  a  long-term  growth  rate.  Impairment  evaluations  are  highly 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________93

 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

subjective. They involve expectations of future cash flows that reflect LivaNova’s judgements and assumptions regarding future 
industry conditions and operations. The estimates, and assumptions used in the application of the Company’s goodwill impairment 
policies  reflect  both  historical  experience  and  an  assessment  of  current  operational,  industry,  market,  economic  and  political 
environments. Quantitative factors used to determine the fair value less cost of disposal of the CGU reflect the Company’s best 
estimates,  and  the  Company  believes  they  are  reasonable.  Future  declines  in  the  CGU’s  operating  performance  or  LivaNova’s 
anticipated business outlook may reduce the estimated fair value of LivaNova’s CGU and result in additional impairment. Factors 
that could have a negative impact on the fair value of the CGUs include, but are not limited to:

•

•
•
•
•

Decreases  in  revenue  as  a  result  of  the  inability  of  the  LivaNova’s  sales  force  to  effectively  market  and  promote  the 
Company’s products;
Increased competition, patent expirations or new technologies or treatments commercialised by competitors;
Declines in anticipated growth rates;
The outcome of litigation, legal proceedings, investigations or other claims resulting in significant cash outflows; and
Increases in the market-participant risk-adjusted WACC 

Refer to “Note 10. Goodwill and Intangible Assets” for a discussion of the sensitivity analyses performed for the discount rate, the 
expected short-term revenue growth rate and a one-year delay in the OSA CGU’s commercialisation date.

Generally,  for  intangible  assets  with  a  definite  useful  life,  the  Company  uses  cash  flow  projections  for  the  whole  useful  life  of 
these assets with a terminal value based on cash flow projections usually in line with or lower than inflation rates for later years.

Discount  rates  used  are  based  on  the  Company’s  estimated  WACC  adjusted  for  specific  country  and  currency  risks  associated 
with cash flow projections as an approximation of the WACC of a comparable market participant. Due to the above factors, actual 
cash  flows  and  values  could  vary  significantly  from  forecasted  future  cash  flows  and  related  values  derived  using  discounting 
techniques.

Goodwill is tested for impairment annually as of 31 December and when circumstances indicate that the carrying value may be 
impaired. Impairment is determined for goodwill by assessing the recoverable amount of each CGU (or group of CGUs) to which 
the goodwill relates. Where the recoverable amount of the cash generating unit is less than their carrying amount, an impairment 
loss is recognised. Impairment losses relating to goodwill cannot be reversed in future years.

LivaNova  conducts  impairment  testing  of  its  indefinite-lived  intangible  assets  on  31  December  each  year.  The  Company  tests 
indefinite-lived  intangible  assets  for  impairment  between  annual  tests  if  an  event  occurs  or  circumstances  change  that  would 
indicate the carrying amount may be impaired. An impairment loss is recognised when the asset's carrying value exceeds its fair 
value.

Research and Development. Research costs are recognised as an expense for the year in which they are incurred. R&D includes 
costs of basic research activities as well as engineering and technical effort required to develop a new product or make significant 
improvement  to  an  existing  product  or  manufacturing  process.  R&D  costs  also  include  regulatory  and  clinical  study  expenses, 
including post-market clinical studies.

Inventories.  LivaNova  states  its  inventories  at  the  lower  of  cost,  using  the  FIFO,  and  net  realizable  value.  The  Company’s 
calculation of cost includes the acquisition cost of raw materials and components, direct labour and overhead. During the years 
ended  31  December  2023  and  2022,  LivaNova  reduced  the  carrying  value  of  inventories  for  those  items  that  are  potentially 
excess, obsolete or slow moving based on changes in customer demand, technology developments or other economic factors by 
$19.9 million and $2.5 million, respectively.

Revenue Recognition. Refer to “Note 3. Revenue Recognition.”

Defined  Benefit  Pension  Plans  and  Other  Post-Employment  Benefits.  The  Company  sponsors  various  retirement  benefit  plans, 
including defined benefit pension  plans (pension  benefits), defined contribution savings plans and termination indemnity plans, 
covering substantially all US employees and employees outside the US. The cost of providing benefits under the defined benefit 
plans is determined separately for each plan using the projected unit credit method.

Re-measurements,  comprising  of  actuarial  gains  and  losses,  the  effect  of  the  asset  ceiling  (excluding  amounts  included  in  net 
interest on the net defined benefit liability) and the return on plan assets (excluding amounts included in net interest on the net 
defined  benefit  liability),  are  recognised  immediately  in  the  consolidated  balance  sheet  with  a  corresponding  debit  or  credit  to 
retained earnings through OCI in the year in which they occur. Re-measurements are not reclassified to the consolidated statement 
of (loss) in subsequent years.

Past service costs are recognised in the consolidated statement of (loss) on the earlier of:

•
•

The date of the plan amendment or curtailment, and
The date on which the Company recognises related restructuring costs

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________94

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

Net interest is calculated by applying the discount rate to the net defined benefit liability or asset. The Company recognises the 
following changes in the net defined benefit obligation under cost of sales and selling, general and administrative expenses in the 
consolidated statement of (loss) (by function):

•

•

Service  costs  comprising  current  service  costs,  past-service  costs,  gains  and  losses  on  curtailment  and  non-routine 
settlements
Net finance expenses or income

Provision for severance indemnity is mandatory for Italian companies and is considered:

•

•

a defined benefit plan with respect to amounts vested up to 31 December 2006 and amounts vesting from 1 January 2007 
for employees who have chosen to maintain the TFR at the Company, for companies with 50 or fewer employees;
a  defined  contribution  plan  with  respect  to  amounts  vesting  as  from  1  January  2007  for  employees  who  have  opted  for 
supplementary  pensions  or  who  have  chosen  to  maintain  the  TFR  at  the  Company,  for  companies  with  more  than  50 
employees.

As  a  defined  benefit  plan,  the  TFR  is  measured  using  the  unit  credit  projection  method  based  on  actuarial  assumptions 
(demographic  assumptions:  mortality,  turnover,  disability  of  the  population  included  in  the  above  plan;  financial  assumptions: 
discount  rate,  benefit  growth  rate,  capitalisation  rate).  The  increase  in  the  present  value  of  the  TFR  is  included  in  personnel 
expense, with the exception of the revaluation of the net liability, which is recorded among items of OCI. The cost of TFR accrued 
through 31 December 2006 no longer includes the component related to future salary increases. Payments of TFR, as a defined 
contribution plan, are also included in personnel expense, and until they are settled financially, they have a balancing entry in the 
statement of financial position in the form of current payables.

Share-Based  Compensation.  LivaNova  grants  share-based  awards  to  directors,  officers  and  key  employees.  The  Company 
measures the cost of services received in exchange for an award of equity instruments based on the grant date fair market value of 
the  award.  The  cost  of  equity-settled  transactions  is  recognised  in  employee  benefits  expense,  together  with  a  corresponding 
increase in retained earnings over the period in which the service and the performance conditions are fulfilled (the vesting period). 
The cumulative expense recognised for equity-settled transactions at each reporting date until the vesting date reflects the extent to 
which the vesting period has expired and the Company’s best estimate of the number of equity instruments that will ultimately 
vest.  LivaNova  issues  new  shares  upon  stock  option  exercises,  otherwise  issuance  of  stock  for  vesting  of  restricted  stock, 
restricted  stock  units,  market  performance-based  restricted  share  units,  operating  performance-based  restricted  share  units  or 
exercises  of  stock  appreciation  rights  are  issued  from  treasury  shares.  LivaNova  has  the  right  to  elect  to  pay  the  cash  value  of 
vested  restricted  stock  units  in  lieu  of  the  issuance  of  new  shares.  The  social  security  contributions  on  employee  share-based 
payment awards are accrued over the service period.

The following share-based awards are offered by the Company:

•

•

SARs. LivaNova may grant SARs that confer upon the grantee the contractual right to receive an amount of cash, stock, or a 
combination of both, that equals the appreciation in the company’s stock from the award’s grant date to the exercise date. 
SARs may be exercised at the grantee’s discretion during the exercise period and do not give the grantee an ownership right 
in the underlying stock. SARs do not involve payment of an exercise price. LivaNova uses the Black-Scholes option pricing 
methodology to calculate the grant date fair market value of SARs and compensation is expensed ratably over the service 
period.  The  Company  determines  the  expected  volatility  of  the  awards  based  on  historical  volatility.  Calculation  of 
compensation for SAR stock awards requires the Company to estimate historical volatility and forfeiture rates.
RS and RSUs. LivaNova may grant service-based RSUs at no purchase cost to the grantee. The grantees of unvested units 
have no voting rights or rights to dividends. Sale or transfer of the stock and stock units is restricted until they are vested. 
The  fair  market  value  of  service-based  RSUs  is  determined  using  the  market  closing  price  on  the  grant  date,  and 
compensation is expensed ratably over the service period. Calculation of compensation for RSU stock awards requires the 
Company to estimate forfeiture rates.

• Market Performance-Based Restricted Share Units. LivaNova may grant market performance-based RSUs at no purchase 
cost to the grantee. The grantees of unvested units have no voting rights or rights to dividends and sale or transfer of the 
units is restricted until they are vested. The number of shares that are ultimately transferred to the grantee is dependent upon 
the Company’s percentile rank of TSR relative to a peer group. The fair market value of market performance-based RSUs is 
determined utilising a Monte Carlo simulation on the grant date and compensation is then expensed ratably over the service 
period.  Calculation  of  compensation  for  market  performance-based  stock  awards  requires  the  Company  to  estimate 
historical volatility and forfeiture rates.
Operating  Performance-Based  Restricted  Share  Units.  LivaNova  may  grant  operating  performance-based  RSUs  at  no 
purchase cost to the grantee. The grantees of unvested units have no voting rights or rights to dividends and sale or transfer 
of  the  units  is  restricted  until  they  are  vested.  The  number  of  shares  that  are  ultimately  transferred  to  the  grantee  is 
dependent upon the Company’s percent achievement of certain targets for cumulative FCF and ROIC. The fair market value 
of  operating  performance-based  RSUs  is  determined  using  the  market  closing  price  on  the  grant  date.  Compensation  is 

•

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________95

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

expensed  ratably  over  the  service  period  and  is  adjusted  based  upon  the  estimated  and  actual  percent  achievement  of 
cumulative adjusted FCF and return on invested capital as compared to target. 

Income  Taxes.  The  tax  expense  for  the  year  comprises  current  and  deferred  tax.  Current  and  deferred  tax  is  recognised  in  the 
consolidated statement of (loss), except to the extent that it relates to items recognised in OCI or directly in equity. In this case, the 
tax is also recognised in OCI or directly in equity, respectively.

The  income  tax  expense  or  credit  for  the  year  is  the  tax  payable  on  the  current  year’s  taxable  income  based  on  the  applicable 
income tax rate for each jurisdiction, adjusted by changes in deferred tax assets and liabilities attributable to temporary differences 
and to unused tax losses.

The current income tax charge is calculated on the basis of the tax laws enacted or substantively enacted at the end of the reporting 
year  in  the  countries  where  the  Company’s  subsidiaries  and  associates  operate  and  generate  taxable  income.  The  Company  is 
subject to taxation on earnings in several countries under various tax regulations. Calculation of taxes on a global scale requires 
the  use  of  estimates  and  assumptions  developed  based  on  the  information  available  at  the  balance  sheet  date.  Management 
establishes provisions where appropriate on the basis of amounts expected to be paid to the tax authorities.

Deferred  taxes  are  recognised  by  the  liability  method  for  temporary  differences  between  the  carrying  amount  of  assets  and 
liabilities in the consolidated balance sheet and their tax base. They are measured at the tax rates that are expected to apply to the 
year when the asset is realised or the liability is settled, based on tax rates (and tax laws) that have been enacted or substantively 
enacted  at  the  balance  sheet  date.  Adjustments  to  deferred  taxes  resulting  from  changes  in  tax  rates  are  recognised  in  the 
consolidated statement of (loss). A deferred tax asset is recognised for all deductible temporary differences to the extent that it is 
probable that taxable profit will be available against which the deductible temporary difference can be utilised. At each year-end, 
the Company reviews the recoverable value of deferred tax assets of tax entities holding significant loss carryforwards. This value 
is  based,  by  tax  entity,  on  the  strategy  for  recoverability  of  the  tax  loss  carryforwards.  Deferred  taxes  are  charged  or  credited 
directly to equity when the tax relates to items that are recognised directly in equity, such as gains and losses on cash flow hedges 
and  actuarial  gains  and  losses  on  defined  benefit  plan  obligations.  Deferred  tax  assets  and  liabilities  are  set  off  when  they  are 
levied on the same taxable entity (legal entity or tax group) by the same taxation authority and the entity has a legally enforceable 
right  of  set  off.  Deferred  taxes  are  recognised  for  all  temporary  differences  associated  with  investments  in  subsidiaries  and 
associates, except to the extent that the Company is able to control the timing of the reversal of the temporary difference and it is 
probable  that  the  temporary  difference  will  not  reverse  in  the  foreseeable  future.  Deferred  tax  balances  are  not  discounted.  As 
required by the amendments to IAS12, the Company has applied the exception and will neither recognize or disclose information 
about deferred tax assets and liabilities relating to the OECD BEPS Pillar Two.

Leases. LivaNova has leases primarily for (i) real estate, including office space and manufacturing, warehouse and research and 
development facilities and (ii) vehicles. LivaNova determines if an arrangement is or contains a lease at its inception or when the 
terms and conditions of a contract are significantly changed. ROU assets and lease liabilities are recognised based on the present 
value of the future minimum lease payments over the lease term at the latter of the Company’s lease standard effective date for 
adoption  or  the  lease  commencement  date.  LivaNova  does  not  record  an  operating  lease  asset  and  corresponding  liability  for 
leases with terms of 12 months or less. LivaNova recognises the lease payments for such short-term leases within profit and loss 
on  a  straight-line  basis  over  the  lease  term.  Variable  lease  payments  that  do  not  depend  on  an  index  or  rate,  such  as  variable 
common  area  rent,  maintenance  charges  and  utility  fees  not  known  upon  lease  commencement,  are  not  included  in  the 
determination  of  the  minimum  lease  payments  and  are  expensed  in  the  period  in  which  the  obligation  for  those  payments  is 
incurred.  Variable  lease  payments  that  depend  on  an  index  or  rate  are  initially  measured  using  the  index  or  rate  as  of  the 
commencement date. As most of the Company’s leases do not provide a readily determinable implicit rate, LivaNova uses its IBR 
based  on  the  information  available  at  the  lease  commencement  date  in  determining  the  present  value  of  future  payments. 
LivaNova’s  IBR  is  determined  using  a  risk-free  rate  adjusted  for  factors  such  as  credit  rating  and  borrowing  currency,  and 
represents  an  estimate  of  the  interest  rate  the  Company  would  incur  at  lease  commencement  to  borrow  the  funds  necessary  to 
obtain an asset of similar value to the ROU asset over the term of a lease. The ROU lease asset also includes any lease payments 
made in advance and excludes lease incentives. LivaNova’s lease terms may include options to extend or terminate the lease when 
it is reasonably certain that the Company will exercise that option. ROU assets are depreciated over the shorter of the asset's useful 
life or the lease term on a straight-line basis. Lease payments are allocated between the liability and finance costs. Finance costs 
are recorded as an expense in the Company statement of (loss) income over the lease period so as to produce a constant periodic 
rate of interest on the remaining balance of the liability. Certain of LivaNova’s leases provide for tenant improvement allowances 
that have been recorded as ROU assets and amortised, using the straight-line method, over the life of the lease. 

LivaNova  applies  certain  practical  expedients  on  an  ongoing  basis,  including  the  practical  expedient  for  short-term  leases  and 
leases of low-value assets pursuant to which a lessee is permitted to make an accounting policy election by class of underlying 
asset not to recognise a lease liability and lease asset. A short-term lease is defined as a lease with a term of 12 months or less and 
does  not  include  an  option  to  purchase  the  underlying  asset  that  the  lessee  is  reasonably  certain  to  exercise.  In  exception  to 
vehicles as it relates to the low-value lease asset policy, the Company has applied these accounting policies to all asset classes in 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________96

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

the Company’s portfolio and will recognise the lease payments for such short-term leases and leases of low-value assets within the 
consolidated statement of (loss) on a straight-line basis over the lease term. 

Accounting  for  leases  has  no  impact  on  the  actual  cash  flows.  However,  lease  accounting  requires  the  capitalisation,  and 
subsequent depreciation, of costs that were previously expenses as paid, which impacts disclosures of cash flows within the cash 
flow statement. 

From a lessor perspective, certain of LivaNova’s agreements that allow the customer to use, rather than purchase, the Company’s 
medical devices meet the criteria of being a lease. 

For additional information refer to “Note 18. Leases.”

Equity. Ordinary Shares are classified as equity. Incremental costs directly attributable to the issue of new shares or options are 
shown in equity as a deduction, net of tax, from the proceeds.

Where any group company purchases the Company’s equity instruments, for example as the result of a share buy-back or a share-
based payment plan, the consideration paid, including any directly attributable incremental costs (net of income taxes) is deducted 
from  equity  attributable  to  the  owners  of  LivaNova  as  treasury  shares  until  the  shares  are  cancelled  or  reissued.  Where  such 
Ordinary  Shares  are  subsequently  reissued,  any  consideration  received,  net  of  any  directly  attributable  incremental  transaction 
costs and the related income tax effects, is included in equity attributable to the owners of LivaNova.

Provisions  and  Warranties.  Provisions  for  legal  claims,  service  warranties  and  make  good  obligations  are  recognised  when  the 
Company has a present legal or constructive obligation as a result of past events, it is probable that an outflow of resources will be 
required  to  settle  the  obligation  and  the  amount  can  be  reliably  estimated.  Provisions  are  not  recognised  for  future  operating 
losses. Where there are a number of similar obligations, the likelihood that an outflow will be required in settlement is determined 
by considering the class of obligations as a whole. A provision is recognised even if the likelihood of an outflow with respect to 
any one item included in the same class of obligations may be small.

Provisions  are  measured  at  the  present  value  of  management’s  best  estimate  of  the  expenditure  required  to  settle  the  present 
obligation  at  the  end  of  the  reporting  year.  The  discount  rate  used  to  determine  the  present  value  is  a  pre-tax  rate  that  reflects 
current market assessments of the time value of money and the risks specific to the liability. The increase in the provision due to 
the passage of time is recognised as finance expenses.

The  Company  offers  a  product  warranty  on  various  products.  The  Company  estimates  the  costs  that  may  be  incurred  under 
warranties and records a liability in the amount of such costs at the time the product is sold. The amount of the reserve recorded is 
equal  to  the  net  costs  to  repair  or  otherwise  satisfy  the  claim.  The  warranty  obligation  is  included  in  current  provisions  on  the 
consolidated balance sheet. Warranty expense is recorded in cost of sales in the consolidated statement of (loss).

Contingent  Consideration.  Contingent  consideration  is  recognised  at  fair  value  at  the  date  of  acquisition  based  on  the 
consideration  expected  to  be  transferred  and  estimated  as  the  probability  of  future  cash  flows,  discounted  to  present  value  in 
accordance  with  accepted  valuation  methodologies.  The  discount  rate  used  is  a  benchmark  yield  curve  for  US  healthcare 
companies, determined at the time of measurement. Contingent consideration is remeasured each reporting year with the change in 
fair value, including accretion for the passage of time, recorded in the consolidated statement of (loss). The change in fair value of 
contingent  consideration  based  on  the  achievement  of  regulatory  milestones  is  recorded  as  research  and  development  expense 
while the change in fair value of sales-based earnout contingent consideration is recorded as cost of sales.

Product Liability Accruals. Accruals for product liability claims are recorded when it is probable that a liability has been incurred 
and the amount of the liability can be reasonably estimated based on existing information. Accruals for product liability claims are 
adjusted periodically as additional information becomes available. The Company accrues an estimate of the legal defense costs 
needed to defend each matter when those costs are probable and can be reasonably estimated.

Contingencies. The Company is subject to product liability claims, government investigations and other legal proceedings in the 
ordinary course of business. Legal fees and other expenses related to litigation are expensed as incurred and included in selling, 
general and administrative expenses in the consolidated statement of (loss). Contingent accruals are recorded when the Company 
determines that a loss is both probable and reasonably estimable. Due to the fact that legal proceedings and other contingencies are 
inherently unpredictable, LivaNova’s assessments involve significant judgement regarding future events.

EPS. Basic (loss) EPS is calculated by dividing the (loss) income for the year attributable to equity holders of the parent by the 
weighted  average  number  of  shares  outstanding  during  the  year.  Diluted  EPS  is  calculated  by  dividing  the  income  (loss) 
attributable  to  equity  holders  of  the  parent  by  the  weighted  average  number  of  shares  outstanding  during  the  year  plus  the 
weighted average number of shares that would be issued on conversion of all the dilutive potential shares into shares. However, 
for the calculation of diluted EPS for the years ended 31 December 2023 and 2022 there is no dilution because to do so would be 
antidilutive  due  to  the  Company  being  in  a  net  loss  position  during  these  years.  Refer  to  “Note  25.  Earnings  Per  Share”  for 
additional information.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________97

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

Critical  Estimates  and  Judgements.  The  preparation  of  LivaNova’s  consolidated  financial  statements  in  conformity  with  IFRS 
requires  management  to  make  estimates  and  judgements  that  affect  the  amounts  reported  in  such  financial  statements  and 
accompanying notes. These estimates and judgements are based on management’s best knowledge of current events and actions 
the  Company  may  undertake  in  the  future.  Actual  results  could  differ  materially  from  those  estimates.  Application  of  the 
following accounting policies requires certain judgements and estimates that have the potential for the most significant impact on 
LivaNova’s consolidated financial statements:

Critical Estimates

•

3T  Litigation  and  Saluggia  Site  Hazardous  Substances  Provisions.  Provisions  for  legal  claims  are  recognised  when  the 
Company has a present legal or constructive obligation as a result of past events, it is probable that an outflow of resources 
will  be  required  to  settle  the  obligation  and  the  amount  can  be  reliably  estimated.  Estimates  are  used  in  assessing  the 
likelihood of a loss being incurred and when determining a reasonable estimate of the loss for each claim. Final settlement 
amounts may be materially different from the provision recorded. For the 3T litigation provision, given the nature of the 
estimate,  no  sensitivities  are  applicable.  For  further  discussions  on  the  Company’s  3T  Litigation  and  Saluggia  Site 
Hazardous Substances Provisions, please refer to “Note 24. Commitments and Contingencies, including the sensitivity to 
discount rates and the range of outcomes for the Saluggia site hazardous substances provision.”

•

• Goodwill and Intangible Assets - In-process research and development. Goodwill and in-process R&D were recognised as 
part  of  the  Company’s  past  merger  and  acquisition  activities  based  on  detailed  valuations  that  use  information  and 
assumptions provided by management. These valuations consider management's best estimates of inputs and assumptions 
that a market participant would use. The key estimates in the valuations include the discount rate as well as the expected 
short-term revenue growth rate and the OSA CGU’s commercialisation date. For a discussion of impairments recognised 
and sensitivity analyses performed, refer to “Note 10. Goodwill and Intangible Assets.”
Embedded Exchange and Conversion Features and Capped Call Derivatives. In June 2020, the Company’s wholly-owned 
subsidiary LivaNova USA issued the 2025 Notes and entered into the related 2025 Capped Calls, and in March 2024, the 
Company issued the 2029 Notes and entered into the related 2029 Capped Calls. The 2025 Notes and 2029 Notes include an 
embedded exchange feature and an embedded conversion feature, respectively, that are bifurcated from the 2025 Notes and 
2029  Notes,  as  applicable.  The  embedded  exchange  or  conversion  feature  derivative  is  measured  at  fair  value  using  a 
binomial lattice model and discounted cash flows that utilize observable and unobservable market data. Each capped call 
derivative  is  measured  at  fair  value  using  the  Black-Scholes  model  utilising  observable  and  unobservable  market  data, 
including stock price, remaining contractual term, expected volatility, risk-free interest rate and expected dividend yield, as 
applicable. The Company uses historical volatility and implied volatility from options traded to determine expected stock 
price volatility which is an unobservable input that is significant to the valuation. For additional information, please refer to 
“Note 4. Financial Risk Management” for a sensitivity analysis of expected stock price volatility and “Note 17. Financial 
Liabilities.”

• Deferred Tax Recoverability. Management has made judgements and estimates regarding the recoverability of deductible 
temporary differences and tax losses carried forward to be utilised from future taxable profits. The Group has decided not to 
recognise UK deferred tax assets relating to losses where UK group relief is not permitted, and other timing differences due 
to the uncertainty involved in determining the future profitability of the Group. For additional information, please refer to 
“Note 23. Income Taxes Expense.”

Critical Judgements

•

Commitments  and  Contingencies.  A  number  of  LivaNova  subsidiaries  are  involved  in  various  government  and  other 
investigations and legal proceedings (product liability, commercial, employment, environmental claims, etc.) arising out of 
the  normal  conduct  of  their  businesses.  The  outcome  of  these  matters  is  not  certain  and  judgement  is  required  in 
determining whether these matters require the recognition of a liability. The most significant matters considered relate to the 
Company’s  3T  device,  the  SNIA  litigation  and  the  Company’s  Saluggia  site.  For  more  information,  see  “Note  24. 
Commitments and Contingencies.” 

Note 3. Revenue Recognition 

LivaNova  generates  revenue  through  contracts  with  customers  consisting  primarily  of  hospitals,  healthcare  institutions  and 
distributors.  Revenue  is  measured  based  on  consideration  specified  in  customer  contracts  and  excludes  amounts  collected  on 
behalf of third parties. The Company measures the consideration based upon the estimated amount to be received. The amount of 
consideration LivaNova ultimately receives varies depending upon the return terms, sales rebates, discounts, and other incentives 
the Company may offer, which are accounted for as variable consideration when estimating the amount of revenue to recognise. 
The estimate of variable consideration requires significant judgment. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________98

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 3. Revenue Recognition

LivaNova  has  historically  experienced  a  low  rate  of  product  returns,  and  the  total  dollar  value  of  product  returns  has  not  been 
significant to the Company’s consolidated financial statements.

LivaNova  recognises  revenue  when  a  performance  obligation  is  satisfied  by  transferring  the  control  of  a  product  or  providing 
service  to  a  customer.  Some  of  LivaNova’s  contracts  include  the  purchase  of  multiple  products  and/or  services.  In  such  cases, 
LivaNova allocates the transaction price based upon the relative estimated stand-alone price of each product and/or service sold. 
LivaNova  records  state  and  local  sales  taxes  net;  that  is,  the  Company  excludes  sales  tax  from  revenue.  Typically,  LivaNova’s 
contracts do not have a significant financing component. LivaNova did not apply the practical expedient under IFRS 15 which 
provides  that  an  entity  is  not  required  to  adjust  the  transaction  price  for  the  effects  of  a  significant  financing  component  if,  at 
contract inception, it expects the period between customer payment and the transfer of goods or services to be one year or less.

LivaNova incurs incremental commission fees paid to the sales force associated with the sale of products. LivaNova applies the 
practical expedient within IFRS 15 and has elected to recognise the incremental costs of obtaining a contract as an expense when 
incurred  if  the  amortisation  period  of  the  asset  the  entity  would  otherwise  recognise  is  one  year  or  less.  As  a  result,  no 
commissions have been capitalised as contract costs since adoption of IFRS 15.

The following is a description of the principal activities (separated by reportable segments) from which LivaNova generates its 
revenue.  For  more  detailed  information  about  LivaNova’s  reportable  segments  including  disaggregated  revenue  results  by 
operating segment, major product line and primary geographic market, see “Note 26. Segment and Geographic Information.”

Cardiopulmonary Products and Services

Cardiopulmonary  products  include  HLM,  oxygenators,  autotransfusion  systems,  perfusion  tubing  systems,  cannulae  and  other 
related accessories.

Cardiopulmonary  products  may  include  performance  obligations  associated  with  assembly  and  installation  of  equipment. 
Accordingly,  LivaNova  allocates  a  portion  of  the  sales  prices  to  installation  obligations  and  recognises  that  revenue  when  the 
service is provided. LivaNova recognises revenue for equipment and accessory product sales when control of the equipment or 
product passes to the customer.

Technical  services  include  installation,  repair  and  maintenance  of  cardiopulmonary  equipment  under  service  contracts  or  upon 
customer  request.  Technical  service  agreements  generally  provide  for  upfront  payments  in  advance  of  rendering  services  or 
periodic billing over the contract term. Amounts billed in advance are deferred and recognised as revenue when the performance 
obligation is satisfied. Technical services are not a significant component of Cardiopulmonary revenue and have been presented 
with the related equipment and accessories revenue.

Neuromodulation Products

Neuromodulation products are comprised of neuromodulation therapy systems for the treatment of DRE and DTD. LivaNova’s 
Neuromodulation product line includes the VNS Therapy System, which consists of an implantable pulse generator, a lead that 
connects the generator to the vagus nerve, and other accessories. LivaNova recognises revenue for Neuromodulation product sales 
when control passes to the customer.

Advanced Circulatory Support Products

LivaNova’s ACS segment was engaged in the design, development, manufacture, marketing and selling of temporary life support 
products.  ACS’s  products,  which  comprise  the  LifeSPARC  and  Hemolung  systems,  and  standalone  cannulae  and  accessories, 
including  ProtekDuo  and  transseptal  (TandemHeart)  cannulae,  simplify  temporary  extracorporeal  cardiopulmonary  life  support 
solutions for critically ill patients. 

ACS  products  are  comprised  of  temporary  life  support,  including  the  LifeSPARC  platform,  ProtekDuo  cannula  kits  and  the 
Hemolung RAS. ACS revenue is recognised when control passes to the customer, usually at the point of shipment.

In  early  2024,  LivaNova  transitioned  all  ACS  standalone  cannulae  and  accessories,  including  ProtekDuo  and  transseptal 
(TandemHeart)  cannulae,  into  its  Cardiopulmonary  segment.  Additionally,  further  sales  of  the  LifeSPARC  and  Hemolung 
Systems were discontinued. For additional information, please refer to “Note 8. Restructuring.”

Contract Balances

Due  to  the  nature  of  LivaNova’s  products  and  services,  revenue  producing  activities  may  result  in  contract  assets  and  contract 
liabilities. These activities relate primarily to Cardiopulmonary technical services contracts for short-term and multi-year service 
agreements. Contract assets are primarily comprised of unbilled revenues, which occur when a performance obligation has been 
completed,  but  not  billed  to  the  customer.  Contract  liabilities  are  made  up  of  deferred  revenue,  which  occurs  when  a  customer 
pays for a service, before a performance obligation has been completed. Contract assets are included within prepaid expenses and 
other  current  assets  on  the  consolidated  balance  sheets  and  were  insignificant  as  of  31  December  2023  and  2022.  As  of  31 
December 2023 and 2022, contract liabilities of $15.3 million and $14.1 million, respectively, were included within current and 
long-term other liabilities on the consolidated balance sheets. During the years ended 31 December 2023 and 2022, net revenue 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________99

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 3. Revenue Recognition

recognised that was included in the contract liability balance at the beginning of the period was $13.7 million and $9.4 million, 
respectively. During the years ended 31 December 2023 and 2022, there was no revenue recognised that related to performance 
obligations satisfied in previous periods.

Note 4. Financial Risk Management

Management of Financial Risk

Increasing  market  fluctuations  may  result  in  significant  earnings  and  cash  flow  volatility  risk  for  LivaNova.  The  Company’s 
operating business as well as its investment and financing activities are affected particularly by changes in foreign exchange rates, 
interest  rates  and  concentration  of  procurement  suppliers  and  customers.  In  order  to  optimize  the  allocation  of  the  financial 
resources across LivaNova's segments and entities, as well as to achieve its aims, LivaNova identifies, analyses and manages the 
associated  market  risks.  The  Company  seeks  to  manage  and  control  these  risks  primarily  through  its  regular  operating  and 
financing activities, and uses derivative financial instruments when deemed appropriate.

The Company’s CFO oversees the management of these risks. The CFO is supported by a senior financial management team that 
advises  on  financial  risks  and  the  appropriate  financial  risk  governance  framework  for  the  Company.  The  senior  financial 
management  team  provides  assurance  to  the  Company’s  senior  management  that  the  Company’s  financial  risk  activities  are 
governed by appropriate policies and procedures and that financial risks are identified, measured and managed in accordance with 
policies and risk appetite. All derivative activities for risk management purposes are carried out by teams that have the appropriate 
skills,  experience  and  supervision.  It  is  the  Company’s  policy  that  no  trading  in  derivatives  for  speculative  purposes  may  be 
undertaken. Intercompany financing or investments of operating units are preferably carried out in their functional currency or on 
a hedged basis. The Board reviews and agrees to policies for managing each of these risks.

Liquidity Risk

Liquidity  risk  results  from  the  Company’s  inability  to  meet  its  financial  liabilities.  LivaNova  follows  a  financing  policy  that  is 
aimed  towards  a  balanced  financing  portfolio,  a  diversified  maturity  profile  and  a  comfortable  liquidity  cushion.  LivaNova 
mitigates  liquidity  risk  by  the  implementation  of  an  effective  working  capital  and  centralized  cash  management  and  arranged 
credit facilities with highly rated financial institutions. In addition, LivaNova constantly monitors funding options available in the 
capital markets, as well as trends in the availability and costs of such funding, with a view to maintaining financial flexibility and 
limiting repayment risks.

The  following  tables  reflect  the  undiscounted  cash  outflows  related  to  settlement  and  repayments,  of  the  Company’s  financial 
liabilities at a balance sheet date. The disclosed expected undiscounted net cash outflows from derivative financial liabilities are 
determined based on each particular settlement date of an instrument and based on the earliest date on which LivaNova could be 
required to pay. Cash outflows for financial liabilities without fixed amount or timing are based on the conditions existing at the 
respective balance sheet date.

Contractual undiscounted future cash outflows as of 31 December 2023 and 2022 were as follows (in thousands):

Due Within 1 
Year

1-2 Years

2-5 Years

Over
 5 Years

Total

2023

Non-derivative financial instruments
Trade payables    . . . . . . . . . . . . . . . . . . . . . . . $ 
Financial liabilities     . . . . . . . . . . . . . . . . . . .
Total   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Financial derivative liabilities
 - on exchange rate risk    . . . . . . . . . . . . . . . . $ 
 - on equity price risk (1)
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

    . . . . . . . . . . . . . . . .

78,922  $ 
18,084 
97,006  $ 

—  $ 

—  $ 

311,029 
311,029  $ 

295,938 
295,938  $ 

—  $ 

312 
312  $ 

78,922 
625,363 
704,285 

3,883  $ 
— 
3,883  $ 

—  $ 

45,569 
45,569  $ 

—  $ 
— 
—  $ 

—  $ 
— 
—  $ 

3,883 
45,569 
49,452 

(1) Refer to the section titled “Equity Price Risk” below.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________100

 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 4. Financial Risk Management

Due Within 1 
Year

1-2 Years

2-5 Years

Over
 5 Years

Total

2022

Non-derivative financial instruments
Trade payables    . . . . . . . . . . . . . . . . . . . . . . . $ 
Financial liabilities      . . . . . . . . . . . . . . . . . . .
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Financial derivative liabilities
- on exchange rate risk      . . . . . . . . . . . . . . . . . $ 
 - on equity price risk (1)
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

   . . . . . . . . . . . . . . . .

72,403  $ 
23,424 
95,827  $ 

—  $ 

15,092 
15,092  $ 

—  $ 

559,486 
559,486  $ 

—  $ 

229 
229  $ 

72,403 
598,231 
670,634 

5,886  $ 
— 
5,886  $ 

—  $ 

85,675 
85,675  $ 

—  $ 
— 
—  $ 

—  $ 
— 
—  $ 

5,886 
85,675 
91,561 

(1) Refer to the section titled “Equity Price Risk” below.

Equity Price Risk 

In  June  2020,  the  Company  issued  $287.5  million  in  cash  exchangeable  senior  notes  and  entered  into  related  capped  call 
transactions.  The  cash  exchangeable  senior  notes  include  an  embedded  exchange  feature  that  is  bifurcated  from  the  cash 
exchangeable  senior  notes.  Please  refer  to  “Note  17.  Financial  Liabilities”  for  further  details.  The  embedded  exchange  feature 
derivative  is  measured  at  fair  value  using  a  binomial  lattice  model  and  discounted  cash  flows  that  utilize  observable  and 
unobservable market data. The capped call derivative is measured at fair value using the Black-Scholes model utilising observable 
and  unobservable  market  data,  including  stock  price,  remaining  contractual  term,  expected  volatility,  risk-free  interest  rate  and 
expected dividend yield, as applicable.

In general, an increase in LivaNova’s stock price or stock price volatility would increase the fair value of the embedded exchange 
feature  and  capped  call  derivatives  which  would  result  in  an  increase  in  expense.  As  time  to  the  expiration  of  the  derivatives 
decreases, the fair value of the derivatives would decrease. The future impact on net income depends on how significant inputs 
such as stock price, stock price volatility and time to the expiration of the derivatives change in relation to other inputs. Changes 
in the fair value of the embedded exchange feature derivative and capped call derivatives are recognised in net gain on embedded 
exchange feature and capped call derivatives on the consolidated statement of (loss).

The fair value of the embedded exchange feature derivative liability and the capped call derivative assets were $45.6 million and 
$38.5 million, respectively, as of 31 December 2023, and the stock price volatility as of 31 December 2023 was 38%. As of 31 
December 2023, a 10% lower volatility, holding other inputs constant, would reduce the fair value for the embedded exchange 
feature  derivative  liability  by  $13.4  million,  and  a  10%  higher  volatility,  holding  other  inputs  constant,  would  increase  the  fair 
value by $13.3 million. As of 31 December 2023, a 10% lower volatility, holding other inputs constant, would decrease the fair 
value of the capped call derivatives by $9.1 million, and a 10% higher volatility, holding other inputs constant, would increase the 
fair value by $4.8 million.

The fair value of the embedded exchange feature derivative liability and the capped call derivative assets were $85.7 million and 
$54.4 million, respectively, as of 31 December 2022, and the stock price volatility as of 31 December 2022 was 43%. As of 31 
December 2022, a 10% lower volatility, holding other inputs constant, would result in approximate fair value for the embedded 
exchange  feature  derivative  of  $70.6  million  and  a  10%  higher  volatility,  holding  other  inputs  constant,  would  result  in 
approximate fair value of $100.3 million. As of 31 December 2022, a 10% lower volatility, holding other inputs constant would 
result in approximate fair value for the capped call derivatives of $52.1 million and a 10% higher volatility, holding other inputs 
constant, would result in approximate fair value of $53.7 million.

Foreign Currency Exchange Rate Risk

FX risk is the risk that reported financial performance of the fair value of future cash flows of a financial instrument will fluctuate 
because  of  changes  in  foreign  exchange  rates.  LivaNova  operates  in  many  countries  and  currencies  and  therefore  currency 
fluctuations may impact LivaNova’s financial results. In the ordinary course of business, LivaNova is exposed to foreign currency 
exchange rate fluctuations, particularly between USD, Euro, Canadian Dollar, GBP and Japanese Yen. LivaNova is exposed to 
currency risk in the following areas:

•

•
•
•

Transaction exposures, related to anticipated sales and purchases and on-balance-sheet receivables/payables resulting from 
such transactions
Translation exposure of foreign-currency intercompany and external debt
Translation exposure of net income in foreign entities
Translation exposure of foreign-currency denominated equity invested in consolidated companies

Due  to  the  global  nature  of  LivaNova’s  operations,  the  Company  is  exposed  to  foreign  currency  exchange  rate  fluctuations. 
Historically,  the  Company  has  maintained  a  foreign  currency  exchange  rate  risk  management  strategy  that  utilizes  cash  flow 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________101

 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 4. Financial Risk Management

hedges and freestanding foreign currency derivatives to reduce the Company’s exposure to unanticipated fluctuations in forecasted 
revenue and costs, inter-company debt, deposits and accounts receivable caused by changes in foreign currency exchange rates. 
Additionally, foreign currency exchange rate exposure is partly balanced by purchasing of goods, commodities and services in the 
respective  currencies,  as  well  as  production  activities  in  the  local  markets.  LivaNova’s  operating  units  are  prohibited  from 
borrowing or investing in foreign currencies on a speculative basis. Upon the settlement of LivaNova’s foreign currency cash flow 
hedges  in  2022  and  following  an  in-depth  analysis  of  the  utility  of  the  Company’s  cash  flow  hedging  program,  LivaNova 
discontinued its foreign currency cash flow hedging program. LivaNova continues to use freestanding derivative forward contracts 
to offset exposure to the variability of the value associated with assets and liabilities denominated in a foreign currency. Any gains 
and losses on the fair value of derivative contracts would generally be offset by gains and losses on the underlying transactions.

The following tables present financial instruments denominated in currencies other than the currency of account of the companies 
holding them which involve the greatest exposure as of 31 December 2023 and 2022 (in thousands):

EUR

USD

2023
GBP

Other

Total

Assets

Cash and cash equivalents denominated in foreign currency       . . $ 

534  $  412,857  $ 

3,199  $ 

7,983  $  424,573 

Trade receivables denominated in foreign currency    . . . . . . . . .
Other assets denominated in foreign currency     . . . . . . . . . . . . . .
Total assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Liabilities
Trade payables denominated in foreign currency        . . . . . . . . . . .

28,795 
11,305 
40,634 

35,067 
4,426 
  452,350 

8 
52 
3,259 

5,655 
(2,528)   
11,110 

69,525 
13,255 
  507,353 

46,540 

1,699 

517 

(15)   

48,741 

Financial liabilities denominated in foreign currency    . . . . . . . .
Other liabilities denominated in foreign currency      . . . . . . . . . . .
Total liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net exposure       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  (81,956)  $  449,509  $ 
Financial derivative liabilities
- not for hedging (1)
Total liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net exposure       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

34,933 
41,117 
  122,590 

3,824  $ 
3,824 
(3,824)  $ 

—  $ 
— 
—  $ 

— 
1,142 
2,841 

1,478 
6,014 
8,009 
(4,750)  $ 

36,844 
433 
51,077 
2,804 
  136,662 
3,222 
7,888  $  370,691 

91  $ 
91 
(91)  $ 

(32)  $ 
(32)   
32  $ 

3,883 
3,883 
(3,883) 

(1) Derivative transactions that do not meet the requirements for hedge accounting.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________102

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 4. Financial Risk Management

Assets
Cash and cash equivalents denominated in 
foreign currency       . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Trade receivables denominated in foreign 
currency        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other assets denominated in foreign currency     . . .
Total assets       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Liabilities
Trade payables denominated in foreign currency     
Financial liabilities denominated in foreign 
currency        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other liabilities denominated in foreign currency      
Total liabilities       . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net exposure    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Financial derivative assets
 - for hedging      . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Total assets       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial derivative liabilities
 - not for hedging (1)       . . . . . . . . . . . . . . . . . . . . . . .
Total liabilities       . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net exposure    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

EUR

USD

JPY

GBP

Other

Total

2022

30  $  304,880  $ 

2,878  $ 

3,777  $ 

6,623  $  318,188 

449 
1 
480 

30,581 
1,958 
  337,419 

— 
— 
2,878 

— 
361 
4,138 

6,952 
18 
13,593 

37,982 
2,338 
  358,508 

15 

998 

264 

217 

845 

2,339 

— 
106 
121 
359  $  335,346  $ 

— 
1,075 
2,073 

— 
— 
264 

2,860 
13,239 
18,438 
2,614  $  (10,778)  $  12,529  $  340,070 

2,840 
11,859 
14,916 

20 
199 
1,064 

—  $ 
— 

1,333  $ 
1,333 

—  $ 
— 

—  $ 
— 

—  $ 
— 

1,333 
1,333 

— 
— 
—  $ 

5,774 
5,774 
(4,441)  $ 

28 
28 
(28)  $ 

68 
68 
(68)  $ 

16 
16 
(16)  $ 

5,886 
5,886 
(4,553) 

(1) Derivative transactions that do not meet the requirements for hedge accounting.

Interest Rate Risk

The Company’s main interest rate risk arises from long-term debt with variable rates, which expose the Company to cash flow 
interest rate risk. Historically, LivaNova entered into interest rate swaps associated with the Initial Term Facility, which qualified 
for and were designated as cash flow hedges. The Company’s interest rate swaps expired on 6 April 2023. LivaNova elected not 
to  renew  the  interest  rate  swaps  as  finance  expenses  associated  with  the  Initial  Term  Facility  is  principally  offset  by  holding  a 
significant  portion  of  the  Initial  Term  Facility  in  a  depository  account,  which  earns  a  floating  rate  of  interest.  During  the  year 
ended 31 December 2023, the Company’s debt at variable rates was denominated in USD and EUR.

As at 31 December 2023, LivaNova Group had the following variable rate financing denominated in USD:

•
•

a Term Loan A from a syndicate of lenders to LivaNova USA, Inc. for $335 million
a local credit facility in favour of LivaNova Colombia Sas for $1.5 million

As at 31 December 2023, non-US Dollar-denominated floating rate debt was immaterial.

As at 31 December 2022, LivaNova Group had the following variable rate financing denominated in USD:

•
•

a Term Loan A from a syndicate of lenders to LivaNova USA, Inc. for $300 million
a local credit facility in favour of LivaNova Colombia Sas for $1.5 million.

As at 31 December 2022, non-US Dollar-denominated floating rate debt was immaterial. 

Credit Risk

LivaNova  trade  receivables  represent  potential  concentrations  of  credit  risk.  This  risk  is  limited  due  to  the  large  number  of 
customers  and  their  dispersion  across  a  number  of  geographic  areas,  as  well  as  the  Company’s  efforts  to  control  LivaNova’s 
exposure to credit risk by monitoring the Company’s receivables, the use of credit approvals and credit limits. Refer to “Note 14. 
Trade  Receivables  and  Other  Receivables”  for  more  details.  In  addition,  LivaNova  has  historically  had  strong  collections  and 
minimal write-offs. While the Company believes that its reserves for credit losses are adequate, essentially all of the Company’s 
trade receivables are concentrated in the hospital and healthcare sectors worldwide, and accordingly, LivaNova is exposed to their 
respective business, economic and country-specific variables. Although LivaNova does not currently foresee a concentrated credit 
risk associated with these receivables, repayment is dependent on the financial stability of these industry sectors and the respective 
countries’ national economies and healthcare systems.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________103

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 4. Financial Risk Management

The  following  table  presents  the  maximum  theoretical  credit  risk  exposure  for  LivaNova  is  an  aggregate  carrying  amount  of 
financial assets as of 31 December 2023 and 2022 (in thousands):

Cash and cash equivalents   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Trade receivables       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Current and non-current financial derivative assets     . . . . . . . . . . . . . . . . . . . . . . . . . . .
Current and non-current financial assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Guarantees    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

266,504  $ 
215,072 
38,496 
28,863 
6,527 
16,356 
571,818  $ 

214,172 
183,110 
55,726 
24,110 
8,087 
30,050 
515,255 

2023

2022

The risk related to cash and cash equivalents, financial assets and financial derivatives assets is limited since all bank and financial 
counter-parties have a high rating.

The guarantees issued by LivaNova are primarily due to unconditional bank guarantees, irrevocable letters of credit, bid bonds, 
guarantees  to  the  governmental  tax  authorities  and  tenancy  guarantees,  and  thus,  the  related  credit  risk  is  remote  and  has  been 
remote as viewed on a historical basis.

LivaNova operates in the medical technology sector for which there is not a significant risk of customer insolvency as a number of 
its  customers  are  related  to  government  agencies.  However,  LivaNova  is  subject  to  risks  related  to  cash  requirements  resulting 
from potentially high average collection periods (days sales outstanding).

Credit risk is managed on a group basis. For banks and financial institutions, only independently rated parties with a minimum 
investment grade credit rating are accepted.

For customers, if there is no independent rating, risk control assesses the credit quality of the customer, taking into account its 
financial  position,  past  experience  and  other  factors.  Individual  risk  limits  are  set  based  on  internal  or  external  information  in 
accordance  with  limits  set  by  the  Company’s  Treasury  Group.  The  compliance  with  and  authorisation  of  credit  limits  by 
customers  is  regularly  monitored  by  line  management.  Additionally,  the  Company  established  a  policy  for  expected  credit  loss 
provisions  based  on  lifetime  expected  credit  losses,  which  provides  the  methodology  to  be  used  to  calculate  an  addition  to  the 
provision for uncollectible receivables for past-due receivables for each LivaNova entity and the ageing of each receivable.

Changes in provisions for uncollectible receivables are explained in “Note 14. Trade Receivables and Other Receivables.”

The following table presents trade receivables by due dates as of 31 December 2023 and 2022 (in thousands) and the expected 
loss rate to which LivaNova is exposed: 

Performing      . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less than 30 days past due       . . . . . . . . . . . . . . .
31-120 days past due   . . . . . . . . . . . . . . . . . . . .
121-365 days past due   . . . . . . . . . . . . . . . . . . .
Total   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Expected 
Loss Rate (1)
0.04% - 6.0%       . . . . . . . . . . . . . . . . . . . . . . . . $ 
0.38% - 12.0%       . . . . . . . . . . . . . . . . . . . . . . . .
0.38% - 30.0%       . . . . . . . . . . . . . . . . . . . . . . . .
0.38% - 30.0%       . . . . . . . . . . . . . . . . . . . . . . . .

2023
180,613  $ 
19,469 
14,683 
307 
215,072  $ 

2022
156,107 
15,445 
11,558 
— 
183,110 

(1) Expected loss rates are applied based upon risk-ranked groupings of countries where the underlying sales are made. 

Trade  receivables  that  are  past  due  were  $34.5  million  and  $27.0  million  at  31  December  2023  and  31  December  2022, 
respectively. Of this amount, 22.1% and 30.0% at 31 December 2023 and 31 December 2022, respectively, were receivables from 
certain  government  hospitals  that  pay  their  suppliers  in  1-2  years  on  average,  and  the  remaining  are  receivables  from  private 
customers, clinics and distributors, some of which have agreed to repayment plans through the renegotiation of payment terms.

At  31  December  2023  and  31  December  2022,  the  amount  of  performing  receivables  that  were  from  government  (public) 
hospitals were 26.9% and 13.0% of total performing receivables, respectively, as presented in the following table (in thousands): 

By Sector

Total

2023
Performing

Past Due

Total

2022
Performing

Past Due

Public    . . . . . . . . . . . . . . . . . . . . $  56,180  $ 
Private     . . . . . . . . . . . . . . . . . . .
Total     . . . . . . . . . . . . . . . . . . . . . $  215,072  $ 

  158,892 

48,559  $ 

132,054 
180,613  $ 

7,621  $  28,460  $ 
26,838 
34,459  $  183,110  $ 

  154,650 

20,359  $ 

135,748 
156,107  $ 

8,101 
18,902 
27,003 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________104

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 4. Financial Risk Management

The following table presents trade receivables by region as of 31 December 2023 and 2022 (in thousands except D.S.O.): 

2023

2022

D.S.O.

Performing

Past Due D.S.O.

Total

Performing

By Region
Italy       . . . . . . . . . . . . .
Spain    . . . . . . . . . . . .
France      . . . . . . . . . . .
Germany      . . . . . . . . .
Rest of Europe      . . . . .
North America     . . . . .
Japan    . . . . . . . . . . . .
Rest of World    . . . . .

Total
136  $  10,500  $ 
110 
62 
22 
76 
44 
104 
109 

4,855 
5,732 
2,405 
32,462 
79,784 
9,404 
69,930 

8,707  $  1,793 
1,618 
3,237 
449 
5,283 
(267)   
2,672 
30,019 
2,443 
  17,126 
62,658 
9,408 
58,629 

  11,301 

(4)   

113  $ 
91 
55 
20 
50 
43 
83 
103 

8,050  $ 
3,917 
4,871 
1,941 
18,314 
69,794 
8,253 
67,970 

Past Due
1,558 
878 
635 
(382) 
2,263 
10,115 
(34) 
11,970 

6,492  $ 
3,039 
4,236 
2,323 
16,051 
59,679 
8,287 
56,000 

Total       . . . . . . . . . . . .

66  $  215,072  $ 

180,613  $  34,459 

60  $  183,110  $ 

156,107  $  27,003 

Revenues are derived from a large number of customers with no customers being individually material.

The average collection period increased from 60 days at 31 December 2022 to 66 at 31 December 2023. The D.S.O., or average 
collection period, is calculated as the ratio of total receivables at the end of the year to revenues generated in the 12 preceding 
months. D.S.O. = (Trade receivables/Revenues) * 365. 

For comparability, the revenue amounts include VAT.

For the purposes of the disclosure of credit risk, there were no past-due balances of a significant amount related to other assets, 
other receivables and financial assets.

Capital management

LivaNova maintains a sufficient amount of capital to meet its development needs, fund the business units' operations and ensure 
the Company continues to be a going concern. The equilibrium of sources of funding, which is also aimed at minimising overall 
capital costs, is achieved by balancing risk capital contributed on a permanent basis by shareholders, and debt capital, which is in 
turn diversified and structured with several due dates and in other currencies. To this end, changes in debt levels in relation to both 
equity and operating profit, and the generation of cash by the business units are constantly kept under control. Please refer to the 
sections above titled “Management of Financial Risk,” “Liquidity Risk,” “Foreign Currency Exchange Rate Risk,” “Interest Rate 
Risk,” “Credit Risk” and “Note 17. Financial Liabilities.”

Note 5. Fair Value Measurements 

Fair  value  is  defined  as  the  price  that  would  be  received  to  sell  an  asset  or  paid  to  transfer  a  liability  in  an  orderly  transaction 
between market participants as of the measurement date. The guidance also establishes a hierarchy for inputs used in measuring 
fair value that maximises the use of observable inputs and minimises the use of unobservable inputs by requiring that the most 
observable  inputs  be  used  when  available.  Observable  inputs  are  inputs  market  participants  would  use  in  valuing  the  asset  or 
liability,  based  on  market  data  obtained  from  sources  independent  of  us.  Unobservable  inputs  are  inputs  that  reflect  the 
Company’s assumptions about the factors market participants would use in valuing the asset or liability developed based upon the 
best information available in the circumstances. The categorisation of financial assets and financial liabilities within the valuation 
hierarchy is based upon the lowest level of input that is significant to the fair value measurement. The hierarchy is broken down 
into three levels defined as follows:

•
•

•

Level 1 – Inputs are quoted prices in active markets for identical assets or liabilities
Level 2 – Inputs include quoted prices for similar assets or liabilities in active markets, quoted prices for identical or similar 
assets or liabilities in markets that are not active and inputs (other than quoted prices) that are observable for the asset or 
liability, either directly or indirectly
Level 3 – Inputs are unobservable for the asset or liability

No  assets  or  liabilities  are  classified  as  Level  1.  Financial  assets  and  liabilities  that  are  classified  as  Level  2  include  derivative 
instruments,  primarily  forward  and  option  currency  contracts  and  interest  rate  swap  contracts,  which  are  valued  using  standard 
calculations  and  models  that  use  readily  observable  market  data  as  their  basis.  At  31  December  2023,  Level  3  assets  include 
investments in private companies, the capped call derivatives associated with the Company’s 2020 cash exchangeable senior notes 
and  convertible  notes  receivable  primarily  associated  with  LivaNova’s  investment  in  ALung.  At  31  December  2023,  level  3 
liabilities include the embedded exchange feature of the Company’s cash exchangeable senior notes and contingent consideration 
recognised as a result of the acquisitions of ImThera and ALung. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________105

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 5. Fair Value Measurements

Assets and Liabilities That Are Measured at Fair Value on a Recurring Basis

The following tables present information by level for assets and liabilities that are measured at fair value on a recurring basis as of 
31 December 2023 and 2022 (in thousands):

Assets
Financial assets at fair value     . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Derivative Assets – capped call derivatives      . . . . . . . . . . . . . .
Convertible notes receivable    . . . . . . . . . . . . . . . . . . . . . . . . . .
Total assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

19,907  $ 
38,496 
275 
58,678  $ 

Liabilities
Derivative Liabilities – not for hedging (exchange rates)    . . . . $ 
Derivative Liabilities – embedded exchange feature      . . . . . . .
Earnout for contingent payments       . . . . . . . . . . . . . . . . . . . . . .
Total Liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

3,883  $ 
45,569 
94,652 

144,104  $ 

Assets
Financial assets at fair value     . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Derivative Assets – for hedging (interest rate swaps)   . . . . . . .
Derivative Assets – capped call derivatives      . . . . . . . . . . . . . .
Convertible notes receivable    . . . . . . . . . . . . . . . . . . . . . . . . . .
Total assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2022

14,288  $ 
1,333 
54,393 
285 
70,299  $ 

Liabilities
Derivative Liabilities – not for hedging (exchange rates)    . . . . $ 
Derivative Liabilities – embedded exchange feature      . . . . . . .
Earnout for contingent payments       . . . . . . . . . . . . . . . . . . . . . .
Total Liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

5,886  $ 
85,675 
85,292 

176,853  $ 

Fair Value Measurements 
Using Inputs Considered as:
Level 2

Level 1

Level 3

—  $ 
— 
— 
—  $ 

—  $ 
— 
— 
—  $ 

—  $ 
— 
— 
—  $ 

19,907 
38,496 
275 
58,678 

3,883  $ 
— 
— 
3,883  $ 

— 
45,569 
94,652 
140,221 

Fair Value Measurements 
Using Inputs Considered as:
Level 2

Level 1

Level 3

—  $ 
— 
— 
— 
—  $ 

—  $ 
— 
— 
—  $ 

—  $ 

1,333 
— 
— 
1,333  $ 

14,288 
— 
54,393 
285 
68,966 

5,886  $ 
— 
— 
5,886  $ 

— 
85,675 
85,292 
170,967 

The following table presents a reconciliation of the beginning and ending balances of our recurring fair value measurements, using 
significant unobservable inputs (Level 3) for the years ended 31 December 2023 and 2022 (in thousands):

Financial 
Assets at 
Fair 
Value

Capped 
Call 
Derivative 
Asset

Convertible 
Notes 
Receivable

Embedded 
Exchange 
Feature 
Derivative 
Liability

As of 1 January 2022     . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  15,811  $  106,629  $ 

Additions      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Changes in fair value recognised in profit or loss (1) (3)
      .
Utilised as business combination consideration (2)     . . . .
As of 31 December 2022    . . . . . . . . . . . . . . . . . . . . . . . . .
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    . . .

Additions (4)
Changes in fair value recognised in profit or loss (1)

1,669 
(192)   
(3,000)   

  14,288 
5,508 
111 

— 

(52,236)   

— 
54,393 
— 

(15,897)   

As of 31 December 2023    . . . . . . . . . . . . . . . . . . . . . . . . . $  19,907  $  38,496  $ 

Less current portion as of 31 December 2023     . . . . . . . .

— 

— 

Long-term portion as of 31 December 2023      . . . . . . . . . . $  19,907  $  38,496  $ 

2,767  $  181,700  $ 

— 
13 
(2,495)   
285 
— 
(10)   
275  $ 
— 
275  $ 

— 

(96,025)   

— 
85,675 
— 

(40,106)   
45,569  $ 
— 
45,569  $ 

(1) During the year ended 31 December 2023, the contingent consideration change in fair value resulted in a increase of $3.8 
million recorded to cost of sales and a increase of $5.6 million recorded to R&D. During the year ended 31 December 2022, 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________106

Contingent 
Consideration 
Liability 
Arrangements
98,382 
16,791 
(29,881) 
— 
85,292 
— 
9,360 
94,652 
13,750 
80,902 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 5. Fair Value Measurements

the  contingent  consideration  change  in  fair  value  resulted  in  a  decrease  of  $10.5  million  recorded  to  cost  of  sales  and  an 
decrease of $19.4 million recorded to R&D.

(2) Amounts utilised as business combination consideration represent “other considerations” utilised in the acquisition of ALung 
during the year ended 31 December 2022. For additional information, please refer to “Note 7. Business Combinations.”
(3) The decrease in fair value associated with contingent consideration arrangements during the year ended 31 December 2022 
was  primarily  related  to  the  change  in  (i)  the  discount  rates  due  to  increasing  interest  rates,  (ii)  the  probability  of  the 
regulatory  milestone-based  payment  associated  with  the  acquisition  of  TandemLife  and  (iii)  the  timing  of  projected 
achievement of a certain regulatory milestone and timing of sales-based earnout payments associated with the acquisition of 
ImThera.

(4)   During  2023,  LivaNova  invested  in  Cadence  Neuroscience,  Inc.,  a  privately  held  medical  device  company  focusing  on 
advancements  in  neuromodulation  to  detect  specific signals from the brain and deliver electrical stimulation to modify  the 
activity of neural circuits.

Level 2

To measure the fair value of its derivative transactions (transactions to hedge exchange risk), LivaNova calculates the mark-to-
market of each transaction using prices quoted in active markets (e.g. the spot exchange rate of a currency for forward exchange 
transactions) and observable market inputs processed for the measurement (e.g. the fair value of an interest rate swap using the 
interest rate curve), or the measurement of an exchange rate option (with the processing of listed prices and observable variables 
such as volatility).

For all level 2 valuations, LivaNova uses the information provided by a third-party as a source for obtaining quoted observable 
prices  and  to  process  market  variables.  In  particular,  for  forward  exchange  rate  transactions,  fair  value  is  calculated  using  the 
forward  market  exchange  rate  on  the  reporting  date  for  each  contract.  The  difference  calculated  between  this  amount  and  the 
contractual forward rate is discounted (present value) to the same reporting date.

The  derivative  valuation  models  incorporate  the  credit  quality  of  counterparts,  adjustments  for  counterparts’  credit  risk  and  the 
Company’s own non-performance risk.

Level 3

Financial assets at fair value consist of investments in equity shares, convertible preferred shares and convertible notes receivable 
of privately held companies for which there are no quoted market prices. These investments fall within Level 3 of the fair value 
hierarchy due to the use of significant unobservable inputs to determine fair value as the investments are privately held entities 
without  quoted  market  prices.  To  determine  the  fair  value  of  these  investments  management  used  all  pertinent  financial 
information  available  related  to  the  entities  including  valuation  reports  prepared  by  third  parties.  Refer  to  “Note  12.  Financial 
Assets” for a further discussion of the Company’s investments.

The embedded exchange feature and capped call derivatives are classified as Level 3 as the Company uses historical volatility and 
implied volatility from options traded to determine expected stock price volatility, an unobservable input that is significant to the 
valuation. 

Earnout for contingent payments related to LivaNova’s acquisitions of ImThera and ALung represents the Company’s contingent 
consideration  liability  as  of  31  December  2023.  This  liability  falls  within  Level  3  of  the  fair  value  hierarchy  due  to  the  use  of 
significant  unobservable  inputs  to  determine  fair  value  as  the  liability  is  estimated  as  the  probability  of  future  cash  flows, 
discounted to present value in accordance with accepted valuation methodologies. The discount rate used is determined at the time 
of  measurement.  Refer  to  “Note  20.  Contingent  Consideration,  3T  Litigation  Provision  Liability  and  Other  Provisions”  for  a 
reconciliation of the changes in the fair value of the Company’s contingent consideration liability.

The following table presents the fair value of LivaNova’s Level 3 contingent consideration arrangements by acquisition as of 31 
December 2023 and 2022 (in thousands):

ImThera      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
ALung      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

80,902  $ 
13,750 
94,652  $ 

69,389 
15,903 
85,292 

The ImThera business combination involved contingent consideration arrangements composed of potential cash payments upon 
the  achievement  of  a  certain  regulatory  milestone  and  a  sales-based  earnout  associated  with  sales  of  products.  The  sales-based 

2023

2022

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________107

 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 5. Fair Value Measurements

earnout  is  valued  using  projected  sales  from  LivaNova’s  internal  strategic  plan.  These  arrangements  are  Level  3  fair  value 
measurements and include the following significant unobservable inputs as of 31 December 2023:

ImThera Acquisition

Valuation Technique

Unobservable Input

Ranges

Regulatory milestone-based payment

Discounted cash flow

Discount rate     . . . . . . . . . . . .

Probability of payment      . . . .

Projected payment year      . . .

7.2%

85%

2026

Sales-based earnout

Monte Carlo simulation

Risk-adjusted discount rate     . 13.6% - 14.0%

Credit risk discount rate   . . .

7.4%  - 7.9%

Revenue volatility    . . . . . . . .

Probability of payment      . . . .

30.8%

85%

Projected years of earnout      .

2026 - 2029

The ALung business combination involved a contingent consideration arrangement composed of potential cash payments upon the 
achievement of certain sales-based thresholds associated with sales of products. The ALung contingent consideration arrangement 
states  that,  in  the  event  that  LivaNova  ceases  the  operations  of  ALung,  LivaNova  would  be  subject  to  a  one-time  phase-out 
payment of $13.8 million. In January 2024, LivaNova announced the wind down of ACS, including ALung, as part of the 2024 
Restructuring Plan. As a result, the ALung contingent consideration arrangement liability was adjusted to the phase-out payment 
amount of $13.8 million as of 31 December 2023.

Transfers

LivaNova reviews the fair value hierarchy classification on a quarterly basis. Changes in the ability to observe valuation inputs 
may result in a reclassification of levels for certain securities within the fair value hierarchy. The Company’s policy is to recognise 
transfers into and out of levels within the fair value hierarchy at the end of the fiscal quarter in which the actual event or change in 
circumstances that caused the transfer occurs. There were no transfers between Level 1, Level 2 or Level 3 during the years ended 
31 December 2023 and 2022. When a determination is made to classify an asset or liability within Level 3, the determination is 
based upon the significance of the unobservable inputs to the overall fair value.

Assets and Liabilities that are Measured at Fair Value on a Non-recurring Basis

Non-financial  assets  such  as  goodwill,  intangible  assets  and  property,  plant  and  equipment  are  usually  measured  at  fair  value 
computed using the fair value less cost of disposal when there is an indicator of impairment and recorded at fair value only when 
impairment  is  recognised.  Financial  assets  such  as  investments  in  shares  are  held  at  cost,  which  LivaNova  believes  it  is  an 
appropriate estimate of fair value unless more recent information is available sufficient to measure fair value. The fair values of 
these non-financial assets are based on the Company’s own judgements about the assumptions that market participants would use 
in pricing the asset and on observable market data, when available. The Company classifies these measurements as Level 3 within 
the fair value hierarchy.

Financial Instruments Not Measured at Fair Value

The carrying values of LivaNova’s cash, cash equivalents and restricted cash, accounts receivable, accounts payable and accrued 
liabilities approximate fair value due to the short-term nature of these items.

The carrying value of LivaNova’s long-term debt including the current portion, as of 31 December 2023, and 2022 was $586.6 
million and $541.4 million, respectively. The fair value of the Company’s Notes as of 31 December 2023, and 2022 was $314.4 
million  and  $328.1  million,  respectively.  For  all  other  long-term  debt  obligations,  the  Company  believes  the  carrying  value 
approximates fair value.

Note 6. Financial Instruments 

The Group uses several instruments to fund its operating activities including short and long-term debt from credit institutions and 
other  lenders  and  short-term  bank  loans.  The  Group’s  other  financial  instruments  consist  of  trade  payables  and  receivables 
resulting  from  operating  activities,  investments  in  other  companies,  assets  and  liabilities  for  financial  derivatives  (primarily 
interest rate swaps and forward foreign currency contracts) and other receivables and payables other than those related to staff, tax 
authorities and welfare agencies.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________108

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 6. Financial Instruments

Classification of financial instruments

The classification of financial instruments measured at fair value changed from being measured through OCI to being measured in 
the  profit  or  loss.  With  regard  to  classification  of  financial  instruments  on  the  basis  of  the  types  as  specified  in  IFRS  9,  the 
following should be noted:

•

Assets and liabilities for financial derivatives related to contracts entered into to mitigate exchange risk on imports 
and  exports  are  classified  under  “Financial  assets/liabilities  at  fair  value  through  OCI”  when  they  meet  the 
requirements  for  being  recognised  as  hedge  accounting  instruments,  and  under  “Financial  assets/liabilities  at  fair 
value through profit or loss” when these requirements are not met.

(in thousands)

Financial 
Assets/
Liabilities at 
Fair Value 
Through Profit 
or Loss

Receivables 
and Loans 
Measured at 
Amortised Cost

Financial 
Assets 
Measured at 
Amortised Cost

Financial 
Liabilities at 
Amortised Cost

Total

Current 
Portion

Non-Current 
Portion

Fair Value

Classification of Financial Instruments at 31 December 2023

Classification

Carrying Amount

Assets
Cash, cash equivalents and restricted cash     . $ 
Trade receivables     . . . . . . . . . . . . . . . . . . . . .

Financial derivative assets      . . . . . . . . . . . . . .

Financial assets   . . . . . . . . . . . . . . . . . . . . . . .

Other assets     . . . . . . . . . . . . . . . . . . . . . . . . . .
Total financial assets    . . . . . . . . . . . . . . . . . . $ 
Liabilities

Financial liabilities    . . . . . . . . . . . . . . . . . . . . $ 

Lease liabilities    . . . . . . . . . . . . . . . . . . . . . . .

Other liabilities      . . . . . . . . . . . . . . . . . . . . . . .

Trade payables    . . . . . . . . . . . . . . . . . . . . . . .
Financial derivative liabilities    . . . . . . . . . . .
Other financial liabilities       . . . . . . . . . . . . . . .
Total financial liabilities     . . . . . . . . . . . . . . . . $ 

— 

— 

38,496 

19,907 

— 

$ 

577,872 

$ 

215,072 

— 

2,073 

6,527 

$ 

— 

— 

— 

6,883 

— 

58,403 

$ 

801,544 

$ 

6,883 

$ 

— 

— 

— 

— 

— 

— 

$ 

577,872 

$ 

577,872 

$ 

215,072 

215,072 

38,496 

28,863 

6,527 

— 

483 

— 

— 

— 

38,496 

28,380 

6,527 

$ 

577,872 

215,072 

38,496 

28,863 

6,527 

$ 

866,830 

$ 

793,427 

$ 

73,403 

$ 

866,830 

$ 

— 

— 

— 

— 

45,569 

— 

45,569 

$ 

— 

— 

— 

— 

— 

— 

— 

$ 

$ 

— 

— 

— 

— 

— 

— 

— 

$ 

586,001 

$ 

586,001 

$ 

17,484 

$ 

568,517 

$ 

652,302 

53,843 

72,492 

78,922 

— 

627 

53,843 

72,492 

78,922 

45,569 

627 

8,369 

— 

78,922 

— 

627 

45,474 

72,492 

— 

45,569 

— 

53,843 

72,492 

78,922 

45,569 

627 

$ 

791,885 

$ 

837,454 

$ 

105,402 

$ 

732,052 

$ 

903,755 

Classification of Financial Instruments at 31 December 2022

Classification

Carrying Amount

Financial 
Assets/
Liabilities at 
Fair Value 
Through 
Profit or Loss

Receivables 
and Loans 
Measured at 
Amortised 
Cost

Financial 
Assets 
Measured at 
Amortised 
Cost

Financial 
Liabilities at 
Amortised 
Cost

Financial 
Assets/
Liabilities at 
Fair Value 
Through OCI

Total

Current 
Portion

Non-Current 
Portion

Fair Value

(in thousands)

Assets

Cash, cash equivalents and 
restricted cash    . . . . . . . . . . . . . . $ 

Trade receivables       . . . . . . . . . . .

Financial derivative assets    . . . .
Financial assets       . . . . . . . . . . . .
Other assets     . . . . . . . . . . . . . . .
Total financial assets    . . . . . . . . $ 

Liabilities

Financial liabilities   . . . . . . . . . . $ 
Lease liabilities   . . . . . . . . . . . .
Other liabilities    . . . . . . . . . . . . .

Trade payables       . . . . . . . . . . . . .

Financial derivative liabilities     .

90,518 

Other financial liabilities       . . . . .
Total financial liabilities    . . . . . $ 

— 

90,518 

$ 

Note 7. Business Combinations

— 

— 

55,726 

14,288 

— 

$ 

515,618 

$ 

183,110 

— 

3,563 

8,087 

$ 

— 

— 

— 

6,259 

— 

70,014 

$ 

710,378 

$ 

6,259 

$ 

— 

— 

— 

— 

— 

— 

$ 

$ 

$ 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

$ 

$ 

— 

— 

— 

— 

— 

— 

— 

$ 

538,936 

$ 

38,925 

65,997 

72,403 

— 

2,727 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

1,043 

— 

$ 

515,618 

$ 

515,618 

$ 

183,110 

183,110 

55,726 

24,110 

8,087 

1,333 

1,679 

— 

— 

— 

54,393 

22,431 

8,087 

$ 

515,618 

183,110 

55,726 

24,110 

8,087 

$ 

786,651 

$ 

701,740 

$ 

84,911 

$ 

786,651 

$ 

538,936 

$ 

20,892 

$ 

518,044 

$ 

636,344 

38,925 

65,997 

72,403 

91,561 

2,727 

9,312 

— 

72,403 

5,886 

2,727 

29,613 

4,471 

— 

85,675 

— 

38,925 

4,471 

72,403 

91,561 

2,727 

$ 

718,988 

$ 

1,043 

$ 

810,549 

$ 

111,220 

$ 

637,803 

$ 

846,431 

As  of  31  December  2021,  LivaNova  owned  a  3%  investment  in  ALung,  a  privately  held  medical  device  company  focused  on 
creating advanced medical devices for treating respiratory failure. On May 2022, LivaNova acquired the remaining 97% of equity 
interests in ALung for a purchase price of up to $110.0 million, consisting of $10.0 million paid at closing, subject to customary 
adjustments,  and  contingent  consideration  of  up  to  $100.0  million  payable  upon  achievement  of  certain  sales-based  milestones 
beginning in 2023 and ending in 2027. Total consideration included approximately $5.5 million of non-cash consideration.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________109

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 7. Business Combinations

The  following  table  presents  the  acquisition  date  fair  value  of  the  consideration  transferred  and  the  fair  value  of  LivaNova’s 
interest in ALung prior to the acquisition, including certain measurement period adjustments (in thousands):

Cash and other considerations (1)
Contingent consideration        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fair value of consideration transferred       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

15,586 
16,791 
32,377 

(1) Please refer to “Note 5. Fair Value Measurements” for information regarding “other considerations.”

The following table presents the preliminary purchase price allocation at fair value for the ALung acquisition, including certain 
measurement period adjustments (in thousands): 

Fair Value of 
Consideration

Purchase Price 
Allocation

Developed technology - 15-year life    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Goodwill       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other assets and liabilities, net      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net assets acquired    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2,900 
26,870 
2,607 
32,377 

Goodwill  arising  from  the  ALung  acquisition,  which  is  not  deductible  for  tax  purposes,  primarily  represents  the  anticipated 
synergies between ALung and LivaNova’s ACS business. The assets acquired, including goodwill, are recognised in LivaNova’s 
ACS segment. The goodwill for the ACS CGU was fully impaired during the year ended 31 December 2022. Please refer to “Note 
10. Goodwill and Intangible Assets” for further details.

LivaNova  recognised  ALung  acquisition-related  expenses  of  approximately  $5.1  million  during  the  year  ended  31  December 
2022, within “Selling, general and administrative” expenses on the Company’s consolidated statement of (loss).

The Company’s consolidated financial statements include the operating results of ALung from the acquisition date. Separate post-
acquisition operating results and pro forma financial information for this acquisition have not been presented as the effect was not 
material.

The ALung contingent consideration payments are triggered upon the achievement of thresholds associated with sales of products 
covered  by  the  purchase  agreement  and  are  estimated  to  occur  during  the  years  reflected  in  the  table  below.  The  sales-based 
earnout  was  valued  using  projected  sales  from  the  LivaNova’s  internal  strategic  plan  and  is  a  Level  3  fair  value  measurement, 
which includes the following significant unobservable inputs (in thousands):

ALung Acquisition
Sales-based earnout

$ 

Fair value at 2 
May 2022

Valuation Technique
16,791  Monte Carlo simulation

Unobservable Input
Risk-adjusted discount rate     .
Credit risk discount rate   . . .
Revenue volatility    . . . . . . . .
Projected years of earnout      .

Ranges
7.0% - 8.4%
6.4% - 8.0%
25.7%
2023 - 2027

The  ALung  contingent  consideration  arrangement  states  that,  in  the  event  that  LivaNova  ceases  the  operations  of  ALung, 
LivaNova would be subject to a one-time phase-out payment of $13.8 million. In January 2024, LivaNova announced the wind 
down  of  ACS,  including  ALung,  as  part  of  the  2024  Restructuring  Plan.  As  a  result,  the  ALung  contingent  consideration 
arrangement  liability  was  adjusted  to  the  phase-out  payment  amount  of  $13.8  million  as  of  31  December  2023.  For  a 
reconciliation  of  the  beginning  and  ending  balance  of  contingent  consideration  liabilities,  refer  to  “Note  5.  Fair  Value 
Measurements.”

Note 8. Restructuring 

LivaNova  initiates  restructuring  plans  to  leverage  economies  of  scale,  streamline  distribution  and  logistics,  and  strengthen 
operational and administrative effectiveness in order to reduce overall costs. A restructuring provision is recorded when a plan is 
approved and communicated to employees.

During  2020,  LivaNova  initiated  a  reorganisation  plan  to  reduce  the  Company’s  cost  structure.  Under  this  plan,  LivaNova 
incurred  restructuring  expenses  of  $9.7  million  during  2021,  primarily  associated  with  severance  costs  for  approximately  54 
employees, and $9.7 million during 2021, primarily associated with severance costs for 27 employees terminated during 2021 and 
lease abandonment costs. The reorganisation plan was completed during 2022.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________110

 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 8. Restructuring

During 2022, management committed to implement a cost-optimization and cost reduction program to adapt to current economic 
conditions,  which  included  a  workforce  reduction  to  be  completed  by  mid-2023.  Under  this  plan,  LivaNova  recognised 
restructuring expense of $1.0 million and $6.6 million during the years ended 31 December 2023 and 2022, respectively. The total 
estimated restructuring costs associated with the plan were approximately $10.0 million including employee termination benefits, 
consulting fees and contract termination costs.

On 5 January 2024, the Board of Directors of LivaNova PLC approved a restructuring plan to enhance the Company’s focus on its 
core  Cardiopulmonary  and  Neuromodulation  segments.  The  main  component  of  this  plan  is  to  wind  down  the  ACS  segment, 
which  the  Company  anticipates  will  be  substantially  complete  by  the  end  of  2024.  LivaNova  recognised  restructuring  expense 
under the 2024 Restructuring Plan of $0.1 million in other operating expenses, and $12.6 million for inventory obsolescence in 
cost  of  sales  on  its  consolidated  statement  of  (loss)  during  the  year  ended  31  December  2023.  Additionally,  the  Company 
determined  that  the  carrying  amount  of  the  ACS  asset  group  exceeded  the  recoverable  amount.  As  such,  LivaNova  recorded 
impairments  of  the  following  long-lived  assets  during  the  year  ended  31  December  2023,  included  within  impairment  of  long-
lived assets on its consolidated statement of (loss) (in thousands):

Intangible assets:

Developed technology     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Trade names    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property, plant and equipment     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Right-of-use assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total impairment of long-lived assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

78,067 
7,117 
3,894 
896 
89,974 

For additional information regarding LivaNova’s 2024 Restructuring Plan, refer to “Note 33. Subsequent Events.”

The following table presents a reconciliation of the beginning and ending balance of the accruals and other reserves recorded in 
connection with LivaNova’s restructuring plans included within current and long-term provisions and current other liabilities on 
the consolidated balance sheets for the years ended 31 December 2023 and 2022 (in thousands):

Employee Severance and 
Other Termination Costs

836 
6,611 
(5,402) 
2,045  (1)
956 
(2,090) 

As of 1 January 2022        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Charges     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cash payments    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
As of 31 December 2022        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Charges     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cash payments    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
As of 31 December 2023        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

911  (2)
(1) The restructuring plans' liabilities are recorded in the Consolidated Balance Sheet as $1.3 million within current and long-

term provisions and $0.7 million within current other liabilities as of 31 December 2022.

(2) The restructuring plans' liabilities are recorded in the Consolidated Balance Sheet as $0.1 million within current and long-

term provisions and $0.8 million within current other liabilities as of 31 December 2023.

The following table presents restructuring expense or reversal by reportable segment for the years ended 31 December 2023 and 
2022 (in thousands):

Cardiopulmonary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Neuromodulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Advanced Circulatory Support      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other (1)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

(55)  $ 
504 
27 
480 
956  $ 

697 
2,651 
1,999 
1,264 
6,611 

(1) Other restructuring expense primarily includes restructuring expense not allocated to segments.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________111

 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 9. Property, Plant and Equipment

Note 9. Property, Plant and Equipment

The following table presents the composition of property, plant and equipment as of 31 December 2023 and 2022 (in thousands):

Buildings and 
Building 
Improvements

Equipment, 
Other, 
Furniture, 
Fixtures

Capital 
Investment in 
Process

Total

Land

At 31 December 2023

Gross amount    . . . . . . . . . . . . . . . . . $ 
Accumulated depreciation and 
impairment         . . . . . . . . . . . . . . . . . .
Net amount     . . . . . . . . . . . . . . . . . . . . . . $ 
At 31 December 2022

Gross amount    . . . . . . . . . . . . . . . . . $ 
Accumulated depreciation and 
impairment         . . . . . . . . . . . . . . . . . .
Net amount     . . . . . . . . . . . . . . . . . . . . . . $ 

14,902  $ 

84,543  $ 

185,692  $ 

7,830  $ 

292,967 

— 
14,902  $ 

(31,106)   
53,437  $ 

(129,014)   
56,678  $ 

— 
7,830  $ 

(160,120) 
132,847 

14,637  $ 

80,611  $ 

174,352  $ 

7,355  $ 

276,955 

— 
14,637  $ 

(26,301)   
54,310  $ 

(118,354)   
55,998  $ 

— 
7,355  $ 

(144,655) 
132,300 

The following table presents the changes in the net amount of each category of property, plant and equipment for the years ended 
31 December 2023 and 2022 (in thousands):

Buildings and 
Building 
Improvements

Equipment, 
Other, 
Furniture, 
Fixtures

Capital 
Investment in 
Process

Total

Land

Net Amount at 1 January 2022      . . . . . . . $ 
Acquisition of ALung   . . . . . . . . . .
Additions      . . . . . . . . . . . . . . . . . . . .
Disposals      . . . . . . . . . . . . . . . . . . . .
Impairment        . . . . . . . . . . . . . . . . . .
Depreciation       . . . . . . . . . . . . . . . . .
Currency translation loss      . . . . . . . .
Reclassifications (1)     . . . . . . . . . . . .
Net Amount at 31 December 2022      . . . .
Additions      . . . . . . . . . . . . . . . . . . . .
Disposals      . . . . . . . . . . . . . . . . . . . .
Impairment        . . . . . . . . . . . . . . . . . .
Depreciation       . . . . . . . . . . . . . . . . .
Currency translation gain        . . . . . . .
Reclassifications      . . . . . . . . . . . . . .
Net Amount at 31 December 2023      . . . . $ 

15,099  $ 
— 
— 
— 
— 
— 
(462)   
— 
14,637 
— 
— 
— 
— 
265 
— 
14,902  $ 

56,368  $ 
— 
823 
(21)   
— 
(4,365)   
(1,546)   
3,051 
54,310 
689 
(55)   
— 
(4,615)   
510 
2,598 

53,437  $ 

59,430  $ 
44 
6,703 
(892)   
(325)   
(14,130)   
(2,672)   
7,840 
55,998 
12,348 
(2,222)   
(3,148)   
(15,068)   
1,061 
7,709 

56,678  $ 

10,203  $ 
— 
9,887 
(197)   
(363)   
— 
(487)   
(11,688)   
7,355 
11,423 

(98)   
(746)   
— 
203 
(10,307)   
7,830  $ 

141,100 
44 
17,413 
(1,110) 
(688) 
(18,495) 
(5,167) 
(797) 
132,300 
24,460 
(2,375) 
(3,894) 
(19,683) 
2,039 
— 
132,847 

(1) Total  reclassifications  during  the  year  ended  31  December  2022  represent  reclassifications  of  $0.8  million  to  intangible 

assets from capital investment in process as assets were placed into service.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________112

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 10. Goodwill and Intangible Assets

Note 10. Goodwill and Intangible Assets 

The following table presents the composition of goodwill and intangible assets as of 31 December 2023 and 2022 (in thousands):

Goodwill

Developed 
Technology

Customer 
Relationships

Trade 
Names

In-Process 
R&D 

Other 
Intangible 
Assets

Software

Total

Intangible Assets

At 31 December 2023

Gross amount      . . . . . . . . . . .
Accumulated amortisation    .

$  458,857 

$ 

103,490  $ 

187,196  $ 

13,280  $ 

112,000  $ 

779  $  57,000  $ 

473,745 

— 

(56,921) 

(84,647) 

(13,280) 

— 

(720) 

(35,718) 

(191,286) 

Net amount    . . . . . . . . . . . . . . . .

$  458,857 

$ 

46,569  $ 

102,549  $ 

—  $ 

112,000  $ 

59  $  21,282  $ 

282,459 

At 31 December 2022

Gross amount      . . . . . . . . . . .
Accumulated amortisation    .

$  453,794 

$ 

217,205  $ 

184,397  $ 

24,368  $ 

112,000  $ 

762  $  45,080  $ 

583,812 

— 

(80,219) 

(72,820) 

(16,483) 

— 

(650) 

(30,270) 

(200,442) 

Net amount    . . . . . . . . . . . . . . . .

$  453,794 

$ 

136,986  $ 

111,577  $ 

7,885  $ 

112,000  $ 

112  $  14,810  $ 

383,370 

The following table presents the changes in the net amount of each category of goodwill and intangible assets for the years ended 
31 December 2023 and 2022 (in thousands):

Net Amount at 1 January 2022     . . .
Acquisition    . . . . . . . . . . . . . .
Additions     . . . . . . . . . . . . . . . .

Amortisation     . . . . . . . . . . . . .
Impairment (1)     . . . . . . . . . . . .
Currency translation loss   . . . .
Reclassifications (1)

    . . . . . . . .
Net Amount at 31 December 2022     
Additions     . . . . . . . . . . . . . . . .

Amortisation     . . . . . . . . . . . . .
Impairment     . . . . . . . . . . . . . .
Currency translation gain /
(loss)        . . . . . . . . . . . . . . . . . . .

Goodwill

Developed 
Technology

Customer 
Relationships

Trade 
Names

In-Process 
R&D 

Other 
Intangible 
Assets

Software

Total

$  579,762 

$ 

151,218  $ 

127,694  $ 

8,654  $ 

112,000  $ 

118  $ 

8,839  $  408,523 

Intangible Assets

26,870 

— 

— 

  (144,990) 

(7,848) 

— 

2,900 

— 

(13,833) 

— 

(3,299) 

— 

  453,794 

136,986 

— 

— 

— 

— 

(14,066) 

(78,067) 

— 

— 

(10,540) 

— 

(5,577) 

— 

111,577 

— 

(10,587) 

— 

— 

— 

(769) 

— 

— 

— 

7,885 

— 

(768) 

(7,117) 

5,063 

1,716 

1,559 

— 

— 

— 

— 

— 

— 

— 

112,000 

— 

— 

— 

— 

— 

6 

— 

9,185 

2,900 

9,191 

(56) 

(3,846) 

(29,044) 

— 

(6) 

50 

112 

— 

(51) 

— 

(2) 

— 

(115) 

747 

— 

(8,997) 

797 

14,810 

  383,370 

11,488 

11,488 

(5,054) 

(30,526) 

— 

38 

(85,184) 

3,311 

Net Amount at 31 December 2023   

$  458,857 

$ 

46,569  $ 

102,549  $ 

—  $ 

112,000  $ 

59  $  21,282  $  282,459 

(1) Reclassifications during the year ended 31 December 2022 represent reclassification $0.8 million from capital investment in 

process to intangible assets as assets were placed into service.

Amortisation of intangible assets charged to the consolidated statement of (loss) totalled $30.5 million and $29.0 million for the 
year  ended  31  December  2023  and  31  December  2022,  respectively,  and  is  included  within  cost  of  sales,  selling,  general  and 
administrative and research and development.

The amortisation periods for LivaNova’s finite-lived intangible assets as of 31 December 2023 were as follows:

Developed technology (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Customer relationships (1)
     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Software      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14
8
3

17
18
5

(1) As  at  31  December  2023,  developed  technology  from  the  Merger  had  a  remaining  useful  life  of  7  to  10  years,  customer 

relationships from the Merger had a remaining useful life of 10 years. 

Minimum Life in Years Maximum Life in Years

The amortisation periods for LivaNova’s finite-lived intangible assets as of 31 December 2022 were as follows:

Developed technology (1)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Customer relationships (1)
    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Trade names    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Software    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14
8
15
3

17
18
15
5

(1) As  at  31  December  2022,  developed  technology  from  the  Merger  had  a  remaining  useful  life  of  8  to  11  years,  customer 
relationships from the Merger had a remaining useful life of 11 years, developed technology from the TandemLife acquisition 

Minimum Life in Years Maximum Life in Years

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________113

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 10. Goodwill and Intangible Assets

had a remaining useful life of 11 years and developed technology from the ALung acquisition had a remaining useful life of 
14 years.

Impairment of Goodwill and Intangible Assets

The  Company’s  CGUs  consist  of  Cardiopulmonary,  Obstructive  Sleep  Apnea,  and  Neuromodulation.  The  carrying  amount  of 
goodwill by CGU as of 31 December 2023 and 2022 were as follows (in thousands): 

      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Cardiopulmonary (1)
Obstructive Sleep Apnea      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Neuromodulation       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

60,103  $ 
82,595 
316,159 
458,857  $ 

55,040 
82,595 
316,159 
453,794 

(1) Cardiopulmonary  goodwill  is  primarily  denominated  in  foreign  currencies  and  is  therefore  subject  to  foreign  exchange 

fluctuations.

LivaNova performed quantitative assessments of the Company’s CGUs as of 31 December 2023 and 2022 in accordance with IAS 
36 "Impairment of Assets." The methodology applied to the Company’s CGUs was fair value less cost of disposal, reflecting past 
experience  and  external  sources  of  information,  including  Board  approved  budgets  covering  a  five-year  period.  Cash  flows 
beyond  the  five-year  period  are  projected  using  the  estimated  growth  rates,  which  are  consistent  with  forecasts  included  in 
industry reports specific to the industry in which each CGU operates. Additionally, these calculations use cash flow projections 
with post-tax discount rates derived from the Company’s benchmarked WACC and an expected short-term revenue growth rate 
for  all  CGUs.  The  Company  has  considered  climate  risk  in  relation  to  impairment  testing  of  goodwill.  While  climate-related 
matters can affect future cash flows and the carrying value being tested, no such impacts were identified related to the impairment 
tests in 2023 or 2022.

As part of LivaNova’s 2022 goodwill impairment assessment, the Company considered that revenue for LivaNova’s ACS CGU 
had declined compared to the prior year period, primarily as a result of a reduction in severe COVID-19 cases, hospital-related 
challenges and product mix. Furthermore, future revenue projections were reduced. Based on these circumstances, the Company 
concluded that the goodwill of LivaNova’s ACS CGU was impaired, including goodwill recognised as part of the acquisition of 
ALung in 2022 (refer to “Note 7. Business Combinations”). The Company performed a quantitative assessment of the goodwill 
using management’s current estimate of future cash flows. Based on the valuation performed, LivaNova determined that the fair 
value  less  cost  of  disposal  of  the  ACS  CGU  was  less  than  the  carrying  value  and  recognised  a  goodwill  impairment  of  $145.0 
million in the Company’s consolidated statement of (loss) during the year ended 31 December 2022.

LivaNova also performed quantitative assessments of the IPR&D recognised in conjunction with the acquisition of ImThera as of 
31 December 2023 and 2022. The fair value less cost of disposal calculation was based on a projection period of 23 years. The 
assessment included a discounted cash flow model test that included a discount rate and an expected short-term revenue growth 
rate. Based on the assessments performed, the Company determined that the IPR&D asset was not impaired. The fair value less 
cost  of  disposal  of  the  IPR&D  asset  recognised  in  conjunction  with  the  acquisition  of  ImThera  exceeded  its  carrying  value  by 
approximately 72.6% or $81.3 million as of 31 December 2023 and by approximately 23.7% or $26.5 million as of 31 December 
2022.

The following tables presents the key assumptions used in performing the goodwill and IPR&D quantitative assessments as of 31 
December 2023 and 2022:

Short-term 
Revenue Growth 
Rate

2023
Short-term 
Revenue Growth 
Rate Years

Goodwill

Cardiopulmonary    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Neuromodulation    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
OSA    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.2% - 13.2%
4.0% - 9.3%
4.0% - 1,468.7%

2024 - 2028
2024 - 2029
2025 - 2038

Indefinite-lived Intangible Assets

Discount 
Rate

12.0%
10.5%
19.0%

IPR&D   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.0% - 1,468.7%

2025 - 2038

18.0%

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________114

 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 10. Goodwill and Intangible Assets

Short-term 
Revenue 
Growth Rate

Short-term 
Revenue 
Growth Rate 
Years

2022

Discount 
Rate

Long-term 
Terminal 
Growth Rate

Long-term 
Terminal Growth 
Rate Year

Goodwill

Cardiopulmonary       . . . . . . . . . . . . .
Neuromodulation       . . . . . . . . . . . . .
OSA      . . . . . . . . . . . . . . . . . . . . . . .
ACS      . . . . . . . . . . . . . . . . . . . . . . .

3.3% - 17.0%
3.7% - 13.2%
5.7% - 710.2%
6.1% - 37.4%

2023 - 2027
2023 - 2027
2025 - 2037
2024 - 2035

11.5%
11.2%
20.0%
15.5%

Indefinite-lived Intangible Assets

IPR&D       . . . . . . . . . . . . . . . . . . . . .

2.0% - 710.2%

2025 - 2037

19.0%

2.0%
2.0%
2.0%
2.0%

N/A

2028+
2028+
2038+
2036+

N/A

The fair value less cost of disposal models used for calculating the recoverable amount is most sensitive to the discount rate, the 
expected  short-term  revenue  growth  rate  and  the  OSA  CGU’s  commercialisation  date.  The  Company  performed  a  sensitivity 
analysis, as of 31 December 2023, for each of these assumptions for each CGU, as applicable, including an increase of 0.5% in the 
discount rate used, a decrease of 0.5% in the expected short-term revenue growth rate and a one-year delay of the OSA CGU’s 
commercialisation  date,  which  LivaNova  considers  to  be  reasonably  possible  changes.  None  of  these  reasonably  possible 
scenarios would result in an impairment of any CGU except for OSA with a one-year delay in commercialisation. A hypothetical 
one-year delay in commercialisation would result in an impairment of the OSA CGU’s goodwill of approximately $9.4 million.

Note 11. Investments in Subsidiaries

Subsidiaries. The Company had the following subsidiaries as of 31 December 2023:

Entity

LivaNova PLC (Italian Branch)

ALung Technologies, Inc.

Caisson Interventional, LLC

Registered Office
Via Enrico Cialdini, 16, 20161 Milano Italy

2500 Jane St., Ste 100, Pittsburgh, PA 15203

6500 Wedgwood Rd., Maple Grove, MN 55311

CardiacAssist, Inc. Dba TandemLife

620 Alpha Drive, Ste 200, Pittsburgh, PA 15238

ImThera Medical, Inc.

100 Cyberonics Boulevard, Houston, TX 77058 USA

LivaNova Australia PTY Limited

Unit 1, 63 Wells Road, Chelsea Heights VIC 3196

LivaNova Austria GmbH

LivaNova Belgium NV

Millennium Tower, Handelskai 94-96, 1200 Wien

Ikaroslaan 83, 1930 Zaventem, Belgium

LivaNova Brasil Comércio e Distribuição de 
Equipamentos Médico-hospitalares Ltda

LivaNova Canada Inc.

LivaNova Cayman Limited

Rua Liege, 54 – Vila Vermelha, 04298-070 – São Paulo - SP - Brasil

8-280 Hillmount Road Markham, ON L6C 3A1

Centralis Cayman Limited
One Capital Place, 3rd Floor
George Town, Grand Cayman
PO Box 1564, Cayman Islands KY1-1110

LivaNova Chile SpA

LivaNova Colombia Sas

Calle Miraflores 222, piso 28 Norte, Santiago, Chile

Avenida Calle 80 No. 69-70 Bodega 37, Bogotá, Colombia

LivaNova Deutschland GmbH

Lindberghstrasse 25, D - 80939 München, Germany

LivaNova España, S.L.

LivaNova Finland OY

Paseo de Gracia 6 1 – 2 08007 Barcelona , Spain

c/o Kalliolaw Asianajotoimisto Oy, Södra kajen 12, 00130 Helsinki, 
Finland

LivaNova Holding S.r.l.

Via Enrico Cialdini, 16, 20161 Milano Italy

LivaNova Hong Kong Limited

4008-4009, 40/F, One Pacific Place, 88 Queensway, Hong Kong

LivaNova Hungary Limited Liability 
Company

LivaNova, Inc.

LivaNova India Private Limited

LivaNova IP Limited

LivaNova Japan K.K.

LivaNova (Thailand) Ltd

Centralis Hungary, 1062 Budapest, Váci út 1-3. "A" torony. ép. 6. em.

100 Cyberonics Boulevard, Houston, TX 77058 USA

603-A, Copia Corporate Suites, Building #09, Jasola District Centre, 
New Delhi, India 110025

20 Eastbourne Terrace, London, England W2 6LG, United Kingdom

11-1 Nagatacho 2 chome, Chiyoda-ku, Tokyo, 100-6110 Japan

999, Gaysorn Building, 5th Floor, Unit 5B-1, Room no 535 ,509-510 
Ploenchit Rd., Lumpini, Patumwan, Bangkok 103304

LivaNova (China) Medical Technology Co. 
Ltd

Room 218, 2nd Floor,No.56 Meisheng Road, Shanghai Pilot Free 
Trade Zone, China

LivaNova Malaysia Sdn. Bhd.

LivaNova Nederland N.V.
LivaNova Norway AS

LivaNova Poland Sp. Z o.o.

Unit A-3-6, TTDI Plaza, Jalan Wan Kadir 3, Taman Tun Dr Ismail, 
60000 Kuala Lumpur, Malaysia

Westerdoksdijk 423, 1013 BX, Amsterdam, Netherlands
c/o AmestoAccounthouse AS, Smeltedigelen 1, 0195 Oslo, Norway

Park Postepu Bud A Ul. Postepu 21 PL-02 676 Warszawa, Poland

Country of 
Incorporation
Italy

% Consolidated
Group 
Ownership
100

US

US

US

US

Australia

Austria

Belgium

Brazil

Canada

Cayman Islands

Chile

Colombia

Germany

Spain

Finland

Italy

Hong Kong

Hungary

US

India

UK

Japan

Thailand

China

Malaysia

Netherlands

Norway

Poland

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

99.99

100

100

99.997

100

100

100

100

100

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________115

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 11. Investments in Subsidiaries

Entity

LivaNova SAS

LivaNova Scandinavia AB
LivaNova Singapore Pte Ltd

LivaNova Site Management S.r.l.
LivaNova Switzerland SA
LivaNova Taiwan Co. Ltd
LivaNova Turkey Medikal Limited Sirketi

LivaNova UK Limited

LivaNova USA, Inc.
LIVN Irishco 2 UC
LIVN Luxco 2 sarl (1)
LIVN UK 2 Co Limited
LIVN UK Holdco Limited
LIVN US 3, LLC

LIVN US 5, LLC

Sorin Group Italia S.r.l.

Sorin Group Rus LLC

Registered Office

24 rue du Gouverneur Général Éboué, 92130 Issy-les-Moulineaux, 
France

Djupdalsvägen 16, 192 51 Sollentuna, Sweden
11 North Buona Vista Drive #13-09, The Metropolis, Singapore 
138589

Via Enrico Cialdini, 16, 20161 Milano Italy
Rue du Grand-Pont 12, 1003 Lausanne
12F, No. 101, Songren Rd. Taipei City, 110414 Taiwan
Esentepe Mahallesi Ecza Sk. Pol Center Sit. C Blok Apt No: 4/1 Sisli/
Istanbul

1370 Montpellier Court, Gloucester Business Park, Gloucester, 
Gloucestershire, GL3 4AH, United Kingdom

100 Cyberonics Boulevard, Houston, TX 77058 USA
Deloitte, 6 Lapps Quay, Cork, T12 TA48, Ireland
15 Rue Edward Steichen L-2540 Luxembourg
20 Eastbourne Terrace, London, England W2 6LG, United Kingdom
20 Eastbourne Terrace, London, England W2 6LG, United Kingdom
100 Cyberonics Boulevard, Houston, TX 77058 USA

100 Cyberonics Boulevard, Houston, TX 77058 USA

Via Enrico Cialdini, 16, 20161 Milano Italy

Marshal Proshlyakov str. 30 office 304 123458 Moscow, Russia

Country of 
Incorporation
France

% Consolidated
Group 
Ownership
100

Sweden

Singapore

Italy

Switzerland

Taiwan

Turkey

UK

US

Ireland

Luxembourg

UK

UK

US

US

Italy

Russia

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

(1) LIVN Luxco 2 sarl was liquidated in December 2023.

All subsidiary undertakings are included in the consolidation. The proportion of the voting rights in the subsidiary undertakings 
held directly by the parent company do not differ from the proportion of Ordinary Shares held.

The  following  tables  present  the  statutory  operating  results  of  Group  companies  that  represent  5%  or  higher  of  external  net 
revenue during the years ended 31 December 2023 and 2022: 

Sorin Group Italia S.r.l. (in thousands of Euros)
Net revenue, including intercompany sales        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Earnings before interest and taxes    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net loss      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2023

2022

243,246 

(6,920)   
(6,169)   

224,078 
(4,281) 
(4,483) 

LivaNova Deutschland GmbH (1) (in thousands of Euros)
Net revenue, including intercompany sales        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Earnings before interest and taxes    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net profit    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2023

2022

151,469 
17,355 
11,046 

103,190 
4,213 
2,276 

(1) LivaNova  Deutschland  GmbH  is  a  100%  consolidated  LivaNova  group  company  that  is  formally  exempt  from  GERMAN 

GAAP auditing and publishing. 

LivaNova USA, Inc. (1) (in thousands of USD)
Net revenue, including intercompany sales        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Earnings before interest and taxes    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net loss      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2023

2022

862,631 
(229,525)   
(341,916)   

766,482 
(13,389) 
(65,340) 

(1) The amounts for LivaNova USA, Inc. are presented under generally accepted accounting principles in the US as there is no 

statutory reporting requirement.

Note 12. Financial Assets 

The following table presents the composition of non-current financial assets as of 31 December 2023 and 2022 (in thousands):

Investments in equity instruments in privately-held companies      . . . . . . . . . . . . . . . . . . $ 
Corporate owned life insurance policies     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prepaid finance costs     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial receivable due from equity investment       . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

19,907  $ 
6,883 
1,315 
275 
28,380  $ 

14,288 
6,259 
1,599 
285 
22,431 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________116

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 12. Financial Assets

The following table lists LivaNova’s non-current financial assets of investments in equity instruments in privately-held companies 
held at cost as of 31 December 2023 and 2022, which the Company believes it is an appropriate estimate of fair value unless more 
recent information is available sufficient to measure fair value, in the consolidated balance sheet (in thousands):

Percent Ownership

2023

2022

ShiraTronics, Inc.     . .

13.6%

13.4%

Cadence 
Neuroscience, Inc.       .

9.1%

0.0%

Noctrix Health, Inc.     

10.5%

10.5%

Ceribell, Inc.      . . . . . .

MD Start II      . . . . . . .

Rainbow Medical 
Ltd.    . . . . . . . . . . . . .

1.4%

9.3%

1.6%

3.0%

9.3%

1.6%

Security
Series A 
Preferred 
Shares
Series B 
Preferred 
Shares
Series A 
Preferred 
Shares
Series B 
Preferred 
Shares
Series A 
Shares

Ordinary 
Shares
Series A 
Preferred 
Shares

Address
9210 Wyoming Ave. N., 
Suite 275, Brooklyn Center, 
MN 55445

Fair Value

2023

2022

$ 

5,750  $ 

5,000 

8201 164th Ave NE Suite 
330, Redmond, WA 98052

5,000 

— 

724 Brannan St., San 
Francisco, CA 94103

360 N Pastoria Avenue 
Sunnyvale, CA 94085
7-11 bd Haussmann, 75009 
Paris, France
85 Medinat Hayehudim St., 
Business Park, G Building, 
Herzeliya Pituach, Israel

100 Avenue de Suffren, 
75015 Paris, France

3,159 

3,159 

3,000 

3,000 

865 

1,069 

1,084 

1,047 

1,049 
19,907  $ 

1,013 
14,288 

Highlife SAS       . . . . .
Total    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

7.0%

7.0%

The  table  below  lists  LivaNova’s  non-current  equity  investments  in  associates  totalling  $2.9  million  and  $2.0  million  as  of  31 
December 2023 and 2022, respectively, which are included within other assets on the consolidated balance sheets: 

MD Start I K.G.     . . . . . . . . . . . . . . . . . . . . .

2023
23.4%

Enopace Biomedical Ltd.    . . . . . . . . . . . . . .

34.5%

2022
23.4%

34.5%

Percent Ownership

Address

7-11 bd Haussmann, 75009 Paris, France
15 Alon ha-Tavor Street, Caesarea, Haifa 
District, Israel
375 West Street, West Bridgewater, MA 
02379
Route de Revel, 31450 Fourquevaux, France
7-11 bd Haussmann, 75009 Paris, France

Cardiosolutions, Inc.       . . . . . . . . . . . . . . . . .
La Bouscarre S.C.I.    . . . . . . . . . . . . . . . . . .
MD Start III (1)    . . . . . . . . . . . . . . . . . . . . . .
(1) As  of  31  December  2023,  LivaNova  is  required  to  fund  follow-on  investments  up  to  approximately  €1.9  million 

35.3%
50.0%
10.4%

35.3%
50.0%
7.9%

(approximately $2.0 million as of 31 December 2023) based on cash calls.

The following table presents the composition of current financial assets as of 31 December 2023 and 2022 (in thousands):

Other receivables     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Derivative financial instruments (1)
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

483  $ 
— 

483  $ 

1,679 
1,333 
3,012 

(1) For additional information refer to “Note 15. Derivative Financial Instruments.”

2023

2022

Note 13. Inventories 

The following table presents the composition of inventories as of 31 December 2023 and 2022 (in thousands):

Raw materials     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Work-in-process    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finished goods       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

81,878  $ 
12,901 
53,108 

147,887  $ 

70,027 
15,508 
43,844 
129,379 

2023

2022

Inventory charged to cost of sales for the years ended 31 December 2023 and 2022 totalled $282.0 million and $238.9 million, 
respectively. Inventories are reported net of the provision for obsolescence which totalled $24.4 million and $8.2 million as of 31 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________117

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 13. Inventories

December  2023  and  31  December  2022,  respectively.  The  provisions  for  obsolescence  at  31  December  2023  and  2022  reflect 
normal obsolescence and includes components that are phased out or expired.

Note 14. Trade Receivables and Other Receivables 

The following table presents the composition of net trade receivables as of 31 December 2023 and 2022 (in thousands):

2023

2022

Trade receivables from third parties    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Expected credit loss provision     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

227,091  $ 
(12,019)   
215,072  $ 

194,972 
(11,862) 
183,110 

LivaNova’s customers consist of hospitals, other healthcare institutions, distributors, organised purchase groups and government 
and private entities. Actual collection periods for trade receivables vary significantly as a function of the nature of the customer 
(e.g. government or private) and its geographic location. 

Trade receivables are reported net of the expected credit loss provision. The following table presents the changes in the expected 
credit loss provision for the years ended 31 December 2023 and 2022 (in thousands):

Beginning of year     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Additions to provision   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Utilisation     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Currency translation (loss) / gain      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
End of year    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

(11,862)  $ 
(399)   
662 
(420)   
(12,019)  $ 

(13,511) 
(186) 
1,175 
660 
(11,862) 

The following table presents the composition of other receivables as of 31 December 2023 and 2022 (in thousands):

Prepaid assets and other current receivables       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Deposit and advances to suppliers      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Guarantee deposits      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Note 15. Derivative Financial Instruments 

2023

2022

18,233  $ 
7,722 
744 
26,699  $ 

16,709 
5,778 
822 
23,309 

Due  to  the  global  nature  of  LivaNova’s  operations,  the  Company  is  exposed  to  foreign  currency  exchange  rate  fluctuations. 
Historically, the Company has entered into foreign FX derivative contracts and interest rate swap contracts to reduce the impact of 
foreign currency exchange rate and interest rate fluctuations, respectively, on earnings and cash flow. 

LivaNova  is  also  exposed  to  equity  price  risk  in  connection  with  the  Company’s  Notes,  including  exchange  and  settlement 
provisions based on the price of LivaNova’s Ordinary Shares at exchange or maturity of the Notes. In addition, the 2025 Capped 
Calls  associated  with  the  2025  Notes  also  include  settlement  provisions  that  are  based  on  the  price  of  LivaNova’s  Ordinary 
Shares, subject to a capped price per share. The Company does not enter into derivative contracts for speculative purposes.

LivaNova measures all outstanding derivatives each period end at fair value and report the fair value as either financial assets or 
liabilities  on  the  consolidated  balance  sheets.  At  inception  of  the  contract,  the  derivative  is  designated  as  either  a  freestanding 
derivative or a hedge. Derivatives that are not designated as hedging instruments are referred to as freestanding derivatives with 
changes in fair value included in earnings. These derivatives are intended to serve as economic hedges and follow the cash flows 
of the economic hedged item. The cash flows from these derivative contracts are reported as operating activities on LivaNova’s 
consolidated statements of cash flows.

If  the  derivative  qualifies  for  hedge  accounting,  changes  in  the  fair  value  of  the  derivative  will  be  recorded  in  AOCI  until  the 
hedged  item  is  recognised  in  earnings  upon  settlement/termination.  FX  derivative  gains  and  losses  in  AOCI  are  reclassified  to 
LivaNova’s consolidated statement of (loss) as shown in the tables below, and interest rate swap gains and losses in AOCI are 
reclassified to finance expenses on LivaNova’s consolidated statement of (loss). The Company evaluates hedge effectiveness at 
inception. Cash flows from derivative contracts are reported as operating activities on the Company’s consolidated statements of 
cash flows.

Freestanding FX Derivative Contracts

The gross notional amount of FX derivative contracts not designated as hedging instruments, outstanding as of 31 December 2023 
and 2022, was $223.4 million and $154.5 million, respectively. These derivative contracts are designed to offset the FX effects in 
earnings of various intercompany loans and trade receivables. The Company recorded net loss for these freestanding derivatives of 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________118

 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 15. Derivative Financial Instruments

$1.3 million and net gain of $4.5 million for the years ended 31 December 2023 and 2022, respectively. These gains and (losses) 
are included in net foreign exchange and other income/(expense) on the Company’s consolidated statement of (loss).

Counterparty Credit Risk

LivaNova is exposed to credit risk in the event of non-performance by the counterparties to the Company’s derivatives.

The two counterparties to the 2025 Capped Calls are financial institutions. To limit the Company’s credit risk, LivaNova selected 
financial institutions with a minimum long-term investment grade credit rating. The Company’s exposure to the credit risk of the 
counterparties is not secured by any collateral. If a counterparty becomes subject to insolvency proceedings, the Company will 
become  an  unsecured  creditor  in  those  proceedings,  with  a  claim  equal  to  LivaNova’s  exposure  at  that  time  under  the  2025 
Capped Calls with that counterparty.

To manage credit risk with respect to LivaNova’s other derivatives, the Company selects and periodically reviews counterparties 
based on credit ratings, limits its exposure with respect to each counterparty, and monitors the market positions. However, if one 
or  more  of  these  counterparties  were  in  a  liability  position  to  the  Company  and  were  unable  to  meet  their  obligations,  any 
transactions with the counterparty could be subject to early termination, which could result in substantial losses for the Company.

Cash Flow Hedges

Foreign Currency Risk. Historically, the Company has utilised FX derivative contracts, designed as cash flow hedges, to hedge 
the  variability  of  cash  flows  associated  with  LivaNova’s  12-month  US  dollar  forecasts  of  revenues  and  costs  denominated  in 
British  Pound,  Japanese  Yen  and  the  Euro.  LivaNova  transfers  to  earnings  from  AOCI  the  gain  or  loss  realised  on  the  FX 
derivative contracts at the time of invoicing. Upon the settlement of LivaNova’s foreign currency cash flow hedges in 2022 and 
following  an  in-depth  analysis  of  the  utility  of  LivaNova’s  cash  flow  hedging  program,  LivaNova  discontinued  its  foreign 
currency cash flow hedging program.

Interest  Rate  Risk.  Historically,  LivaNova  entered  into  interest  rate  swaps  associated  with  the  Initial  Term  Facility,  which 
qualified for and were designated as cash flow hedges. The Company’s interest rate swaps expired on 6 April 2023. LivaNova 
elected not to renew the interest rate swaps as finance expenses associated with the Initial Term Facility is principally offset by 
holding a significant portion of the Initial Term Facility in a depository account, which earns a floating rate of interest.

There was no hedge ineffectiveness or component of FX derivative contracts excluded in the measurement of hedge effectiveness 
during the years ended 31 December 2023 and 31 December 2022.

The gross notional amounts of open derivative contracts designated as cash flow hedges for interest rate swap contracts as of 31 
December 2023 and 2022 was nil and $0.2 million, respectively.

The after-tax net gain (loss) associated with derivatives designated as cash flow hedges for interest rate swap contracts recorded in 
the ending balance of AOCI and the amount expected to be reclassified to earnings in the next 12 months as of 31 December 2023 
and 2022 was nil and $1.0 million, respectively.

Presentation in Financial Statements

The following tables present the pre-tax (losses) gains for derivative contracts designated as cash flow hedges recognised in OCI 
and the amount reclassified to earnings from AOCI for the years ended 31 December 2023 and 2022 (in thousands):

2023

Description of Derivative Contract
Interest rate swap contracts      . . . . . . . . . . . Finance expenses      . . . . . . . . . . . . . . . . . . . $ 
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Location in Earnings of
Reclassified Gain or Loss

Loss Recognised 
in OCI

Description of Derivative Contract

Location in Earnings of
Reclassified Gain or Loss
Net foreign exchange and other income/
(expense)       . . . . . . . . . . . . . . . . . . . . . . . . . $ 

FX derivative contracts     . . . . . . . . . . . . . .
FX derivative contracts     . . . . . . . . . . . . . . SG&A     . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest rate swap contracts      . . . . . . . . . . . Finance expenses      . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Gain Reclassified
from AOCI to
Earnings

(433)  $ 
(433)  $ 

2022

533 
533 

(Loss) Gain 
Recognised in 
OCI

Loss Reclassified
from AOCI to
Earnings

(4,602)  $ 
— 
914 
(3,688)  $ 

(382) 
(5,165) 
(52) 
(5,599) 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________119

 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 15. Derivative Financial Instruments

LivaNova offsets fair value amounts associated with the Company’s derivative instruments on its consolidated balance sheets that 
are executed with the same counterparty under master netting arrangements. The Company’s netting arrangements include a right 
to set off or net together purchases and sales of similar products in the settlement process.

The following tables present the fair value, and the location of, derivative contracts reported on the consolidated balance sheets as 
of 31 December 2023 and 2022 (in thousands):

2023
Derivatives Not Designated as 
Hedging Instruments

Asset Derivatives

Liability Derivatives

Balance Sheet Location

Fair Value (1)

Balance Sheet Location

Fair Value (1)

Capped call derivatives        . . . . . .

Long-term financial derivative 
assets       . . . . . . . . . . . . . . . . . . . $ 

38,496 

FX derivative contracts     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Embedded exchange feature        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Accrued liabilities and 
other    . . . . . . . . . . . . . . . . . . $ 

Long-term financial 
derivative liabilities    . . . . . .

Total derivatives not designated as hedging instruments     . . . . . . .

38,496 

         . . . . . . . . . . . . . . . . . . . . .

Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

38,496 

         . . . . . . . . . . . . . . . . . . . . . $ 

3,883 

45,569 

49,452 

49,452 

(1) For  the  classification  of  input  used  to  evaluate  the  fair  value  of  the  Company’s  derivatives,  refer  to  “Note  5.  Fair  Value 

Measurements.”

2022
Derivatives Designated as 
Hedging Instruments

Interest rate swap contracts       . . .
Total derivatives designated as hedging instruments    . . . . . . .

1,333 
1,333 

Balance Sheet Location
Prepaid expenses and other 
current assets     . . . . . . . . . . . . . $ 

Asset Derivatives

Liability Derivatives

Fair Value (1)

Balance Sheet Location

Fair Value (1)

Derivatives Not Designated as 
Hedging Instruments

FX derivative contracts     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Accrued liabilities and 
other    . . . . . . . . . . . . . . . . . . $ 

5,886 

Capped call derivatives        . . . . . .

Long-term financial derivative 
assets       . . . . . . . . . . . . . . . . . . .

Embedded exchange feature   . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total derivatives not designated as hedging instruments     . . . . . . .
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

54,393 

54,393 
55,726 

Long-term financial 
derivative liabilities    . . . . . .
         . . . . . . . . . . . . . . . . . . . . .
         . . . . . . . . . . . . . . . . . . . . . $ 

85,675 
91,561 
91,561 

(1) For  the  classification  of  inputs  used  to  evaluate  the  fair  value  of  the  Company’s  derivatives,  refer  to  “Note  5.  Fair  Value 

Measurements.”

Note 16. Shareholders’ Equity 

LivaNova  is  incorporated  in  England  and  Wales  as  a  public  company  limited  by  shares.  The  principal  legislation  under  which 
LivaNova  operates  is  the  Companies  Act  2006,  and  regulations  made  thereunder.  LivaNova  Ordinary  Shares  were  registered 
under the US Securities Act, pursuant to the Registration Statement on Form S-4 (File No. 333-203510), as amended, filed with 
the SEC by LivaNova and declared effective on 19 August 2015. LivaNova’s Ordinary Shares are listed on the Nasdaq under the 
ticker symbol “LIVN.” 

The following table presents LivaNova PLC’s authorised share capital as of 31 December 2023 and 2022 (in number of shares):

Authorised share capital, Ordinary Shares of £1 each, unlimited shares authorised
Issued (1)
     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Outstanding    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1)  Allotted, fully paid and issued. 

2023

2022

53,942,151 
53,918,222 

53,851,979 
53,564,664 

Preferred shares. LivaNova may issue preferred shares by special resolution or by determination by the Board of LivaNova.

Group  reconstruction  reserve.  The  'Group  reconstruction  reserve'  represents  the  excess  of  value  attributed  to  shares  and  share 
appreciation rights issued during the acquisition of Sorin S.p.A on 19 October 2015 over the nominal value of those shares and 
share  rights.  Additionally,  on  6  August  2021,  the  Company  closed  an  offering  and  issued  4,181,818  ordinary  shares,  par  value 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________120

 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 16. Shareholders' Equity

£1.00 per share, at an offering price of $82.50 per share. Net proceeds from the offering were approximately $322.5 million, after 
deducting  underwriting  discounts,  commissions  and  offering  expenses,  of  which  $316.7  million  was  recognised  as  group 
reconstruction reserve.

Treasury shares. Shares held by the EBT are issued to employees and directors at exercise of share-based compensation grants. 
The  balance  of  shares  in  the  EBT  are  reported  as  treasury  shares.  LivaNova  PLC  did  not  issue  any  additional  shares  to  the 
Company’s EBT during the years ended 31 December 2023 or 31 December 2022. As of 31 December 2023 and 2022, LivaNova 
held 23,929 and 287,315 shares in treasury.

AOCI.  The  table  below  presents  the  change  in  each  component  of  AOCI,  net  of  tax  and  the  reclassifications  out  of  AOCI  into 
accumulated losses (in thousands). Taxes were not provided for foreign currency translation adjustments for the years ended 31 
December 2023 and 2022 as translation adjustment related to earnings are intended to be reinvested in the countries where earned.

Beginning Balance - 1 January 2022     . . . . . . . . . . . . . . $ 

(945)  $ 

(2,206)  $ 

(2,133)  $ 

(5,284) 

Change in 
Unrealised 
(Loss) Gain on 
Derivatives

Foreign 
Currency 
Translation 
Adjustments

Revaluation of 
Net (Asset) 
Liability for 
Defined Benefits

Total

Other comprehensive (loss) income before 
reclassifications, before tax    . . . . . . . . . . . . . .
Tax benefit    . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other comprehensive (loss) income before 
reclassifications, net of tax   . . . . . . . . . . . . . . . . .
Reclassification of loss from accumulated 
other comprehensive loss, before tax        . . . . . .
Tax effect    . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reclassification of loss from accumulated other 
comprehensive loss, after tax      . . . . . . . . . . . . . . .
Net other comprehensive income (loss), net of tax     .
Ending Balance - 31 December 2022      . . . . . . . . . . . . .

Other comprehensive (loss) income before 
reclassifications, before tax    . . . . . . . . . . . . . .
Tax benefit    . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other comprehensive (loss) income before 
reclassifications, net of tax   . . . . . . . . . . . . . . . . .
Reclassification of gain from accumulated 
other comprehensive loss, before tax        . . . . . .
Tax effect    . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reclassification of gain from accumulated other 
comprehensive loss, after tax      . . . . . . . . . . . . . . .
Net other comprehensive (loss) income, net of tax     .
Ending Balance - 31 December 2023      . . . . . . . . . . . . . $ 

Note 17. Financial Liabilities 

(3,688)   
— 

(22,170)   

— 

915 
38 

(24,943) 
38 

(3,688)   

(22,170)   

953 

(24,905) 

5,599 
— 

5,599 
1,911 
966 

(433)   
— 

(433)   

(533)   
— 

(533)   
(966)   

—  $ 

— 
— 

— 

(22,170)   
(24,376)   

12,045 
— 

12,045 

— 
— 

— 
— 

5,599 
— 

— 
953 
(1,180)   

5,599 
(19,306) 
(24,590) 

(190)   
9 

11,422 
9 

(181)   

11,431 

— 
— 

(533) 
— 

— 
12,045 
(12,331)  $ 

— 
(181)   
(1,361)  $ 

(533) 
10,898 
(13,692) 

The  following  table  presents  the  outstanding  principal  amounts  of  LivaNova’s  unsecured  long-term  debt  facilities  as  of  31 
December 2023 and 2022 (in thousands, except interest rates):

Term Facilities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2020 Cash Exchangeable Senior Notes   . . . . . . . . . . . . . . . .
Bank of America, US (1)    . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bank of America Merrill Lynch Banco Múltiplo S.A.     . . . . .
Mediocredito Italiano      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total long-term facilities       . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less current portion of long-term debt    . . . . . . . . . . . . . . . . .
Total long-term debt obligations       . . . . . . . . . . . . . . . . . . . . . $ 

Maturity
July 2027

239,568  December 2025
January 2025
N/A
N/A

2022

2023
328,459  $  289,294 
255,500 
1,500 
1,500 
6,462 
— 
1,601 
— 
511 
542 
538,936 
586,001 
20,892 
17,484 
568,517  $  518,044 

Interest Rate
9.02%
3.00%
8.09%
16.2%
0.50% - 3.47%

(1) Represents  borrowings  with  a  LIBOR-based  variable  interest  rate  that  has  not  yet  transitioned  to  SOFR  or  an  alternative 

interest rate benchmark.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________121

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 17. Financial Liabilities

The following table presents the movements associated with the outstanding principal amounts of LivaNova’s long-term debt for 
the year ended 31 December 2023 (in thousands):

Beginning of 
Fiscal Year 
2023

 Borrowing

Scheduled 
Principal 
Reductions

Amortisation 
of Prepaid 
Loan Fees

FX - 
Translation 
and Other

End of 
Fiscal Year 
2023

Term Facilities    . . . . . . . . . . . . . . . . . . . . . . . . . . $  289,294  $ 
2020 Cash Exchangeable Senior Notes    . . . . . . .
Bank of America, US      . . . . . . . . . . . . . . . . . . . .
Bank of America Merrill Lynch Banco 
Múltiplo S.A.     . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mediocredito Italiano       . . . . . . . . . . . . . . . . . . . .
Other       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  538,936  $ 

1,601 
511 

239,568 

6,462 

1,500 

50,000  $ 

(12,813)  $ 

1,978  $ 

—  $  328,459 

— 

— 

— 

— 
— 
50,000  $ 

— 

— 

(7,143)   

(1,668)   
— 
(21,624)  $ 

15,932 

— 

— 

— 

— 

681 

255,500 

1,500 

— 

— 
— 
17,910  $ 

— 
67 
31 
542 
779  $  586,001 

The following table presents the movements associated with the outstanding principal amounts of LivaNova’s long-term debt for 
the year ended 31 December 2022 (in thousands):

Beginning of 
Fiscal Year 
2022

Net 
Borrowings

Scheduled 
Principal 
Reductions

Amortisation 
of Prepaid 
Loan Fees

FX - 
Translation 
and Other

End of 
Fiscal Year 
2022

—  $  290,377  $ 

(1,875)  $ 

792  $ 

—  $  289,294 

Term Facilities        . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2020 Cash Exchangeable Senior Notes   . . . . . . .
Bank of America Merrill Lynch Banco 
Múltiplo S.A.   . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mediocredito Italiano        . . . . . . . . . . . . . . . . . . . .

225,140 

6,113 

3,379 

— 

— 

— 

Bank of America, US      . . . . . . . . . . . . . . . . . . . .
Bridge Loan Facility      . . . . . . . . . . . . . . . . . . . . .
Other    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  236,732  $  505,857  $ 

— 
215,480 
— 

1,500 
— 
600 

— 

— 

(1,594)   

— 

(220,000)   

— 

(223,469)  $ 

14,428 

— 

239,568 

— 

— 

— 
4,520 
— 
19,740  $ 

349 

(184) 

6,462 

1,601 

1,500 
— 
— 
— 
(89) 
511 
76  $  538,936 

Revolving Credit

The  outstanding  principal  amount  of  LivaNova’s  short-term  unsecured  revolving  credit  agreements  and  other  agreements  with 
various banks was $0.6 million and $2.5 million as of 31 December 2023 and 2022, respectively, with an average interest rate of 
4.94% and loan terms ranging from overnight to 364 days as of 31 December 2023.

On 13 August 2021, LivaNova PLC and its wholly-owned subsidiary, LivaNova USA as borrower, entered into a First Lien Credit 
Agreement with the lenders and issuing banks party thereto and Goldman Sachs Bank USA, as First Lien Administrative Agent 
and  First  Lien  Collateral  Agent,  relating  to  a  $125  million  senior  secured  multi-currency  revolving  credit  facility  to  be  made 
available to the borrower, referred to as the 2021 First Lien Credit Agreement. The 2021 First Lien Credit Agreement, as amended 
from time to time, expires on 13 August 2026 and bears interest at a rate equal to, for US dollar-denominated loans, an adjusted 
SOFR with a floor of 0.00%, or a Base Rate, plus, in each case, a variable margin based on the Company’s Total Net Leverage 
Ratio,  as  defined  in  the  agreement.  Interest  is  paid  monthly  or  quarterly,  as  selected  by  the  borrower,  with  any  outstanding 
principal  due  at  maturity.  The  2021  First  Lien  Credit  Agreement  also  contemplates  the  payment  of  commitment  fees  on  the 
unused  portion  of  the  commitments,  at  a  variable  percentage  based  on  the  Company’s  Total  Net  Leverage  Ratio.  As  of  31 
December 2023 and 2022, the applicable commitment fee percentage was 0.5% per annum. The 2021 First Lien Credit Agreement 
is available for working capital and other general corporate purposes and, if drawn, can be repaid at any time without premium or 
penalty.  As  of  31  December  2023,  LivaNova  was  in  compliance  with  the  financial  covenants  contained  in  its  2021  First  Lien 
Credit Agreement.

There were no outstanding borrowings under the 2021 First Lien Credit Agreement’s $125 million revolving credit facility as of 
31 December 2023 and 2022.

Bridge Loan Facility

On  24  February  2022,  LivaNova  PLC  and  its  wholly-owned  subsidiary  LivaNova  USA  entered  into  an  Incremental  Facility 
Amendment No. 1 to the 2021 First Lien Credit Agreement, relating to the €200 million Bridge Loan Facility. On 16 March 2022, 
LivaNova  entered  into  Amendment  No.  2  to  the  2021  First  Lien  Credit  Agreement,  which  converted  the  available  borrowings 
under the Bridge Loan Facility from €200 million to $220 million and converted the EURIBOR rate in the 2021 First Lien Credit 
Agreement to SOFR. LivaNova delivered a borrowing notice for $220 million in connection with the Bridge Loan Facility, which 
was funded on 17 March 2022. 

On  18  March  2022,  LivaNova  PLC,  acting  through  its  Italian  branch,  entered  into  an  Indemnity  Letter  and  an  Account  Pledge 
Agreement with Barclays, further to which Barclays issued the SNIA Litigation Guarantee. As security for the SNIA Litigation 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________122

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 17. Financial Liabilities

Guarantee, LivaNova is required to grant cash collateral to Barclays in USD in an amount equal to the USD equivalent of 105% of 
the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. The proceeds of the Bridge Loan Facility were used 
by  LivaNova  to  post  a  portion  of  the  cash  collateral  supporting  the  SNIA  Litigation  Guarantee.  Cash  collateral  classified  as 
restricted  cash  on  the  consolidated  balance  sheets  as  of  31  December  2023  and  2022  was  $311.4  million  and  $301.4  million, 
respectively.  For  additional  information  regarding  the  SNIA  litigation,  please  refer  to  “Note  24.  Commitments  and 
Contingencies.”

Debt  discounts  and  issuance  costs  related  to  the  Bridge  Loan  Facility  were  approximately  $4.5  million.  Amortisation  of  debt 
discount and issuance costs for the Bridge Loan Facility was $4.5 million for the year ended 31 December 2022 and is included in 
finance expenses on the consolidated statement of (loss). 

The Bridge Loan Facility was repaid in full on 6 July 2022.

Term Facilities

On 6 July 2022, LivaNova and its wholly-owned subsidiary, LivaNova USA, entered into Incremental Facility Amendment No. 2, 
which provides for LivaNova USA to, among other things, obtain commitments for term loan facilities from a syndicate of lenders 
in an aggregate principal amount of $350 million consisting of (i) the Initial Term Facility with an aggregate principal amount of 
$300 million and (ii) the Delayed Draw Term Facility with an additional aggregate principal amount of $50 million. On 6 April 
2023, LivaNova drew $50 million under the Delayed Draw Term Facility for general corporate purposes.

Proceeds from the Initial Term Facility were used to repay in full the Bridge Loan Facility on 6 July 2022, with the remainder 
used for general corporate purposes of the Company. The Term Facilities have a maturity of the earlier of (i) five years or (ii) 91 
days prior to 15 December 2025, the maturity date of the 2020 Cash Exchangeable Senior Notes, unless by that date LivaNova 
USA  will  have  either  redeemed  or  refinanced  the  2025  Notes,  or  set  aside  an  amount  of  cash  equal  to  the  then-outstanding 
principal amount of the 2025 Notes. The Term Facilities bear interest at a rate equal to an adjusted term SOFR plus a variable 
margin  based  on  the  Company’s  consolidated  total  net  leverage  ratio.  As  of  31  December  2023,  the  applicable  margin  over 
adjusted term SOFR was equal to 3.5% per annum. The Term Facilities are subject to an original issue discount of 1.5% of their 
principal amount. The Term Facilities are subject to quarterly principal repayment, based on the following amortisation schedule: 
(i) during the first year from the initial funding date: 1.9%; (ii) year two: 5.0%; (iii) year three: 5.0%; (iv) year four: 7.5%; and (v) 
year five: 10.0%, with the remainder to be paid at maturity. The effective interest rate of the Term Facilities at of 31 December 
2023 was 6.53%.

The 2021 First Lien Credit Agreement, as amended, contains customary representations, warranties and covenants, including the 
requirement to maintain a Senior Secured First Lien Net Leverage Ratio, calculated as the ratio of Consolidated Senior Secured 
First Lien Net Indebtedness to Consolidated EBITDA, as defined in the credit agreement, for the period of four consecutive fiscal 
quarters ended on the calculation date, of not more than 3.50 to 1.00 and an Interest Coverage Ratio, calculated as the ratio of 
Consolidated  EBITDA  to  Consolidated  Interest  Expense,  both  as  defined  in  the  credit  agreement,  for  the  period  of  four 
consecutive fiscal quarters ended on the calculation date, of not less than 3.00 to 1.00. As of 31 December 2023 , the Company 
was in compliance with the financial covenants contained in the 2021 First Lien Credit Agreement.

Debt  discounts  and  issuance  costs  related  to  the  Initial  Term  Facility  were  approximately  $9.6  million.  Amortisation  of  debt 
discount and issuance costs for the Initial Term Facility was $2.0 million and $0.8 million for the years ended 31 December 2023 
and 2022, respectively, and is included in finance expenses on the consolidated statement of (loss). The unamortised discount and 
issuance  costs  related  to  the  Initial  Term  Facility  as  of  31  December  2023  and  2022  was  $6.8  million  and  $8.7  million, 
respectively. Issuance costs related to the Delayed Draw Term Facility were approximately $1.6 million. Amortisation of issuance 
costs for the Delayed Draw Term Facility was $0.5 million and $1.1 million for the years ended 31 December 2023 and 2022, 
respectively, and is included in finance expenses on the consolidated statement of (loss). The issuance costs related to the Delayed 
Draw Term Facility were fully amortized as of 31 December 2023. The unamortised issuance cost related to the Delayed Draw 
Term Facility as of 31 December 2022 was $0.5 million and is included within prepaid expenses and other current assets on the 
consolidated balance sheets.

2020 Cash Exchangeable Senior Notes

On 17 June 2020, LivaNova’s wholly-owned subsidiary, LivaNova USA, issued the 2025 Notes by private placement to qualified 
institutional  buyers  pursuant  to  Rule  144A  under  the  Securities  Act.  The  sale  of  the  2025  Notes  resulted  in  approximately 
$278.0 million in net proceeds to the Company after deducting issuance costs. Interest is payable semiannually in arrears on 15 
June and 15 December of each year. The EIR of the 2025 Notes as of 31 December 2023 was 9.95%. The 2025 Notes mature on 
15 December 2025 unless earlier exchanged, repurchased, or redeemed.

Debt  discounts  and  issuance  costs  related  to  the  2025  Notes  were  approximately  $82.0  million  and  included  $75.0  million  of 
discount attributable to the embedded exchange feature, discussed below, and $7.0 million of allocated issuance costs to the 2025 
Notes related to legal, bank and accounting fees. Amortisation of debt discount and issuance costs for the 2025 Notes was $15.9 
million and $14.4 million for the years ended 31 December 2023 and 2022, respectively, and is included in finance expenses on 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________123

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 17. Financial Liabilities

the consolidated statement of (loss). The unamortised discount related to the 2025 Notes as of 31 December 2023 and 2022 was 
$32.0 million and $47.9 million, respectively.

Holders  of  the  2025  Notes  are  entitled  to  exchange  the  2025  Notes  at  any  time  during  specified  periods,  at  their  option.  This 
includes the right to exchange the 2025 Notes during any calendar quarter, if the last reported sale price of LivaNova’s ordinary 
shares, with a nominal value of £1.00 per share, is greater than or equal to 130% of the exchange price, or $79.27 per share for at 
least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the 
last trading day of the immediately preceding calendar quarter. The exchange condition was not satisfied on 31 December 2023. 
As  a  result,  the  Company  has  included  its  obligations  from  the  2025  Notes  and  the  associated  embedded  exchange  feature 
derivative  as  a  long-term  liability  on  the  consolidated  balance  sheets  as  of  31  December  2023.  Additionally,  the  exchange 
condition  was  not  satisfied  on  31  March  2024.  As  such,  the  2025  Notes  are  not  currently  exchangeable.  The  2025  Notes  are 
exchangeable  solely  into  cash  and  are  not  exchangeable  into  ordinary  shares  of  LivaNova  or  any  other  security  under  any 
circumstances. The initial exchange rate for the 2025 Notes is 16.3980 ordinary shares per $1,000 principal amount of 2025 Notes 
(equivalent to an initial exchange price of approximately $60.98 per share). The exchange rate is subject to adjustment in certain 
circumstances, as set forth in the 2024 Indenture.

The  Company  may  redeem  the  2025  Notes  at  its  option  on  or  after  20  June  2023  and  prior  to  the  51st  scheduled  trading  day 
immediately preceding the maturity date, in whole or in part, if the last reported sale price per ordinary share has been at least 
130%  of  the  exchange  price  then  in  effect  for  at  least  20  trading  days  (whether  or  not  consecutive),  including  the  trading  day 
immediately  preceding  the  date  on  which  the  Company  provides  notice  of  redemption,  during  any  30  consecutive  trading  day 
period  ending  on,  and  including,  the  trading  day  immediately  preceding  the  date  on  which  the  Company  provides  notice  of 
redemption,  at  a  redemption  price  equal  to  100%  of  the  principal  amount  of  the  2025  Notes  to  be  redeemed,  plus  accrued  and 
unpaid interest to, but excluding, the redemption date. Additionally, the Company may redeem the 2025 Notes at its option, prior 
to their stated maturity, in whole but not in part, in connection with certain tax-related events.

Embedded Exchange Feature

The embedded exchange feature of the 2025 Notes requires bifurcation from the 2025 Notes and is accounted for as a derivative 
liability. The fair value of the 2025 Notes’ embedded exchange feature derivative at the time of issuance was $75.0 million and 
was  recorded  as  debt  discount  on  the  2025  Notes.  This  discount  is  amortised  as  finance  expenses  using  the  effective  interest 
method over the term of the 2025 Notes. The 2025 Notes’ embedded exchange feature derivative is carried on the consolidated 
balance  sheets  at  its  estimated  fair  value  and  is  adjusted  at  the  end  of  each  reporting  period,  with  the  unrealised  gain  or  loss 
reflected within net gain on embedded exchange feature and capped call derivatives on the consolidated statement of (loss). The 
fair value of the embedded exchange feature derivative liability was $45.6 million and $85.7 million as of 31 December 2023 and 
2022, respectively. 

Capped Call Transactions

In  connection  with  the  pricing  of  the  2025  Notes,  the  Company  entered  into  2025  Capped  Calls  with  certain  of  the  initial 
purchasers  of  the  2025  Notes  or  their  respective  affiliates.  The  2025  Capped  Calls  cover,  subject  to  anti-dilution  adjustments 
substantially similar to those applicable to the 2025 Notes, the number of LivaNova’s ordinary shares underlying the 2025 Notes 
and are expected generally to offset any cash payments the Company is required to make upon exchange of the 2025 Notes in 
excess of the principal amount thereof in the event that the market value per ordinary share, as measured under the 2025 Capped 
Calls, is greater than the strike price of the 2025 Capped Calls, with such offset being subject to an initial cap price of $100.00 per 
share. If the Company’s share price exceeds the cap price, the proceeds under the 2025 Capped Calls would not fully offset the 
excess principal amount due to the holders of the 2025 Notes. The 2025 Capped Calls expire on 15 December 2025 and must be 
settled in cash. If the 2025 Capped Calls are converted or redeemed early, settlement occurs at their termination value, which is 
equal  to  their  fair  value  at  the  time  of  the  conversion  or  redemption.  The  2025  Capped  Calls  are  carried  on  the  consolidated 
balance  sheets  as  a  derivative  asset  at  their  estimated  fair  value  and  are  adjusted  at  the  end  of  each  reporting  period,  with 
unrealised gain or loss reflected within net gain on embedded exchange feature and capped call derivatives on the consolidated 
statement  of  (loss).  The  fair  value  of  the  capped  call  derivative  assets  was  $38.5  million  and  $54.4  million  as  of  31  December 
2023 and 2022, respectively. As of 31 December 2023, the capped call derivative assets were classified as long-term.

Note 18. Leases

LivaNova  has  leases  primarily  for  (i)  office  space,  (ii)  manufacturing,  warehouse  and  R&D  facilities  and  (iii)  vehicles. 
LivaNova’s leases have remaining lease terms up to 15 years, some of which include options to extend the leases, some of which 
include options to terminate the leases at the Company’s sole discretion, and some of which call for variable lease payments. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________124

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 18. Leases

Right-of-Use Assets and Lease Liabilities

The following table presents the changes in ROU assets and lease liabilities by class of assets for the years ended 31 December 
2023 and 2022 (in thousands):

Balance as of 31 December 2021     . . . . . . . . . . . . $ 

36,405  $ 

3,519  $ 

196  $ 

40,120 

$ 

47,364 

Real Estate

Vehicles

Others

Total ROU 
Assets

Lease 
Liabilities

Additions   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depreciation expense (1)       . . . . . . . . . . . . . . . . . . .
Disposals, modifications and other      . . . . . . . . . . .

Finance expenses      . . . . . . . . . . . . . . . . . . . . . . . . .

Lease payments      . . . . . . . . . . . . . . . . . . . . . . . . . .

6,125 

1,019 

203 

7,347 

(8,597)   

(1,757)   

(249)   

(10,603) 

375 

— 

NA

(16)   

— 

NA

4 

— 

NA

363 

— 

7,339 

NA

(2,479) 

1,461 

NA  

(12,441) 

Currency translation adjustments     . . . . . . . . . . . .

(2,145)   

(283)   

(7)   

(2,435) 

Balance as of 31 December 2022     . . . . . . . . . . . .

Additions   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depreciation expense (1)       . . . . . . . . . . . . . . . . . . .
Disposals, modifications and other      . . . . . . . . . . .
Finance expenses      . . . . . . . . . . . . . . . . . . . . . . . . .
Lease payments      . . . . . . . . . . . . . . . . . . . . . . . . . .
Currency translation adjustments     . . . . . . . . . . . .
Balance as of 31 December 2023     . . . . . . . . . . . . $ 

32,163 

24,148 

2,482 

1,332 

147 

649 

34,792 

26,129 

(8,430)   

(1,596)   

(265)   

(10,291) 

(1,597)   
— 
NA
577 
46,861  $ 

(118)   
— 
NA
82 
2,182  $ 

(15)   
— 
NA
6 
522  $ 

(1,730) 
— 
NA  
665 
49,565 

$ 

(1) Depreciation expense is included in the consolidated statement of (loss) in cost of sales, R&D and SG&A.

Contractual maturities of LivaNova’s lease liabilities as of 31 December 2023 were as follows (in thousands):

2024    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2025    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2026    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2027    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2028    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Thereafter   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total lease payments     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less: Amount representing finance charges      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net present value of lease liabilities       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Contractual maturities of LivaNova’s lease liabilities as of 31 December 2022 were as follows (in thousands):

2023       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2024       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2025       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2026       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2027       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Thereafter      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total lease payments      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less: Amount representing finance charges      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net present value of lease liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(2,319) 

38,925 

26,009 

NA

(1,830) 
1,573 
(11,687) 
853 
53,843 

10,938 
9,517 
6,888 
5,997 
5,139 
32,167 
70,646 
(16,803) 
53,843 

10,520 
8,095 
5,372 
3,998 
3,570 
12,747 
44,302 
(5,377) 
38,925 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________125

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 18. Leases

Lease Payments not Recognised as a Liability

LivaNova has elected not to recognise a lease liability for short-term leases (leases with an expected term of 12 months or less) or 
for leases of low value assets. Payments made under such leases are expensed on a straight-line basis. In addition, certain variable 
lease  payments  (i.e.,  variable  maintenance  and  utility  expenses)  are  not  permitted  to  be  recognised  as  lease  liabilities  and  are 
expensed as incurred. Expenses recognised during 2023 and 2022 relating to payments not included in the measurement of lease 
liabilities is as follows (in thousands):

Short-term leases    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Lease of low value     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Variable lease payments      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

751  $ 
707 
884 
2,342  $ 

468 
508 
580 
1,556 

2023

2022

At  31  December  2023  and  2022,  LivaNova  was  committed  to  future  lease  payments  of  approximately  $3.6  million  and  $2.5 
million, respectively, relating to short-term leases and leases of low value assets that are not reflected in the measurement of lease 
liabilities. These payments will generally be made ratably over the next 3 to 5 years.

Furthermore,  lessor  lease  revenue  constituted  less  than  0.5%  and  less  than  0.5%  of  total  net  revenue  for  the  year  ended  31 
December 2023 and 2022, respectively.

Note 19. Other Liabilities

The following table presents the composition of non-current other liabilities as of 31 December 2023 and 2022 (in thousands):

Amounts due to employees     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Contract liabilities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

8,336  $ 
4,608 
231 
13,175  $ 

7,224 
3,829 
642 
11,695 

The following table presents the composition of current other liabilities as of 31 December 2023 and 2022 (in thousands):

2023

2022

Accrued employee-related charges      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Amounts due to employees     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Legal and administrative expenses     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contract liabilities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Current lease liabilities (1)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest payable     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amounts due to health and social security institutions    . . . . . . . . . . . . . . . . . . . . . . . . .
Provisions for agents, returns and other      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Royalty accrual        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Derivative financial instruments (2)
     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Research and development costs    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Current advances from customers     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other current liabilities and accrued expenses     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(1) For additional information refer to “Note 18. Leases.”
(2) For additional information refer to “Note 15. Derivative Financial Instruments.”

62,935  $ 
27,033 
17,794 
10,725 
8,369 
7,840 
4,662 
4,464 
4,441 
3,883 
2,462 
1,923 
21,718 
178,249  $ 

50,361 
17,754 
8,700 
10,226 
9,312 
— 
4,076 
517 
3,950 
5,886 
7,020 
1,907 
27,037 
146,746 

Note 20. Contingent Consideration, 3T Litigation Provision Liability and Other Provisions

The following table presents the composition of non-current provisions as of 31 December 2023 and 2022 (in thousands):

Contingent consideration (1)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Saluggia site remediation (2)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Litigation provision liability (2)
        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other reserves (3)
      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

80,902  $ 
42,184 
3,104 
657 
126,847  $ 

85,292 
37,654 
3,006 
2,251 
128,203 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________126

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 20. Contingent Consideration, Litigation Provision Liability and Other Provisions

(1) For additional information refer to “Note 5. Fair Value Measurements.”
(2) For additional information refer to “Note 24. Commitments and Contingencies.”
(3) Other reserves includes provisions for uncertain tax positions (inclusive of penalties and interest), and restructuring.

The following table presents the composition of current provisions as of 31 December 2023 and 2022 (in thousands):

Contingent consideration (1)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Litigation provision liability (2)
        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Italian medical device payback law (2)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other reserves (3)
      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

13,750  $ 
17,156 
8,223 
4,717 
43,846  $ 

— 
29,481 
6,414 
3,532 
39,427 

(1) For additional information refer to “Note 5. Fair Value Measurements.”
(2) For additional information refer to “Note 24. Commitments and Contingencies.”
(3) Other  reserves  includes  provisions  for  contractual  warranty  obligation,  product  remediation,  Saluggia  site  remediation, 

restructuring, and other individually immaterial items. 

The  following  table  presents  the  changes  in  the  non-current  provisions  for  the  years  ended  31  December  2023  and  2022  (in 
thousands):

Contingent 
Consideration (1)

Saluggia Site 
Remediation (2)

Litigation 
Provision 
Liability (2)

Other 
Reserves (3)

Total

1 January 2022      . . . . . . . . . . . . . . . . . . . . $ 
Change in fair value    . . . . . . . . . . . . .
Additions to provision      . . . . . . . . . . .
Reclassifications (to) from current     . .
Currency translation gains       . . . . . . . .
31 December 2022       . . . . . . . . . . . . . . . . .
Change in fair value      . . . . . . . . . . . .
Additions to provision      . . . . . . . . . . .
Release of provisions     . . . . . . . . . . . .
Reclassifications (to) / from current  .
Currency translation losses / (gains)    
31 December 2023       . . . . . . . . . . . . . . . . . $ 

86,830  $ 
(18,329)   
16,791 
— 
— 
85,292 
6,893 
— 
— 

(11,283)   

— 
80,902  $ 

43,460  $ 
(2,869)   
— 
(428)   
(2,509)   
37,654 
1,468 
2,269 
— 
(430)   
1,223 
42,184  $ 

6,625  $ 
— 
— 
(3,449)   
(170)   
3,006 
— 
— 
— 
171 
(73)   
3,104  $ 

2,020  $  138,935 
(21,198) 
— 
17,136 
345 
(3,877) 
— 
(2,793) 
(114)   
128,203 
2,251 
8,361 
— 
2,039 
(230)   
(1,404) 
(1,404)   
(11,542) 
— 
40 
1,190 
657  $  126,847 

(1) For additional information refer to “Note 5. Fair Value Measurements.”
(2) For additional information refer to “Note 24. Commitments and Contingencies.”
(3) Other reserves includes provisions for uncertain tax positions (inclusive of penalties and interest), and restructuring.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________127

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 20. Contingent Consideration, Litigation Provision Liability and Other Provisions

The following table presents the changes in the current provisions for the years ended 31 December 2023 and 2022 (in thousands):

Contingent 
Consideration (1)

Litigation 
Provision 
Liability (2)

Italian Medical 
Device Payback 
Law (2)

Other 
Reserves (3)

Total

1 January 2022     . . . . . . . . . . . . . . . . . . . . . . . $ 
Change in fair value      . . . . . . . . . . . . . . .
Additions to provision         . . . . . . . . . . . . .
Utilisation   . . . . . . . . . . . . . . . . . . . . . . .
Release of provisions      . . . . . . . . . . . . . .
Reclassifications from non-current      . . . .
Currency translation gains        . . . . . . . . . .
31 December 2022     . . . . . . . . . . . . . . . . . . . .
Change in fair value      . . . . . . . . . . . . . . .
Additions to provision         . . . . . . . . . . . . .
Utilisation   . . . . . . . . . . . . . . . . . . . . . . .
Release of provision    . . . . . . . . . . . . . . .
Reclassifications from / (to) non-
current    . . . . . . . . . . . . . . . . . . . . . . . . . .
Currency translation losses     . . . . . . . . . .
31 December 2023     . . . . . . . . . . . . . . . . . . . . $ 

11,552  $ 
(11,552)   

— 
— 
— 
— 
— 
— 
2,467 
— 
— 
— 

32,845  $ 
— 
22,309 
(28,867)   

— 
3,449 
(255)   

29,481 
— 
40,921 
(53,652)   

— 

11,283 
— 
13,750  $ 

(171)   
577 
17,156  $ 

5,533  $ 
— 
881 
— 
— 
— 
— 
6,414 
— 
1,809 
— 
— 

— 
— 
8,223  $ 

3,231  $ 
— 
1,314 
(979)   
24 
428 
(486)   
3,532 
— 
3,179 
(2,711)   
37 

53,161 
(11,552) 
24,504 
(29,846) 
24 
3,877 
(741) 
39,427 
2,467 
45,909 
(56,363) 
37 

430 
250 
4,717  $ 

11,542 
827 
43,846 

(1) For additional information refer to “Note 5. Fair Value Measurements.”
(2) For additional information refer to “Note 24. Commitments and Contingencies.”
(3) Other includes provisions for contractual warranty obligation, product remediation, Saluggia site remediation, restructuring, 

and other individually immaterial items.

Note 21. Share-Based Plans

Share-Based Plans

On 16 October 2015, LivaNova approved the adoption of the Company’s 2015 Plan, which was previously approved by the Board 
of the Company on 14 September 2015 subject to such shareholder approval. The 2015 Plan was adopted in order to facilitate the 
grant  of  cash  and  equity  incentives  to  non-employee  directors,  employees  (including  the  Company’s  named  executive  officers) 
and  consultants  of  the  Company  and  certain  of  LivaNova’s  affiliates  and  to  enable  the  Company  and  certain  of  LivaNova’s 
affiliates to obtain and retain services of these individuals. The Plan became effective as of 19 October 2015. The 2022 Plan was 
adopted by the Board of Directors on 20 April 2022 and approved by the shareholders of LivaNova PLC on 13 June 2022. Awards 
may be granted under the 2015 Plan and 2022 Plan in the form of share options, SARs, RS, RSUs, other share and cash-based 
awards and dividend equivalents. 

During  the  year  ended  31  December  2023,  LivaNova  issued  share-based  compensatory  awards  with  terms  approved  by  the 
Compensation Committee of LivaNova’s Board of Directors. The awards with service conditions generally vest ratably over four 
years and are subject to forfeiture unless service conditions are met. The market performance-based awards that were issued cliff 
vest  after  three  years  subject  to  the  rank  of  LivaNova’s  total  shareholder  return  for  the  three-year  period  ending  31  December 
2025 relative to the total shareholder returns for a peer group of companies. The adjusted FCF and ROIC operating performance-
based awards that were issued, cliff vest after three years subject to the achievement of certain thresholds of cumulative results for 
the three-year period ending 31 December 2025.

As  of  31  December  2023  and  2022,  there  were  approximately  12,098  and  317,200  shares  available  for  future  grants  to  the 
Company’s  Non-Executive  Directors  under  the  2015  Plan  and  1,422,656  and  1,900,000  shares  pursuant  to  Options  or  Stock 
Appreciation  Rights  and  902,967  and  1,137,785  shares  pursuant  to  other  types  of  awards  available  for  future  grants  to  the 
Company’s  employees  under  the  2022  Plan,  respectively.  In  June  2023,  the  Company’s  shareholders  approved  the  A&R  2022 
Plan. The A&R 2022 Plan increases the aggregate number of ordinary shares that can be issued under the 2022 Plan pursuant to 
options or SARs from 1,900,000 to 2,250,000 and the number of ordinary shares that can be issued pursuant to awards other than 
options or SARs from 1,200,000 to 1,500,000.

The Company also provides a ESPP. Compensation expense related to the ESPP for the years ended 31 December 2023 and 2022 
was $1.1 million and $1.2 million, respectively.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________128

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 21. Share-Based Plans

Share-Based Compensation

The  following  table  presents  the  amounts  of  share-based  compensation  recognised  in  the  consolidated  statement  of  (loss),  by 
expense category for the years ended 31 December 2023 and 2022 (in thousands):

Cost of sales       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Selling, general and administrative        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Research and development    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

883  $ 

26,857 
5,444 

33,184  $ 

1,447 
35,442 
7,673 
44,562 

The  following  table  presents  the  amounts  of  equity-settled  share-based  compensation  expense  recognised  in  the  consolidated 
statement of (loss) by type of arrangement for the years ended 31 December 2023 and 2022 (in thousands):

2023 (1)

2022

Service-based stock appreciation rights       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Service-based restricted stock units    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Market performance-based restricted stock units     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating performance-based restricted stock units   . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ESPP    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

12,440  $ 
18,595 
866 
162 
1,121 

33,184  $ 

13,967 
21,414 
4,651 
3,338 
1,192 
44,562 

(1) For  information  regarding  the  forfeiture  of  share-based  compensation  awards  of  Damien  McDonald,  LivaNova’s  former 

CEO, refer to the Remuneration Report on pages 53 to 74, which forms part of these financial statements. 

Share Appreciation Rights and Share Options

LivaNova  uses  the  Black-Scholes  option  pricing  methodology  to  calculate  the  grant  date  fair  market  value  of  SARs.  The 
following  table  lists  the  assumptions  the  Company  utilised  as  inputs  to  the  Black-Scholes  model  during  the  years  ended  31 
December 2023 and 2022:

2023
$42.71
$42.71
—
3.7%
5.3
45.1%

2022
$82.04
$82.04
—
2.5%
5.3
42.2%

Weighted average share price       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exercise price       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dividend yield (1)
    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Risk-free interest rate - based on grant date (2)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expected option term - in years per group of employees/consultants (3)      . . . . . . . . . . .
Expected volatility at grant date (4)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(1) LivaNova has not paid dividends and no future dividends have been approved.
(2) LivaNova  uses  yield  rates  on  US  Treasury  securities  for  a  period  that  approximated  the  expected  term  of  the  award  to 

estimate the risk-free interest rate.

(3) The Company estimated the expected term of the awards granted using historic data of actual time elapsed between the date 
of grant and the exercise or forfeiture of options or SARs for employees. For consultants, the expected term is the remaining 
time until expiration of the option or SAR.

(4) Refer  to  “Note  2.  Basis  of  Preparation,  Use  of  Accounting  Estimates  and  Material  Accounting  Policies  -  Share-Based 

Compensation” for further information regarding expected volatility.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________129

 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 21. Share-Based Plans

The following tables present the activity for service-based SARs and stock option awards during the years ended 31 December 
2023 and 2022:

Outstanding – beginning of year      . . . . . . . . . . . . . . . . . . . . . .
Granted     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exercised      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Forfeited     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expired      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Outstanding – end of year        . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fully vested and exercisable – end of year   . . . . . . . . . . . . . . .
Fully vested and expected to vest – end of year (1)
    . . . . . . . . .
(1) Includes the impact of expected future forfeitures.

2023

Number of
Optioned
Shares
2,806,836  $ 
974,204  $ 
(232,980)  $ 
(297,831)  $ 
(295,927)  $ 
2,954,302  $ 

1,455,930  $ 
2,883,388  $ 

Wtd. Avg.
Exercise 
Price

68.46 
42.71 
44.24 
56.67 
75.12 
62.40 

69.81 
62.67 

2022

Number of
Optioned
Shares
2,634,373  $ 
553,050  $ 
(93,191)  $ 
(150,881)  $ 
(136,515)  $ 
2,806,836  $ 

1,460,162  $ 
2,756,467  $ 

Wtd. Avg.
Exercise 
Price

65.94 
82.04 
48.86 
67.46 
89.41 
68.46 

67.43 
68.35 

The weighted average remaining contractual life for the share options and SARs outstanding at 31 December 2023 and 2022 is 
6.85 years and 6.67 years, respectively.

The  aggregate  intrinsic  value  of  the  options  and  SARs  outstanding  at  31  December  2023  and  2022  is  $12.0  million  and  $10.1 
million, respectively. The aggregate intrinsic value of options and SARs is based on the difference between the fair market value 
of the underlying share at the end of the year using the market closing share price, and exercise price for in-the-money awards.

The following table presents outstanding options and SARs by exercise price range as of 31 December 2023 and 2022 (in number 
of shares):

$31–50      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$51–70      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$71–90      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$91–110      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$111–130      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2023

2022

1,382,590 
246,905 
1,033,883 
288,562 
2,362 
2,954,302 

835,090 
343,994 
1,271,084 
353,364 
3,304 
2,806,836 

Year Ended 31 December

2023

2022

Weighted average grant date fair value of SARs granted during the year (per share)     . . . . . . . . . . $ 
Aggregate intrinsic value of SARs and stock options exercised during the year (in thousands)      . . $ 

19.44  $ 
1,905  $ 

34.13 
2,143 

Restricted Share and Restricted Share Units Awards

The following tables detail the activity for service-based RS and RSUs awards for the years ended 31 December 2023 and 2022:

Non-vested shares beginning of year        . . . . . . . . . . . . . .
Granted      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Vested       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Forfeited       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Non-vested shares end of year    . . . . . . . . . . . . . . . . . . . .

2023
Wtd. Avg. Grant 
Date Fair Value

2022
Wtd. Avg. Grant 
Date Fair Value

Number of 
Shares
741,892  $ 
528,128  $ 
(333,013)  $ 
(154,470)  $ 
782,537  $ 

Number of 
Shares
791,157  $ 
328,980  $ 
(298,865)  $ 
(79,380)  $ 
741,892  $ 

68.02 
43.31 
66.37 
56.09 
54.40 

64.53 
76.35 
68.11 
64.85 
68.02 

Weighted average grant date fair value of service-based RSUs issued during the year (per share)       . . $ 
Aggregate fair value of RSUs that vested during the year (in thousands)   . . . . . . . . . . . . . . . . . . . . . . $ 

43.31  $ 
14,853  $ 

76.35 
22,793 

Year Ended 31 December

2023

2022

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________130

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 21. Share-Based Plans

Market and Performance-Based Restricted Share and Performance-Based Restricted Share Units Awards

The following tables detail the activity for performance-based and market-based restricted share and restricted share unit awards 
for the years ended 31 December 2023 and 2022:

Non-vested shares beginning of year     . . . . . . . . . . . . . . .

Granted      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

189,117  $ 

Vested      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(75,877)  $ 

Forfeited    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Performance adjustments (1)
Non-vested shares end of year    . . . . . . . . . . . . . . . . . . . .

   . . . . . . . . . . . . . . . . . . . . . .

(171,804)  $ 

(64,950)  $ 

207,020  $ 

2023
Wtd. Avg. Grant 
Date Fair Value

Number of 
Shares
330,534  $ 

2022
Wtd. Avg. Grant 
Date Fair Value

Number of 
Shares
345,944  $ 

88,354  $ 

(11,340)  $ 

(11,474)  $ 

(80,950)  $ 

330,534  $ 

70.45 

40.63 

40.94 

65.83 

42.52 

66.84 

68.36 

92.53 

95.13 

41.70 

91.58 

70.45 

(1) Represents  the  difference  between  the  target  units  granted  and  the  actual  units  awarded  based  upon  the  attainment  of 

performance goals for the Company.

Year Ended 31 December
2022
2023

Weighted average grant date fair value of performance-based restricted share units 
granted during the year (per share)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Aggregate fair value of performance-based restricted share units that vested during 
the year (in thousands)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

40.63  $ 

3,641  $ 

92.53 

877 

Note 22. Employee Retirement Plans

LivaNova sponsors several defined benefit pension plans, which include plans in the US, Italy, Germany, Japan and France. The 
Company  maintains  a  frozen  cash  balance  retirement  plan  in  the  US  that  is  a  contributory,  defined  benefit  plan  designed  to 
provide the benefit in terms of a stated account balance dependent on the employer's promised interest-crediting rate. In Italy and 
France the Company maintains a severance pay defined benefit plan that obligates the employer to pay a severance payment in 
case  of  resignation,  dismissal  or  retirement.  In  other  jurisdictions  LivaNova  sponsors  non-contributory,  defined  benefit  plans 
designated to provide a guaranteed minimum retirement benefits to eligible employees. Certain members of the Company’s key 
management participate in the Company's defined benefit pension plans. Please refer to “Note 27. Related Parties”

As  of  31  December  2023  and  2022,  the  total  net  liability  of  LivaNova’s  US  and  non-US  defined  benefit  pension  plans  was 
$9.0 million and $9.6 million, respectively.

As of 31 December 2023 and 2022, the US defined benefit pension plan was partially funded, with an net liability of $2.6 million 
and $4.3 million, respectively. 

As of 31 December 2023 and 2022, the Non-US defined benefit pension plans for Italy and France were unfunded, with an net 
liability totalling $5.3 million and $5.6 million respectively. 

As  of  31  December  2023  and  2022,  the  Non-US  defined  benefit  pension  plan  for  Germany  was  partially  funded,  with  an  net 
liability of $1.1 million and $1.1 million respectively. 

As of 31 December 2023 and 2022, the Non-US defined benefit pension plan for Japan was wholly funded, with a net surplus 
position of nil and $1.4 million, respectively. LivaNova has no right to the Japan pension asset surplus. As such, an asset ceiling is 
applied and no surplus assets are recognized.

Risks Related to Defined-benefit Plans

The defined benefit plans expose the Group to various demographic and economic risks such as longevity risk, investment risks, 
currency and interest rate risk and in some cases inflation risk. The latter plays a role in the assumed wage increase and in some 
smaller  plans  where  indexation  is  mandatory.  Pension  fund  Trustees  are  responsible  for  and  have  full  discretion  over  the 
investment  strategy  of  the  plan  assets.  In  general  Trustees  manage  pension  fund  risks  by  diversifying  the  investments  of  plan 
assets and by (partially) matching interest rate risk of liabilities.

The Company has an active de-risking strategy in which it constantly looks for opportunities to reduce the risks associated with its 
defined  benefit  plans.  The  plans  are  governed  by  Trustees  who  have  a  legal  obligation  to  evenly  balance  the  interests  of  all 
stakeholders and operate under the local regulatory framework.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________131

 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 22. Employee Retirement Plans

The change in benefit obligations and funded status of LivaNova’s US and non-US pension benefits are as follows (in thousands):

US Pension Benefits

2023

2022

Present 
Value of 
Benefit 
Obligation

Fair Value 
of Plan 
Assets

Net 
Liability

Present 
Value of 
Benefit 
Obligation

Fair Value 
of Plan 
Assets

Net 
Liability

Beginning of year       . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

9,790  $ 

(5,516)  $ 

4,274  $  12,578  $ 

(8,020)  $ 

4,558 

Interest cost      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total amount recognised in the statement of 
(loss) income        . . . . . . . . . . . . . . . . . . . . . . . . . . . .

409 

409 

Actuarial gain     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(416)   

— 

— 

— 

409 

409 

254 

254 

(416)   

(1,361)   

— 

— 

— 

Actual return on plan assets       . . . . . . . . . . . . . . . . . . .
Total amount recognised in other comprehensive 
income      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

— 

(598)   

(598)   

— 

1,189 

(416)   

(598)   

(1,014)   

(1,361)   

1,189 

Employer contributions       . . . . . . . . . . . . . . . . . . . . . . .

— 

(1,118)   

(1,118)   

— 

(367)   

Payments from plan:

Plan settlements    . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(245)   

245 

— 

(1,369)   

1,369 

(316)   
Benefits paid    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
End of year      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
9,222  $ 
Amounts recognised on the consolidated balance sheet consist of:
Non-current (2)
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Recognised liability     . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2,551 
2,551 

       . . . . . . . . . . . . . . . . . . $ 
       . . . . . . . . . . . . . . . . . . $ 

4,274 
4,274 

316 
(6,671)  $ 

— 
2,551  $ 

(312)   
9,790  $ 

313 
(5,516)  $ 

254 

254 

(1,361) 

1,189 

(172) 

(367) 

— 

1 
4,274 

Present 
Value of 
Benefit 
Obligation

8,532  $ 
239 
239 

Beginning of year       . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Current service cost     . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest cost      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total amount recognised in the statement of 
(loss) income        . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Actuarial loss/(gain)      . . . . . . . . . . . . . . . . . . . . . . . . .
Actual return on plan assets       . . . . . . . . . . . . . . . . . . .
Total amount recognised in other comprehensive 
86 
income      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
136 
Foreign currency exchange rate changes and other      .
— 
Employer contributions       . . . . . . . . . . . . . . . . . . . . . . .
(972)   
Benefits paid    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
End of year      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
8,260  $ 
Amounts recognised on the consolidated balance sheet consist of:
Non-current (2)
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Recognised liability     . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

478 
86 
— 

6,367 
6,367 

2023
Fair Value 
of Plan 
Assets
(3,232)  $ 
— 
— 

— 
— 
78 

Non-US Pension Benefits (1)

Net 
Liability

Present 
Value of 
Benefit 
Obligation

5,300  $  10,817  $ 

239 
239 

478 
86 
78 

259 
83 

342 
(831)   
— 

2022
Fair Value 
of Plan 
Assets
(3,142)  $ 
— 
— 

— 
— 
80 

Net 
Liability

7,675 
259 
83 

342 
(831) 
80 

78 
101 
(263)   
26 
(3,290)  $ 

164 
237 
(263)   
(946)   
4,970  $ 

(831)   
(736)   
— 
(1,060)   
8,532  $ 

80 
58 
(265)   
37 
(3,232)  $ 

(751) 
(678) 
(265) 
(1,023) 
5,300 

       . . . . . . . . . . . . . . . . . . $ 
       . . . . . . . . . . . . . . . . . . $ 

5,300 
5,300 

(1) In certain non-US countries, fully funding pension plans is not a common practice. Consequently, certain pension plans have 

been partially funded.

(2) These amounts are included within provision for employee severance indemnities and other employee benefit provisions on 
the  consolidated  balance  sheet  as  well  as  social  security  taxes  payable  associated  with  LivaNova’s  share-based  incentive 
plans.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________132

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 22. Employee Retirement Plans

The  following  table  presents  the  composition  of  actuarial  (gain)/loss  for  LivaNova’s  US  and  non-US  pension  plans  during  the 
years ended 31 December 2023 and 2022 (in thousands):

2023

2022

US Pension 
Benefits

Non-US 
Pension 
Benefits

US Pension 
Benefits

Non-US 
Pension 
Benefits

Financial assumption   . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Demographic assumption    . . . . . . . . . . . . . . . . . . . . . .
Experience  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(443)  $ 
(69)   
96 
(416)  $ 

200  $ 
36 
(150)   
86  $ 

(1,632)  $ 
26 
245 
(1,361)  $ 

(1,184) 
108 
245 
(831) 

The following table presents the major actuarial assumptions used in determining the benefit obligations and net periodic benefit 
costs for LivaNova’s significant US and Non-US defined benefit plans as weighted averages for the years ended 31 December 
2023 and 2022:

2023

2022

US 
Pension 
Benefits

Non-US 
Pension 
Benefits

US 
Pension 
Benefits

Non-US 
Pension 
Benefits

Actuarial assumptions used to determine benefit obligation:
Discount rate     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rate of compensation increase    . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Actuarial assumptions used to determine net periodic benefit cost:
Discount rate     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rate of compensation increase    . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expected return on plan assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.93%
N/A

0.96% – 3.20%
2.50% – 3.50%

5.10%
N/A

0.45% – 3.70%
2.50% – 3.00%

5.10%
N/A
5.00%

0.96% – 3.20%
3.38% – 3.50%
N/A

2.41%
N/A
5.00%

0.45% – 3.70%
2.50% – 3.50%
N/A

To determine the discount rate for LivaNova’s US benefit plan, the Company used the FTSE Above Median Pension Discount 
Curve. For the discount rate used for the other non-US benefit plans the Company considers local market expectations of long-
term returns, primarily utilising the Iboxx Corporate Index Bond rating AA, duration higher than 10 years. The resulting discount 
rates are consistent with the duration of plan liabilities. 

The  expected  long-term  rate  of  return  on  plan  assets  assumption  for  LivaNova’s  US  benefit  plan  was  derived  from  a  study 
conducted by the Company’s investment managers. The study includes a review of anticipated future long-term performance of 
individual asset classes and consideration of the appropriate asset allocation strategy given the anticipated requirements of the plan 
to determine the average rate of earnings expected on the funds invested to provide for the pension plan benefits.

Retirement Benefit Plan Investment Strategy

In the US, the Company has an account that holds the defined benefit frozen balance pension plan assets. The Plan Committee sets 
investment guidelines for US pension plans with the assistance of an external consultant. The plan assets in the US are invested in 
accordance with sound investment practices that emphasize long-term fundamentals. The investment objectives for the plan assets 
in the US are to achieve a positive rate of return that would be expected to close the current funding deficit and so enable us to 
terminate the frozen pension plan at a reasonable cost. These guidelines are established based on market conditions, risk tolerance, 
funding requirements and expected benefit payments. The Plan Committee also oversees the investment allocation process, selects 
the  investment  managers,  and  monitors  asset  performance.  The  investment  portfolio  contains  a  diversified  portfolio  of  fixed 
income and equity index funds. Securities are also diversified in terms of domestic and international securities, short- and long-
term securities, growth and value styles, large cap and small cap stocks.

Outside the US, pension plan assets are typically managed by decentralized fiduciary committees. There is a significant variation 
in policy asset allocation from country to country. Local regulations, local funding rules, and local financial and tax considerations 
are part of the funding and investment allocation process in each country. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________133

 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 22. Employee Retirement Plans

The following table presents LivaNova’s US and Non-US pension plan target allocations by asset category as of 31 December 
2023 and 2022:

2023

2022

US Pension 
Benefits

Non-US 
Pension 
Benefits

US Pension 
Benefits

Non-US 
Pension 
Benefits

Equity Securities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Debt Securities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 29 %
 70 %
 1 %

 1 %
 85 %
 14 %

 29 %
 70 %
 1 %

 1 %
 84 %
 15 %

Retirement Benefit Fair Values

The following is a description of the valuation methodologies used for retirement benefit plan assets measured at fair value:

Equity  Mutual  Funds:  Valued  based  on  the  year-end  net  asset  values  of  the  investment  vehicles.  The  net  asset  values  of  the 
investment  vehicles  are  based  on  the  fair  values  of  the  underlying  investments  of  the  partnerships  valued  at  the  closing  price 
reported in the active markets in which the individual security is traded. Equity mutual funds have a daily reported net asset value 
and LivaNova classifies these investments as Level 2.

Fixed Income Mutual Funds: Valued based on the year-end net asset values of the investment vehicles. The net asset values of the 
investment vehicles are based on the fair values of the underlying investments of the partnerships valued based on inputs other 
than quoted prices that are observable.

Money Markets: Valued based on quoted prices in active markets for identical assets.

The  following  tables  provide  information  by  level  for  the  US  retirement  benefit  plan  assets  that  are  measured  at  fair  value,  as 
defined by IFRS as of 31 December 2023 and 2022 (in thousands). Refer to “Note 5. Fair Value Measurements” for discussion of 
the fair value measurement terms of Levels 1, 2, and 3.

Equity mutual funds   . . . . . . . . . . . . . . . . $ 
Fixed income mutual funds       . . . . . . . . . .
Money market funds    . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Equity mutual funds   . . . . . . . . . . . . . . . . $ 
Fixed income mutual funds       . . . . . . . . . .
Money market funds    . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

1,882  $ 
4,571 
85 
6,538  $ 

1,591  $ 
3,843 
68 
5,502  $ 

Fair Value Measurement Using Inputs Considered as:
Level 2

Level 3

Level 1

—  $ 
— 
85 
85  $ 

1,882  $ 
4,571 
— 
6,453  $ 

Fair Value Measurement Using Inputs Considered as:
Level 2

Level 1

Level 3

—  $ 
— 
68 
68  $ 

1,591  $ 
3,843 
— 
5,434  $ 

— 
— 
— 
— 

— 
— 
— 
— 

The following tables provide information by level for the Non-US retirement benefit plan assets that are measured at fair value, as 
defined by IFRS as of 31 December 2023 and 2022 (in thousands). Refer to “Note 5. Fair Value Measurements” for discussion of 
the fair value measurement terms of Levels 1, 2, and 3.

Equity mutual funds   . . . . . . . . . . . . . . . . $ 
Fixed income mutual funds       . . . . . . . . . .
Money market funds    . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Equity mutual funds   . . . . . . . . . . . . . . . . $ 
Fixed income mutual funds       . . . . . . . . . .
Money market funds    . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

23  $ 

1,530 
340 
1,893  $ 

42  $ 

2,742 
448 
3,232  $ 

Fair Value Measurement Using Inputs Considered as:
Level 2

Level 3

Level 1

—  $ 
— 
340 
340  $ 

23  $ 

1,530 
— 
1,553  $ 

Fair Value Measurement Using Inputs Considered as:
Level 2

Level 3

Level 1

—  $ 
— 
448 
448  $ 

42  $ 

2,742 
— 
2,784  $ 

— 
— 
— 
— 

— 
— 
— 
— 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________134

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 22. Employee Retirement Plans

Retirement Benefit Funding Plan

LivaNova has the policy to make the minimum required contribution to fund the US pension plan as determined by MAP – 21 and 
the Highway and Transportation Funding Act of 2014. LivaNova contributed $1.4 million and $0.6 million to the pension plans 
(US and non-US) during the years ended 31 December 2023 and 2022, respectively. LivaNova anticipates that the Company will 
make contributions to the US pension plan of approximately $0.2 million during fiscal year 2024. Contributions to the non-US 
pension plans in fiscal year 2023 are not expected to be material. The weighted average duration of the defined benefit plans is 
approximately 8 years and 10 years for US plan and Non-US plans respectively. 

Benefit payments, including amounts to be paid from LivaNova’s assets, and reflecting expected future service, as appropriate, as 
of 31 December 2023, were expected to be paid as follows (in thousands):

US Plan

Non-US 
Plans

2024       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2025       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2026       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2027       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2028       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2029 - 2033  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Above 2033      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

3,495  $ 
829 
877 
667 
509 
2,105 
740 
9,222  $ 

514 
537 
657 
594 
664 
3,886 
1,408 
8,260 

Benefit payments, including amounts to be paid from LivaNova’s assets, and reflecting expected future service, as appropriate, as 
of 31 December 2022, were expected to be paid as follows (in thousands):

US Plan

Non-US 
Plans

2023       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2024       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2025       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2026       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2027       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2028 - 2032  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Above 2032      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

3,820  $ 
688 
853 
908 
673 
2,196 
652 
9,790  $ 

740 
589 
675 
634 
730 
3,769 
1,395 
8,532 

Defined Contribution Plans. LivaNova sponsors defined contribution plans, including the Cyberonics, Inc. Employee Retirement 
Savings Plan, which qualifies under Section 401(k) of the US Internal Revenue Code, covering US employees, the Cyberonics, 
Inc. Non-Qualified Deferred Compensation Plan, covering certain US middle and senior management and the Belgium Defined 
Contribution  Pension  Plan  for  Cyberonics’s  Belgium  employees.  LivaNova  incurred  expenses  for  LivaNova’s  defined 
contribution plans of $11.1 million and $9.0 million for the years ended 31 December 2023 and 31 December 2022, respectively.

Note 23. Income Taxes Expense

The  following  table  presents  the  composition  of  income  tax  expense  for  the  years  ended  31  December  2023  and  2022  (in 
thousands):

Current Tax:
Charge in respect to current period     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Charge in respect to prior period   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total current tax expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred Tax:
Relating to the origination and reversal of temporary differences     . . . . . . . . . . . . . . . .
Relating to changes in tax rates and legislation      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total deferred tax credit       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income tax expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

(9,762)  $ 
(7,073)   
(16,835)   

(857)   
1,905 
1,048 
(15,787)  $ 

(6,293) 
(3,216) 
(9,509) 

4,927 
2,394 
7,321 
(2,188) 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________135

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 23. Income Taxes Expense

The following table presents a reconciliation of the statutory income tax rate to LivaNova’s effective income tax rate expressed as 
a percentage of income before income taxes for the years ended 31 December 2023 and 2022:

2023

2022

Statutory tax rate at UK rate    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 19.0 %
Change in unrecognised deferred tax assets (1)   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 (1.5) 
Foreign tax rate differential    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 9.5 
US state and local tax provision, net of federal benefit      . . . . . . . . . . . . . . . . . . . . . . . .
 (2.3) 
Impairment of goodwill and intangible assets (1)         . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 (27.5) 
Consulting Fees    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 (0.4) 
Effect of changes in tax rate      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 3.3 
Research and development tax credits     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 1.1 
Base erosion anti-abuse tax      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 (2.6) 
Other, net     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 (1.2) 
Effective tax rate      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 (2.6) %
(1) During  the  years  ended  31  December  2023  and  2022,  ACS  impairments  increased  the  tax  rate  by  $21.0  million  and 

 23.5 %
 (35.9) 
 6.0 
 (3.4) 
 (3.0) 
 (2.5) 
 1.5 
 0.3 
 0.4 
 (5.6) 
 (18.7) %

$24.6 million, respectively. For additional information, refer to “Note 30. Exceptional Items.”

LivaNova continues to monitor the adoption of Pillar Two by the taxing jurisdictions in which it operates. The UK has enacted 
legislation providing for a minimum effective tax rate of 15% through a “multinational top-up tax” and a “domestic top-up tax” 
for accounting periods beginning on or after 31 December 2023. Draft UK legislation has also been published for an UTPR to be 
introduced, although not before accounting periods beginning on or after 31 December 2024. A UTPR would be a backstop rule 
intended to ensure that amounts of multinational top-up tax that are not collected under foreign global minimum tax rules can in 
certain circumstances be collected instead in the UK.

As  required  by  the  amendments  to  IAS  12,  the  Company  has  applied  the  exception  and  will  neither  recognise  nor  disclose 
information  about  deferred  tax  assets  and  liabilities  relating  to  Pillar  Two  income  taxes.  The  Company  does  not  expect  the 
adoption  of  Pillar  Two  to  have  a  significant  impact.  Refer  to  “Note  2.  Basis  of  Preparation,  Use  of  Accounting  Estimates  and 
Material Accounting Policies.”

Deferred Tax Assets and Liabilities

The following table presents the change in net deferred tax assets (liabilities) as recognised in the balance sheet during the years 
ended 31 December 2023 and 2022 (in thousands):

2023

2022

At the beginning of the year       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Deferred tax benefit, net      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax recorded in equity   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
At the end of the year       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

103,406  $ 
1,048 
(176)   
104,278  $ 

100,318 
7,321 
(4,233) 
103,406 

The following table provides the net deferred tax assets expected to be recognised within the next 12 months and after the next 12 
months as of 31 December 2023 and 2022 (in thousands):

Within the next 12 months    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
After the next 12 months     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net deferred tax assets       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

36,351  $ 
67,927 

104,278  $ 

26,019 
77,387 
103,406 

2023

2022

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________136

 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 23. Income Taxes Expense

Deferred tax assets and liabilities on a gross basis are summarised as follows (in thousands):

31 December 
2023

Activity During the Year Ended 31 December 2023
Consolidated 
Statement of 
(Loss)

Shareholders' 
Equity

Tax Rate 
Change (1)

1 January 2023

Deferred tax assets:

NOLs      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Tax credit carryforwards    . . . . . . . . . . . . . . .
Deferred compensation     . . . . . . . . . . . . . . . .
Accruals and reserves      . . . . . . . . . . . . . . . . .
Inventory       . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gross deferred tax assets (2)     . . . . . . . . . . . . . . .
Deferred tax liabilities:

Gain on sale of intellectual property      . . . . . .
Property, equipment & intangible assets     . . .
Other       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gross deferred tax liabilities     . . . . . . . . . . . . . .
Deferred tax assets (liabilities), net      . . . . . . . . . $ 

82,693  $ 
764 
6,956 
85,307 
10,397 
4,331 
190,448 

— 

(85,525)   
(645)   
(86,170)   
104,278  $ 

6,163  $ 
477 
(1,473)   
(5,080)   
893 
(3,789)   
(2,809)   

12,603 
(10,069)   
(582)   
1,952 
(857)  $ 

1,066  $ 
— 
(267)   
(814)   
(97)   
712 
600 

207 
1,161 

(63)   

1,305 
1,905  $ 

169  $ 

12 
(617)   
642 
(281)   
97 
22 

— 
(198)   
— 
(198)   
(176)  $ 

75,295 
275 
9,313 
90,559 
9,882 
7,311 
192,635 

(12,810) 
(76,419) 
— 
(89,229) 
103,406 

Reported in the consolidated balance sheet (after jurisdictional netting):

Net deferred tax assets     . . . . . . . . . . . . . . . . . $ 
Deferred tax liabilities    . . . . . . . . . . . . . . . . .
Deferred tax assets, net (2)     . . . . . . . . . . . . . . $ 

113,364 

       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(9,086)         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

104,278 

       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

110,734 
(7,328) 
103,406 

(1) UK  tax  rate  to  increase  to  25%,  effective  1  April  2023.  The  change  in  tax  rate  for  2023  was  primarily  due  to  the  NOLs 

generated during 2023 net of group relief being measured to a tax rate 19%.

(2) During  the  year  ended  31  December  2023,  the  net  deferred  tax  assets  increased  from  net  operating  losses  in  the  UK  less 

amortisation of intangibles. 

31 December 
2022

Activity During the Year Ended 31 December 2022
Consolidated 
Statement of 
(Loss)

Shareholders' 
Equity

Tax Rate 
Change (1)

1 January 2022

Deferred tax assets:

Net operating loss carryforwards        . . . . . . . . $ 
Tax credit / (expense) carryforwards  . . . . . .
Deferred compensation     . . . . . . . . . . . . . . . .
Accruals and reserves      . . . . . . . . . . . . . . . . .
Inventory       . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gross deferred tax assets (2)     . . . . . . . . . . . . . . .
Deferred tax liabilities:

75,295  $ 
275 
9,313 
90,559 
9,882 
7,311 
192,635 

12,995  $ 
(550)   
(1,967)   
(1,682)   
987 
(10,015)   
(232)   

3,075  $ 
— 
(1,800)   
(1,166)   
(214)   
(758)   
(863)   

(14,257)  $ 
— 
(9,795)   
19,893 
265 
155 
(3,739)   

73,482 
825 
22,875 
73,514 
8,844 
17,929 
197,469 

(Loss) / gain on sale of intellectual property     
Property, equipment & intangible assets     . . .
Gross deferred tax (liabilities) / assets    . . . . . . .
Deferred tax assets (liabilities), net      . . . . . . . . . $ 

(12,810)   
(76,419)   
(89,229)   
103,406  $ 

12,811 
(7,652)   
5,159 
4,927  $ 

943 
2,314 
3,257 
2,394  $ 

33 
(527)   
(494)   
(4,233)  $ 

(26,597) 
(70,554) 
(97,151) 
100,318 

Reported in the consolidated balance sheet (after jurisdictional netting):

Net deferred tax assets     . . . . . . . . . . . . . . . . . $ 
Deferred tax liabilities    . . . . . . . . . . . . . . . . .
Deferred tax assets, net (2)     . . . . . . . . . . . . . . $ 

110,734 

       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(7,328)         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

103,406 

       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

107,869 
(7,551) 
100,318 

(1) UK received royal assent in July 2021 and provided for the UK tax rate to increase to 25%, effective 1 April 2023, there was 
a revaluation to increase deferred taxes in 2021. The change in tax rate for 2022 was primarily due to losses and other tax 
assets generated during 2022 and remeasured to 1 April 2023 tax rate of 25%.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________137

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 23. Income Taxes Expense

(2) During the year ended 31 December 2022, the net deferred tax assets increased from net operating losses in the UK offset by 

increased unrecognised deferred tax assets in US.

LivaNova  remeasured  certain  deferred  tax  assets  and  liabilities  based  on  the  rates  at  which  they  are  expected  to  reverse  in  the 
future. 

LivaNova periodically assesses the recoverability of the Company’s deferred tax assets by considering whether it is probable that 
some  or  all  of  the  actual  benefit  of  those  assets  will  be  realised.  To  the  extent  that  realization  does  not  meet  the  “probable” 
criterion,  the  Company  does  not  recognise  a  deferred  tax  asset.  LivaNova  periodically  reviews  the  adequacy  and  necessity  of 
unrecognised  deferred  tax  assets  by  considering  significant  positive  and  negative  evidence  relative  to  the  Company’s  ability  to 
recover deferred tax assets and to determine the timing and amount of the unrecognised deferred tax assets that should be released. 
This evidence includes: profitability in the most recent quarters; internal forecast profitability and expected utilization period; size 
of  deferred  tax  asset  relative  to  estimated  profitability;  the  potential  effects  on  future  profitability  from  increasing  competition, 
healthcare reforms and overall economic conditions; limitations and potential limitations on the use of LivaNova’s NOLs due to 
ownership changes; and the implementation of prudent and feasible tax planning strategies, if any.

As  required  by  the  amendments  to  IAS  12,  the  Company  has  applied  the  exception  and  will  neither  recognise  nor  disclose 
information about deferred tax assets and liabilities relating to Pillar Two income taxes.

Deferred tax assets and liabilities are classified as non-current assets and liabilities.

Net Operating Loss Carryforwards

LivaNova had the following NOL carryforwards as of 31 December 2023 which can be used to reduce LivaNova’s income tax 
payable in future years (in thousands):

Region

Gross Amount

Tax Effected 
Amount
Without
Expiration

Tax Effected 
Amount With 
Expiration

Europe     . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
US Federal    . . . . . . . . . . . . . . . . . . . . . . . $ 
US State    . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Rest of World    . . . . . . . . . . . . . . . . . . . . $ 

426,244  $ 
32,100  $ 
182,335  $ 
23,206  $ 

100,818  $ 
35  $ 
2,349  $ 
7,578  $ 

— 
6,706 
8,493 
128 

Starting
Expiration Year
Unlimited
2028
2023
2025

LivaNova had the following NOL carryforwards as of 31 December 2022 which can be used to reduce our income tax payable in 
future years (in thousands):

Region

Gross Amount

Tax Effected 
Amount
Without
Expiration

Tax Effected 
Amount With 
Expiration

Europe     . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
US Federal    . . . . . . . . . . . . . . . . . . . . . . . $ 
US State    . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Rest of World    . . . . . . . . . . . . . . . . . . . . $ 

429,156  $ 
112,259  $ 
180,411  $ 
11,609  $ 

104,075  $ 
8,474  $ 
2,349  $ 
3,437  $ 

— 
15,100 
8,727 
306 

Starting
Expiration Year
Unlimited
2023
2023
2025

Included  in  the  table  above  are  deferred  tax  assets  that  have  not  been  recognised  with  respect  of  the  following  items  as  of  31 
December 2023 and 2022 (in thousands):

Tax loss carryforwards    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Tax credits    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World tax credits   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accruals and reserves      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other deferred tax assets (1)
     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

43,415  $ 
38,486 
481 
65,625 
29,760 
177,767  $ 

67,173 
40,648 
996 
— 
40,477 
149,294 

(1) Other deferred tax assets includes property, equipment, intangible assets, inventory, and other items.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________138

 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 23. Income Taxes Expense

For  losses  incurred  after  April  2017  in  the  UK,  the  Company  anticipates  a  recoverability  of  these  operating  loss  carryforwards 
beginning in 2025 as the Company expects an increase in taxable income due to the full amortisation of certain intangible assets. 
The  Company  is  relying  on  estimated  future  income  projections  and  judgement  on  the  growth  of  the  projected  income  for  the 
recoverability of the deferred tax assets corresponding the NOLs. The Company estimates it will be able to recover its tax loss in 
less than 10 years through UK Group relief, as the UK Group will realize substantially an increase of taxable income as a result of 
increased revenues from royalty income, interest income, and decreased amortisation of intangible assets beginning in 2024.

No provision has been made for income taxes on undistributed earnings of foreign subsidiaries as of 31 December 2023 because it 
is the Company’s intention to indefinitely reinvest undistributed earnings of the Company’s foreign subsidiaries. In the event of 
the distribution of those earnings in the form of dividends, a sale of the subsidiaries, or certain other transactions, the Company 
may  be  liable  for  income  taxes.  There  should  be  no  material  tax  liability  on  future  distributions  as  most  jurisdictions  with 
undistributed  earnings  have  various  participation  exemptions  /  no  withholding  tax.  These  unrecognised  differences  are  not 
expected to reverse in the foreseeable future. 

Uncertain Tax Positions

Tax authorities may disagree with certain positions the Company has taken and assess additional taxes. The Company regularly 
assess the likely outcomes of LivaNova’s tax positions in order to determine the appropriateness of the Company’s reserves for 
uncertain tax positions. However, there can be no assurance that LivaNova will accurately predict the outcome of these audits and 
the actual outcome of an audit could have a material impact on the Company’s consolidated results of income, financial position 
or cash flows. If all of LivaNova’s unrecognised tax benefits as of 31 December 2023 were recognised, $0.5 million would impact 
the  Company’s  effective  tax  rate  and  $4.9  million  would  be  in  the  form  of  an  unrecognised  net  operating  loss  carryforward. 
LivaNova believes it is reasonably possible that, within the next twelve months, there will not be any settlement of uncertain tax 
positions with various tax authorities nor the expiration of statutes of limitations, and recognised tax benefits should not decrease.

Accrued  interest  related  to  uncertain  tax  positions  totalled  $0.7  million  and  $0.3  million  as  of  31  December  2023  and  31 
December 2022, respectively, and were included in non-current provisions on the Company’s consolidated balance sheet.

Other Matters

LivaNova PLC is domiciled and resident in the UK. LivaNova’s subsidiaries conduct operations and earn income in numerous 
countries and are subject to the laws of taxing jurisdictions within those countries, and the income tax rates imposed in the tax 
jurisdictions  in  which  LivaNova’s  subsidiaries  conduct  operations  vary.  As  a  result  of  the  changes  in  the  overall  level  of  the 
Company’s  income,  and  the  changes  in  tax  laws,  the  Company’s  consolidated  effective  income  tax  rate  may  vary  from  one 
reporting year to another.

The major jurisdictions where LivaNova is subject to income tax examinations as of 31 December 2023 are as follows:

Jurisdiction
US - federal and state    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Italy    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Germany    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
England and Wales    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Canada     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Earliest Year Open
2020
2018
2019
2019
2019

Note 24. Commitments and Contingencies

Saluggia Site Hazardous Substances

LSM, formerly a subsidiary of Sorin, one of the companies that merged into LivaNova PLC in 2015, manages site services for the 
campus in Saluggia, Italy. In addition to being a former LivaNova manufacturing facility, the Saluggia campus is also the location 
of manufacturing facilities of third parties, a cafeteria for workers, and storage facilities for hazardous substances and equipment 
previously  used  in  a  nuclear  research  centre,  later  turned  nuclear  medicine  business,  between  the  1960s  and  the  late  1990s. 
Pursuant  to  authorisation  from  the  Italian  government,  LSM  has,  and  continues  to,  perform  ordinary  maintenance,  secure  the 
facilities, monitor air and water quality and file applicable reports with the competent environmental authorities.

In 2020, LSM received correspondence from National Inspectorate for Nuclear Safety and Radiation Protection, a sub-body of the 
ISIN requesting that, within five years, LSM demonstrate the financial capacity to meet its obligations under Italian law to clean 
and dismantle any contaminated buildings and equipment, as well as to deliver hazardous substances to a national repository. This 
repository  will  be  built  by  the  Italian  government  at  a  location  and  time  yet  to  be  determined.  ISIN  subsequently  published 
Technical  Guide  n.  30,  which  identifies  the  technical  criteria,  and  general  safety  and  protection  requirements  for  the  design, 
construction, operation and dismantling of temporary storage facilities for the hazardous substances. In January 2021, a list of 67 
potential sites for the national repository was published. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________139

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 24. Commitments and Contingencies

Although  there  is  no  legal  obligation  to  begin  any  work  or  deliver  the  hazardous  substances,  as  the  performance  of  these 
obligations  is  contingent  on  the  construction  of  the  as-yet  unbuilt  national  repository,  based  on  the  aforementioned  factors,  the 
Company concluded its obligation to clean, dismantle, and deliver any hazardous substances to a national repository is probable 
and reasonably estimable. Accordingly, in 2020, LivaNova recognised a $49.5 million provision for this matter, which is included 
within other operating expenses on the consolidated statement of (loss). The provision was determined utilising the middle of the 
estimated  range  of  loss  of  $39.7  million  to  $50.5  million.  The  estimated  liability  as  of  31  December  2023  and  2022  was 
$42.7 million and  $38.1  million,  respectively. The  increase in the Saluggia site remediation provision from 31 December 2022 
was due to adjustments associated with expected disposal costs resulting from inflation, as well as a decrease in the discount rate 
applied. A 0.5% increase or decrease in the discount rate applied would not have a material impact on the provision. The timing of 
any cash outflows associated with this provision is uncertain given the factors noted above, however LivaNova does not currently 
expect  to  incur  significant  cash  outflows  associated  with  this  matter  in  the  next  two  years.  Refer  to  “Note  20.  Contingent 
Consideration, 3T Litigation Provision Liability and Other Provisions” for additional information.

SNIA Environmental Liability

Sorin was created as a result of a spin-off from SNIA in 2004, and in 2015, Sorin was merged into LivaNova. SNIA subsequently 
became  insolvent,  and  the  Public  Administrations,  sought  compensation  from  SNIA  in  an  aggregate  amount  of  approximately 
$3.8  billion  for  remediation  costs  relating  to  the  environmental  damage  at  chemical  sites  previously  operated  by  SNIA’s  other 
subsidiaries.

There are proceedings relating to the SNIA bankruptcy to which LivaNova is not a party in the Bankruptcy Court of Udine and the 
Bankruptcy Court of Milan. In 2011, the Bankruptcy Court of Udine held that the Public Administrations were not creditors of 
either SNIA or its subsidiaries in connection with their claims in the Italian insolvency proceedings. The Public Administrations 
appealed.  In  2016,  the  Court  of  Udine  rejected  the  appeal,  and  the  Public  Administrations  appealed  to  the  Supreme  Court. 
Similarly, in 2014, the Bankruptcy Court of Milan held that the Public Administration were not creditors of either SNIA or its 
subsidiaries. The Public Administrations appealed. In April 2022, Bankruptcy Court of Milan declared the Public Administrations 
to be a non-privileged creditor of SNIA for up to €454 million, and the Public Administrations appealed to the Supreme Court.

In  2012,  SNIA  filed  a  civil  action  against  Sorin  in  the  Civil  Court  of  Milan  asserting  joint  liability  of  a  parent  and  a  spun-off 
company;  the  Public  Administrations  entered  voluntarily  into  the  proceeding,  asking  Sorin,  as  jointly  liable  with  SNIA,  to  pay 
compensation  for  SNIA’s  environmental  damages.  In  2016,  the  Court  of  Milan  dismissed  all  legal  actions  of  SNIA  and  of  the 
Public  Administrations  further  requiring  the  Public  Administrations  to  pay  Sorin  approximately  €292,000  (approximately 
$323,000 as of 31 December 2023) for legal fees. The Public Administrations appealed the 2016 Decision to the Court of Appeal. 
On 5 March 2019, the Court of Appeal issued a partial decision on the merits declaring Sorin/LivaNova jointly liable with SNIA 
for SNIA’s environmental liabilities in an amount up to the fair value of the net worth received by Sorin because of the Sorin spin-
off, an estimated €572.1 million (approximately $633.1 million as of 31 December 2023). LivaNova appealed the partial decision 
on liability to the Italian Supreme Court in August 2019.

In  November  2021,  the  Court  of  Appeal  delivered  the  remainder  of  its  decision,  ordering  LivaNova  to  pay  damages  of 
approximately  €453.6  million  (approximately  $502.0  million  as  of  31  December  2023).  LivaNova  appealed  the  decision  on 
damages  in  December  2021.  On  21  February  2022,  the  Court  of  Appeal  notified  the  Company  that  it  granted  the  Company  a 
suspension with respect to the payment of damages until a decision has been reached on the appeal to the Italian Supreme Court. 
This  suspension  was  subject  to  LivaNova  providing  a  first  demand  bank  guarantee  of  €270.0  million  (approximately  $298.8 
million  as  of  31  December  2023)  within  30  calendar  days,  and  on  21  March  2022,  LivaNova  delivered  the  guarantee,  thereby 
satisfying the condition. 

In November 2022, in response to one of a number of appeals asserted by LivaNova, the Supreme Court issued an ordinance, a 
procedural document, whereby the Supreme Court referred a question on interpretation of a European directive on demergers to 
the  ECJ.  Specifically,  the  ordinance  asks  the  ECJ  to  provide  a  binding  decision  as  to  whether  a  company  resulting  from  a 
demerger  can  be  held  jointly  and  severally  liable  not  only  for  the  established  liabilities  of  the  demerged  company  that  were 
articulated at the time of demerger, but also for the environmental liabilities of the demerged company that materialized after the 
demerger  which  are  derived  from  actions  performed  prior  to  the  demerger.  Following  receipt  of  the  binding  decision  from  the 
ECJ, which is expected in 2024, the Supreme Court is expected to incorporate and issue a decision in response to all of the appeals 
of  LivaNova  and  counter-appeals  submitted  by  the  Public  Administrations.  While  the  timing  of  the  decisions  by  the  ECJ  and, 
subsequently,  the  Supreme  Court  are  uncertain,  the  Company  believes  that  the  final  decision  from  the  Supreme  Court  is  not 
expected until at least 2025.

In 2011, Caffaro, a SNIA subsidiary, sold its Brescia chemical business to Caffaro Brescia, a third party belonging to the Todisco 
group,  and  as  part  of  the  acquisition,  Caffaro  Brescia  agreed  to  secure  hydraulic  barriers  at  the  site  and  maintain  existing 
environmental  security  measures.  In  2020,  Caffaro  Brescia  declared  it  was  withdrawing  from  its  agreement  to  maintain  the 
environmental  measures.  In  2021,  LivaNova  (in  addition  to  Caffaro  Brescia,  and  other  non-LivaNova  entities)  received  an 
administrative  order  from  the  Italian  Ministry  of  the  Environment  requiring  the  Company  to  ensure  the  maintenance  of  the 
environmental measures and to guarantee that such works remain fully operational, the annual management and maintenance for 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________140

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 24. Commitments and Contingencies

which is estimated at approximately €1 million per year. The receipt of the Order appears to be based on the aforementioned Court 
of  Appeal  decision  regarding  LivaNova’s  alleged  joint  liability  with  SNIA  for  SNIA’s  environmental  liabilities.  LivaNova’s 
response, dated 16 February 2021, disputes the grounds upon which the Order is based. LivaNova also appealed the Order in the 
Administrative Court in Brescia.

LivaNova  has  not  recognised  a  liability  in  connection  with  these  related  matters  because  any  potential  loss  is  not  currently 
probable.

Product Liability Litigation

The Company continues to be involved in litigation involving LivaNova’s 3T device. The litigation includes the cases remaining 
in the US District Court for the Middle District of Pennsylvania, various US state court cases, and in jurisdictions outside the US. 
As of 25 April 2024, the Company was aware of approximately 70 filed and unfiled claims worldwide. The complaints generally 
seek damages and other relief based on theories of strict liability, negligence, breach of express and implied warranties, failure to 
warn,  design  and  manufacturing  defect,  fraudulent  and  negligent  misrepresentation  or  concealment,  unjust  enrichment,  and 
violations of various state consumer protection statutes.

During the years ended 31 December 2023 and 2022 LivaNova recorded an additional liability of $40.9 million and $22.3 million, 
respectively, due to new information received about the nature of certain claims. As of 31 December 2023, the provision for these 
matters was $20.3 million. While the amount accrued represents LivaNova’s best estimate for those filed and unfiled claims that 
LivaNova believes are both probable and estimable at this time, and which are a subset of the filed and unfiled claims worldwide 
of  which  the  Company  is  currently  aware,  the  actual  liability  for  resolution  of  these  matters  may  vary  from  the  Company’s 
provision. The remaining claims for which a provision has not been recorded are remote or the potential loss is not estimable at 
this time.

Caisson Contract Litigation

On  25  November  2019,  LivaNova  received  notice  of  a  lawsuit  initiated  by  former  members  of  Caisson,  a  subsidiary  of  the 
Company  acquired  in  2017.  The  lawsuit,  Todd  J.  Mortier,  as  Member  Representative  of  the  former  Members  of  Caisson 
Interventional,  LLC  v.  LivaNova  USA,  Inc.,  was  filed  in  the  US  District  Court  for  the  District  of  Minnesota.  The  complaint 
alleged (i) breach of contract, (ii) breach of the covenant of good faith and fair dealing and (iii) unjust enrichment in connection 
with  the  Company’s  operation  of  Caisson’s  transcatheter  mitral  valve  replacement  program  and  the  Company’s  20  November 
2019  announcement  that  it  was  ending  the  program  at  the  end  of  2019.  The  lawsuit  sought  damages  arising  out  of  the  2017 
acquisition  agreement,  including  various  regulatory  milestone  payments.  In  May  2022,  the  District  Court  granted  LivaNova’s 
motion for summary judgment, and in June 2023, the Eighth Circuit Court of Appeals affirmed the decision. The Company now 
considers Caisson’s claim against LivaNova to be closed.

Mitral Demand Letter

On  29  July  2022,  LivaNova  received  a  demand  letter  from  Mitral  for  approximately  €20.8  million  ($23.0  million  as  of  31 
December  2023)  for  breach  of  warranty  claims  under  the  A&R  Purchase  Agreement.  Specifically,  the  claims  allege  failure  to 
disclose certain information relating to a supplier, thereby allegedly impacting the profitability of Mitral’s business in China and 
Japan.  On  22  March  2023,  Mitral  served  a  formal  claim  on  LivaNova  in  the  High  Court  of  Justice  Commercial  Court  (King’s 
Bench  Division)  alleging  damages  flowing  from  the  aforementioned  asserted  breaches  of  warranties  in  the  A&R  Purchase 
Agreement,  and  the  Company  filed  its  Defense  on  17  May  2023.  In  November  2023,  the  Company  entered  into  a  settlement 
agreement with Mitral regarding the aforementioned matter pursuant to which the Company paid to Mitral less than €1.0 million 
($1.1 million as of 31 December 2023), including costs. The Company now considers this matter closed.

Italian MedTech Payback Measure

As previously disclosed, in 2015, the Italian Parliament introduced rules regarding public contracts with the National Healthcare 
System for the supply of goods and services. In particular, the law introduced a “payback” measure requiring companies selling 
medical devices in Italy to repay a percentage of the healthcare expenditures exceeding the regional maximum caps for medical 
devices. In the intervening years since the rules were first issued, there has been considerable uncertainty about how the law will 
operate  and  what  the  exact  timeline  is  for  finalization.  In  August  2022,  a  decree  was  published  which  provided  guidance  and 
timetables for the rule. In response, LivaNova filed an appeal at the Administrative Court against the Decree of the Ministry of 
Health  assessing  the  amount  payable  and  against  the  MedTech  Payback  Guidelines.  LivaNova  also  filed  appeals  against  the 
regions requesting payments. In August 2023, the Administrative Court upheld LivaNova’s request to suspend the effect of the 
requests  for  payment  by  the  regions,  pending  the  decision  by  the  court  on  the  merits  of  the  case.  In  November  2023,  the 
Administrative Court, in a separate matter, asked the Constitutional Court whether the payback law is compliant with the Italian 
Constitution and pending the decision by the Constitutional Court, all cases brought by medical device companies in this matter 
are suspended. The Company has accrued for the “payback” law since 2015 based on market and product information. As of 31 
December 2023 and 2022, the total amount reserved for this matter was $8.2 million and $6.4 million, respectively; however, the 
actual liability could vary.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________141

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 24. Commitments and Contingencies

Other Matters

Additionally,  LivaNova  is  the  subject  of  various  pending  or  threatened  legal  actions  and  proceedings  that  arise  in  the  ordinary 
course  of  LivaNova’s  business.  These  matters  are  subject  to  many  uncertainties  and  outcomes  that  are  not  predictable  and  that 
may not be known for extended periods of time. Since the outcome of these matters cannot be predicted with certainty, the costs 
associated  with  them  could  have  a  material  adverse  effect  on  the  LivaNova’s  consolidated  net  income,  financial  position  or 
liquidity.

Note 25. Earnings Per Share

Basic EPS is calculated by dividing the profit for the year attributable to owners of the parent by the weighted average number of 
Ordinary  Shares  outstanding  during  the  year.  Diluted  EPS  is  calculated  by  dividing  the  net  profit  attributable  to  owners  of  the 
parent  by  the  weighted  average  number  of  Ordinary  Shares  outstanding  during  the  year  plus  the  weighted  average  number  of 
Ordinary Shares that would be issued on conversion of all the dilutive potential Ordinary Shares into Ordinary Shares.

The  following  table  sets  forth  the  basic  and  diluted  weighted-average  shares  outstanding  used  in  the  computation  of  basic  and 
diluted EPS for the years ended 31 December 2023 and 2022 (in thousands of shares, except per share amounts):

Numerator:
Loss attributable to owners of the parent    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(100,382)  $ 

(86,294) 

2023

2022

Denominator:
Basic weighted average shares outstanding      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Add effects of share-based compensation instruments(1)    . . . . . . . . . . . . . . . . . . . . . . . .
Diluted weighted average shares outstanding.        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

53,939 
273 
54,212 

Basic loss per share   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Diluted loss per share        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(1.86)  $ 
(1.85)  $ 

53,472 
— 
53,472 

(1.61) 
(1.61) 

(1) Excluded  from  the  computation  of  diluted  EPS  for  the  years  ended  31  December  2023  and  31  December  2022  were  stock 
options, SARs and RSUs totalling 3.0 million and 3.9 million, respectively, because to include them would have been anti-
dilutive.

Note 26. Segment and Geographic Information

Segment Information

LivaNova  identifies  operating  segments  based  on  how  it  manages,  evaluates  and  internally  reports  its  business  activities  to  the 
Company’s CODM, who is the CEO of LivaNova, for purposes to allocate resources, develop and execute its strategy and assess 
performance. For the periods presented herein, LivaNova has three reportable segments: Cardiopulmonary, Neuromodulation and 
Advanced Circulatory Support. Net revenue of the Company’s reportable segments includes revenues from the sale of products 
that  each  reportable  segment  develops  and  manufactures  or  distributes.  For  exceptional  items,  please  refer  to  “Note  30. 
Exceptional Items.”

LivaNova’s  Cardiopulmonary  segment  is  engaged  in  the  design,  development,  manufacture,  marketing  and  selling  of 
cardiopulmonary  products,  including  heart-lung  machines,  oxygenators,  autotransfusion  systems,  perfusion  tubing  systems, 
cannulae and other related accessories. 

LivaNova’s Neuromodulation segment is engaged in the design, development, manufacture, marketing and selling of devices that 
deliver neuromodulation therapy for treating DRE and DTD. Neuromodulation products include the VNS Therapy System, which 
consists  of  an  implantable  pulse  generator,  a  lead  that  connects  the  generator  to  the  vagus  nerve,  and  other  accessories.  It  also 
includes the development and management of clinical testing of LivaNova’s aura6000 System for treating obstructive sleep apnea. 
LivaNova’s  Neuromodulation  segment  also  includes  costs  associated  with  LivaNova’s  former  heart  failure  program,  which  the 
Company began to wind down during 2023.

LivaNova’s ACS segment was engaged in the design, development, manufacture, marketing and selling of temporary life support 
products.  ACS’s  products,  which  comprise  the  LifeSPARC  and  Hemolung  systems,  and  standalone  cannulae  and  accessories, 
including  ProtekDuo  and  transseptal  (TandemHeart)  cannulae,  simplify  temporary  extracorporeal  cardiopulmonary  life  support 
solutions for critically ill patients. For additional information, please refer to “Note 33. Subsequent Events.”

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________142

 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 26. Segment and Geographic Information

Geographic Information

LivaNova  operates  under  three  geographic  regions:  United  States,  Europe,  and  Rest  of  World.  The  table  below  presents  net 
revenue by operating segment and geographic region for the years ended 31 December 2023 and 2022 (in thousands):

2023

2022

Cardiopulmonary

United States        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Europe (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Neuromodulation

United States        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Europe (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Advanced Circulatory Support

United States        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Europe (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other Revenue (2)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Totals

188,299  $ 
156,606 
244,072 
588,977 

407,493 
57,435 
54,782 
519,710 

39,252 
751 
319 
40,322 
4,536 

159,489 
127,064 
213,761 
500,314 

374,542 
50,291 
52,160 
476,993 

37,527 
1,447 
327 
39,301 
5,197 

United States        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Europe (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total (3) (4)    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

635,044 
214,792 
303,709 
1,153,545  $ 

571,558 
178,802 
271,445 
1,021,805 

(1) Includes  countries  in  Europe  where  the  Company  has  a  direct  sales  presence.  Countries  where  sales  are  made  through 

distributors are included in “Rest of World.” 

(2) Other revenue primarily includes rental income not allocated to segments.
(3) Net revenue to external customers includes $41.5 million and $32.3 million in the UK, LivaNova’s country of domicile, for 

the years ended 31 December 2023 and 2022, respectively.

(4) No  single  customer  represented  over  10%  of  the  Company’s  consolidated  net  revenue.  No  country’s  net  revenue 

exceeded 10% of the Company’s consolidated revenue except for the US.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________143

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 26. Segment and Geographic Information

The following table presents a reconciliation of segment income to operating loss for the years ended 31 December 2023 and 2022 
(in thousands):

Cardiopulmonary        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Neuromodulation        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Advanced Circulatory Support      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Segment income       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other operating expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exceptional items - See Note “Note 30. Exceptional Items”     . . . . . . . . . . . . . . . . . . . . .
Operating loss      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

37,886  $ 

152,460 
(35,463)   
(90,528)   
64,355 
(3,308)   
(130,895)   
(69,848)  $ 

17,869 
171,919 
(21,163) 
(80,505) 
88,120 
(7,737) 
(166,789) 
(86,406) 

The following table presents capital expenditures for tangible assets of plant, property and equipment and for software intangible 
assets by operating segment for the years ended 31 December 2023 and 2022 (in thousands):

Cardiopulmonary        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Neuromodulation        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Advanced Circulatory Support      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other (1)
     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

22,326  $ 
1,201 
1,210 
10,370 
35,107  $ 

13,828 
369 
1,773 
10,622 
26,592 

(1) Other capital expenditures primarily include corporate capital expenditures not allocated to segments.

The  following  table  presents  non-current  assets,  net  of  accumulated  depreciation,  amortisation  and  impairment,  by  primary 
geographic  market  as  of  31  December  2023  and  2022.  Non-current  assets  for  this  purpose  consist  of  property,  plant  and 
equipment, intangible assets, goodwill and ROU assets (in thousands):

United States    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Europe    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

531,157  $ 
355,463 
37,108 

923,728  $ 

629,647 
336,599 
38,010 
1,004,256 

Note 27. Related Parties 

Interests  in  subsidiaries  are  set  out  in  “Note  11.  Investments  in  Subsidiaries.”  Transactions  between  the  Company  and  its 
subsidiaries, which are related parties, have been eliminated on consolidation and are not disclosed in this note.

The following receivable balance arose from financing transactions with equity investments as of 31 December 2023 and 2022 (in 
thousands):

Consolidated Balance Sheet
Financial assets - non-current
Noctrix Health, Inc.      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

275  $ 

285 

The following financing transaction was entered into with an equity investment during the years ended 31 December 2023 and 
2022 (in thousands):

Consolidated Statement of (Loss)
Finance (expense)/income
Noctrix Health, Inc.      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

(10)  $ 

13 

Total compensation in respect of key management, who are defined as the Board and certain members of senior management, is 
considered to be a related party transaction. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________144

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 27. Related Parties

The  total  compensation  in  respect  of  key  management  during  the  years  ended  31  December  2023  and  2022  was  as  follows  (in 
thousands):

Salaries and short term benefits     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Social security costs    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pension costs    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Termination benefits     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Share-based compensation      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

6,779  $ 
781 
359 
2,379 
2,809 

13,107  $ 

6,734 
1,058 
712 
— 
12,012 
20,516 

Amounts  received  or  receivable  under  share-based  payment  arrangements  by  key  management  during  the  years  ended  31 
December 2023 and 2022 were $6.8 million and $3.9 million, respectively.

There were no other related party transactions in the year.

Details of directors’ remuneration are included in pages 53 to 74 of the Remuneration Report, which forms part of these financial 
statements. 

Note 28. Consolidated Statement of (Loss) by Nature

The following table presents the consolidated statement of (loss) by nature for the years ended 31 December 2023 and 2022 (in 
thousands):

Net revenue     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Cost of materials, service used and change in inventory      . . . . . . . . . . . . . . . . . . . . . . . . . .
Personnel expense    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Impairment of long-lived assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Litigation provision, net       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amortisation of intangibles      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depreciation and impairment of property, plant and equipment      . . . . . . . . . . . . . . . . . . . .
Other operating costs   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depreciation of right-of-use assets   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Additions to provisions     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Impairment of goodwill   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss on sale of Heart Valve business      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating loss       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance expenses     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net gain on embedded exchange feature and capped call derivatives     . . . . . . . . . . . . . . . .
Net foreign exchange and other income/(expense)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Share of loss from equity accounted investments       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss before tax     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income tax expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss attributable to owners of the parent     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Year Ended 31 December
2022
2023
1,021,805 
1,153,545  $ 
(457,096) 
(524,753)   
(408,698) 
(480,337)   
— 
(89,974)   
(21,663) 
(40,921)   
(29,044) 
(30,526)   
(19,183) 
(19,683)   
(15,853) 
(19,881)   
(10,603) 
(10,291)   
(7,027)   
(945) 
(144,990) 
— 
(136) 
— 
(86,406) 
(49,709) 
43,789 
8,273 
(53) 
(84,106) 
(2,188) 
(86,294) 

(104)   
(84,595)   
(15,787)   
(100,382)  $ 

(69,848)   
(60,450)   
24,209 
21,598 

The  following  table  presents  the  items  included  within  net  foreign  exchange  and  other  income/(expense)  on  the  consolidated 
statement of (loss) for the years ended 31 December 2023 and 2022 (in thousands): 

Interest income      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Dividend income    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Foreign exchange rate (loss) gain       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

22,012  $ 

1,540 
(705)   
(1,249)   
21,598  $ 

4,697 
305 
378 
2,893 
8,273 

2023

2022

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________145

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 29. Employee Compensation Costs

Note 29. Employee Compensation Costs

The following table presents employee compensation costs for the years ended 31 December 2023 and 2022 (in thousands):

Wages and salaries     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Social security costs    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other pension costs    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Share-based payments (1)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other employee costs    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Year Ended 31 December
2022
2023

311,088  $ 
34,329 
19,835 
33,184 
81,901 

480,337  $ 

284,054 
27,799 
18,929 
44,562 
33,354 
408,698 

(1) Represents  share-based  payments  included  in  personnel  expense.  Refer  to  “Note  21.  Share-Based  Plans”  for  total  share-

based compensation expense.

The  following  table  presents  the  monthly  average  number  of  employees  by  geographic  region  during  the  years  ended  31 
December 2023 and 2022:

Europe     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
US       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rest of World     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 30. Exceptional Items

2023

2022

1,395 
1,201 
322 
2,918 

1,387 
1,167 
306 
2,860 

The  following  exceptional  items  are  included  within  operating  loss  for  the  years  ended  31  December  2023  and  2022  (in 
thousands):

Impairment of long-lived assets (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Litigation provision, net (2)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Impairment of goodwill (3)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss on sale of Heart Valve business      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

89,974  $ 
40,921 
— 
— 
130,895  $ 

— 
21,663 
144,990 
136 
166,789 

(1) For additional information refer to “Note 8. Restructuring.”
(2) For  additional  information  refer  to  “Note  20.  Contingent  Consideration,  3T  Litigation  Provision  Liability  and  Other 

Provisions” and “Note 24. Commitments and Contingencies.”

(3) For additional information refer to “Note 10. Goodwill and Intangible Assets.”

Note 31. Auditors’ Remuneration

The following table presents auditors’ remuneration for the years ended 31 December 2023 and 2022 (in thousands):

Year Ended 31 December
2022
2023

Total audit fees payable to the Company’s Auditors       . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Audit-related services (1)
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax advisory and compliance services     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other assurance services      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

5,687  $ 
20 
849 
2 
6,558  $ 

5,250 
35 
299 
1 
5,585 

(1) Audit-related services consist of aggregate fees to PricewaterhouseCoopers LLP for assurance services related to consents 

associated with Registration Statements on Form S-8.

Note 32. New Accounting Pronouncement 

The  following  provides  a  description  of  new  accounting  standards  that  were  adopted  and  their  impact  on  LivaNova’s  financial 
statements:

IFRS 17 Insurance Contracts. IFRS 17 ‘Insurance Contracts’ provides a new general model for accounting for contracts where the 
issuer  accepts  significant  insurance  risk  from  another  party  and  agrees  to  compensate  that  party  if  a  future  uncertain  event 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________146

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 32. New Accounting Pronouncements

adversely  affects  them.  IFRS  17  replaces  IFRS  4  'Insurance  Contracts'.  The  standard  was  adopted  by  LivaNova  on  1  January 
2023, and did not materially impact the Company’s results of operations.

Amendment  to  IAS  1  and  IFRS  Practice  Statement  2  -  Disclosure  of  Accounting  Policies.  An  Amendment  to  IAS  1  and  IFRS 
Practice Statement 2 - ‘Disclosure of Accounting Policies’ was issued in February 2021 the IASB issued a new amendment to IAS 
1  on  disclosure  of  "material"  accounting  policies  rather  than  "significant"  accounting  policies.  The  amendments  define  what 
"material  accounting  policy  information"  is  and  explain  how  to  identify  it.  It  also  clarifies  that  immaterial  accounting  policy 
information does not need to be disclosed, but if so, it should not obscure the relevant accounting information. To support this 
change, the IASB also amended the "IFRS Practice Statement 2 Making Materiality Judgments" to provide guidance on how to 
apply the concept of materiality to accounting policy disclosures. The amendment was adopted by LivaNova on 1 January 2023, 
and did not materially impact the Company’s results of operations.

Amendment to IAS 8 - Accounting Policies, Change in Estimate and Error Rectification. An Amendment to IAS 8 - ‘Accounting 
Policies, Change in Estimate and Error Rectification’ was issued in February 2021 clarifies how entities must distinguish changes 
in  accounting  policies  from  changes  in  accounting  estimates,  as  changes  in  accounting  estimates  are  applied  prospectively  to 
future  transactions  and  other  future  events,  but  changes  in  accounting  policies  are  generally  applied  retrospectively  to  past 
transactions and other past events, as well as to the current period. The amendment was adopted by LivaNova on 1 January 2023, 
and did not materially impact the Company’s results of operations. 

Amendment to IAS 12 - Income Taxes. An Amendment to IAS 12 - ‘Income Taxes’ was issued in May 2021 and requires entities 
to  recognise  deferred  tax  on  transactions  that,  on  initial  recognition,  give  rise  to  equal  amounts  of  taxable  and  deductible 
temporary differences. This typically applies to lease transactions (right-of-use assets and lease liabilities) and decommissioning 
and restoration obligations, as an example, and will require the recognition of additional deferred tax assets and liabilities. The 
amendment was adopted by LivaNova on 1 January 2023, and did not materially impact the Company’s results of operations.

The following provides a description of future adoption of a new accounting standard that may have an impact on LivaNova’s 
financial statements when adopted:

Amendment to IAS 1 Presentation of Financial Statements. An Amendment to IAS 1 ‘Presentation of Financial Statements’ was 
issued  in  January  2020  and  further  clarified  in  October  2022,  with  the  objective  of  clarifying  that  liabilities  are  classified  as 
current or non-current, depending on the rights that exist at the end of the period. The classification is not affected by the entity's 
expectations or events after the reporting date. The amendment also clarifies what "settlement" of a liability refers to under IAS 1. 
The amendments to IAS 1 are effective as of 1 January 2024. The group does not expect the new amendment to materially impact 
its results of operations.

Amendment to IAS 12 - Income Taxes. An Amendment to IAS 12 - ‘International Tax Reform – Pillar Two Model Rules’ was 
issued  in  May  2023  and  adopted  from  that  date.  The  rule  provides  temporary  exception  to  the  requirements  to  recognise  and 
disclose information about deferred tax assets and liabilities related to Pillar Two and provide targeted disclosure requirements for 
affected entities. Pillar Two global minimum tax rules applicable to multinational groups with global revenue over €750 million. 
The  UK  has  enacted  legislation  providing  for  a  minimum  effective  tax  rate  of  15%  through  a  “multinational  top-up  tax”  and  a 
“domestic  top-up  tax”  for  accounting  periods  beginning  on  or  after  31  December  2023.  Draft  UK  legislation  has  also  been 
published  for  an  UTPR  to  be  introduced,  although  not  before  accounting  periods  beginning  on  or  after  31  December  2024.  A 
UTPR would be a backstop rule intended to ensure that amounts of multinational top-up tax that are not collected under foreign 
global minimum tax rules can in certain circumstances be collected instead in the UK. The Company has applied the exception to 
recognising  and  disclosing  information  about  deferred  tax  assets  and  liabilities  related  to  Pillar  Two.  The  Company  does  not 
expect the adoption of Pillar Two to have a significant impact. Refer to “Note 23. Income Taxes Expense” for further information.

Note 33. Subsequent Events 

CEO

On 1 March 2024, Vladimir A. Makatsaria was appointed as Chief Executive Officer of LivaNova and as a member of the Board. 
In  connection  with  Mr.  Makatsaria’s  appointment,  William  A.  Kozy  stepped  down  from  his  role  as  Interim  Chief  Executive 
Officer of the Company on 1 March 2024 but remains the Chair of the Board.

Restructuring

In January 2024, the Company reorganised its operating and reporting structure upon initiating the 2024 Restructuring Plan and 
transitioned all ACS standalone cannulae and accessories, including ProtekDuo and transseptal (TandemHeart) cannulae, into its 
Cardiopulmonary  segment.  Operations  for  other  ACS  products,  including  LifeSPARC  and  Hemolung  systems,  will  be 
discontinued by the end of 2024. For additional information, please refer to “Note 8. Restructuring.”

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________147

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 33. Subsequent Events

In  connection  with  the  2024  Restructuring  Plan,  LivaNova  expects  to  incur  pre-tax  restructuring  charges  in  the  range  of 
approximately $15 million to $20 million. The anticipated charges are comprised of approximately $10 million to $12 million in 
severance  expenses  and  retention  bonuses  and  approximately  $5  million  to  $8  million  in  other  expenses,  including  lease 
termination, facilities remediation, and asset disposal expenses. LivaNova expects the majority of the severance expenses to be 
incurred in the first half of 2024. Retention bonuses will be earned over the period of service, which is expected to be over the full 
year  of  2024.  All  future  cash  payments  related  to  these  restructuring  charges  are  expected  to  be  paid  out  during  2024.  These 
estimates  are  subject  to  change.  During  the  three  months  ended  31  March  2024,  LivaNova  recorded  restructuring  expense  of 
$9.2 million associated with the 2024 Restructuring Plan. 

Effective in 2024, LivaNova changed its reportable segments corresponding to the above-mentioned restructuring and changes in 
how  the  Company’s  CODM  regularly  reviews  information,  allocates  resources  and  assesses  performance.  The  Company’s 
changes to its reportable segments are summarised as follows:

•

•

LivaNova’s  ACS  segment  will  be  included  within  “Other,”  excluding  the  ACS  standalone  cannulae  and  accessories 
business.
LivaNova’s  ACS  standalone  cannulae  and  accessories  business  will  be  included  within  the  Cardiopulmonary  reportable 
segment.

Financial Liabilities

Indenture and Notes

On 8 March 2024, LivaNova issued $345 million aggregate principal amount of its 2.50% convertible senior notes due 2029. The 
2029 Notes were issued pursuant to an indenture, dated as of 8 March 2024, between LivaNova and Citibank, N.A., as trustee. 
Additionally,  on  8  March  2024,  LivaNova’s  wholly-owned  subsidiary,  LivaNova  USA,  Inc.,  entered  into  separate  and 
individually  negotiated  transactions  with  certain  holders  of  LivaNova  USA,  Inc.’s  existing  Cash  Exchangeable  Senior  Notes, 
issued by LivaNova USA, Inc. and guaranteed by LivaNova, to repurchase $230 million aggregate principal amount of the Cash 
Exchangeable  Senior  Notes  for  an  aggregate  cash  amount  of  approximately  $270.5  million  (including  accrued  and  unpaid 
interest), and unwound a corresponding portion of the 2025 Capped Calls.

LivaNova  received  net  proceeds  from  the  offering  of  approximately  $333.0  million,  after  deducting  the  initial  purchasers’ 
discount  and  estimated  offering  expenses  payable  by  LivaNova.  LivaNova  used  (1)  approximately  $31.6  million  of  the  net 
proceeds of the offering to pay the cost of entering into 2029 Capped Calls described below, (2) approximately $270.5 million of 
the net proceeds of the offering to pay the purchase price for the Note Repurchases and (3) the remaining proceeds for general 
corporate purposes.

The 2029 Notes are general senior unsecured obligations of LivaNova. The 2029 Notes will bear interest at a rate of 2.50% per 
year, payable semiannually in arrears on March 15 and September 15 of each year, beginning on 15 September 2024. The 2029 
Notes will mature on 15 March 2029, unless earlier repurchased, redeemed or converted in accordance with their terms.

The initial conversion rate of the 2029 Notes is 14.4085 of LivaNova’s ordinary shares, with a nominal value of £1.00 per share, 
per  $1,000  principal  amount  of  the  2029  Notes  (equivalent  to  an  initial  conversion  price  of  approximately  $69.40  per  ordinary 
share). Upon conversion of the 2029 Notes, LivaNova will pay cash up to the aggregate principal amount of the 2029 Notes to be 
converted  and  pay  or  deliver,  as  the  case  may  be,  cash,  LivaNova’s  ordinary  shares,  or  a  combination  of  cash  and  LivaNova’s 
ordinary shares, at LivaNova’s election, in respect of the remainder, if any, of LivaNova’s conversion obligation in excess of the 
aggregate principal amount of the 2029 Notes being converted.

Holders may convert their 2029 Notes at their option at any time prior to the close of business on the business day immediately 
preceding  15  December  2028  only  under  the  following  circumstances:  (1)  during  any  calendar  quarter  commencing  after  the 
calendar  quarter  ending  on  30  June  2024  (and  only  during  such  calendar  quarter),  if  the  last  reported  sale  price  of  LivaNova’s 
ordinary shares for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, 
and  including,  the  last  trading  day  of  the  immediately  preceding  calendar  quarter  is  greater  than  or  equal  to  130%  of  the 
conversion  price  on  each  applicable  trading  day;  (2)  during  the  five  business  day  period  after  any  ten  consecutive  trading  day 
period in which the trading price per $1,000 principal amount of 2029 Notes for each trading day of the 2029 Notes Measurement 
Period was less than 98% of the product of the last reported sale price of LivaNova’s ordinary shares and the conversion rate on 
each such trading day; (3) if LivaNova calls such 2029 Notes for redemption, at any time prior to the close of business on the 
second  scheduled  trading  day  immediately  preceding  the  redemption  date,  but  only  with  respect  to  the  2029  Notes  called  (or 
deemed called) for redemption; or (4) upon the occurrence of specified corporate events. On or after 15 December 2028 until the 
close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert their 2029 
Notes at any time, regardless of the foregoing circumstances.

The conversion rate will be subject to adjustment in some events but will not be adjusted for any accrued and unpaid interest. In 
addition, following certain corporate events that occur prior to the maturity date or if LivaNova delivers a notice of redemption, 
LivaNova  will,  in  certain  circumstances,  increase  the  conversion  rate  for  a  holder  who  elects  to  convert  its  2029  Notes  in 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________148

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
Note 33. Subsequent Events

connection  with  such  a  corporate  event  or  convert  its  2029  Notes  called  (or  deemed  called)  for  redemption  in  connection  with 
such notice of redemption, as the case may be.

On or after 22 March 2027, LivaNova may redeem for cash all or part of the 2029 Notes, at LivaNova’s option, if the last reported 
sale price of LivaNova’s ordinary shares has been at least 130% of the conversion price then in effect for at least 20 trading days 
(whether or not consecutive) during any 30 consecutive trading day period (including the last trading day of such period) ending 
on,  and  including,  the  trading  day  immediately  preceding  the  date  on  which  LivaNova  provides  notice  of  redemption.  The 
redemption  price  will  be  equal  to  100%  of  the  principal  amount  of  the  2029  Notes  to  be  redeemed,  plus  accrued  and  unpaid 
interest to, but excluding, the redemption date (unless the redemption date falls after a regular record date but on or prior to the 
immediately succeeding interest payment date, in which case LivaNova will pay the full amount of accrued and unpaid interest to 
the holder of record as of the close of business on such regular record date, and the redemption price will be equal to 100% of the 
principal amount of the 2029 Notes to be redeemed). No sinking fund is provided for the 2029 Notes. LivaNova may also redeem 
the 2029 Notes at its option, at any time, in whole but not in part, only upon the occurrence of certain tax related events.

If  LivaNova  undergoes  a  fundamental  change,  holders  may  require  LivaNova  to  repurchase  for  cash  all  or  any  portion  of  the 
holders’  2029  Notes  at  a  fundamental  change  repurchase  price  equal  to  100%  of  the  principal  amount  of  the  2029  Notes  to  be 
repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date.

Capped Call Transactions

In connection with the pricing of the 2029 Notes, LivaNova entered into privately negotiated capped call transactions with certain 
of  the  initial  purchasers  or  their  respective  affiliates  and  another  financial  institution,  as  option  counterparties.  LivaNova 
subsequently  entered  into  additional  capped  call  transactions  with  the  option  counterparties  in  connection  with  the  initial 
purchasers’  exercise  in  full  of  their  option  to  purchase  additional  2029  Notes.  The  2029  Capped  Calls  cover,  subject  to  anti-
dilution  adjustments  substantially  similar  to  those  applicable  to  the  2029  Notes,  the  number  of  LivaNova’s  ordinary  shares 
initially underlying the 2029 Notes.

The 2029 Capped Calls are expected generally to compensate (through the payment of cash to LivaNova) for potential dilution to 
LivaNova’s ordinary shares upon conversion of any 2029 Notes and to offset any cash payments made in excess of the principal 
amount of converted 2029 Notes, as the case may be, in the event that the market price of ordinary shares, as measured under the 
terms of the 2029 Capped Calls, exceeds the strike price of the 2029 Capped Calls, which initially corresponds to the conversion 
price  of  the  2029  Notes  and  is  subject  to  customary  anti-dilution  adjustments  substantially  similar  to  those  applicable  to  the 
conversion  rate  of  the  2029  Notes.  If,  however,  the  market  price  per  ordinary  share,  as  measured  under  the  terms  of  the  2029 
Capped Calls, exceeds the cap price of the 2029 Capped Calls, there would nevertheless be dilution the effect of which would not 
be compensated for and/or there would not be an offset of such cash payments, in each case, to the extent that such market price 
exceeds such cap price of the 2029 Capped Calls. The cap price of the 2029 Capped Calls is initially $94.2840 per share, which 
represents a premium of 80% over the last reported sale price of LivaNova’s ordinary shares on 5 March 2024 and is subject to 
certain adjustments under the terms of the 2029 Capped Calls.

Incremental Facility Amendment No. 3 to the 2021 First Lien Credit Agreement

In connection with the offering  of  the  2029  Notes,  LivaNova, along with LivaNova USA, Inc., entered into a new incremental 
facility amendment to its First Lien Credit Agreement dated 13 August 2021 with the lenders and issuing banks party thereto and 
Goldman Sachs Bank USA, as First Lien Administrative Agent and First Lien Collateral Agent, as from time to time amended.

The Incremental Facility Amendment No. 3 provides for LivaNova USA, Inc. to, among other things, obtain commitments for a 
new revolving facility from a syndicate of lenders in an aggregate principal amount of $225 million. The Incremental Revolving 
Facility will be available to be drawn by LivaNova USA, Inc. until the fifth anniversary of the entering into of the Incremental 
Facility Amendment No. 3 and entirely replaced the $125 million revolving facility previously provided for under the 2021 First 
Lien Credit Agreement. Additionally, the Incremental Facility Amendment No. 3 lowered the Interest Coverage Ratio to 2.00 to 
1.00. Proceeds of the Incremental Revolving Facility will be used for general corporate purposes.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________149

LIVANOVA PLC
Table of Contents

COMPANY STATEMENT OF INCOME      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

COMPANY STATEMENT OF COMPREHENSIVE INCOME     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

COMPANY BALANCE SHEET    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

COMPANY STATEMENT OF CHANGES IN EQUITY       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 1. Nature of Operations        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 2. Basis of Preparation, Use of Accounting Estimates and Material Accounting Policies       . . . . . . . . . . . . . . . . . . . . . .

Note 3. Property, Plant and Equipment     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 4. Intangible Assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 5. Investments in Subsidiaries    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 6. Financial Assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 7. Other Assets   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 8. Trade and Other Receivables and Expected Credit Loss Provision      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 9. Derivative Financial Instruments   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note 10. Shareholders' Equity       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 11. Financial Liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 12. Other Liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 13. Leases      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 14. Share-Based Compensation Plans    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 15. Income Taxes Credit     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 16. Commitments and Contingencies      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 17. Related Parties     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 18. Company Statement of Income by Nature   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 19. Employee Compensation Costs     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 20. Auditors’ Remuneration       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note 21. Subsequent Events     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

151

152

153

154

155

155

162

163

163

166

166

166

167

168
169
170
170
171
173
174
175
175
175
175
176

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________150

LIVANOVA PLC
Company Statement of Income

LIVANOVA PLC
Company Statement of Income
(In thousands)

Year Ended 31 December

Note

2023

2022

Revenue      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating expenses     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating loss    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income from subsidiary undertakings      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance income       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance expenses      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net foreign exchange and other income/(expense)        . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss before tax     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income tax credit     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income for the financial year     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11

15

$ 

$ 

25,853  $ 
(72,729)   
(46,876)   
47,500 
21,959 
(32,985)   
1,789 
(8,613)   
11,884 

3,271  $ 

28,996 
(85,864) 
(56,868) 
60,925 
10,983 
(27,688) 
(1,955) 
(14,603) 
16,617 
2,014 

See accompanying notes to the parent company financial statements.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________151

 
 
 
 
 
 
 
 
 
 
 
 
LIVANOVA PLC
Company Statement of Comprehensive Income

LIVANOVA PLC
Company Statement of Comprehensive Income
(In thousands)

Income for the financial year      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Items of other comprehensive loss  that will subsequently be reclassified to income or 
loss:

Foreign currency translation differences        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total items of other comprehensive income (loss) that will subsequently be reclassified to 
income or loss      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Items of other comprehensive income that will not subsequently be reclassified to income 
or loss:

Remeasurements of net assets for defined benefits     . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax impact     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total items of other comprehensive income that will not subsequently be reclassified to 
income or loss      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total other comprehensive income/(loss) , net of taxes      . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total comprehensive income/(loss)  for the year, net of taxes         . . . . . . . . . . . . . . . . . . . . . . $ 

Year Ended 31 December

2023

2022

3,271  $ 

2,014 

18,127 

18,127 

— 
— 

— 
18,127 
21,398  $ 

(32,237) 

(32,237) 

10 
— 

10 
(32,227) 
(30,213) 

See accompanying notes to the parent company financial statements.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________152

 
 
 
 
 
 
 
 
 
 
 
 
LIVANOVA PLC
Company Balance Sheet

LIVANOVA PLC
Company Balance Sheet
(In thousands)

ASSETS
Non-current assets

31 December

Note

2023

2022

Investments in subsidiaries       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax assets       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other assets       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total non-current assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Trade receivables  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other receivables     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax receivable     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cash and cash equivalents      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Restricted cash  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total current assets     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total assets       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LIABILITIES AND SHAREHOLDERS’ EQUITY
Shareholders’ equity

Called up share capital     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Merger relief reserve      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Share premium account     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Capital redemption reserve     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Treasury shares    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accumulated other comprehensive loss       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Retained earnings     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total shareholders’ equity     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Non-current liabilities

Financial liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other liabilities       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total non-current liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Current liabilities

Financial liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Trade payables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other liabilities       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total current liabilities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total liabilities and shareholders’ equity      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5
6
15
7

8
8
6

10
10
10
10
10
10

11
12

11

12

Registration number 09451374

See accompanying notes to the parent company financial statements.

$  2,962,917  $  2,938,074 
— 
90,487 
53,904 
3,082,465 
11,686 
8,466 
55,585 
5,212 
148,502 
301,446 
530,897 
$  4,139,250  $  3,613,362 

490,362 
101,438 
65,899 
3,620,616 
8,489 
11,769 
38,990 
8,291 
139,727 
311,368 
518,634 

$ 

82,533  $ 
383,179 
40,058 
1,897 

82,424 
383,179 
37,031 
1,897 
(375) 
(21,965) 
2,354,666 
$  2,874,410  $  2,836,857 

(56)   
(3,838)   

2,370,637 

$ 

—  $ 

5,203 
5,203 

509,849 
7,780 
517,629 

1,226,654 
9,694 
23,289 
1,259,637 

229,738 
6,824 
22,314 
258,876 
$  4,139,250  $  3,613,362 

The financial statements on pages 150 to 176 were approved by the Board and were signed on its behalf on 25 April 2024 by:

VLADIMIR MAKATSARIA
CHIEF EXECUTIVE OFFICER & DIRECTOR

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________153

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LIVANOVA PLC
Company Statement of Changes in Equity

LIVANOVA PLC
Company Statement of Changes in Equity
(In thousands)

Ordinary Shares

Number
of 
Shares

Share
Capital

Merger 
Relief
Reserve

Share
Premium

Capital
Redemption
Reserve

Treasury
Shares

Note

Accumulated 
Other
Comprehensive 
Income/(Loss) 

Retained
Earnings

Total 
Shareholders’ 
Equity

Balance at 1 January 2022    . . . . . . . . . . . . .

  53,762 

$ 82,295  $  383,179 

$  33,257 

$ 

1,897 

$ 

(650)  $ 

10,262 

$ 2,323,106 

$ 

2,833,346 

Share-based compensation plans   . . . . . . . .

14

Total transactions with owners, recognised 
directly in shareholders’ equity   . . . . . . . . .

Net income for the year      . . . . . . . . . . . . . . .

Other comprehensive loss      . . . . . . . . . . . . .

Total comprehensive loss (income) for the 
year    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Balance at 31 December 2022    . . . . . . . . . .

90 

90 

— 

— 

129 

129 

  — 

  — 

— 

  — 

— 

— 

— 

— 

— 

  53,852 

  82,424 

  383,179 

Share-based compensation plans   . . . . . . . .

14

Total transactions with owners, recognised 
directly in shareholders’ equity   . . . . . . . . .

Net income for the year      . . . . . . . . . . . . . . .
Other comprehensive income    . . . . . . . . . .
Total comprehensive income for the year     .

90 

90 

— 

— 

— 

109 

109 

  — 

  — 

  — 

— 

— 

— 

— 

— 

3,774 

3,774 

— 

— 

— 

37,031 

3,027 

3,027 

— 

— 

— 

— 

— 

— 

— 

— 

1,897 

— 

— 

— 

— 

— 

275 

275 

— 

— 

— 

(375) 

319 

319 

— 

— 

— 

— 

— 

— 

(32,227) 

29,546 

33,724 

29,546 

2,014 

— 

33,724 

2,014 

(32,227) 

(32,227) 

2,014 

(30,213) 

(21,965) 

  2,354,666 

2,836,857 

— 

— 

— 

18,127 

18,127 

12,699 

16,154 

12,699 

3,272 

— 

3,272 

16,154 

3,272 

18,127 

21,399 

Balance at 31 December 2023    . . . . . . . . . .

  53,942 

$ 82,533  $  383,179 

$  40,058 

$ 

1,897 

$ 

(56)  $ 

(3,838)  $ 2,370,637 

$ 

2,874,410 

See accompanying notes to the parent company financial statements.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________154

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 1. Nature of Operations

LIVANOVA PLC
Notes to the Financial Statements

Note 1. Nature of Operations

Company information. LivaNova PLC (LivaNova PLC, the Company, Group, we or our) is a public limited company incorporated 
in the UK under the Companies Act 2006 (Registration number 09451374). The Company is domiciled in England and Wales and 
its registered address is 20 Eastbourne Terrace, London, W2 6LG, United Kingdom.

Background.  LivaNova  PLC  was  organised  under  the  laws  of  England  and  Wales  on  20  February  2015  for  the  purpose  of 
facilitating  the  business  combination  of  Cyberonics,  Inc.,  a  Delaware  corporation  and  Sorin  S.p.A.,  a  joint  stock  company 
organised under the laws of Italy. As a result of the business combination, LivaNova PLC, headquartered in London, became the 
holding  company  of  the  combined  businesses  of  Cyberonics  and  Sorin.  The  business  combination  became  effective  in  October 
2015. LivaNova’s Ordinary Shares are listed for trading on the Nasdaq under the symbol “LIVN.” As part of the Mergers, Sorin 
undertook a cross-border legal entity merger with LivaNova (the Sorin merger) under which LivaNova was the surviving ultimate 
holding company. 

Description  of  the  business.  LivaNova  PLC,  headquartered  in  London,  is  a  global  medical  device  company.  The  Company 
designs, develops, manufactures and sells innovative products and therapies that are consistent with our mission to provide hope 
for patients and their families through innovative medical technologies, delivering life-changing improvements for both the Head 
and Heart. LivaNova is comprised of three reportable segments: Cardiopulmonary, Neuromodulation and Advanced Circulatory 
Support, corresponding to our primary business units.

Note 2. Basis of Preparation, Use of Accounting Estimates and Material Accounting Policies

Basis of Preparation. The separate financial statements of LivaNova PLC have been prepared on a going concern basis under the 
historical  cost  convention,  except  for  derivative  financial  instruments  and  share-based  compensation  plans  that  have  been 
measured  at  fair  value  in  accordance  with  the  Companies  Act  2006  as  applicable  to  companies  using  FRS  101.  The  financial 
statements  are  presented  in  US  dollars  and  all  values  are  rounded  to  the  nearest  thousands,  except  when  otherwise  indicated. 
LivaNova PLC’s accounting policies have been applied consistently in 2023 as compared to 2022, other than where new policies 
have been adopted.

Going  Concern.  Based  on  LivaNova  PLC’s  current  business  plan,  the  Company  believes  that  its  existing  cash  and  cash 
equivalents  and  future  cash  generated  from  operations  will  be  sufficient  to  fund  LivaNova  PLC’s  expected  operating  needs, 
working  capital  requirements,  capital  expenditures  and  debt  service  requirements  for  a  period  of  at  least  12-months  from  the 
issuance  of  these  financial  statements.  LivaNova  PLC  regularly  reviews  its  capital  needs  and  consider  various  investing  and 
financing  alternatives  to  support  the  Company’s  requirements.  Therefore,  it  is  appropriate  to  adopt  the  going  concern  basis  in 
preparing  these  consolidated  financial  statements.  In  addition,  the  LivaNova  PLC  Consolidated  Group  (Consolidated  Group) 
conditions may impact the value of the Company's investments in its subsidiaries and the Company's ability to recover amounts 
due from subsidiaries. As such, please refer to the Consolidated Group’s going concern assessment included with “Note 2. Basis 
of Preparation, Use of Accounting Estimates and Material Accounting Policies” to the Consolidated Group financial statements in 
this Annual Report.

As of 31 December 2023, LivaNova PLC had a net current liability position on the Company balance sheet of $741.0 million due 
to  a  partially  completed  intercompany  financing  restructuring.  The  intercompany  financing  restructuring  was  subsequently 
completed on 2 January 2024, alleviating the net current liability position. For additional information, please refer to “Note 11. 
Financial Liabilities.”

Reclassifications.  LivaNova  PLC  has  reclassified  certain  prior  year  amounts  on  the  Company  balance  sheets  and  Company 
statements  of  income  for  comparative  purposes.  These  reclassifications  had  no  material  impact  on  the  Company’s  financial 
condition or results of operations.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________155

NOTES TO THE FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

The  financial  statements  for  the  years  ended  31  December  2023  and  31  December  2022  of  LivaNova  have  been  prepared  in 
accordance with Financial Reporting Standard 101 ‘Reduced Disclosure Framework’ (FRS 101). The following exemptions from 
the requirements of IFRS have been applied in the preparation of these financial statements, in accordance with FRS 101:

Standard Disclosure
The following paragraphs of IAS 1, ‘Presentation of 
financial statements’      . . . . . . . . . . . . . . . . . . . . . . . . .

IFRS 7, ‘Financial Instruments: Disclosures’       . . . . . .
The following paragraphs of IFRS 13, ‘Fair Value 
Measurement’        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IAS 7, ‘Statement of Cash Flows’    . . . . . . . . . . . . . . .
The following paragraphs of IFRS 2, ‘Share-based 
Payment’   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

The following paragraphs of IAS 8, ‘Accounting 
policies, changes in accounting estimates and errors’     

The following paragraphs of IAS 24, ‘Related Party 
Disclosures’     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Exemption
10(d) – statement of cash flows;
16 – statement of compliance with all IFRS;
38A – requirement for minimum of two primary statements, including 
cash flow statements;
38B-D – additional comparative information;
111 – statement of cash flow information; and
134 to136 – capital management disclosures.
Full exemption.
91 to 99 – disclosure of valuation techniques and inputs used for fair 
value measurement of assets and liabilities.
Full exemption.
45(b) and 46 to 52 – details of the number and weighted average 
exercise prices of share options, and the fair value of services received 
is determined.
30 and 31 – requirement for the disclosure of information when an 
entity has not applied a new IFRS that has been issued but is not yet 
effective.
17 – key management compensation;
18A – key management services provided by a separate management 
entity; and
the requirements to disclose related party transactions entered into 
between two or more members of a group, provided that any subsidiary 
which is a party to the transaction is wholly owned by such a member.

New Accounting Pronouncements. 

The  following  provides  a  description  of  new  accounting  standards  that  were  adopted  and  their  impact  on  LivaNova’s  financial 
statements:

Amendment  to  IAS  1  and  IFRS  Practice  Statement  2  -  Disclosure  of  Accounting  Policies.  An  Amendment  to  IAS  1  and  IFRS 
Practice Statement 2 - ‘Disclosure of Accounting Policies’ was issued in February 2021 the IASB issued a new amendment to IAS 
1  on  disclosure  of  "material"  accounting  policies  rather  than  "significant"  accounting  policies.  The  amendments  define  what 
"material  accounting  policy  information"  is  and  explain  how  to  identify  it.  It  also  clarifies  that  immaterial  accounting  policy 
information does not need to be disclosed, but if so, it should not obscure the relevant accounting information. To support this 
change, the IASB also amended the "IFRS Practice Statement 2 Making Materiality Judgments" to provide guidance on how to 
apply the concept of materiality to accounting policy disclosures. The amendment was adopted by LivaNova on 1 January 2023, 
and did not materially impact the Company’s results of operations.

Amendment to IAS 8 - Accounting Policies, Change in Estimate and Error Rectification. An Amendment to IAS 8 - ‘Accounting 
Policies, Change in Estimate and Error Rectification’ was issued in February 2021 clarifies how entities must distinguish changes 
in  accounting  policies  from  changes  in  accounting  estimates,  as  changes  in  accounting  estimates  are  applied  prospectively  to 
future  transactions  and  other  future  events,  but  changes  in  accounting  policies  are  generally  applied  retrospectively  to  past 
transactions and other past events, as well as to the current period. The amendment was adopted by LivaNova on 1 January 2023, 
and did not materially impact the Company’s results of operations.

Amendment to IAS 12 - Income Taxes. An Amendment to IAS 12 - ‘Income Taxes’ was issued in May 2021 and requires entities 
to  recognise  deferred  tax  on  transactions  that,  on  initial  recognition,  give  rise  to  equal  amounts  of  taxable  and  deductible 
temporary differences. This typically applies to lease transactions (right-of-use assets and lease liabilities) and decommissioning 
and restoration obligations, as an example, and will require the recognition of additional deferred tax assets and liabilities. The 
amendment was adopted by LivaNova on 1 January 2023, and did not materially impact the Company’s results of operations.

The following provides a description of future adoption of a new accounting standard that may have an impact on LivaNova’s 
financial statements when adopted:

The following provides a description of future adoption of a new accounting standard that may have an impact on LivaNova’s 
financial statements when adopted:

Amendment to IAS 1 Presentation of Financial Statements. An Amendment to IAS 1 ‘Presentation of Financial Statements’ was 
issued  in  January  2020  and  further  clarified  in  October  2022,  with  the  objective  of  clarifying  that  liabilities  are  classified  as 
current or non-current, depending on the rights that exist at the end of the period. The classification is not affected by the entity's 
expectations or events after the reporting date. The amendments also clarify what "settlement" of a liability refers to under IAS 1. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________156

NOTES TO THE FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

The amendments to IAS 1 are effective as of 1 January 2024. The Company does not expect the new amendment to materially 
impact its results of operations.

Amendment to IAS 12 - Income Taxes. An Amendment to IAS 12 - ‘International Tax Reform – Pillar Two Model Rules’ was 
issued  in  May  2023  and  adopted  from  that  date.  The  rule  provides  temporary  exception  to  the  requirements  to  recognise  and 
disclose information about deferred tax assets and liabilities related to OECD BEPS Pillar Two and provide targeted disclosure 
requirements  for  affected  entities.  Pillar  Two  global  minimum  tax  rules  applicable  to  multinational  groups  with  global  revenue 
over €750 million. The UK has enacted legislation providing for a minimum effective tax rate of 15% through a “multinational 
top-up tax” and a “domestic top-up tax” for accounting periods beginning on or after 31 December 2023. Draft UK legislation has 
also been published for an UTPR to be introduced, although not before accounting periods beginning on or after 31 December 
2024. A UTPR would be a backstop rule intended to ensure that amounts of multinational top-up tax that are not collected under 
foreign  global  minimum  tax  rules  can  in  certain  circumstances  be  collected  instead  in  the  UK.  The  Company  has  applied  the 
exception to recognising and disclosing information about deferred tax assets and liabilities related to Pillar Two. The Company 
does  not  expect  the  adoption  of  Pillar  Two  to  have  a  significant  impact.  Refer  to  “Note  15.  Income  Taxes  Credit”  for  further 
information.

Investments  in  Subsidiaries.  Investments  in  subsidiaries  are  accounted  for  at  cost  less  any  provision  for  impairment.  LivaNova 
PLC assesses at each reporting date, whether there is an indication that an investment may be impaired. If any indication exists, 
the Company estimates the investment’s recoverable amount. Where the carrying amount of an investment exceeds its recoverable 
amount, the investment is considered impaired and is written down to its recoverable amount.

Foreign Currency. LivaNova PLC’s functional currency is the US dollar; however, a portion of the revenues earned, and expenses 
incurred  are  denominated  in  currencies  other  than  the  US  dollar.  LivaNova  PLC  determines  the  functional  currency  of  the 
Company’s subsidiaries that exist and operate in different economic and currency environments based on the primary economic 
environment in which the subsidiary operates, that is, the currency of the environment in which an entity primarily generates and 
expends cash. 

The Euro is the functional currency of LivaNova PLC - Italian Branch, a branch of LivaNova PLC, and the assets, liabilities and 
equity of this branch are translated into US dollars based on a combination of both current and historical exchange rates, while 
their  revenues  earned  and  expenses  incurred  are  translated  into  US  dollars  at  average  period  exchange  rates.  Translation 
adjustments are included as AOCI on the Company balance sheet. Gains and losses arising from transactions denominated in a 
currency  different  from  an  entity’s  functional  currency  are  included  in  FX  and  other  losses  on  LivaNova  PLC’s  Company 
statement of income. Taxes are not provided on cumulative translation adjustments, as substantially all translation adjustments are 
related to earnings which are intended to be indefinitely reinvested in the countries where earned. 

The Euro exchange rate to USD used in preparing the Company financial statements was as follows:

Year ended 31 December 2023      . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Year ended 31 December 2022      . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Weighted Average Rate Euro
0.924732
0.951016

Closing Rate Euro
0.903590
0.935410

Financial  Instruments.  A  financial  instrument  is  any  contract  that  gives  rise  to  a  financial  asset  of  one  entity  and  a  financial 
liability or equity instrument of another entity. Financial assets and financial liabilities are offset with the net amount reported in 
the Company balance sheet only if there is a current enforceable legal right to offset the recognised amounts and intent to settle on 
a net basis, or to realise the assets and settle the liabilities simultaneously.

(a)

Financial Assets

Initial Recognition and Measurement. Financial assets are classified, at initial recognition, as financial assets at fair value through 
income  or  loss,  trade  receivables  and  other  assets,  investments,  financial  assets,  or  as  derivatives  designated  as  hedging 
instruments  in  an  effective  hedge,  as  appropriate.  The  Company  determines  the  classification  of  its  financial  assets  at  initial 
recognition. All financial assets are recognised initially at fair value plus, in the case of assets not at fair value through income or 
loss,  transaction  costs  that  are  attributable  to  the  acquisition  of  the  financial  asset.  Purchases  or  sales  of  financial  assets  that 
require delivery of assets within a time frame established by regulation or convention in the marketplace (regular way trades) are 
recognised on the trade date, i.e., the date on which the Company commits to purchase or sell the asset.

The subsequent measurement and impairment of financial assets depends on their classification as described below:

Financial  Assets  at  Fair  Value  through  Income  or  Loss.  Financial  assets  at  fair  value  through  income  or  loss  include  financial 
assets held for trading and financial assets designated upon initial recognition at fair value through income or loss. Financial assets 
are classified as held-for trading if they are acquired for the purpose of selling or re-purchasing in the near term. This category 
includes  derivative  financial  instruments  entered  into  by  the  Company  that  are  not  designated  as  hedging  instruments  in  hedge 
relationships  as  defined  by  IFRS  9.  LivaNova  PLC  uses  freestanding  derivative  forward  contracts  to  offset  exposure  to  the 
variability  of  the  value  associated  with  assets  and  liabilities  denominated  in  a  foreign  currency.  These  derivatives  are  not 
designated as hedges, and therefore changes in the value of these forward contracts are recognised in the Company statement of 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________157

NOTES TO THE FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

income,  thereby  offsetting  the  current  net  income  (loss)  effect  of  the  related  change  in  value  of  foreign  currency  denominated 
assets and liabilities. Changes in the fair value of LivaNova PLC’s derivatives designated as hedges are recognised through OCI.

Trade  Receivables  and  Other  Financial  Assets.  Loans  and  receivables  are  non-derivative  financial  assets  with  fixed  or 
determinable payments that are not quoted in an active market. After initial measurement, such financial assets are subsequently 
measured  at  amortised  cost  using  the  EIR  method,  less  impairment.  Amortised  cost  is  calculated  by  taking  into  account  any 
discount  or  premium  on  acquisition  and  fees  or  costs  that  are  an  integral  part  of  the  EIR.  The  EIR  amortisation  is  included  in 
finance  income  in  the  Company  statement  of  income.  The  receivable  balance  consists  primarily  of  trade  receivables  from 
LivaNova PLC’s subsidiaries as a result of intercompany re-charges, services and management fees. LivaNova PLC maintains an 
expected  credit  loss  provision  for  expected  credit  losses  based  on  the  Company’s  estimates  of  the  ability  of  LivaNova  PLC’s 
subsidiaries and third-party customers to make required payments, historical credit experience, existing economic conditions and 
expected  future  trends.  LivaNova  PLC  writes  off  uncollectable  accounts  against  the  provision  when  all  reasonable  collection 
efforts have been exhausted. Loans, together with the associated provision are written off when there is no realistic prospect of 
future recovery and all collateral has been realised or has been transferred to the Company. The losses arising from impairment are 
recognised  in  the  Company’s  statement  of  income.  Refer  to  “Note  8.  Trade  and  Other  Receivables  and  Expected  Credit  Loss 
Provision” for further information.

Financial  Asset  Derecognition.  A  financial  asset  (or,  where  applicable,  a  part  of  a  financial  asset  or  part  of  a  group  of  similar 
financial assets) is derecognised when:

•
•

The rights to receive cash flows from the asset have expired, or
The  Company  has  transferred  its  rights  to  receive  cash  flows  from  the  asset  or  has  assumed  an  obligation  to  pay  the 
received  cash  flows  in  full  without  material  delay  to  a  third  party  under  a  ‘pass-through  arrangement,  and  either  (a)  the 
Company has transferred substantially all the risks and rewards of the asset, or (b) the Company has neither transferred nor 
retained substantially all the risks and rewards of the asset, but has transferred control of the asset.

(b)

Financial Liabilities

Initial Recognition and Measurement. Financial liabilities are classified, at initial recognition, as financial liabilities at fair value 
through  income  or  loss,  loans  and  borrowings  (bank  debt),  payables,  or  as  derivatives  designated  as  hedging  instruments  in  an 
effective hedge, as appropriate. All financial liabilities are recognised initially at fair value and, in the case of loans, borrowings 
and payables, net of directly attributable transaction costs. The Company’s financial liabilities include trade and other payables, 
loans and bank debt including bank overdrafts, and derivative financial instruments.

The measurement of financial liabilities depends on their classification, as follows:

Financial  Liabilities  at  Fair  Value  through  Income  or  Loss.  Financial  liabilities  at  fair  value  through  income  or  loss  include 
financial  liabilities  held-for-trading  and  financial  liabilities  designated  upon  initial  recognition  at  fair  value  through  income  or 
loss.  Financial  liabilities  are  classified  as  held-for-trading  if  they  are  acquired  for  the  purpose  of  selling  in  the  near  term.  This 
category includes derivative financial instruments entered into by the Company that are not designated as hedging instruments in 
hedge relationships as defined by IAS 39, which the Company has elected to apply. Gains or losses on liabilities held-for-trading 
are recognised in the Company statement of income. Financial liabilities designated upon initial recognition at fair value through 
income or loss are designated at the initial date of recognition, and only if the criteria in IAS 39 are satisfied. The Company has 
not designated any financial liabilities at fair value through income or loss.

Loans and Borrowings. After initial recognition, interest bearing loans and borrowings are subsequently measured at amortised 
cost  using  the  EIR  method.  Gains  and  losses  are  recognised  in  the  Company  statement  of  income  when  the  liabilities  are  de-
recognised  as  well  as  through  the  EIR  method  amortisation  process.  Amortised  cost  is  calculated  by  taking  into  account  any 
discount  or  premium  on  acquisition  and  fees  or  costs  that  are  an  integral  part  of  the  EIR.  The  EIR  amortisation  is  included  in 
finance expenses in the Company statement of income.

Financial Liability Derecognition. A financial liability is de-recognised when the obligation under the liability is discharged or 
cancelled or expires. When an existing financial liability is replaced by another from the same lender on substantially different 
terms,  or  the  terms  of  an  existing  liability  are  substantially  modified,  such  an  exchange  or  modification  is  treated  as  a  de-
recognition  of  the  original  liability  and  the  recognition  of  a  new  liability.  The  difference  in  the  respective  carrying  amounts  is 
recognised in the Company statement of income.

Derivative  financial  instruments  and  hedge  accounting.  LivaNova  PLC  uses  currency  exchange  rate  derivative  contracts  to 
manage  the  impact  of  currency  exchange  rate  changes  on  the  Company  statement  of  income  and  cash  flows.  Derivatives  are 
initially recognised at fair value on the date a derivative contract is entered into and are subsequently re-measured at fair value. 
The method of recognising the resulting gain or loss depends on whether the derivative is designated as a hedging instrument, and 
if so, the nature of the item being hedged. LivaNova PLC evaluates hedge effectiveness at inception and on an ongoing basis. If a 
derivative  is  no  longer  expected  to  be  highly  effective,  hedge  accounting  is  discontinued.  Hedge  ineffectiveness,  if  any,  is 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________158

NOTES TO THE FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

recorded  in  the  Company  statement  of  income.  Cash  flows  from  derivative  contracts  are  reported  as  operating  activities  in  the 
consolidated statement of cash flows.

When a hedging instrument expires, sold or is terminated, or when a hedge no longer meets the criteria for hedge accounting, any 
cumulative  gain  or  loss  existing  in  equity  at  that  time  remains  in  equity  and  is  recognised  when  the  forecast  transaction  is 
ultimately  recognised  in  the  Company  statement  of  income.  When  a  forecast  transaction  is  no  longer  expected  to  occur,  the 
cumulative gain or loss that was reported in equity is immediately reclassified to the Company statement of income.

In  order  to  minimise  income  statement  and  cash  flow  volatility  resulting  from  currency  exchange  rate  changes,  historically 
LivaNova PLC has entered into derivative instruments, principally forward currency exchange rate contracts. These contracts are 
designed to hedge anticipated foreign currency transactions and changes in the value of specific assets and liabilities and of some 
revenue. At inception of the forward contract, the derivative is designated as either a freestanding derivative or a cash flow hedge. 
For derivative instruments that are designated and qualify as a cash flow hedge, the effective portion of the gain or loss on the 
derivative instrument is reported as a component of AOCI and reclassified to the Company statement of income to offset exchange 
differences originated by the hedged item or to adjust the value of loss. Upon the settlement of LivaNova PLC’s foreign currency 
cash flow hedges in 2022 and following an in-depth analysis of the utility of LivaNova PLC’s cash flow hedging program, the 
Company discontinued its foreign currency cash flow hedging program. LivaNova PLC does not enter into currency exchange rate 
derivative contracts for speculative purposes.

LivaNova PLC uses interest rate derivative instruments to manage the exposure to interest rate movements and to reduce the risk 
of increased borrowing costs by converting floating-rate debt into fixed-rate debt. Under these agreements, LivaNova PLC agrees 
to exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to agreed-
upon notional principal amounts. The interest rate swaps are structured to mirror the payment terms of the underlying loan. The 
fair value of the interest rate swaps is reported on the consolidated balance sheets as assets or liabilities (current or non-current) 
depending upon the gain or loss position of the contract and the maturity of the future cash flows of each contract. The gain or loss 
on these derivatives is reported as finance expenses.

Cash and Cash Equivalents. LivaNova PLC considers all highly liquid investments with an original maturity of three months or 
less, consisting of demand deposit accounts and money market mutual funds, to be cash equivalents. Cash equivalents are carried 
on the Company balance sheet at cost, which approximated their fair value.

Restricted Cash. The Company classifies cash that is not available for use in its operations as restricted cash within current assets 
on the consolidated balance sheet. As of 31 December 2023, LivaNova PLC’s restricted cash balance totalled $311.4 million and 
was  comprised  of  cash  deposits  with  Barclays  held  as  collateral  for  the  SNIA  Litigation  Guarantee.  As  security  for  the  SNIA 
Litigation  Guarantee,  LivaNova  PLC  is  required  to  grant  cash  collateral  to  Barclays  in  USD  in  an  amount  equal  to  the  USD 
equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. For additional information 
regarding  the  SNIA  litigation,  please  refer  to  “Note  24.  Commitments  and  Contingencies”  of  the  Company’s  consolidated 
financial statements in this Annual Report.

Non-monetary  Assets.  PP&E.  PP&E  is  carried  at  cost,  less  accumulated  depreciation  and  any  accumulated  impairment  losses. 
Maintenance  and  repairs,  and  minor  replacements  are  charged  to  expense  as  incurred,  while  significant  renewals  and 
improvements are capitalised. LivaNova PLC computes depreciation using the straight-line method over estimated useful lives. 
Where  an  item  of  PP&E  comprises  several  parts  with  different  useful  lives,  each  part  is  recognised  as  a  separate  item  and 
depreciated  over  its  useful  life.  Useful  life  and  residual  value  of  PP&E  are  reviewed  at  each  year-end.  As  necessary,  the 
occurrence of changes to the useful life or residual value is recognised prospectively as a change in accounting estimates.

Leasehold improvements are depreciated over the shorter of the useful life of an asset or the lease term. 

The following table presents the estimated useful lives for all classes of depreciable PP&E, as of 31 December 2023 and 2022:

Leasehold improvements (years)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Equipment, furniture, fixtures (years)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2023
up to 10
up to 3

2022
up to 10
up to 3

Where there are any internal or external indications that the value of an item of PP&E may be impaired, the recoverable amount of 
the group of CGUs to which it belongs is calculated. If the recoverable amount is less than the carrying amount of the group of 
CGUs, a provision for impairment is recorded. PP&E is reviewed for impairment annually on 31 of December.

Impairment of Long-Lived Assets. The Company assesses at each reporting date whether there is an indication that an asset may be 
impaired. If any indication exists, or when annual impairment testing for an asset is required, the Company estimates the asset’s 
recoverable amount. An asset’s recoverable amount is the higher of an asset’s CGU’s fair value less costs of disposal and its value 
in use. It is determined for an individual asset, unless the asset does not generate cash inflows that are largely independent of those 
from other assets or groups of assets. Where the carrying amount of an asset or CGU exceeds its recoverable amount, the asset is 
considered impaired and is written down to its recoverable amount.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________159

NOTES TO THE FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

Revenue. Revenue largely consists of intercompany re-charges, services and management fees. Revenue is measured at the fair 
value of the consideration received or receivable. The Company recognises revenue when the amount of revenue can be reliably 
measured, it is probable that future economic benefits will flow to the entity and specific criteria have been met.

Leases. LivaNova PLC has leases primarily for (i) real estate, including office space and manufacturing, warehouse and research 
and development facilities and (ii) vehicles. LivaNova PLC determines if an arrangement is or contains a lease at its inception or 
when the terms and conditions of a contract are significantly changed. ROU assets and lease liabilities are recognised based on the 
present value of the future minimum lease payments over the lease term at the latter of LivaNova PLC’s lease standard effective 
date  for  adoption  or  the  lease  commencement  date.  LivaNova  PLC  does  not  record  an  operating  lease  asset  and  corresponding 
liability for leases with terms of 12 months or less. The Company recognises the lease payments for such short-term leases within 
profit and loss on a straight-line basis over the lease term. Variable lease payments that do not depend on an index or rate, such as 
variable  common  area  rent  maintenance  charges  and  utility  fees  not  known  upon  lease  commencement,  are  not  included  in  the 
determination  of  the  minimum  lease  payments  and  are  expensed  in  the  period  in  which  the  obligation  for  those  payments  is 
incurred.  Variable  lease  payments  that  depend  on  an  index  or  rate  are  initially  measured  using  the  index  or  rate  as  of  the 
commencement date. As most of LivaNova PLC’s leases do not provide a readily determinable implicit rate, LivaNova PLC uses 
the Company’s IBR based on the information available at the lease commencement date in determining the present value of future 
payments.  LivaNova  PLC’s  IBR  is  determined  using  a  risk-free  rate  adjusted  for  factors  such  as  credit  rating  and  borrowing 
currency, and represents an estimate of the interest rate the Company would incur at lease commencement to borrow the funds 
necessary to obtain an asset of similar value to the ROU asset over the term of a lease. The ROU lease asset also includes any 
lease  payments  made  in  advance  and  excludes  lease  incentives.  LivaNova  PLC’s  lease  terms  may  include  options  to  extend  or 
terminate the lease when it is reasonably certain that LivaNova PLC will exercise that option. ROU assets are depreciated over the 
shorter of the asset's useful life or the lease term on a straight-line basis. Lease payments are allocated between the liability and 
finance costs. Finance costs are recorded as an expense in the Company statement of income over the lease period so as to produce 
a constant periodic rate of interest on the remaining balance of the liability. Certain of the Company’s leases provide for tenant 
improvement allowances that have been recorded as ROU assets and depreciated, using the straight-line method, over the life of 
the lease. 

LivaNova PLC applies certain practical expedients on an ongoing basis, including the practical expedient for short-term leases and 
leases of low-value assets pursuant to which a lessee is permitted to make an accounting policy election by class of underlying 
asset not to recognise a lease liability and lease asset. A short-term lease is defined as a lease with a term of 12 months or less and 
does  not  include  an  option  to  purchase  the  underlying  asset  that  the  lessee  is  reasonably  certain  to  exercise.  In  exception  to 
vehicles as it relates to the low-value lease asset policy, the Company has applied these accounting policies to all asset classes in 
LivaNova PLC’s portfolio and will recognise the lease payments for such short-term leases and leases of low-value assets within 
the Company statement of income on a straight-line basis over the lease term. 

Accounting  for  leases  has  no  impact  on  the  actual  cash  flows.  However,  lease  accounting  requires  the  capitalisation,  and 
subsequent depreciation, of costs that were previously expenses as paid, which impacts disclosures of cash flows within the cash 
flow statement. 

From  a  lessor  perspective,  certain  of  LivaNova  PLC’s  agreements  that  allow  the  customer  to  use,  rather  than  purchase,  the 
Company’s medical devices meet the criteria of being a lease. 

For additional information refer to “Note 13. Leases.”

Share-Based Compensation Plans. LivaNova PLC grants share-based awards to directors, officers and key employees during each 
fiscal year. LivaNova PLC measures the cost of employee services received in exchange for an award of equity instruments based 
on  the  grant  date  fair  market  value  of  the  award.  The  cost  of  equity-settled  transactions  is  recognised  in  employee  benefits 
expense, together with a corresponding increase in equity over the period in which the service and the performance conditions are 
fulfilled  (the  vesting  period).  The  cumulative  expense  recognised  for  equity-settled  transactions  at  each  reporting  date  until  the 
vesting date reflects the extent to which the vesting period has expired and the Company’s best estimate of the number of equity 
instruments that will ultimately vest. LivaNova PLC issues new shares upon stock option exercises, otherwise issuance of stock 
for  vesting  of  restricted  stock,  restricted  stock  units,  market  performance-based  restricted  share  units,  operating  performance-
based restricted share units or exercises of stock appreciation rights are issued from treasury shares. LivaNova PLC has the right 
to elect to pay the cash value of vested restricted stock units in lieu of the issuance of new shares. The social security contributions 
on employee share-based payment awards are accrued over the service period.

The following share-based awards are offered by the Company:

•

SARs. A SAR confers upon an employee the contractual right to receive an amount of cash, share, or a combination of both 
that equals the appreciation in the Company’s common share from an award’s grant date to the exercise date. SARs may be 
exercised at the employee’s discretion during the exercise period and do not give the employee an ownership right in the 
underlying share. The SARs may be settled in LivaNova PLC shares and/or cash, as determined by LivaNova PLC and as 
set forth in the individual award agreements. SARs do not involve payment of an exercise price. LivaNova PLC uses the 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________160

NOTES TO THE FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

Black-Scholes option pricing methodology to calculate the grant date fair market value of SARs. The Company determines 
the expected volatility on historical volatility.

•

RS and RSUs. LivaNova PLC may grant RS and RSUs at no purchase cost to the grantee. The grantees of unvested RSUs 
have no voting rights or rights to dividends. Sale or transfer of the stock and stock units is restricted until they are vested. 
The fair market value of service-based RS and RSUs is determined using the market closing price on the grant date, and 
compensation is expensed ratably over the vesting period. Calculation of compensation for stock awards requires estimation 
of employee turnover and forfeiture rates. LivaNova PLC has the right to elect to pay the cash value of vested restricted 
share units in lieu of the issuance of new shares. Under LivaNova PLC’s share-based compensation plans the Company re-
purchases  a  portion  of  these  shares  from  LivaNova  PLC’s  employees  to  permit  the  Company’s  employees  to  meet  their 
minimum statutory tax withholding requirements on vesting of their restricted share.

• Market  Performance-Based  Restricted  Share  Units.  LivaNova  PLC  may  grant  market  performance-based  RSUs  at  no 
purchase cost to the grantee. The grantees of the units have no voting rights or rights to dividends. Sale or transfer of the 
units is restricted until they are vested. The number of shares that are ultimately transferred to the grantee is dependent upon 
the Company’s percentile rank of TSR relative to a peer group. The fair market value of market performance-based RSUs is 
determined  utilising  a  Monte  Carlo  simulation  on  the  grant  date  and  compensation  is  expensed  ratably  over  the  service 
period. Calculation of compensation for market performance-based stock awards requires estimation of employee turnover, 
historical volatility and forfeiture rates.

•

Operating Performance-Based Restricted Share Units. LivaNova PLC may grant operating performance-based RSUs at no 
purchase cost to the grantee. The grantees of the units have no voting rights or rights to dividends. Sale or transfer of the 
units is restricted until they are vested. The number of shares that are ultimately transferred to the grantee is dependent upon 
the  Company’s  achievement  of  certain  thresholds  for  cumulative  adjusted  FCF  and  adjusted  ROIC.  Adjusted  ROIC  was 
introduced as an additional performance indicator in 2021. The fair market value of operating performance-based RSUs is 
determined using the market closing price on the grant date. Compensation is expensed ratably over the service period and 
adjusted  based  upon  the  percent  achievement  of  cumulative  adjusted  FCF.  Calculation  of  compensation  expense  for 
operating  performance-based  stock  awards  requires  estimation  of  employee  turnover,  adjusted  FCF,  adjusted  ROIC  and 
forfeiture rates.

Income  Taxes.  The  tax  expense  for  the  year  comprises  current  and  deferred  tax.  Current  and  deferred  tax  is  recognised  in  the 
Company statement of income, except to the extent that it relates to items recognised in OCI or directly in equity. In this case, the 
tax is also recognised in OCI or directly in equity, respectively.

The income tax expense or benefit for the year is the tax payable on the current year’s taxable income based on the applicable 
income tax rate adjusted by changes in deferred tax assets and liabilities attributable to temporary differences and to unused tax 
losses.

The  current  income  tax  expense  is  calculated  on  the  basis  of  the  tax  laws  enacted  or  substantively  enacted  at  the  end  of  the 
reporting  year.  Management  establishes  provisions  where  appropriate  on  the  basis  of  amounts  expected  to  be  paid  to  the  tax 
authorities.

Deferred  taxes  are  recognised  by  the  liability  method  for  temporary  differences  between  the  carrying  amount  of  assets  and 
liabilities in the balance sheet and their tax base. They are measured at the tax rates that are expected to apply to the year when the 
asset is realised or the liability is settled, based on tax rates (and tax laws) that have been enacted or substantively enacted at the 
balance sheet date. Adjustments to deferred taxes resulting from changes in tax rates are recognised in the Company statement of 
income. A  deferred  tax  asset  is recognised  for all  deductible temporary differences to the extent that it is probable that taxable 
profit will be available against which the deductible temporary difference can be utilised. At each year-end, the Company reviews 
the recoverable value of deferred tax assets of tax entities holding significant loss carryforwards. This value is based, by tax entity, 
on the strategy for recoverability of the tax loss carryforwards. Deferred taxes are charged or credited directly to equity when the 
tax relates to items that are recognised directly in equity, such as gains and losses on cash flow hedges and actuarial gains and 
losses on defined benefit plan obligations. Deferred tax assets and liabilities are set off when they are levied on the same taxable 
entity by the same taxation authority and the entity has a legally enforceable right of set off. Deferred taxes are recognised for all 
temporary differences associated with investments in subsidiaries and associates, except to the extent that the Company is able to 
control the timing of the reversal of the temporary difference and it is probable that the temporary difference will not reverse in 
the  foreseeable  future.  As  required  by  the  amendments  to  IAS12,  the  Company  has  applied  the  exception  and  will  neither 
recognise  nor  disclose  information  about  deferred  tax  assets  and  liabilities  relating  to  Pillar  Two  income  taxes.  Deferred  tax 
balances are not discounted.

Equity. Ordinary Shares are classified as equity. Incremental costs directly attributable to the issue of new shares or options are 
shown in equity as a deduction, net of tax, from the proceeds.

Where any group company purchases the Company’s equity instruments, for example as the result of a share buy-back or a share-
based payment plan, the consideration paid, including any directly attributable incremental costs (net of income taxes) is deducted 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________161

NOTES TO THE FINANCIAL STATEMENTS
Note 2. Basis of Preparation, Use of Accounting Estimates and Significant Accounting Policies

from equity attributable to the owners of LivaNova PLC as treasury shares until the shares are cancelled or reissued. Where such 
Ordinary  Shares  are  subsequently  reissued,  any  consideration  received,  net  of  any  directly  attributable  incremental  transaction 
costs and the related income tax effects, is included in equity attributable to the owners of LivaNova PLC.

Contingencies. The Company is subject to product liability claims, government investigations and other legal proceedings in the 
ordinary course of business. Legal fees and other expenses related to litigation are expensed as incurred and included in SG&A in 
the Company statement of income. Contingent accruals are recorded when the Company determines that a loss is both probable 
and reasonably estimable. Due to the fact that legal proceedings and other contingencies are inherently unpredictable, LivaNova 
PLC’s assessments involve significant judgement regarding future events.

Critical Estimates and Judgements. The preparation of LivaNova PLC’s financial statements in conformity with FRS 101 requires 
management  to  make  judgements  that  affect  the  amounts  reported  in  such  financial  statements  and  accompanying  notes.  These 
estimates and judgements are based on management’s best knowledge of current events and actions the Company may undertake 
in the future. Actual results could differ materially from those estimates. Application of the following accounting policies requires 
certain judgements and estimates that have the potential for the most significant impact on the Company’s financial statements:

Critical Estimates

•

•

Impairment  of  Investments  in  Subsidiaries.  LivaNova  PLC  performed  impairment  trigger  assessments  wherein  the 
Company compared the net assets of LivaNova PLC’s subsidiaries with their respective carrying values as of 31 December 
2023. Where a trigger was identified, the Company performed impairment assessments utilising the discounted cash flow 
models used in the assessment of the Group’s CGUs for impairment. LivaNova also performed sensitivity analyses as of 31 
December 2023, which did not result in any potential impairment of the Company’s investments. Refer to the consolidated 
financial  statements  “Note  10.  Goodwill  and  Intangible  Assets”  under  section  “Impairment  of  Goodwill  and  Intangible 
Assets” for key assumptions and a sensitivity analysis over these key assumptions. 
Deferred  Tax  Recoverability.  Management  has  made  estimates  regarding  the  recoverability  of  deductible  temporary 
differences  and  tax  losses  carried  forward  to  be  utilised  from  future  taxable  profits.  The  Company  has  decided  not  to 
recognise UK deferred tax assets relating to losses where UK group relief is not permitted, and other timing differences due 
to the uncertainty involved in determining the future profitability of the Company. For additional information, please refer 
to “Note 15. Income Taxes Credit.” 

Critical Judgements 

•

Commitments  and  Contingencies.  Due  to  the  fact  that  legal  proceedings  and  other  contingencies  are  inherently 
unpredictable,  LivaNova  PLC’s  assessments  involve  significant  judgement  regarding  future  events.  See  “Note  16. 
Commitments and Contingencies.”

Note 3. Property, Plant and Equipment 

The following table presents the composition of property, plant and equipment as of 31 December 2023 and 2022 (in thousands):

Leasehold 
Improvements

Equipment, 
Furniture & 
Fixtures

Total

At 31 December 2023

Gross amount      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Accumulated depreciation      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net amount     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

At 31 December 2022

Gross amount      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Accumulated depreciation      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net amount     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

1,436  $ 
(879)   
557  $ 

1,378  $ 
(739)   
639  $ 

3,581  $ 
(3,329)   

252  $ 

3,401  $ 
(3,157)   

244  $ 

5,017 
(4,208) 
809 

4,779 
(3,896) 
883 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________162

 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 3. Property, Plant and Equipment

The following table presents the changes in the net amount of each category of property, plant and equipment for the years ended 
31 December 2023 and 2022 (in thousands):

Leasehold 
Improvements

Equipment, 
Furniture & 
Fixtures

Total

Net Amount at 1 January 2022      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Additions with currency translation     . . . . . . . . . . . . . . . . . . . . . . .
Disposals      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depreciation (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Amount at 31 December 2022      . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Additions with currency translation     . . . . . . . . . . . . . . . . . . . . . . .
Depreciation (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Amount at 31 December 2023      . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

461  $ 
306 
(16)   
(112)   
639 
50 
(132)   
557  $ 

143  $ 
155 
— 
(54)   
244 
72 
(64)   
252  $ 

604 
461 
(16) 
(166) 
883 
122 
(196) 
809 

(1) Depreciation  costs  charged  to  the  Company  statement  of  income,  within  operating  expenses,  totalled  $0.2  million  for  the 

years ended 31 December 2023 and 2022.

Note 4. Intangible Assets 

The following table presents the composition of intangible assets as of 31 December 2023 and 2022 (in thousands):

Patents

Licenses

Software and 
Other

Total

At 31 December 2023

Gross amount       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Accumulated amortisation     . . . . . . . . . . . . . . . . . . . . .
Net amount       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

At 31 December 2022

Gross amount       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Accumulated amortisation     . . . . . . . . . . . . . . . . . . . . .
Net amount       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

7,369  $ 
(7,369)   
—  $ 

7,119  $ 
(7,119)   
—  $ 

1,256  $ 
(1,256)   
—  $ 

1,213  $ 
(1,213)   
—  $ 

8,651  $ 
(7,723)   
928  $ 

8,132  $ 
(7,283)   
849  $ 

17,276 
(16,348) 
928 

16,464 
(15,615) 
849 

The following table presents the changes in the net amount of each category of intangible assets for the years ended 31 December 
2023 and 2022 (in thousands):

Software and Other

Net amount at 1 January 2022      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Additions with currency translation     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amortisation (1)
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Amount at 31 December 2022        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Additions with currency translation     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amortisation (1)
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Net Amount at 31 December 2023        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

1,053 
325 
(529) 
849 
4 
75 
928 

(1) Amortisation costs were charged to the Company statement of income within operating expenses during the years ended 31 

December 2023 and 2022.

Amortisation is charged on a straight-line basis. The amortisation periods for LivaNova PLC’s finite-lived intangible assets as of 
31 December 2023 and 2022 were as follows:

Minimum Life in Years Maximum Life in Years

Licenses       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Software and other    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5
5

5
5

Note 5. Investments in Subsidiaries

The following table presents the composition of investments in subsidiaries as of 31 December 2023 and 2022 (in thousands):

Gross amount    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Net book value    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2,962,917  $ 
2,962,917  $ 

2,938,074 
2,938,074 

2023

2022

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________163

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 5. Investments in Subsidiaries

The  following  table  presents  the  changes  in  investments  in  subsidiaries  for  the  years  ended  31  December  2023  and  2022  (in 
thousands):

Net Amount at 1 January 2022      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Disposals    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Currency translation     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Amount at 31 December 2022      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Currency translation     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Amount at 31 December 2023      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Cost

2,978,918 
(1,117) 
1,592 
(41,319) 
2,938,074 
1,093 
23,750 
2,962,917 

The  following  table  presents  the  composition  of  investments  in  subsidiaries  as  of  31  December  2023  and  2022  (in  thousands, 
except ownership percent):

Percent Ownership (1)
2022
2023

Investments in Subsidiaries

2023

2022

LIVN UK Holdco Limited      . . . . . . . . . . . . . . . . . . . .
100.00 $ 
LivaNova Canada Inc.    . . . . . . . . . . . . . . . . . . . . . . . .
100.00  
LivaNova USA, Inc.       . . . . . . . . . . . . . . . . . . . . . . . . .
100.00  
LivaNova Nederland N.V.    . . . . . . . . . . . . . . . . . . . . .
100.00  
LivaNova Switzerland SA     . . . . . . . . . . . . . . . . . . . . .
100.00  
LivaNova Cayman Limited    . . . . . . . . . . . . . . . . . . . .
100.00  
LivaNova Hungary Limited Liability Company      . . . .
100.00  
Sorin Group Italia S.r.l.     . . . . . . . . . . . . . . . . . . . . . . .
98.98  
86.42  
LivaNova Site Management S.r.l.      . . . . . . . . . . . . . . .
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

100.00
100.00
100.00
100.00
100.00
100.00
100.00
98.98
86.42

3,884  $ 

12,526 
1,081,079 
109,525 
6,325 
950,020 
100,202 
681,428 
17,928 
2,962,917  $ 

3,884 
12,522 
1,080,330 
109,422 
6,325 
950,020 
100,202 
658,066 
17,303 
2,938,074 

(1) The Company's voting right percentage is equal to its ownership percentage.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________164

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 5. Investments in Subsidiaries

The following table presents the details of directly and indirectly owned subsidiaries as of 31 December 2023:

Country of 
Incorporation
Italy

% Consolidated 
Group 
Ownership
100

Parent Name

Parent % 
Ownership

LivaNova Canada, Inc. *

8-280 Hillmount Road Markham, ON L6C 3A1

Canada

Entity

Registered Office

LivaNova PLC (Italian Branch)

Via Enrico Cialdini, 16, 20161 Milano Italy

ALung Technologies, Inc.

2500 Jane St., Ste 100, Pittsburgh, PA 
15203

Caisson Interventional, LLC

6500 Wedgwood Rd., Maple Grove, MN 55311

CardiacAssist, Inc. Dba TandemLife

620 Alpha Drive, Ste 200, Pittsburgh, PA 15238

ImThera Medical, Inc.

LivaNova Australia PTY Limited

LivaNova Austria GmbH

100 Cyberonics Boulevard, Houston, TX 77058 
USA

Unit 1, 63 Wells Road, Chelsea Heights VIC 
3196

Millennium Tower, Handelskai 94-96, 1200 
Wien

LivaNova Belgium NV

Ikaroslaan 83, 1930 Zaventem, Belgium

LivaNova Brasil Comércio e 
Distribuição de Equipamentos 
Médico-hospitalares Ltda

Rua Liege, 54 – Vila Vermelha, 04298-070 – 
São Paulo - SP - Brasil

LivaNova Cayman Limited *

LivaNova Chile SpA

LivaNova Colombia Sas

LivaNova Deutschland GmbH

LivaNova España, S.L.

LivaNova Finland OY

Centralis Cayman Limited
One Capital Place, 3rd Floor
Calle Miraflores 222, piso 28 Norte, Santiago, 
Chile
Avenida Calle 80 No. 69-70 Bodega 37, Bogotá, 
Colombia

Lindberghstrasse 25, D - 80939 München, 
Germany

Paseo de Gracia 6 1 – 2 08007 Barcelona , Spain

c/o Kalliolaw Asianajotoimisto Oy, Södra kajen 
12, 00130 Helsinki, Finland

LivaNova Holding S.r.l.

Via Enrico Cialdini, 16, 20161 Milano Italy

LivaNova Hong Kong Limited

4008-4009, 40/F, One Pacific Place, 88 
Queensway, Hong Kong

LivaNova Hungary Limited Liability 
Company *

  Centralis Hungary, 1062 Budapest, Váci út 1-3. 

"A" torony. ép. 6. em.

LivaNova, Inc.

LivaNova India Private Limited

LivaNova IP Limited *

LivaNova Japan K.K.

LivaNova (Thailand) Ltd

100 Cyberonics Boulevard, Houston, TX 77058 
USA

603-A, Copia Corporate Suites, Building #09, 
Jasola District Centre, New Delhi, India 110025

20 Eastbourne Terrace, London, England W2 
6LG, United Kingdom

11-1 Nagatacho 2 chome, Chiyoda-ku, Tokyo, 
100-6110 Japan

999, Gaysorn Building, 5th Floor, Unit 5B-1, 
Room no 535 ,509-510 Ploenchit Rd., Lumpini, 
Patumwan, Bangkok 103304

US

US

US

US

Australia

Austria

Belgium

Brazil

Cayman Islands

Chile

Colombia

Germany

Spain

Finland

Italy

Hong Kong

Hungary

US

India

UK

Japan

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

LivaNova USA, Inc.

LivaNova USA, Inc.

LivaNova USA, Inc.

LivaNova USA, Inc.

LivaNova Nederland N.V.

LivaNova Nederland N.V.

LivaNova Nederland N.V.

Sorin Group Italia S.r.l.

LivaNova PLC

LivaNova PLC

LivaNova UK Limited

Sorin Group Italia S.r.l.

Sorin Group Italia S.r.l.

LivaNova Nederland N.V.

Sorin Group Italia S.r.l.

Sorin Group Italia S.r.l.

LivaNova Nederland N.V.

LivaNova PLC

LivaNova USA, Inc.

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

99.99

LivaNova Nederland N.V.

99.99

100

100

LivaNova PLC

LivaNova Nederland N.V.

100

100

Thailand

99.997

LivaNova Nederland N.V.

99.997

LivaNova (China) Medical 
Technology Co. Ltd

Room 218, 2nd Floor,No.56 Meisheng Road, 
Shanghai Pilot Free Trade Zone, China

LivaNova Malaysia Sdn. Bhd.

LivaNova Nederland N.V. *

LivaNova Norway AS

LivaNova Poland Sp. Z o.o.

LivaNova SAS

Unit A-3-6, TTDI Plaza, Jalan Wan Kadir 3, 
Taman Tun Dr Ismail, 60000 Kuala Lumpur, 
Malaysia

Westerdoksdijk 423, 1013 BX, Amsterdam, 
Netherlands

c/o AmestoAccounthouse AS, Smeltedigelen 1, 
0195 Oslo, Norway

Park Postepu Bud A Ul. Postepu 21 PL-02 676 
Warszawa, Poland

24 rue du Gouverneur Général Éboué, 92130 
Issy-les-Moulineaux, France

LivaNova Scandinavia AB

Djupdalsvägen 16, 192 51 Sollentuna, Sweden

LivaNova Singapore Pte Ltd

11 North Buona Vista Drive #13-09, The 
Metropolis, Singapore 138589

China

Malaysia

Netherlands

Norway

Poland

France

Sweden

Singapore

LivaNova Site Management S.r.l. *

Via Enrico Cialdini, 16, 20161 Milano Italy

Italy

LivaNova Switzerland SA *

Rue du Grand-Pont 12, 1003 Lausanne

LivaNova Taiwan Co. Ltd

12F, No. 101, Songren Rd. Taipei City, 110414 
Taiwan

LivaNova Turkey Medikal Limited 
Sirketi

Esentepe Mahallesi Ecza Sk. Pol Center Sit. C 
Blok Apt No: 4/1 Sisli/Istanbul

LivaNova UK Limited

LivaNova USA, Inc. *

LIVN Irishco 2 UC

LIVN Luxco 2 sarl (1)

LIVN UK 2 Co Limited

1370 Montpellier Court, Gloucester Business 
Park, Gloucester, Gloucestershire, GL3 4AH, 
United Kingdom

100 Cyberonics Boulevard, Houston, TX 77058 
USA

Deloitte, 6 Lapps Quay, Cork, T12 TA48, 
Ireland

15 Rue Edward Steichen L-2540 Luxembourg

Luxembourg

20 Eastbourne Terrace, London, England W2 
6LG, United Kingdom

UK

Switzerland

Taiwan

Turkey

UK

US

Ireland

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

100

LivaNova Holding S.r.l.

LivaNova Nederland N.V.

LivaNova PLC

Sorin Group Italia S.r.l.

LivaNova Nederland N.V.

LivaNova Nederland N.V.

Sorin Group Italia S.r.l.

LivaNova Nederland N.V.

LivaNova PLC
Sorin Group Italia S.r.l.

LivaNova PLC

LivaNova Nederland N.V.

LivaNova Nederland N.V.

LivaNova Nederland N.V.

LivaNova PLC

LIVN UK Holdco Limited

LIVN UK Holdco Limited

LIVN US 5, LLC

100

100

100

100

100

100

100

100

86
14

100

100

100

100

100

100

100

100

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________165

Parent % 
Ownership
100

100

100

99
1

100

— 
— 
— 

NOTES TO THE FINANCIAL STATEMENTS
Note 5. Investments in Subsidiaries

Entity

Registered Office

LIVN UK Holdco Limited *

LIVN US 3, LLC

LIVN US 5, LLC

20 Eastbourne Terrace, London, England W2 
6LG, United Kingdom

100 Cyberonics Boulevard, Houston, TX 77058 
USA

100 Cyberonics Boulevard, Houston, TX 77058 
USA

Sorin Group Italia S.r.l. *

Via Enrico Cialdini, 16, 20161 Milano Italy

Sorin Group Rus LLC

Marshal Proshlyakov str. 30 office 304 123458 
Moscow, Russia

Represents a direct investment of LivaNova PLC.

*
(1) LIVN Luxco 2 sarl was liquidated in December 2023.

Note 6. Financial Assets 

Country of 
Incorporation
UK

% Consolidated 
Group 
Ownership
100

US

US

Italy

Russia

100

100

100

100

Parent Name

LivaNova PLC

LivaNova, Inc.

LIVN US 3, LLC

LivaNova PLC
LivaNova Holding S.r.l.

Sorin Group Italia S.r.l.

The following table presents the composition of non-current financial assets as of 31 December 2023 and 2022 (in thousands):

Note due from subsidiary (1)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Other      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

490,151  $ 
211 
490,362  $ 

2023

2022

(1) On 31 December 2023, LivaNova PLC entered into a $490.2 million Promissory Note with LivaNova USA, Inc. at a 8.19% 
fixed  interest  rate  per  annum  with  accrued  interest  and  principal  due  1  December  2030.  This  note  was  classified  as  non-
current at 31 December 2023. 

The following table presents the composition of current financial assets as of 31 December 2023 and 2022 (in thousands):

Due in less than 12 months
Due from subsidiaries (1)
Other      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

38,942  $ 
48 
38,990  $ 

54,635 
950 
55,585 

(1) LivaNova PLC, in the management of LivaNova centralized treasury and acting as in-house bank of the Group, loans excess 
cash to subsidiaries. Interest accrues and is paid quarterly at LIBOR plus 1.5% per annum. Principal amounts are due on 
demand with 10 day notice.

Note 7. Other Assets

The following table presents the composition of non-current other assets as of 31 December 2023 and 2022 (in thousands):

Receivables from subsidiaries associated with the Company’s share-based incentive plans      . . $ 
Right-of-use assets (1)
Intangible assets (2)
Property, plant and equipment (3)
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

59,455  $ 
4,707 
928 
809 
65,899  $ 

46,886 
5,286 
849 
883 
53,904 

2023

2022

(1) For additional information refer to “Note 13. Leases.”
(2) For additional information refer to “Note 4. Intangible Assets.”
(3) For additional information refer to “Note 3. Property, Plant and Equipment.”

Note 8. Trade and Other Receivables and Expected Credit Loss Provision

The following table presents the composition of net trade receivables as of 31 December 2023 and 2022 (in thousands):

Trade receivables due from third parties       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Trade receivables due from LivaNova subsidiaries (1)      . . . . . . . . . . . . . . . . . . . . . . . . .
Expected credit loss provision     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

261  $ 

8,483 
(255)   
8,489  $ 

274 
11,658 
(246) 
11,686 

(1)  Trade receivables due from subsidiaries are paid within 90 days and no interest is charged. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________166

 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 8. Trade Receivables and Allowance for Bad Debt

Trade receivables are reported net of the expected credit loss provision. The following table presents the changes in the expected 
credit loss provision for the years ended 31 December 2023 and 2022 (in thousands):

2023

2022

Beginning of year    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Utilization     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Currency translation gains/(losses)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

246  $ 

— 

9 

End of year     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

255  $ 

The following table presents the composition of other receivables as of 31 December 2023 and 2022 (in thousands):

2023

2022

Deposit and advances to suppliers       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

10,322  $ 

Prepaid assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Guarantee deposits      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Derivative financial instruments (1)
Total        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1) For additional information refer to “Note 9. Derivative Financial Instruments.”

1,289 

158 

— 

11,769  $ 

Note 9. Derivative Financial Instruments

269 
(7) 

(16) 

246 

4,704 

2,271 

158 

1,333 

8,466 

LivaNova  PLC  enter  into  FX  derivative  contracts  and  interest  rate  swap  contracts  to  reduce  the  impact  of  foreign  currency 
exchange  rate  and  interest  rate  fluctuations,  respectively,  on  earnings  and  cash  flow.  For  additional  details  refer  to  LivaNova 
PLC’s accounting policy “Derivatives” included within “Note 2. Basis of Preparation, Use of Accounting Estimates and Material 
Accounting Policies.”

Freestanding FX Derivative Contracts

The  gross  notional  amount  of  FX  derivative  contracts,  not  designated  as  hedging  instruments,  outstanding  as  of  31  December 
2023  and  31  December  2022  was  $223.4  million  and  $154.5  million,  respectively.  These  derivative  contracts  are  designed  to 
offset the FX effects in earnings of various intercompany loans and trade receivables. 

Cash Flow Hedges

Foreign Currency Risk. Historically, the Company has utilised FX derivative contracts, designed as cash flow hedges, to hedge the 
variability  of  cash  flows  associated  with  LivaNova  PLC’s  12-month  US  dollar  forecasts  of  revenues  and  costs  denominated  in 
British Pound, Japanese Yen and the Euro. LivaNova PLC transfers to earnings from AOCI the gain or loss realised on the FX 
derivative contracts at the time of invoicing. Upon the settlement of LivaNova PLC’s foreign currency cash flow hedges in 2022 
and following an in-depth analysis of the utility of LivaNova PLC’s cash flow hedging program, the Company discontinued its 
foreign currency cash flow hedging program.

Interest  Rate  Risk.  Historically,  LivaNova  entered  into  interest  rate  swaps  associated  with  the  Initial  Term  Facility,  which 
qualified for and were designated as cash flow hedges. The Company’s interest rate swaps expired on 6 April 2023. LivaNova 
elected not to renew the interest rate swaps as finance expenses associated with the Initial Term Facility is principally offset by 
holding a significant portion of the Initial Term Facility in a depository account, which earns a floating rate of interest.

The  amount  and  location  of  the  gains  and  (losses)  in  the  Company  statement  of  income  related  to  derivative  instruments  not 
designated as hedging instruments for the years ended 31 December 2023 and 2022 were follows (in thousands):

Derivatives Not Designated as Hedging Instruments

Foreign currency exchange rate contracts     . . . . . . . .
Interest rate swap contracts       . . . . . . . . . . . . . . . . . . . Finance expenses      . . . . . . .

Location
Net foreign exchange and 
other income/(expense)   . . $ 

2023

2022

(1,297)  $ 
— 

4,479 
966 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________167

 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 9. Derivative Financial Instruments

Presentation in Financial Statements

The following tables present the fair value, and the location of, derivative contracts reported in the Company balance sheet as of 
31 December 2023 and 2022 (in thousands):

2023

Liability Derivatives

Derivatives Not Designated as Hedging Instruments
FX derivative contracts    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Current financial derivative liabilities      . . . . . . . . $ 
Total derivatives not designated as hedging instruments     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Balance Sheet Location

Fair Value

3,883 
3,883 
3,883 

2022

Asset Derivatives

Liability Derivatives

Derivatives Not Designated as Hedging 
Instruments

Balance Sheet 
Location

Fair 
Value

Balance Sheet 
Location

Fair 
Value

Interest rate swap contracts      . . . . . . . . . . . . . . . . . . .

Current financial 
derivative assets    . . . . . $ 

1,333 

FX derivative contracts    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1,333 
Total derivatives not designated as hedging instruments       . . . . . . . . . . . . . . . .
1,333 
Total     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Current financial 
derivative liabilities      . . $ 
     . . . . . . . . . . . . . . . . . .
     . . . . . . . . . . . . . . . . . . $ 

5,886 
5,886 
5,886 

Note 10. Shareholders' Equity 

Called up share capital

The following table presents LivaNova PLC’s authorised called up share capital as of 31 December 2023 and 2022 (in number of 
shares):

Authorised called up share capital, Ordinary Shares of £1 each, unlimited shares 
authorised
Issued (1)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Outstanding    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1)  Allotted, fully paid and issued. 

2023

2022

53,942,151 
53,918,222 

53,851,979 
53,564,664 

Preferred shares. LivaNova may issue preferred shares by special resolution or by determination by the Board of LivaNova.

Treasury shares. Shares held by the EBT are issued to employees and directors at exercise of share-based compensation grants. 
The  balance  of  shares  in  the  EBT  are  reported  as  treasury  shares.  LivaNova  PLC  did  not  issue  any  additional  shares  to  the 
Company’s EBT during the years ended 31 December 2023 or 31 December 2022. As of 31 December 2023 and 2022, LivaNova 
held 23,929 and 287,315 shares in treasury.

Reserves

Merger relief reserve. On 19 October 2015 pursuant to the Mergers, the merger relief reserve was recognised in the amount of 
$2,649.6 million as a result of the share exchange transaction of the Sorin and Cyberonics Mergers with and into the Company. 
During  the  year  ended  31  December  2016,  the  Company  capitalised  $2,583.1  million  of  the  reserves  in  order  to  create 
distributable reserves in the financial statement of the Company. Additionally, on 6 August 2021, the Company closed an offering 
and issued 4,181,818 ordinary shares, par value £1.00 per share, at an offering price of $82.50 per share. Net proceeds from the 
offering were approximately $322.5 million, after deducting underwriting discounts, commissions and offering expenses, of which 
$316.7 million was recognised as merger relief reserve. The reserves may be used for any corporate purpose of the Company for 
which realised profits are required. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________168

 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 10. Shareholders’ Equity

Capital redemption reserve. The capital redemption reserve represents transfers from distributable reserves in accordance with the 
Company’s legislation upon the redemption of ordinary called up share capital.

Accumulated Other Comprehensive Income. The following table presents the change in each component of AOCI, net of tax, and 
the reclassifications out of AOCI into net earnings for the years ended 31 December 2023 and 2022 (in thousands):

Foreign 
Currency
Translation
Adjustments

Revaluation of 
Net (Asset) 
Liability for 
Defined 
Benefits

Total

Balance as of 1 January 2022    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Reclassification of (loss) gain from accumulated other comprehensive 
income, before tax    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax effect    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reclassification of (loss) gain from accumulated other comprehensive 
income, after tax    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net other comprehensive (loss) income, net of tax     . . . . . . . . . . . . . . . . . . . . . .
Balance as of 31 December 2022     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reclassification of gain from accumulated other comprehensive income, 
before tax     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax effect    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reclassification of gain from accumulated other comprehensive income, after 
tax     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net other comprehensive income, net of tax      . . . . . . . . . . . . . . . . . . . . . . . . . . .
Balance as of 31 December 2023     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Note 11. Financial Liabilities 

10,292  $ 

(30)  $ 

10,262 

(32,237)   

— 

(32,237)   
(32,237)   
(21,945)   

18,127 
— 

18,127 
18,127 
(3,818)  $ 

10 
— 

10 
10 
(20)   

— 
— 

— 
— 
(20)  $ 

(32,227) 
— 

(32,227) 
(32,227) 
(21,965) 

18,127 
— 

18,127 
18,127 
(3,838) 

During 2023, LivaNova commenced an intercompany financing restructuring that was subsequently completed in 2024. As part of 
this intercompany financing restructuring, on 31 December 2023 LivaNova PLC entered into a Promissory Note with LivaNova 
USA,  Inc.  for  $490.2  million  (refer  to  “Note  6.  Financial  Assets”)  and  the  $509.8  million  Promissory  Note,  discussed  below, 
between LivaNova PLC and LivaNova USA, Inc. was relieved. These and other subsidiary transactions resulted in an increase in 
LivaNova PLC’s due to subsidiaries of $950.0 million, included below within current financial liabilities. The $950.0 million due 
to subsidiary was subsequently relieved on 2 January 2024 via a distribution.

The  following  table  presents  the  principal  amounts  of  long-term  financial  liabilities  as  of  31  December  2023  and  2022  (in 
thousands): 

Notes payable to LivaNova subsidiaries (1)
     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

—  $ 
—  $ 

509,849 
509,849 

(1) On 15 October 2020, LivaNova PLC entered into a $509.8 million Promissory Note with LivaNova USA, Inc. at 4.75% fixed 
interest  rate  per  annum  with  accrued  interest  and  principal  due  14  October  2030.  This  note  was  subsequently  assigned  to 
LivaNova Hungary Limited Liability Company in 2020.

The  following  table  presents  the  principal  amounts  of  current  financial  liabilities  as  of  31  December  2023  and  2022  (in 
thousands):

2023

2022

2023

2022

Due to LivaNova subsidiaries (1)
Short-term facilities   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

1,226,626  $ 

28 

1,226,654  $ 

229,678 
60 
229,738 

(1) LivaNova PLC, in the management of LivaNova centralized treasury and acting as in-house bank of the Group, holds cash on 
deposit  from  subsidiaries.  Interest  accrues  and  is  paid  quarterly  on  balances  at  the  applicable  interest  index  rate,  of  each 
currency, less 0,50%.

Finance expenses. Finance expenses of $33.0 million and $27.7 million for the years ended 31 December 2023 and 31 December 
2022, respectively, consisted primarily of interest on the Company’s debt facilities. Refer to the Company statement of income. 
Finance expenses associated with subsidiary debt amounted to $32.6 million and $26.7 million for the years ended 31 December 
2023 and 31 December 2022, respectively.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________169

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 12. Other Liabilities

Note 12. Other Liabilities

The following table presents the composition of non-current other liabilities as of 31 December 2023 and 2022 (in thousands):

       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Lease liabilities (1)
Provision for employee severance indemnities and other employee benefit 
provisions      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

4,523  $ 

680 
5,203  $ 

(1) For additional information refer to “Note 13. Leases.”

The following table presents the composition of current other liabilities as of 31 December 2023 and 2022 (in thousands):

2023

2022

2023

2022

Accrued employee-related charges      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Liabilities with subsidiaries      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Derivative financial instruments (1)
    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax payable   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amounts due to health and social security institution       . . . . . . . . . . . . . . . . . . . . . . . . .
Lease liabilities (2)
       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amounts due to employees    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other current liabilities and accrued expenses        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(1) For additional information refer to “Note 9. Derivative Financial Instruments.”
(2) For additional information refer to “Note 13. Leases.”

Note 13. Leases

4,427  $ 
4,093 
3,883 
2,557 
1,319 
716 
496 
5,798 

23,289  $ 

5,611 

2,169 
7,780 

5,706 
1,542 
5,886 
1,239 
569 
976 
491 
5,905 
22,314 

LivaNova  PLC  has  leases  primarily  for  (i)  real  estate,  including  office  space  and  manufacturing,  warehouse  and  research  and 
development facilities and (ii) vehicles. LivaNova PLC’s leases have remaining lease terms up to 15 years, some of which include 
options to extend the leases, and some of which include options to terminate the leases at the Company’s sole discretion.

Right-of-Use Assets and Lease Liabilities

The following table presents the changes in ROU assets and lease liabilities by class of assets for the years ended 31 December 
2023 and 2022 (in thousands):

Real Estate

Vehicles

Right-of-Use 
Assets

Lease 
Liabilities

Balance as of 1 January 2022   . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Additions     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depreciation expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disposals      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance expenses      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lease payments       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Currency translation adjustments    . . . . . . . . . . . . . . . . . . . . . . . . .
Balance as of 31 December 2022    . . . . . . . . . . . . . . . . . . . . . . . . .
Additions     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depreciation expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disposals      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance expenses      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lease payments       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Currency translation adjustments    . . . . . . . . . . . . . . . . . . . . . . . . .
Balance as of 31 December 2023    . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2,400  $ 
3,791 
(949)   
— 
— 
NA
(5)   

5,237 
53 
(803)   
— 
— 
NA
216 
4,703  $ 

98  $ 
26 
(56)   
(11)   
— 
NA
(8)   
49 
— 
(40)   
(7)   
— 
NA
2 
4  $ 

$ 

2,498 
3,817 
(1,005) 
(11) 
— 
NA  
(13) 
5,286 
53 
(843) 
(7) 
— 
NA  
218 
4,707 

$ 

4,174 
3,816 
NA
(11) 
189 
(1,537) 
(44) 
6,587 
53 
NA
(782) 
232 
(966) 
115 
5,239 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________170

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 13. Leases

Contractual maturities of LivaNova PLC’s lease liabilities as of 31 December 2023 were as follows (in thousands):

2024       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2025       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2026       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2027       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2028       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Thereafter      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total lease payments      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less: Amount representing finance charges      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net present value of lease liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Contractual maturities of LivaNova PLC’s lease liabilities as of 31 December 2022 were as follows (in thousands):

2023       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2024       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2025       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2026       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2027       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Thereafter      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total lease payments      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less: Amount representing finance charges      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net present value of lease liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

872 
956 
640 
463 
463 
2,930 
6,324 
(1,085) 
5,239 

1,107 
1,325 
976 
615 
447 
3,277 
7,747 
(1,160) 
6,587 

Lease  payments  of  approximately  $1.0  million  were  made  during  the  year  ended  31  December  2023  in  connection  with  lease 
agreements  of  which  $0.7  million  represents  the  principal  portion  classified  in  financing  activities  and  $0.2  million  for  interest 
classified in operating activities.

Lease  payments  of  approximately  $1.5  million  were  made  during  the  year  ended  31  December  2022  in  connection  with  lease 
agreements  of  which  $1.3  million  represents  the  principal  portion  classified  in  financing  activities  and  $0.2  million  for  interest 
classified in operating activities.

Note 14. Share-Based Compensation Plans

Share-Based Compensation Plans

On 16 October 2015, LivaNova PLC approved the adoption of the Company’s 2015 Plan, which was previously approved by the 
Board  of  the  Company  on  14  September  2015  subject  to  such  shareholder  approval.  The  2015  Plan  was  adopted  in  order  to 
facilitate the grant of cash and equity incentives to non-employee directors, employees (including the Company’s named executive 
officers)  and  consultants  of  the  Company  and  certain  of  LivaNova  PLC’s  affiliates  and  to  enable  the  Company  and  certain  of 
LivaNova PLC’s affiliates to obtain and retain services of these individuals. The Plan became effective as of 19 October 2015. 
The 2022 Plan was adopted by the Board of Directors on 20 April 2022 and approved by the shareholders of LivaNova PLC on 13 
June 2022. Awards may be granted under the 2015 Plan and 2022 Plan in the form of stock options, SARs, RS, RSUs and other 
share-based awards. The awards with service conditions generally vest ratably from two to four years and are subject to forfeiture 
unless service conditions are met. The market performance-based awards that were issued cliff vest after three years subject to the 
rank of LivaNova’s total shareholder return for the three-year period ending 31 December 2024 relative to the total shareholder 
returns  for  a  peer  group  of  companies.  The  adjusted  FCF  and  adjusted  ROIC  operating  performance-based  awards  that  were 
issued cliff vest after three years subject to the achievement of certain thresholds of cumulative results for those metrics for the 
three-year  period  ending  31  December  2024.  As  of  31  December  2023,  there  were  approximately  12,098  shares  available  for 
future  grants  under  the  2015  Plan,  respectively  and  1,422,656  shares  pursuant  to  Options  or  Stock  Appreciation  Rights  and 
902,967 shares pursuant to other types of awards available for future grants to LivaNova PLC’s employees under the 2022 Plan.

Share Options and Share Appreciation Rights

Options and SARs
Exercised      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Outstanding - end of year      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Year Ended 31 December

2023

2022

Number of
Optioned 
Shares

Wtd. Avg. 
Exercise 
Price

Number of
Optioned 
Shares

Wtd. Avg. 
Exercise 
Price

193,625  $ 
344,938  $ 

44.39 
61.51 

7,067  $ 
797,842  $ 

45.55 
63.94 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________171

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 14. Share-Based Compensation Plans

The  weighted  average  remaining  contractual  life  for  the  share  options  and  SARs  outstanding  at  31  December  2023  and  31 
December 2022 was 6.0 years and 5.9 years, respectively.

The aggregate intrinsic value of the options and SARs outstanding at 31 December 2023 and 31 December 2022 was $1.2 million 
and  $3.6  million,  respectively.  The  aggregate  intrinsic  value  of  options  and  SARs  is  based  on  the  fair  market  value  of  the 
underlying share at the end of the year using the difference between the market closing share price, and exercise price for in-the-
money awards.

The following table presents outstanding options and SARs by exercise price range as of 31 December 2023 and 2022 (in number 
of shares):

Outstanding Options
$41-50     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$51-60     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$61-70     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$71-80     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$81-90     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$91-100     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$101-110     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$121-130     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Restricted Share and Restricted Share Units Awards

2023

2022

135,323 
76,402 
— 
49,412 
59,093 
24,334 
374 
— 
344,938 

303,421 
135,173 
— 
109,485 
174,247 
75,025 
— 
491 
797,842 

The following tables detail the activity for service-based restricted share and restricted share unit awards for the years ended 31 
December 2023 and 2022:

2023

2022

Number of
Shares

Wtd. Avg. Grant
Date Fair Value

Number of
Shares

Wtd. Avg. Grant
Date Fair Value

Non-vested at end of year     . . . . . . . . . .

100,888  $ 

53.88 

157,400  $ 

67.57 

Aggregate fair value of service-based share grants that vested during the year (in 
thousands)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

5,028  $ 

5,247 

2023

2022

Market and Performance-Based Restricted Share and Performance-Based Restricted Share Units Awards

The following tables detail the activity for performance-based and market-based restricted share and restricted share unit awards 
for the years ended 31 December 2023 and 2022:

2023

2022

Number of
Shares

Wtd. Avg. Grant
Date Fair Value

Number of
Shares

Wtd. Avg. Grant
Date Fair Value

Non-vested at end of year       . . . . . . . . . .

75,917  $ 

69.37 

254,863  $ 

70.59 

Aggregate fair value of performance-based share grants that vested during the year 
(in thousands)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

4,283  $ 

4,774 

2023

2022

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________172

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 15. Income Taxes Credit

Note 15. Income Taxes Credit

The following table presents the composition of income tax credit for the years ended 31 December 2023 and 2022 (in thousands):

Current Tax:
(Charge) credit in respect to current period       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Credit (charge) in respect to prior period     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total current tax benefit     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred Tax:
Relating to the origination and reversal of temporary differences         . . . . . . . . . . . . . . . . . . . .
Relating to changes in tax rates and legislation    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total deferred tax credit    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income tax credit   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2023

2022

(402)  $ 
671 
269 

12,529 

(914)   

11,615 
11,884  $ 

255 
(76) 
179 

12,106 
4,332 
16,438 
16,617 

The  following  table  presents  a  reconciliation  of  the  statutory  income  tax  rate  to  LivaNova  PLC’s  effective  income  tax  rate 
expressed as a percentage of income before income tax credit for the years ended 31 December 2023 and 2022:

Statutory tax rate at UK rate     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Change in tax rate (1)
     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Permanent differences   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Distribution of subsidiary earnings      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax on UK CFC interest       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Impairment      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Equity compensation   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other, net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Effective tax rate      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2023

2022

 23.5 %
 10.9 
 (3.7) 
 129.6 
 (4.4) 
 — 
 (5.2) 
 (12.7) 
 138.0 %

 19.0 %
 32.3 
 (4.6) 
 79.3 
 (5.1) 
 3.9 
 (14.6) 
 3.6 
 113.8 %

(1) The change in tax rate for 2023 was primarily due to the NOLs generated during 2023 net of group relief being measured to 
a tax rate 19%. The change in tax rate for 2022 was primarily due to the NOLs generated during 2022 net of group relief 
being measured to a tax rate 19% and revaluation of deferred tax assets at 25% for changes in law effective 1 April 2023. 

Deferred tax assets and liabilities on a gross basis are summarised as follows (in thousands):

Activity During the Year Ended 31 December 2023

31 December 
2023

Company 
Statement of 
Income 

Tax Rate 
Change (1)

Shareholders’ 
Equity

Net operating loss carryforwards       $ 
Accruals and reserves      . . . . . . . . .
Share-based compensation       . . . . .
Lease assets and other       . . . . . . . . .
Total deferred tax assets   . . . . . . .
Lease liabilities and other      . . . . . .
Total deferred tax liabilities       . . . .
Total deferred tax assets, net    . . . . $ 

79,923  $ 
66 
1,037 
20,233 
101,259 

(179)   
(179)   
101,438  $ 

10,375  $ 
— 
(2,556)   
3,499 
11,318 
(1,211)   
(1,211)   
12,529  $ 

(625)  $ 
— 
22 
(306)   
(909)   
5 
5 
(914)  $ 

1 January 2023
70,173 
66 
4,235 
17,040 
91,514 
1,027 
1,027 
90,487 

—  $ 
— 
(664)   
— 
(664)   
— 
— 
(664)  $ 

(1) The UK tax rate to increase to 25%, effective 1 April 2023, the tax rate movement of deferred tax assets/liabilities from 1 

January through 31 March 2023.

LivaNova continues to monitor the adoption of Pillar Two by the taxing jurisdictions in which it operates. The UK has enacted 
legislation providing for a minimum effective tax rate of 15% through a “multinational top-up tax” and a “domestic top-up tax” 
for accounting periods beginning on or after 31 December 2023. Draft UK legislation has also been published for an UTPR to be 
introduced, although not before accounting periods beginning on or after 31 December 2024. A UTPR would be a backstop rule 
intended to ensure that amounts of multinational top-up tax that are not collected under foreign global minimum tax rules can in 
certain circumstance be collected instead in the UK. 

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________173

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 15. Income Taxes Credit

As  required  by  the  amendments  to  IAS  12,  the  Company  has  applied  the  exception  and  will  neither  recognise  nor  disclose 
information  about  deferred  tax  assets  and  liabilities  relating  to  Pillar  Two  income  taxes.  The  Company  does  not  expect  the 
adoption  of  Pillar  Two  to  have  a  significant  impact.  Refer  to  “Note  2.  Basis  of  Preparation,  Use  of  Accounting  Estimates  and 
Material Accounting Policies.”

Activity During the Year Ended 31 December 2022

31 December 
2022

Company 
Statement of 
Income (Loss) 

Tax Rate 
Change (1)

Shareholders’ 
Equity

Net operating loss carryforwards       $ 
Accruals and reserves      . . . . . . . . .
Share-based compensation       . . . . .
Lease assets and other       . . . . . . . . .
Total deferred tax assets   . . . . . . .
Lease liabilities and other      . . . . . .
Total deferred tax liabilities       . . . .
Total deferred tax assets, net    . . . . $ 

70,173  $ 
66 
4,235 
17,040 
91,514 
1,027 
1,027 
90,487  $ 

9,351  $ 
— 
(992)   
4,594 
12,953 
852 
852 
12,101  $ 

2,489  $ 
— 
— 
1,844 
4,333 
— 
— 
4,333  $ 

1 January 2022
58,333 
66 
8,497 
10,540 
77,436 
113 
113 
77,323 

—  $ 
— 
(3,270)   
62 
(3,208)   
62 
62 
(3,270)  $ 

(1) UK received royal assent in July 2021, and provided for the UK tax rate to increase to 25%, effective 1 April 2023, there was 

a revaluation to increase deferred taxes in 2021. 

As of 31 December 2023, deferred tax assets have not been recognised with respect of the following items (in thousands):

Region

Gross Amount

Tax Benefit

Amount with No 
Expiration

UK NOL     . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Non UK NOL   . . . . . . . . . . . . . . . . . . . . .
Non UK - Other deferred tax assets (1)
       . .
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

40,437  $ 
520 
1,064 
42,021  $ 

10,109  $ 
125 
255 
10,489  $ 

10,109 
125 
— 
10,234 

Carryforward 
Period
Unlimited
Unlimited
Various

As of 31 December 2022, deferred tax assets have not been recognised with respect of the following items (in thousands):

Region

Gross Amount

Tax Benefit

Amount with No 
Expiration

UK NOL     . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Non UK NOL   . . . . . . . . . . . . . . . . . . . . .
Non UK - Other deferred tax assets     . . . .
Total      . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

40,437  $ 
2,878 
1,067 
44,382  $ 

10,109  $ 
691 
256 
11,056  $ 

10,109 
691 
— 
10,800 

Carryforward 
Period
Unlimited
Unlimited
Various

(1) Unrecognised assets of $0.5 million is included in other in the effective tax rate reconciliation for 2023. 

For  losses  incurred  after  April  2017  in  the  UK,  the  Company  anticipates  a  recoverability  of  these  operating  loss  carryforwards 
beginning in 2025 as the Company expects an increase in taxable income due to the full amortisation of certain intangible assets. 
The  Company  is  relying  on  estimated  future  income  projections  and  judgement  on  the  growth  of  the  projected  income  for  the 
recoverability of the deferred tax assets corresponding the NOLs. The Company estimates it will be able to recover its tax loss in 
less than 10 years through UK Group relief, as the UK Group will realize substantially an increase of taxable income as a result of 
increased revenues from royalty income, interest income, and decreased amortisation of intangible assets beginning in 2024.

No provision has been made for income taxes on undistributed earnings of foreign subsidiaries as of 31 December 2023 because it 
is the Company’s intention to indefinitely reinvest undistributed earnings of the Company’s foreign subsidiaries. In the event of 
the distribution of those earnings in the form of dividends, a sale of the subsidiaries, or certain other transactions, the Company 
may  be  liable  for  income  taxes.  There  should  be  no  material  tax  liability  on  future  distributions  as  most  jurisdictions  with 
undistributed  earnings  have  various  participation  exemptions  /  no  withholding  tax.  These  unrecognised  differences  are  not 
expected to reverse in the foreseeable future. 

Note 16. Commitments and Contingencies

Refer to “Note 24. Commitments and Contingencies” of the LivaNova consolidated financial statements in this Annual Report.

Certain subsidiaries of LivaNova PLC have entered into agreements with Bank of America, including for the issuance of credit 
cards and local credit facilities, for which LivaNova PLC has provided an indemnity letter up to $40 million to Bank of America 
covering the liabilities of the subsidiaries under the agreements. As of 31 December 2023, the assessed fair value of the Bank of 
America agreement was deemed immaterial.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________174

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 17. Related Parties

Note 17. Related Parties

Interests in subsidiaries are set out in “Note 5. Investments in Subsidiaries.” Receivables from subsidiaries are set out in “Note 6. 
Financial  Assets.”  Trade  receivables  due  from  LivaNova  subsidiaries  are  set  out  in  “Note  8.  Trade  and  Other  Receivables  and 
Expected Credit Loss Provision.” Receivables from subsidiaries associated with the Company’s share-based incentive plans are 
set out in “Note 7. Other Assets.” Notes payable to LivaNova subsidiaries are set out in “Note 11. Financial Liabilities.” Current 
liabilities  with  subsidiaries  are  set  out  in  “Note  12.  Other  Liabilities.”  Refer  to  the  consolidated  financial  statements  “Note  27. 
Related Parties” for key management personnel and related parties. Refer to consolidated financial statements “Note 12. Financial 
Assets” for related party financial assets. 

Note 18. Company Statement of Income by Nature

The following table presents the Company statement of income by nature for the years ended 31 December 2023 and 2022 (in 
thousands):

Revenue  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Cost of materials and services used      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Personnel expense     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amortisation and depreciation      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating loss      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance expenses     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income from subsidiary undertakings   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finance income     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net foreign exchange and other income/(expense)    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss before taxes    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income tax credit   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income for the financial year      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Note 19. Employee Compensation Costs

Year Ended 31 December

2023

2022

25,853  $ 
(52,189)   
(19,282)   
(1,258)   
(46,876)   
(32,985)   
47,500 
21,959 
1,789 
(8,613)   
11,884 

3,271  $ 

28,996 
(49,065) 
(35,136) 
(1,663) 
(56,868) 
(27,688) 
60,925 
10,983 
(1,955) 
(14,603) 
16,617 
2,014 

Details of directors’ remuneration are included in the Remuneration Report on pages 53 to 74, which forms part of these financial 
statements. 

The  average  monthly  employee  numbers  on  a  full-time  equivalent  basis,  including  executive  directors  were  61  and  68  for  the 
years  ended  31  December  2023  and  2022,  respectively.  LivaNova  PLC’s  employees  are  principally  engaged  in  Corporate 
activities. 

The following table presents employee compensation costs of LivaNova PLC for the years ended 31 December 2023 and 2022 (in 
thousands):

Wages and salaries        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Social security costs        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pension costs      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Share-based payments       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other employee costs        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Note 20. Auditors’ Remuneration 

2023

2022

8,138  $ 
3,710 
1,318 
(812)   
6,928 
19,282  $ 

8,180 
4,022 
2,153 
14,119 
6,662 
35,136 

The following table presents the Company auditors’ remuneration for the years ended 31 December 2023 and 2022 (in thousands):

Year Ended 31 December

2023

2022

Fees payable to the Company’s Auditors for the audit of parent company financial 
statements (1)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
(1) Refer to “Note 31. Auditors’ Remuneration” of the LivaNova consolidated financial statements in this Annual Report for non-

82  $ 

82 

audit fees.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________175

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTES TO THE FINANCIAL STATEMENTS
Note 21.  Subsequent Events

Note 21. Subsequent Events

Refer  to  “Note  11.  Financial  Liabilities”  to  these  Company  financial  statements  and  to  “Note  33.  Subsequent  Events”  to  the 
Consolidated Group financial statements in this Annual Report.

_______________________________ LivaNova PLC | 2023 UK Annual Report ______________________________176