TStart by going up with the ♠A. The ♠K may drop from East, and even if doesn’t, you will remain with a low trump in dummy to ruff a club. If you duck, East may win and return a spade, and you’ll be in trouble.
The idea is to set up a long trick in one of the red suits for a club discard while ruffing your other club. The play should go like this assuming you arbitrarily decide to set up dummy’s fifth heart:♠A (assume East follows low), ♦A, heart ruff, ♥A, heart ruff, ♣A, heart ruff. If West overruffs, having led low from K–x (the actual lead when this deal was played) and three hearts, you can still get rid of both clubs via a club ruff and the fifth heart.
If the third heart ruff lives, ruff a club and discard your last club on the fifth heart, losing just one trick to the ♠K.
Notice that if you duck the spade at trick one, you cannot make the contract if West led from K–x–x, even if West has four hearts and a friendly 3=4=3=3 pattern because West will ruff the established heart low and still have the trump king. You need West to have an even friendlier 3=4=4=2 pattern with the ♣K x! Sure.
Thanks to Jon Shuster, Gainesville FL.