A life saved: UTHealth Houston mobile ECMO team’s first-ever deployment for the Chevron Houston Marathon

UTHealth Houston physicians and nurses who make up the mobile ECMO team, worked to save Johnson's life after he had a heart attack during the marathon. (Photo by UTHealth Houston)

After his noninvasive procedure, Lee Johnson, right, was able to return home and is back to taking regular walks with his wife, left. (Photo courtesy of Johnson)

Lee Johnson, a healthy 65-year-old runner, was 200 yards from finishing his 10th half-marathon, when he suddenly collapsed with cardiac arrest just feet from crossing the Chevron Houston Marathon ribbon.

“I went completely unconscious and then woke up in an ambulance,” Johnson said.

Another runner, a Houston Police Department officer, a Cy-Fair firefighter, and an athletic trainer from an area hospital reacted quickly at the scene to start CPR and delivered two shocks with an automated external defibrillator. However, Johnson’s pulse was not restored.

With CPR in progress, he was transported to the marathon’s field hospital located at the George R. Brown Convention Center, led by Joseph P. Gill, MD, assistant professor in the Department of Emergency Medicine at McGovern Medical School at UTHealth Houston and associate medical director of the race.

At the center, a team of UTHealth Houston doctors, nurses, pharmacists, and a cardiac perfusionist were on call with a mobile extracorporeal membrane oxygenation (ECMO) machine.

The ECMO machine was generously donated to UTHealth Houston by the Wyatt Ranches Foundation.

The ECMO is a heart-and-lung pump machine. It is designed to take blood from the body, remove carbon dioxide, and return oxygen-filled blood, so that critical brain and blood cells are not lost during the restricted blood flow caused during injuries such as cardiac arrest.

Johnson had regained a faint pulse when he arrived to the UTHealth Houston Mobile ECMO medical team, who took over his care and was ready to place him on the pump if his heart were to stop again. The team administered IV anti-arrhythmic medication and a femoral catheter to prepare Johnson for placement on the ECMO. He began to stabilize but was still in critical condition.

Johnson was transported by members of the UTHealth Houston team and the Houston Fire Department to Memorial Hermann-Texas Medical Center, where his care was turned over to the emergency and cardiology teams.

Within days, Ramesh Hariharan, MD, professor of cardiovascular medicine at the medical school, discovered that Johnson's cardiac arrest was not caused by the more common ventricular tachycardia or ventricular fibrillation, a rapid heartbeat rhythm originating in the lower two chambers of the heart. Instead, he was surprised to find that Johnson has atrial fibrillation, where the irregular beats occur in the heart’s upper two chambers called the atria and overflow into the ventricles.

Johnson’s heart rate reached 250-280 beats per minute, which Hariharan said is unusual, given atrial fibrillation presents a common rhythm at 150-200 beats per minute and increases the risk for stroke and worsens heart failure. Common symptoms in patients experiencing this are palpitations and dizziness, especially when under duress or stress. It rarely results in cardiac arrest.

“There are life-threatening irregular heart rhythms that differ from each other and are known to cause cardiac arrest. Atrial fibrillation is not known to cause it in patients unless the heart rate extends to 280 beats per minute and is under stress, like running in a marathon,” Hariharan said.

Hariharan performed a pulmonary vein isolation ablation procedure to treat small areas of the heart muscle and placed an implantable loop recorder to monitor his heartbeat. Johnson made a complete recovery after the noninvasive surgery.

With every minute that passes when someone is in cardiac arrest, Hariharan said their chance of survival is reduced by 10%.

“Because Johnson received CPR from bystanders so quickly, it helped save his life,” Hariharan said.

From the marathon medical team and first responders to the emergency care teams, each person was a link in the chain of Johnson’s survival, said Bentley Bobrow, MD, professor and chair of the Department of Emergency Medicine. The UTHealth Houston emergency medical staff who were on site and treated Johnson were John Waller-Delarosa, MD; Richard Witkov, MD; Carrie Bakunas, MD; and Lisa Janowiak, BS, CCP.

“I’m pretty lucky to be here today. I will be forever grateful for the marathon CPR volunteers and the medical staff for their fast response in bringing me back from a cardiac arrest,” Johnson said. “Consequently, from their actions, I will fully recover to live and run for many more years. I won the lottery in having them spring into immediate action on that marathon Sunday when it critically mattered.”

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