Minneapolis Heart Project Labeled a Success

MINNEAPOLIS - Four months ago, Rex Veeder went to sleep with no idea that he was in trouble.

As he lay in bed, his heart stopped without warning. It's what doctors call "sudden cardiac arrest." Veeder didn't know he was on the verge of becoming a grim statistic: As a rule, it's fatal about 95 percent of the time.

But Veeder, 60, was in the right place - St. Cloud, Minn. - at the right time. He is one of a growing number of cardiac-arrest patients who have lived to tell the tale, thanks to an unusual project by a University of Minnesota heart specialist, Dr. Keith Lurie.

Lurie's idea was to train an entire community, from high school kids to paramedics to hospital workers, to handle these life-and-death emergencies in new ways. One of the first test sites was St. Cloud.

In less than two years, the project, called Take Heart America, has boosted survival rates so dramatically there is now a survivors support group. Of the 50 or so people in St. Cloud who have had the full treatment - from CPR to a state-of-the-art cooling therapy - roughly half have survived, Lurie said.

"We've had some spectacular saves," he said.

Veeder, an assistant vice president at St. Cloud State University, was one of them. All he remembers is feeling unusually tired after a night out. He went straight to bed.

His wife, Marcia, heard him gasp and realized he was turning blue. She called 911 and started CPR, hoping the paramedics would arrive in time.

Many people think of it as a massive heart attack, but doctors say it's a distinct - and even more deadly - disorder. The heart just stops, often because of an abnormal heart rhythm or injury.

Historically, rescue attempts have done little good. "For almost 50 years we've been doing CPR with no change in outcome," said Dr. Charles Lick, head of ambulance services at Allina Hospitals and a leader in the project. "In the old days, we'd get people's hearts started but they'd be brain dead, so we weren't doing any good."

Lurie, a professor and cardiologist, had puzzled over why there wasn't more progress against a condition that kills nearly 1,000 people a day nationwide.

In the 1990s, Lurie invented a device called the ResQPOD, inspired by a toilet plunger, to improve the pumping action of CPR. Later, he began to study what he called the weak links in the "chain of survival" - what happens after someone suffers a cardiac arrest. That led to his four-point plan, based on the latest research, which became Take Heart America:

-Train more people in CPR.

-Give ambulance crews the latest CPR training and rescue equipment.

-Spread defibrillators, which can shock a heart back to life, around the community.

-Use cooling devices to help prevent brain damage.

He raised funds from the medical industry and foundations, and he persuaded four communities to test it: Austin, Texas; Columbus, Ohio; Anoka County, Minn.; and St. Cloud.

By June, when the ambulance arrived at Veeder's St. Cloud home, the program was in full swing.

The rescue team shocked his heart with a portable defibrillator and rushed him to St. Cloud Hospital in a coma, where his body was cooled to about 92 degrees, which doctors have found can protect brain cells.

Veeder woke up in the hospital a few days later. He was back at work in two weeks. "Of course it frightens you," said Veeder, who has five children and four grandchildren. "It gets you thinking about your priorities in life." Now, he hopes to resume his favorite hobbies, writing poetry and painting.

"It's a very exciting breakthrough, what's happening with the Take Heart America program," said Mary Newman, of the Sudden Cardiac Arrest Foundation in Pittsburgh. Other cities use some of the ideas, but she said there is no more comprehensive program.

In early October, dozens of Sauk Rapids-Rice High School ninth-graders filed into a classroom for a crash course on CPR (cardio-pulmonary resuscitation).

The only way cardiac arrest victims have a chance, Lurie said, is if bystanders know what to do. Typically, more than half die before rescue teams can get there. So in the test sites, Take Heart America attempts to prepare everyone, starting with teenagers.

"Pick up a mannequin and spit out your gum," said Jill Emery, a health teacher.

Students sprawled on the floor and blew up inflatable pillows, shaped like a head and chest, to hone their skills. "How many of you know someone who had a heart attack?" asked Renae Illies, the volunteer instructor. After a show of hands, she introduced them to Bob Kempenich, 54, of Little Falls, Minn.

Two years ago, his heart stopped when he was working at a convenience store, and two bystanders performed CPR. "If it weren't for them, I wouldn't be alive today," he told the kids. He was the first to get the cooling treatment at St. Cloud Hospital. Now he has started a survivors support group.

Two years ago, experts revised the CPR guidelines to emphasize more chest compressions and fewer breaths.

"What happens when you give them too much air?" Illies asked the ninth-graders.

"They puke," a boy shouted.

"They puke! You're right," she replied.

The key, she said, is to give just enough air (two one-second breaths) followed by 30 chest compressions. Like a drill sergeant, she starts counting down, and the kids pump on their mannequins in unison.

Their homework will be to go home and teach CPR to two other people with the help of kits from the American Heart Association.

"That's the beauty of this," said Janet Steinkamp, who oversees the St. Cloud program. "It multiplies. You train five people and they train 10 more."

Lurie admits that "the chances of these ninth-graders actually going out and performing CPR this year or next year or the next year are pretty small. But the chance of them knowing and retaining it, and using it some time in their life is not."

Even if the program is perfectly executed, no one expects Take Heart America to eradicate the problem. The group projects that at best a third of patients could survive.

But even that would mean tens of thousands of lives, said Lick, of Allina. "It's a big problem. So even if we can get to 30 percent, that's a lot of people."