Introduction: Survival rate after cardiac arrest strongly depends on the delay occurring from the onset of basic life support and defibrillation (BLSD). Providing more BLSD trained bystanders could improve survival on the territory. The present study was a randomized controlled trial aimed to evaluate the feasibility and efficacy of a peer to peer BLSD teaching approach compared to the conventional professional-led teaching approach, in high school students. Methods: In years 2010-2015, 520 high school 15-18 years old italian students were randomly assigned to a peer-led BLSD training approach or to a professional-led BLSD training approach. At the end of the course, a final exam by 2 blinded instructors was held. Results: Chest compressions' percentage with adequate depth was 53.5 + 31.8 % in the peerled group and 55.4 + 33.6 % (mean + SD) in the professional-led group ( p ¼ ns). The proportion of participants who could ensure an adequate mean compression rate was 74 % in the peer-led group, but only 36 % in the professional-led group ( p ¼ 0.011). The percentage of correct use of AED was 53.5 + 31.8 % in the peer-led group and 52.4 + 35.6 % in the professional-led group ( p ¼ ns). On the 20-point questionnaire administered after training, the peer-led group scored an average of 17.2 + 2.3 whereas the professional-led group scored 19.8 + 2.0 ( p ¼ ns). Conclusions: Peer-led BLSD training for high school students is feasible and could be as effective as a professional-led approach. Moreover, in our opinion and experience, peer-led BLSD training results with a better feedback and trainee attitude when compared to conventional trainiing. It is still unclear if the formation of peer instructors could be done by peer education, and if final exams should be only performed by professional instructors. Background: Inappropriate shocks in cardioverter-defibrillator (ICD) recipients have been associated with increased adverse cardiac events. However, the temporal relation between inappropriate therapies (InT) and adverse events is unclear. Methods: Retrospective cohort study of consecutive patients who underwent cardioverter-defibrillator (ICD) implantation for primary prevention between 2002 and 2015. InT were defined as ICD shock or anti-tachycardia pacing with no underlying ventricular fibrillation or ventricular tachycardia. Data on hospitalizations and mortality was systematically assessed using a nationwide healthcare platform, and patient records were analyzed to determine the cause of hospitalization or death. A Cox proportional hazards model was employed to estimate the incidence of MACE (hospitalization for heart failure or cardiovascular death) with a time-dependent covariate for InT. MACEs were classified as early (,6 months after InT) or late (!6 months after InT). Results: A total of 312 patients were analyzed, with a median follow-up of 37.7 months, range 6 to 146 months (12.2 years). InT occurred in 41 patients (13.1%) with a mean time from implantation to InT of 4.4 years. The normalized incidence of MAC...
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