If you think of the heart as a computer, a sudden cardiac arrest is like the computer freezing up. There’s nothing structurally wrong with the computer, and a reboot will get it back up and running smoothly. According to Dr. Glenn Laub, director of the Heart Hospital at St. Francis Medical Center in Trenton, an electrical shock to the heart delivered by a defibrillator is like that reboot. It delivers the jolt and resets the heart so that its electrical activity can resume its normal function.
Laub is also CEO of the Defibtech, a manufacturer of AEDs (automated external defibrillator), based in Guilford, Connecticut. His company’s defibrillators were on hand at the Olympic games in Turino, and will soon be in police cars and fire trucks throughout New Jersey.
The holder of 10 patents in the field of medical technology, Laub was extensively involved in the invention and development of the company defibrillator. “From a pure engineering perspective,” says Laub, “I contributed to the development of the software that analyzes the patient’s electrocardiogram to determine if a shock is necessary. This is a critical component of the technology for two reasons. It is a non-trivial task from an engineering perspective. It is a critical analysis — if a shock is administered in an inappropriate situation, it can result in harm to the patient.”
Laub founded the company along Gintaras Vaisnys, an engineer he had mentored when he was an undergraduate at Yale. He is involved on a day-to-day basis with the management of the company, participating in strategic and management decisions and formulating and reviewing clinical policies and issues.
“Rather than commuting to Connecticut,” says Laub, a Princeton resident, “I usually work in New Jersey, enabled by technology to interact with other members of the team. I teleconference and use web enabled collaboration, as well as spend considerable time on the phone and E-mail.”
Now promoting his company’s AEDs, Laub says that “the key is to get these devices simple enough to use by anyone and anywhere so there’s no delay in getting the shock to the person that may save his life.” He cites this recent story in Princeton: Just one week after police received their defibrillators, they were able to save the life of a Witherspoon Street store employee who had suffered cardiac arrest on the job.
“After police cars, we need to put these devices in public spaces like health clubs, movie theaters, the mall, anywhere there are lots of people,” says Laub. “Then we need to put them in homes, because that’s where many cardiac arrests occur. It’s the same scenario as a fire extinguisher. It doesn’t make sense to only put fire extinguishers in fire trucks and then wait for them to get to your house. You should have a fire extinguisher in your house, and it makes sense to have a defibrillator as well.”
Statistics from the American Heart Association reveal that about 400,000 Americans die each year from sudden cardiac arrest and an astounding 19 percent of those sudden deaths occur in children between the ages of 1 and 13. Without defibrillation, only 2 to 5 percent of victims of sudden cardiac arrest survive, compared with 50 to 70 percent of those who receive defibrillation within 3 to 5 minutes.
Where a person suffers cardiac arrest can make the difference between life and death. For example, says Laub, if you suffer cardiac arrest in New York City your survival rate likelihood would be 2 percent. If you had that same attack at Chicago’s O’Hare International Airport, you would have a 50 percent chance of survival because there is a defibrillator every few hundred yards inside the terminal.
Laub says the new devices are so easy to use that even a young child can be trained within minutes to save someone’s life. “Our device has a button and it starts talking and it tells you what to do. Remove the pad from the back of the unit. Apply the pad to the victim’s bare chest as shown. There’s a picture. If a shock is necessary, it tells you to apply the pad and press the flashing red button. A lot of times, at that point, the victim will wake up. If the victim is drunk and passed out, the device will interpret his electrocardiogram and determine the shock is not necessary and tell you that.”
But how effective is the device at home when so many cardiac incidents may occur when the victim is alone? “Yes, there are times you may be alone at home, “ Laub acknowledges, “but there are many other times when you or a guest or visitor might need a defibrillator for an emergency situation and you’ll have one right there. It’s those few minutes that will make the difference.”
Almost all the new CPR courses offered by hospitals and schools train their students in the use of a defibrillator. It’s becoming part of basic medical training, not just for the professional, but for the lay person as well.
In the best of all possible worlds, Laub says, every home and office would have a defibrillator, and that day is getting closer to reality with the costs coming down considerably over the last few years. Just five years ago, AEDs cost about $4,000, a major obstacle to their wide-scale deployment. But prices have come down dramatically recently, and an AED can be purchased for about $1,000 to $1,200. The pads cost $40 and are good for one use. The battery, which is good for five years, costs $100. “While it may initially seem expensive, over the years, it is a good investment. And how do you put a price on a life that is saved?” asks Laub.
Laub was born in Westbury, New York. His father, a profound influence on his life, was a civil engineer who owned his own firm in New York. Laub says he was “clever, entrepreneurial. He solved lots of engineering type problems, and came up with novel solutions in the construction industry.” His mother had been an English major and was very active in non-profit educational and political issues. Laub, the youngest of three, has two older sisters.
Laub attended a children’s science program at Columbia University when he was a child, and he says that the experience led to his career choice. “I was six years old and every Saturday my dad would drive me in to Manhattan,” he recounts. “It was the highlight of my week, to be able to talk to my dad on the way in, talk to professors all day long, and then talk to my dad on the way home. We talked science. He was — and still is — a very unusual person, a scholar-athlete before anybody really knew what that was. He was the child of immigrants from Austria who went to City College on a scholarship, stood six-foot-four, played center, and was in the Hall of Fame for basketball.”
Columbia’s science enrichment program was open to 6 to 8 year-olds through a competitive entrance exam, and Laub had been chosen from literally thousands of kids who had applied. He remembers one of the questions on that screening test with vivid clarity. “They asked me how I would measure the height of a skyscraper. First I said I would go up to top and lower a string to the bottom and measure the string. But then I said that would be too time-consuming. I told them that I would measure the height of one floor and multiply by the number of floors in the skyscraper. They let me into the program.”
Laub acknowledges that while he was great at science, he was terrible at English and could not write or spell. That dismayed his mother, the English major, greatly. At that point the family began to investigate private school options. Laub and his family chose the Lawrenceville School, and, at the age of 13, he enrolled as a boarding student.
“During my first semester in English, I had to go after class for remedial work, my grammar and spelling were so poor. The same guy who had given me a C in English in the ninth grade gave me an A plus as a senior. I ended up graduating with honors. They took me from not being able to write at all to being a writer who has written numerous articles in medical journals and all sorts of research papers.”
Laub graduated from Lawrenceville in 1974, and holds a bachelor’s from Yale and an M.D. from Dartmouth. As an undergraduate, he did computer programming and ran the computer portion of a chemical engineering laboratory. One day during an open house, the son of a well-known Yale professor, then a New Haven high school student, came to him and asked him to teach him how to use the computer. This student, Gintaras Vaisnys, came to Yale and took over Laub’s job in the lab.
Vaisnys and Laub teamed up in 1999 to co-found Defibtech. The AED they developed was judged beautiful as well as useful when it was chosen by the Museum of Modern Art in New York City for inclusion in its SAFE: Design Takes On Risk exhibit.
When he is not working for Defibtech, Laub is performing open heart surgery at St. Francis. Following a residency in surgery at NYU-Bellevue Medical Center he accepted a fellowship in cardiac surgery at Allegheny General in Pittsburgh. He thought he would be a trauma surgeon, but one of his instructors told him to do a cardiac surgery fellowship first. He performed his first heart surgery and was hooked. “I loved the technical aspects of it,” he says. “You have to be technically very good. Calm. That’s me. I feel very relaxed in the operating room. The pressure doesn’t bother me.” The surgeon and father of two laughs. “In fact, for me, it’s much harder to change a baby’s diaper than it is to do heart surgery.”
After his fellowship, Laub took a job at the Deborah Heart-Lung Center in Browns Mills. On his first day there he spied the woman he would marry. “It was tough to get a date with her,” he remembers. “I tried and tried and finally I was able to weasel a date.” Karen Laub, a former cardiac nurse, now is an active volunteer for the American Heart Association.
The Laubs have two children at Princeton Day School, to which they have donated one dozen defibrillators, which have been placed strategically across the campus.
“The defibrillator is so easy to use, it’s revolutionary. The price point has changed the dynamics of defibrillator deployment in this country,” says Laub. “As a heart surgeon I’ve probably operated on more than 300 patients a year for the last 18 years. But by deploying more defibrillators and making them cheaper and easier to use, we can save more than 50,000 lives a year across the country, more than every person who dies in a traffic accident every year. I can save more lives by deploying defibrillators than I can in the operating room.”