In Depth with Brad Byrd: Dr. Kumbar talks about device to reduce risk of stroke


Have you checked your pulse lately? Millions of Americans may have Atrial Fibrillation and not know it.

In simple terms, your heart is not pumping at a steady rate with skips or pulses. It can lead to heart failure or stroke or both.

Tonight, we are talking about a new technology that can reduce the risk of stroke. You can hold it in the palm of your hand.

Full Transcription

Brad Byrd: Welcome to In Depth. Have you checked your pulse lately? How do you feel? Millions of Americans may have Atrial Fibrillation and not know it. In simple terms, your heart is not pumping at a steady rate with skips or pulses. It can lead to heart failure or stroke or both. Tonight, we are talking about a new technology that can reduce the risk of stroke. You can hold it in the palm of your hand. Joining me tonight is Dr. Chandra Kumbar he is an electro physiologist, with the Deaconess Heart Group. Thank you very much for joining us tonight Dr. Kumbar. You know stroke touches people of all ages, but millions of Americans have this and they don’t even know it. And that is the problem.

Dr. Chandra Kumbar: yes, well I think you heard it right, there are so many people who have atrial fibrillation and don’t even know they have one. The symptoms are not very common – they could be subtle and sometimes they can be very dramatic. Patients can have very fast heart rates, they can feel light headed or dizzy. Sometimes it can be very subtle, and they feel tired, exhausted, lack of energy, feel like just not right. And patients who have heart failure or diabetes are patients with PR diagnosis of stroke or heart failure systems. They tend to have a higher risk of stroke when they have atrial fibrillation. Women, especially over age 65, tend to have a higher risk of stroke and men again with any of the risk factors start having higher risks of stroke. So, it’s important for us to increase the awareness that if something is not right, it’s better for us to go get it checked out.

Brad Byrd:  Well, Dr. Kumbar, actor, Luke Perry just last week had a massive stroke and died the next day. That got a lot of people thinking, so what should you look for? And this is not to tell people if you have a twitch here or there or whatever – when should I go to the emergency room or I gotta see a doctor?

Dr. Chandra Kumbar: If symptoms like palpitations, like rapid heart rates, if the heart is beating really fast – if you feel dizzy, light headed, or if you have things where patients tend to have out of the ordinary lifestyle changes – like someone who can walk their dog easily every day, but now they can’t walk. People can’t walk to the mailbox and back without feeling short of breath. Every time they climb a flight of stairs, they get short of breath. Things that are subtle like that, it’s good for us to go back and make sure, it’s not related to the heart.

Brad Byrd: And it can be mistaken for symptoms of maybe I have a bad cold, or bronchitis

Dr. Chandra Kumbar: yes, it’s very common for patients to feel like it may be related to common cold, flu symptoms, and some might think they’re entitled to be tired. In reality it might not be the case – it’s the atrial fibrillation that’s making their lifestyle worse a little bit at a time. And then they get used to that quality of life, which they assume it’s all related to age.

Brad Byrd: I’m going to put up a word right now – it is F.A.S.T. and these are symptoms to look for, say if you have a loved one, a spouse who may be having a problem with any of these symptoms – facial, weakness in the arms, speech difficulty, what should you do?  That last letter is very important. 

Dr. Chandra Kumbar: I think T is very critical, if you notice any of these symptoms, like facial droop, or if your speech is impaired or your vision is bad you can’t move your extremities, you should call 911 or go to the nearest ER so you can be evaluated for stroke symptoms. Time is of essence because the brain once you lose it you won’t gain it back. It’s critically important that we intervene in a timely manner.

Brad Byrd: And that brings us to a device called the Watchman, there are several drugs out on the market that can thin the blood, keep the blood in a flow that will reduce the risk of clots, but there are side effects of that, but if I could just show, or you can show people this device – and that’s the watchman. This literally will touch your heart and explain to us how this works, we’re going to throw some animation up first and this will pretty much demonstrate. There it is. What’s happening here?

Dr. Chandra Kumbar: So, the video is showing how the Watchman device actually works. Left atrium is the left upper part of the heart and the appendage is an extra pouch, which comes out of the left atrium.

Brad Byrd: And that’s right there to the right?

Dr. Chandra Kumbar: Right, so the watchman sits there in that extra pouch completely seals it off so over time the body has to create a layer of skin on top of it. And that skin makes the chamber almost go away. There’s no space for the blood to go and stay and clot and cause a stroke. The best part is for patients that are at risk for stroke, who should be on a blood thinner. After using the watchmen those patients can stop using blood thinners, which helps them decrease the risk of bleeding in relation to stroke, bleeding like complications with the stomach.

Brad Byrd: You brought this in tonight, if we can take a look at this. This is pretty close to the actual size, would you say?

Dr. Chandra Kumbar: Yes, if I could just walk you through, this has four chambers. There are two lower chambers, right and left. And then two upper chambers, right and left. And the left upper chamber is where the left upper appendage is.

Brad Byrd: And a lot of people don’t know about that appendage.

Dr. Chandra Kumbar: Because in reality, it doesn’t serve a whole lot of purpose except when you have atrial fibrillation – it increases the odds of clot formations and stroke. So, when we do the Watchman, it’s a nonsurgical approach, which means we put the Watchman in a small catheter that goes into the groin all the way to the heart and then we cross over to the left upper part of the heart. Look at the left upper appendage and then make sure that this size fits. So, once we place the Watchman, we want to make sure there’s no leak around it and there’s no trauma to the heart.  And then the self-expanding nature of the watchman device, makes it go inside there and slowly expand and then seal it off.

Brad Byrd: Ok I’m taking my pulse right now, right here on the set and it feels like I have a steady heartbeat. But that doesn’t tell the whole story, it is a tool that you can do to self-check.

Dr. Chandra Kumbar: I think checking pulse is great and now with all the wearable devices such as Apple Watch and FitBits and things like that, we do have an opportunity to identify silent atrial fibrillation. Silent means, patients don’t really have any symptoms, but it is there. Because if you can identify atrial fibrillation early on, you can prevent stroke down the road. I think that is most important.

Brad Byrd: And check with your insurance carrier, it’s my understanding that several insurance companies will cover the cost of this.

Dr. Chandra Kumbar: I think it is a medically appropriate device and for patients who are high risk for bleeding and high risk for stroke – it is an alternative. And when we do console patients, it’s fairly extensive in terms of walking them through the procedure and more than one physician talks to the patient. Just so the patient doesn’t get all the information related to the watchman device.

Brad Byrd: Well, Dr. Kumbar thank for a lesson tonight that we can all learn from. And in many ways, it can save lives. Thank you so much for being here with us tonight.

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(This story was originally published on March 6, 2019)

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