Impact of operators experience on peri-procedural outcomes with Watchman FLX: Insights from the FLX-SPA registry Moreno Terribas, Gerardo Trejo Velasco, Blanca Atrial fibrillation Left atrial appendage occlusion Devices Outcomes Dr. I. Cruz-González is proctor for Lifetech Scientific [Shenzhen] Co., China and was funded by ISCIII (PI19/00658), co-funded by ERDF, “A way to make Europe” and Gerencia Regional Salud de CyL (GRS 3031/A/19). Dr. A. Pérez de Prado is proctor for and has received Research grants from Boston Scientific [Marlborough, Massachusetts, US]. Dr R. Estévez-Loureiro and Dr. JM. Ruiz-Nodar are proctors for Boston Scientific [Marlborough, Massachusetts, US]. No other disclosures exist. Background: The Watchman FLX is a device upgrade of the Watchman 2.5 that incorporates several design enhancements intended to simplify left atrial appendage occlusion (LAAO) and improve procedural outcomes. This study compares peri-procedural results of LAAO with Watchman FLX (Boston Scientific, Marlborough, Massachusetts) in centers with varying degrees of experience with the Watchman 2.5 and Watchman FLX. Methods: Prospective, multicenter, “real-world” registry including consecutive patients undergoing LAAO with the Watchman FLX at 26 Spanish sites (FLX-SPA registry). Implanting centers were classified according to the center's prior experience with the Watchman 2.5. A further division of centers according to whether or not they had performed ≤ 10 or > 10Watchman FLX implants was prespecified at the beginning of the study. Procedural outcomes of institutions stratified according to their experience with the Watchman 2.5 and FLX devices were compared. Results: 359 patients [mean age 75.5 (SD8.1), CHA2DS2-VASc 4.4 (SD1.4), HAS-BLED 3.8(SD0.9)] were included. Global success rate was 98.6%, successful LAAO with the first selected device size was achieved in 95.5% patients and the device was implanted at first attempt in 78.6% cases. There were only 9(2.5%) major peri-procedural complications. No differences in efficacy or safety results according to the centeŕs previous experience with Watchman 2.5 and procedural volume with Watchman FLX existed. Conclusions: The Watchman FLX attains high procedural success rates with complete LAA sealing in unselected, real-world patients, along with a low incidence of peri-procedural complications, regardless of operatoŕs experience with its previous device iteration or the number of Watchman FLX devices implanted. 2022-02-03T11:56:33Z 2022-02-03T11:56:33Z 2022-02 info:eu-repo/semantics/article I. Cruz-González et al. Impact of operators experience on peri-procedural outcomes with Watchman FLX: Insights from the FLX-SPA registry, IJC Heart & Vasculature 38 (2022) 100941. [https://doi.org/10.1016/j.ijcha.2021.100941] http://hdl.handle.net/10481/72644 10.1016/j.ijcha.2021.100941 eng http://creativecommons.org/licenses/by-nc-nd/3.0/es/ info:eu-repo/semantics/openAccess Atribución-NoComercial-SinDerivadas 3.0 España Elsevier