Summary: Keith Lurie, M.D. Co-Director, Cardiac Arrhythmia Center, Central Minnesota Heart Center, St. Cloud, MN Staff Cardiologist, St. Cloud Hospital Professor of Internal and Emergency Medicine, University of Minnesota Chief Medical Officer, Advanced Circulatory Systems Dr. Lurie – thank you for this opportunity to discuss impedance threshold device technology and the ROC PRIMED study. I see that you attended Stanford School of Medicine. Where did you complete your undergraduate degree? Yale University Did you enjoy medical school? Very much so. I could not afford to go without working and I worked 20 hours/week in a lab to pay my way. I was exposed to some fantastic teachers and became a researcher in the process. Why did you choose Cardiology? I worked in med school in a lab that did heart transplant research. I became interested in the biochemistry and pharmacology of the heart, did lots of heart transplants in animals, and became fascinated by the complexity and beauty of the cardiovascular system. I also like to do procedures so it was a natural. You did your residency at the University of Pennsylvania and a fellowship at the University of California – San Francisco. Could you briefly explain to my readers the difference between a residency and a fellowship? During residency you learn how to become a doctor and during a fellowship you narrow down to a specialty or subspecialty area. So during residency I became an internal medicine doctor (instead of, for example, a surgeon). During my fellowship I became a cardiologist and then later a cardiac electrophysiologist. How did you end up at the University of Minnesota? I wanted to stay in academic medicine, the U of Minnesota had an excellent program, and my sister and brother-in-law both were academic docs at the U of Minnesota. My wife and I loved San Francisco but it was a difficult place to raise a family and have an academic career. We have been very happy in Minnesota. You’re also an inventor, the holder of several patents, and the founder of a company. Did you always see yourself as an inventor and an entrepreneur? In college I never thought about becoming an inventor and I never wanted to become a businessman. I studied architecture and discovered I had some creativity but decided to go to medical school as I also loved biology. In 1990 I reported in JAMA on the use of a toilet plunger by family members who performed CPR on their dad with a household plunger (CPR: the P Stands for Plumbers Helper). A colleague told me I should patent the idea. I told him I knew nothing about patents but if he wanted to enlighten me I was game. Twenty years later I know a lot more about this process. I started Advanced Circulatory Systems Inc in 1997 against my better judgment as I really did not want to become a businessman. However, while studying the plunger idea we discovered the idea of an impedance threshold device (ITD) and no other medical device company was interested in the ITD concept we discovered at the U of Minnesota. Every time we tested the ITD in pigs during CPR is was pretty amazing. Blood flow to the heart and brain was 4x higher with the ITD and active compression decompression (ACD) CPR (plunger CPR) compared with manual standard CPR and 2x higher with the ITD and standard CPR vs standard CPR alone. Ultimately I realized I could write lots of papers but not necessarily impact patient care through research. Alternatively I could potentially start a company to get this technology out into clinical use and maybe help make a bigger difference. It has been a long journey, with some very high points and a few low points. One very high point was when the plunger device, (the CardioPump) and the ITD were used together on our 2007 U of Minnesota cardiac electrophysiology fellow after he had an out-of-hospital cardiac arrest while jogging in Minneapolis 1 month after he finished his EP training. He survived,
