Interview with Dr. Med. Vet. Boulet: Managing Atrial Fibrillation with the Piavet System

Text by Hana Autin, Representative of Piavita France

It’s our pleasure to have Dr. Cédric Boulet, from the Clinic Vet’Arenes agreed to interview with us after using the Piavet System on a regular basis for over 6 months.

 Piavita team

B: Dr. Cédric Boulet

P: You’ve been using the Piavet System for 6 months now. How has our system helped you in your everyday job?

B: The System has made my life easier because vets are used to doing everything themselves, checking on patients every hour has become part of our job. It’s nice to be able to have a continuous monitoring of what’s going on, without bothering sick patients, instead of having a few values every hour / two hours.

P: Has the easy installation helped in any way?

B: Of course, especially for the ECG that’s usually a pain to install and set up. But for overnight monitoring I still shave and use ECG gel… old habits die hard, I’m sorry (laughs).

P: Do you use the System for all patients or for specific use cases?

B: I use the Piavet mainly for colic patients for pain management and patients that suffer from atrial fibrillation for treatment management.

What is atrial fibrillation? 

AF is a disease of the heart’s atria. The heart is divided in two sides, left and right and both sides have an atrium and a ventricule. The atria’s job is to collect blood returning to the heart whereas the strong ventricules are designed to pump fresh blood out into the arteries. Atria’s blood supply to the ventricules would usually adapt during an effort, to pump more blood into the system to keep up. AF prevents a good strong contraction from happening and usually causes poor performance in a horse. That’s usually how it is physically diagnosed : the horse raced well but was unable to finish or he performed really well one day and really badly the next. What usually happens is that you can see a clear arrhythmia on the ECG especially where the P wave should be and lots of little electrical signals in between complexes, these are called fibrillations.

Healthy ECG for a horse.
Black arrows pointing to the regular P wave and red arrow pointing to the ventricular electrical activity.
ECG of a Horse suffering from Atrial Fibrillation. 
Black arrows pointing to irregular P waves and red arrows showing irregular electrical activity (in strength) from the ventricules caused by AF.

 What’s the treatment? 

The treatment most used for AF is Quinidine, a sodium blocking anti-arrhythmic. It’s very effective but has a huge amount of side affects that go anywhere from mild depression to death… These side effects are dose dependant which means that with close monitoring, most of these can be avoided. Treatment is usually given every two hours but depending on each patient, it’s very important to check vitals and ECG before another dose is given.

P: How does our system help for Atrial Fibrillation patients?

B: Well when you give Quinidine to a patient, you have to keep a very close eye on him to make sure he’s getting better but that he’s not suffering from any side effects that could end very badly. The Piavet System’s continuous ECG/Heart rate monitoring is a great help in these cases. I don’t have to bother the patient hourly, I just check his reading and I know whether he is ready for another dose of Quinidine or if I should wait some more. Treatment management is much easier and saves a lot of time with the Piavet for AF patients.

P: So altogether, and considering the specific cases we just talked about, what do you think about the system?

B: I really think the Piavet brings something more to the vet in terms of monitoring. This level of monitoring is usually used only for anaesthesia or bad intensive care patients. The Piavet System makes it possible for all the other patients that also may benefit from that level of monitoring and in that sense, makes everything easier for the vets, for the patients and for the owners.

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