And our bias is to go for transactions that are going to enable us to create more value by leveraging our clinical development strength, our manufacturing capabilities and our commercial reach. So hence, why the majority of the deals that you see in our pharmaceutical side are at an earlier stage. Are we looking broader than that? Yes, we do. But mainly, we find more opportunities to create value at an earlier stage. For example, this year, we did a number of deals that went less publicized. We did, as I commented before, a deal with CNBG now called AbelZeta (ph) in CAR-T with CD19 and CD20, which we believe could be a best-in-class CAR-T in this area that could launch in this decade or at the end of the year, we also did another deal in antibody drug conjugates with a Korean company called LegoChem, which was underreported.
But we continue to work in identifying deals in our pharmaceutical space that enables us to be able to put all our capabilities to work in the clinical development side, in manufacturing and in commercial. And that’s been the source of very significant value creation in products that all of you know, like DARZALEX or CARVYKTI that come from that type of approach of going earlier on into the development process.
Jessica Moore: Thank you, David. We have time for one last question.
Operator: Our final question today is coming from Rick Wise from Stifel.
Frederick Wise: All right. Good morning. Thanks you. Maybe you could expand a little bit more on your electrophysiology comments. You had an extraordinary quarter. I’m guessing the new products helped. Maybe you could give us a little more color on maybe quantify the impact — the negative impact from China VBP? And looking ahead, we’ve got not — we’ve got one PFA device approved in U.S., another one seemingly coming in the next month or three maybe. How should we think about the EP franchise as we look ahead to ’24? What are you incorporating in your thinking? Thank you so much.
Joaquin Duato: So thank you for the question. Great, and strong results of our EP franchise in 2023. And you should think about our EP franchise in 2024 as also a strong year, another year of growth, a strong growth for our EP franchise. If I look at the — to your point that the drivers of growth in 2023, it was across the board. I mean it was in Asia-Pacific, in the U.S. and EMEA. It was driven by the procedure recovery, but also by new product performance and some offset also, a slight offset of value-based procurement in China. The new products that we introduced this year are the engine generator, our mapping catheters OCTARAY and OPTRELL. And also, importantly, our QDOT MICRO Catheter in radio frequency ablation that has efficacy results higher than any PFA catheter.
And that together with our strong commercial execution and broad clinical support across the board has driven this result in electrophysiology that in the fourth quarter was 25% growth globally, 22% growth in the U.S. and 29% outside of the U.S. So very strong results. So we have a strong leadership in electrophysiology and 20 years of understanding this field. And when it comes to our strategy in cardiac ablation, we have multiple strategies, but one core strategy is our CARTO mapping system. That is a fundamental pillar of our strategy in cardiac ablation that supports procedural efficiency and very importantly, now low to zero fluoroscopy workflow. For the electrophysiologist, it’s very important to know where they are and what are they doing to the heart anatomy.
Otherwise, they are flying blind if they don’t have a mapping system. And the CARTO system, it’s providing the electrophysiologist real-time feedback and very important parameters like tissue proximity, contact force measurement and ablation indexes that give them an idea of how durable deletion is going to be and what are going to be the outcomes of the procedures. So that’s key for us to be able to have a workflow that enables the type of progress that electrophysiologists have been already used to with radio frequency ablation. And hence, all our suite of catheters, it’s is going to be from day 1 fully integrated in our mapping system. We have 5,000 CARTO systems already deployed globally and an extensive network of mappers to support the electrophysiologist.
When it comes to our catheters, we are developing a full portfolio of options. You commented on VARIPULSE, our multi-electrode catheter that was approved in Japan. We are developing a focal and a large focal catheter and also a single shot one. So electrophysiologists are going to be able to choose the catheter that is more appropriate for their anatomy and for the workflow that they are selecting. We have five clinical trials active, three of them have completed. And we have submitted our VARIPULSE catheter for CE Mark and we plan submitting the VARIPULSE catheter to the U.S. FDA in 2024. Ultimately, PFA is an important option, but RF is also here to stay. That’s why we believe that having the workflow and the procedure efficiency that CARTO gives you plus the option of having a catheter like our dual energy catheter that would enable electrophysiologists to simply change depending on the anatomy of deletion from PFA to RFA, it’s going to be important for the future.
And it’s going to help them adopting PFA as this is the most widely used catheter in the world. So very positive about our growth in 2024 based on the strength that we have in this area. I’m positive about the outlook of our ablation business moving forward. As we have commented in multiple occasions, atrial fibrillation, it’s an area that is still undertreated. And the outcomes of radio frequency ablation and most likely, the outcomes of PFA have shown significant improvement even compared to medical therapy. So very positive about the outlook of our — and the strength of our atrial fibrillation business.
Jessica Moore: Thank you, Rick, and thanks to everyone for your questions and your continued interest in our company. We apologize to those we couldn’t get to because of time, but don’t hesitate to reach out to the Investor Relations team with any remaining questions you may have. I will now turn the call back over to Joaquin for some brief closing remarks.
Joaquin Duato: Thank you, Jess. The strong performance we delivered in ‘23 gives me great confidence in the trajectory of our business. As I said earlier, we are entering 2024 from a position of strength, and we have multiple catalysts for growth. No other company is as well positioned as Johnson & Johnson to lead the next wave of health care innovation. And we look forward to sharing our progress in the year ahead. Thank you.
Operator: Thank you. This concludes today’s Johnson & Johnson’s fourth quarter 2023 earnings conference call. You may now disconnect.
