Darrell Sapp, Post-Gazette William Beck takes a call in his office at the McKees Rocks municipal building last week. The borough manager is back at work 21/2 months after suffering cardiac arrest Jan. 6. At Allegheny General Hospital, doctors lowered his body temperature to 91 degrees to reduce chances of brain and organ damage. Click photo for larger image.

William Beck was the model of fitness his entire life. He ate a low-fat diet, did yoga, lifted weights and walked three brisk miles a day.

So mystery and grief hung heavy when he collapsed from a cardiac arrest Jan. 6 inside the Teutonia M???erchor club on the North Side.

For 15 minutes, the 58-year-old McKees Rocks borough manager was a goner. "He was dead -- D-E-A-D -- dead," said Dr. Jerome E. Granato, Mr. Beck's cardiologist and medical director of Allegheny General Hospital's Coronary Care Unit.

But in a happy turn of fate, in large part due to a new therapy offered at AGH, Mr. Beck was revived and now is doing amazingly well.

Two and a half months after his cardiac arrest -- a disease that kills 250,000 people each year -- he has returned to work part-time at McKees Rocks with plans soon to return full time. He is walking 45 minutes each day with plans soon to return to a full hour.

Reasons abound for such startling success after an often-fatal episode. He's physically fit. Several people at the club provided quick cardiopulmonary resuscitation. The ambulance service was close by and transported him without delay to AGH only blocks away.

But most surprising, he shows no diminished mental capacity after being lost to the world for 15 drama-filled minutes. For those who do survive cardiac arrest, brain damage often occurs, doctors say.

Which brings us to that new therapy at AGH. When Mr. Beck reached the emergency room that Saturday night, doctors gave him what might be described as the big chill.

For 24 hours, his body temperature was kept at 91 degrees Fahrenheit, which put him in a state of hibernation. That slowed his metabolism and reduced his need for oxygen in his brain and internal organs.

Reducing the oxygen need protects the brain and other organs and lowers the incidence of brain, kidney and other organ damage.

In the emergency room, AGH doctors followed established hospital criteria and inserted a cooling catheter into the femoral vein in his groin area to cool the blood as it pumped bodywide. It caused Mr. Beck's body temperature to drop almost 8 degrees below the normal 98.6.

Throughout the procedure he remained sedated to prevent shivering. He was unaware his body was on ice.

Two days later, Dr. Granato saw progress in Mr. Beck, even though he eventually had to fight through a serious case of aspiration pneumonia.

His near full recovery has made him poster man for hypothermia's success in preserving brain and organ function in cardiac arrest patients.

A heart attack can prompt cardiac arrest -- a situation in which the heart rhythm goes chaotic, making it quiver rather than beat, Dr. Granato said. The heart quits pumping blood, leaving vital organs depleted of oxygen -- a situation that can cause significant damage to the brain, kidneys and other organs, or death if quick emergency action is not taken.

But an electrolyte imbalance caused by dehydration, influenza or other health problems that deplete the system of potassium, magnesium and other minerals also can cause cardiac arrest. That's most likely what happened to Mr. Beck, whose heart arteries were clear. Despite the cardiac arrest, his heart was the picture of health, Dr. Granato said.

During a cardiac arrest, he said, all organs are deprived of oxygen for a period of minutes to a half hour. The quivering or chaotic heartbeat, known as fibrillation, must be corrected with an electrical shock via a defibrillator. Once oxygen returns to the brain, further damage can occur.

Clinical trials showed a 20 percent increase survival with hypothermia, Dr. Granato said. There are now calls for paramedics to use the cooling procedure in the field en route to the hospital. But an entire institution must adopt the protocol to make it successful.

The American Heart Association has approved the procedure in the wake of extensive overseas clinical trials.

But putting the therapy into practice in many hospitals has been slow.

UPMC Presbyterian does about 50 hypothermic therapies a year, said Dr. Clifton Callaway, assistant professor of emergency medicine. He said a doctor at Mercy Hospital also is using the therapy on patients.

Out of every 100 cardiac arrests they respond to, city paramedics succeed in getting 30 to the hospital.

Of those, only seven or eight will be discharged from the hospital, he said. But that number is one or two higher than would occur without hypothermic therapy.

"We believe the people who do go home have fewer neurological problems that impair the quality of life," Dr. Callaway said.

The percentage increase of survival could translate nationwide into tens of thousands of saved lives each year.

For now, Dr. Callaway said, there's an upswing in hospitals using the therapy and in two years it will be more routine. City doctors who perform the therapy are collegial in promoting its use.

Dr. Ankur Doshi, AGH emergency medical specialist, agreed the brain-protecting therapy "is a well-established procedure all patients should get if they are in a coma" after a cardiac arrest.

Dr. Ashis Tayal, an AGH stroke neurologist, said trials are under way to use the therapy to help stroke victims. Another University of Pittsburgh Medical Center study also is using hypothermia to treat victims of head trauma. Early trials show promise in both cases.

Without the therapy, cardiac-arrest patients have a greater risk of suffering dementia, loss of memory or severe devastation of mental capacity, Dr. Tayal said.

AGH doctors have used the procedure in cardiac arrest victims five times since November, and three of those patients survived the procedure. Two, including Mr. Beck, walked out of the hospital.

The third survived the initial cardiac arrest but did not survive further complications and another cardiac arrest days later.

Although the cases are few, AGH's success rate points to the value of the therapy.

"This is not investigative," Dr. Tayal said. "We consider this to be a standard of care and should be a standard of care to return people to circulation."

Without the procedure, Dr. Granato said, the discussion about Mr. Beck would require a more serious tone.

To prevent a future cardiac arrest, Mr. Beck had a defibrillator placed in his chest, despite a low probability of a recurrence, Dr. Granato said.

Mr. Beck said he didn't regain full consciousness for nine days.

He remained in the hospital for weeks in large part due to pneumonia.

He now is undergoing rehabilitation and looking forward to an April 3 checkup.

He and his wife, Fran, praised AGH for successfully returning him to normal activity without any reductions in brain power.

"My goal is to get back to a normal life," he said, noting he hates cold weather and is surprised he withstood hypothermic therapy.

"I can't tolerate my body being cold, but it worked," he said. "It boggles my mind, really."

And talk about perfect timing. He said he has many reasons to thank AGH for saving his life.

One key reason: His daughter Kirsten, 28, is due to have the Becks' first grandchild April 15.