What are the NICE recommendations for treatment of patients with pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on ECG?

name removed 23 Oct 2012 (Account suspended) made this Freedom of Information request to National Institute for Health and Clinical Excellence

This request has been closed to new correspondence. Contact us if you think it should be reopened.

The request was partially successful.

name removed 23 Oct 2012 (Account suspended)

30 December 2011

Dear National Institute for Health and Clinical Excellence,

I am writing to you to make a Freedom of Information Request and hope that you will be able to respond to me via this Whatdotheyknow charity website.

1] What are the NICE recommendations for treatment of patients with pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on ECG?

2] What are the NICE recommendations about which specific drugs must NOT be given to patients with pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on ECG?

3] What are the NICE recommendations about surgery in patients with pre-existing Sinus Tachycardia and Right Atria Enlargement as found on ECG?

4]Does NICE have any recommendations to help the surgeon prepare such a patient for treatment, and during surgery, and post-surgery? And if so, what are they?

5]Does NICE have any recommendations about patients who are to be given Clozapine who have a pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on ECG?

I ask these questions because I have been unable to discover the NICE recommendations in these particular circumstances. If they do exist, please may I have them, as it has been impossible for me to find them anywhere on the internet.

Thank you very much for your help,

Yours sincerely,

[first name removed] [last name removed]

NICE Mail, National Institute for Health and Clinical Excellence

Dear [first name removed]

 

We have experienced some technical problems which means that some of our
responses have not been sent. We are therefore taking the precaution of
resending this email to ensure that you receive this acknowledgement of
your FOI request.

 

Reference No: EH17449

 

FREEDOM OF INFORMATION ACT 2000

 

Thank you for your request for information, received at this office on 3
January 2012, in which you requested the following:

 

I am writing to you to make a Freedom of Information Request and hope that
you will be able to respond to me via this Whatdotheyknow charity website.

   

     1] What are the NICE recommendations for treatment of patients with
pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on
ECG?

   

     2] What are the NICE recommendations about which specific drugs must
NOT be given to patients with pre-existing Sinus Tachycardia and Right
Atrial Enlargement as found on ECG?

   

     3] What are the NICE recommendations about surgery in patients with
pre-existing Sinus Tachycardia and Right Atria Enlargement as found on
ECG?

   

     4]Does NICE have any recommendations to help the surgeon prepare such
a patient for treatment, and during surgery, and post-surgery? And if so,
what are they?

   

     5]Does NICE have any recommendations about patients who are to be
given Clozapine who have a pre-existing Sinus Tachycardia and Right Atrial
Enlargement as found on ECG?

 

 

Your request will now be considered and you will receive a response within
the statutory timescale of 20 working days as defined by the Act, subject
to the information not being exempt or containing a reference to a third
party. In some circumstances we may be unable to achieve this deadline. If
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earliest opportunity.

 

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NICE.

 

Should you need to discuss this further please contact the enquiry
handling team on 0845 003 7781.

 

Regards

Janet 

 

Janet Fahie

Communications Executive

National Institute for Health and Clinical Excellence

Level 1A | City Tower | Piccadilly Plaza | Manchester M1 4BD | United
Kingdom
Tel: 44 (0)845 003 7781 | Fax: 44 (0)845 003 7785

Web: [1]http://nice.org.uk

 

[2]NICE Annual Conference 2012,  15-16 May, Birmingham, UK

 

 

 

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name removed 23 Oct 2012 (Account suspended)

Dear Janet, NICE,

Thank you very much for your reply and I look forward to receiving the response to my FOI Request in due course. Please may you place the response at this charity website http://www.whatdotheyknow.com as I am sure that many people will welcome knowing the data.

With best wishes,

[first name removed]

[first name removed] [last name removed]

NICE Mail, National Institute for Health and Clinical Excellence

Dear [first name removed]

 

Enquiry Reference No: EH17449

 

FREEDOM OF INFORMATION ACT 2000

 

I write in response to your request for information, received at this
office on 3 January 2012, in which you requested the following
information:

 

     1] What are the NICE recommendations for treatment of patients with
pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on
ECG?

   

     2] What are the NICE recommendations about which specific drugs must
NOT be given to patients with pre-existing Sinus Tachycardia and Right
Atrial Enlargement as found on ECG?

   

     3] What are the NICE recommendations about surgery in patients with
pre-existing Sinus Tachycardia and Right Atria Enlargement as found on
ECG?

   

     4] Does NICE have any recommendations to help the surgeon prepare
such a patient for treatment, and during surgery, and post-surgery? And if
so, what are they?

   

     5] Does NICE have any recommendations about patients who are to be
given Clozapine who have a pre-existing Sinus Tachycardia and Right Atrial
Enlargement as found on ECG?

 

 

Your request for information has now been considered and accepted with the
following response being issued in compliance with the Act.

 

1] What are the NICE recommendations for treatment of patients with
pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on
ECG?

 

I can confirm that we do not hold this information as we have not made
recommendations for treatment of patients with pre-existing sinus
tachycardia and right atrial enlargement.

 

2] What are the NICE recommendations about which specific drugs must NOT
be given to patients with pre-existing Sinus Tachycardia and Right Atrial
Enlargement as found on ECG?

 

I can confirm that we do not hold this information as we have not made
recommendations about which specific drugs should not be given to patients
with pre-existing sinus tachycardia and right atrial enlargement.

 

3] What are the NICE recommendations about surgery in patients with
pre-existing Sinus Tachycardia and Right Atria Enlargement as found on
ECG?

 

I can confirm that we do not hold this information as we have not made
recommendations about surgery in patients with pre-existing sinus
tachycardia and right atrial enlargement.

 

4] Does NICE have any recommendations to help the surgeon prepare such a
patient for treatment, and during surgery, and post-surgery? And if so,
what are they?

 

I can confirm that we do not hold this information as we have not made
recommendations about surgery in patients with pre-existing sinus
tachycardia and right atrial enlargement.

 

5] Does NICE have any recommendations about patients who are to be given
Clozapine who have a pre-existing Sinus Tachycardia and Right Atrial
Enlargement as found on ECG?

 

NICE has published recommendations on the use of clozapine in the
treatment of Parkinson’s disease, schizophrenia, and psychosis with
co-existing substance misuse. We do not refer specifically to patients who
have a pre-existing sinus tachycardia and right atrial enlargement, but
where we recommend clozapine as a treatment option, we highlight the need
for careful monitoring of patients due to the known side effects of the
drug. You can find all our recommendations which relate to the use of
clozapine on our website, [1]www.nice.org.uk. If you have any further
questions relating to our recommendations on clozapine, please let me
know.

 

You may wish to note that we have published a range of guidance on the
treatment of heart conditions, including a clinical guideline and quality
standard on chronic heart failure and a clinical guideline on the
management of atrial fibrillation. All of the guidance documents are
freely available via our website.

 

I hope this information is helpful to you.

 

The response on this occasion took 7 working days.

 

If you are unhappy with this response and wish to make a formal complaint
it must be made in writing by letter, fax or email within 20 working days
of the Institute’s response to you and sent to:

 

Alana Christopher

Associate Director, Corporate Office

National Institute for Health and Clinical Excellence MidCity Place

71 High Holborn

London WC1V 6NA

Email: [2][email address]

 

Once we have received your complaint, you will be sent an acknowledgement
within two working days. The Associate Director, Corporate Office, will
review your complaint and a full reply will be sent to you within 20
working days.

 

If you are not content with the outcome your complaint, you may apply
directly to the Information Commissioner for a decision who can be
contacted at: The Information Commissioner’s Office, Wycliffe House, Water
Lane, Wilmslow, Cheshire SK9 5AF.

 

Kind regards

Janet

 

Janet Fahie

Communications Executive

National Institute for Health and Clinical Excellence

Level 1A | City Tower | Piccadilly Plaza | Manchester M1 4BD | United
Kingdom
Tel: 44 (0)845 003 7781 | Fax: 44 (0)845 003 7785

Web: [3]http://nice.org.uk

 

[4]NICE Annual Conference 2012,  15-16 May, Birmingham, UK

 

 

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2. mailto:[email address]
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4. http://bit.ly/tc5UZX

name removed 23 Oct 2012 (Account suspended)

Dear Janet,

Thank you very much for your speedy response which is greatly appreciated.

I am somewhat surprised that NICE has not made any specific recommendations vis-a-vis pre-existing sinus tachycardia and right atrial enlargementm, as found on ECG, because I believe it needs to be considered how important/trivial the condition is / or potentially could be if left untreated and / or treatment is given without taking this pre-existing condition into account.

How serious is a 6-month pattern of elevated heartbeat especially in the context of antipsychotic medication?

And how serious is "enlarged right atrial enlargement"?

Do either conditions have the potential to go on to heart failure?

Or atrial fibrillation?

And does Bisoprolol treat either sinus tachycardia or enlarged right atrial enlargement?

My concern is if a pscyhiatrist deems it appropriate and acceptable to adminster clozapine IN THE CONTEXT OF PRE-EXISTING SINUS TACHYCARDIA AND RIGHT ATRIAL ENLARGEMENT. For if Clozapine is KNOWN to have the danger of bringing on heart problems, is it not a very real danger to place a known heart patient - I am right, am I not that such a person would be termed a "heart patient" - please confirm - onto Clozapine in any event?

I have prior experience with Avandia and Bisoprolol. Whilst Bisoprolol is still in the British Medical Formulary, Avandia is suspended by the European Medical Agency. What worries me is the issue of clozapine in view of the real dangers as recognised by NICE, and therefore I would like to have a moratorium on the use of clozapine at all.

Thank you very much for your help, and I look forward to having further information from you.

With best wishes

[first name removed]

name removed 23 Oct 2012 (Account suspended)

Dear National Institute for Health and Clinical Excellence,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of National Institute for Health and Clinical Excellence's handling of my FOI request 'What are the NICE recommendations for treatment of patients with pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on ECG?'.

A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/wh...

Yours sincerely,

[first name removed] [last name removed]

NICE Mail, National Institute for Health and Clinical Excellence

Dear [first name removed],

 

Thank you for contacting the National Institute of Health and Clinical
Excellence (NICE) again. Please accept my apologies that your enquiry was
not responded to sooner. Unfortunately my colleague who was managing your
enquiry has been on leave and I have just picked up your message now.

 

I have read the email that you sent on 12^th January 2012 in which you ask
a number of questions that unfortunately NICE is unable to answer as
either we have not produced guidance on this topic or the questions refer
to something that is outside the remit of NICE.

 

You ask:

 

1.    How serious is a 6-month pattern of elevated heartbeat especially in
the context of antipsychotic medication?

2.    And how serious is "enlarged right atrial enlargement"?

3.    Do either conditions have the potential to go on to heart failure?
Or atrial fibrillation?

 

NICE provides recommendations to support health care professionals based
on evidence and best practice, but we do not provide clinical advice. NICE
guidance is available to support healthcare professionals in their work,
but it is their own clincial knowledge that would decide on the questions
above, so unfortunately I cannot provide you with an answer to these
questions.

 

You also ask:

 

4.    And does Bisoprolol treat either sinus tachycardia or enlarged right
atrial enlargement?

 

NICE has not been asked to produce guidance on the use of Bisoprolol. For
information, the topics that NICE provide guidance on are referred by the
Department of Health.

 

5.    If Clozapine is KNOWN to have the danger of bringing on heart
problems, is it not a very real danger to place a known heart patient - I
am right, am I not that such a person would be termed a "heart patient" –
please confirm - onto Clozapine in any event?

 

It is not within the remit of NICE to confirm whether or not such a person
would be termed a ‘heart patient’. But on the topic of clozapine NICE has
produced recommendations on its use in the Clinical Guideline for
Schizophrenia CG82. The recommentaton is that clozapine should only be
offered after two different antipsychotics (including an atypical one)
have failed to control the condition. However it is important to note that
these are recommendations and a clinician would be expected to apply their
clinical judgment as to whether an individual patient should be prescribed
clozapine, taking into consideration any other known health issues. These
recommendations are available from [1]http://guidance.nice.org.uk/CG82.

You also request a moratorium on the use of clozapine. If you have
concerns about the safety and use of clozapine, you can report this
to the Medicines and Healthcare Products Regulatory Agency (MHRA), through
their Yellow Card scheme. The MHRA are responsible for issuing licences
for drugs and for investigating any safety concerns. You can find out more
about the MHRA and how to report concerns about a drug on their website -
[2]www.mhra.org.uk.

 

Again I am sorry for the delay in responding to your email and I hope that
this has answered your enquiry. If you do still wish to request an
internal review of the way in which your FOI request previous to this
enquiry was handled, then please contact the Enquiry Handling team again.

 

Kind regards,

 

Jamie Murphy

Communications Manager (Enquiry Handling)

National Institute for Health and Clinical Excellence
Level 1A | City Tower | Piccadilly Plaza | Manchester M1 4BD | United
Kingdom
Tel: 0845 003 7781 | Fax: 44 (0)845 003 7785

Web: [3]http://nice.org.uk

 

The information contained in this message and any attachments is intended
for the addressee(s) only. If you are not the addressee, you may not
disclose, reproduce or distribute this message. If you have received this
message in error, please advise the sender and delete it from your system.
Any personal data sent in reply to this message will be used in accordance
with provisions of the Data Protection Act 1998 and only for the purposes
of the Institute's work.

All messages sent by NICE are checked for viruses, but we recommend that
you carry out your own checks on any attachment to this message. We cannot
accept liability for any loss or damage caused by software viruses.

http://www.nice.org.uk

References

Visible links
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2. http://www.mhra.org.uk/
3. http://nice.org.uk/

name removed 23 Oct 2012 (Account suspended) left an annotation ()

16 FEBRUARY 2012

I have contacted the ICO to ask them to check with NICE regarding this issue.

name removed 23 Oct 2012 (Account suspended)

Dear Mr Cameron Prime Minister of Great Britain and Northern Ireland, Mr Turner MP for the Isle of Wight and National Institute for Health and Clinical Excellence,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of National Institute for Health and Clinical Excellence's handling of my FOI request 'What are the NICE recommendations for treatment of patients with pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on ECG?'.

A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/wh...

I am very concerned to be given to understand the remit of NICE

Yours sincerely,

[first name removed] [last name removed]

Alana Christopher, National Institute for Health and Clinical Excellence

Dear [first name removed]

FOI request internal review

I refer to you request for an internal review of our decision relating to
your requests under the Freedom of Information Act 2000 for various
enquiries relating to:

“What are the NICE recommendations for treatment of patients with
pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on
ECG?”

Specifically you have asked the following questions:

1.    What are the NICE recommendations for treatment of patients with
pre-existing Sinus Tachycardia and Right Atrial Enlargement as found on
ECG?

2.    What are the NICE recommendations about which specific drugs must
NOT be given to patients with pre-existing Sinus Tachycardia and Right
Atrial Enlargement as found on ECG?

3.    What are the NICE recommendations about surgery in patients with
pre-existing Sinus Tachycardia and Right Atria Enlargement as found on
ECG?

4.    Does NICE have any recommendations to help the surgeon prepare such
a patient for treatment, and during surgery, and post-surgery? And if so,
what are they?

5.    Does NICE have any recommendations about patients who are to be
given Clozapine who have a pre-existing Sinus Tachycardia and Right Atrial
Enlargement as found on ECG?

I have reviewed the initial response to your request and I can confirm
that NICE does not hold recorded information in relation to questions 1-4
as NICE has not made any recommendations on specific drugs which should
not be given to patients with pre-existing sinus tachycardia and right
atrial enlargement. Nor has NICE made any recommendations about surgery in
patients with pre-existing sinus tachycardia and right atrial enlargement.

With respect to point five above the only recommendations NICE has made in
respect of clozapine has been in the treatment of Parkinson’s disease,
schizophrenia and psychosis with co-existing substance misuse. The
information NICE holds on this topic is exempt under section 21 of the
Freedom of Information Act 2000 as it is reasonably accessible to you via
the NICE website at [1]www.nice.org.uk

Following this request you made enquiries on further enquiries on:

1.    How serious is a 6-month pattern of elevated heartbeat especially in
the context of antipsychotic medication?

2.    And how serious is "enlarged right atrial enlargement"?

3.    Do either conditions have the potential to go on to heart failure?
Or atrial fibrillation?

4.    And does Bisoprolol treat either sinus tachycardia or enlarged right
atrial enlargement?

5.    If Clozapine is KNOWN to have the danger of bringing on heart
problems, is it not a very real danger to place a known heart patient – I
am right, am I not that such a person would be termed a "heart patient" –
please confirm - onto Clozapine in any event?

I have reviewed the responses given to these further enquiries and
concluded they were correctly handled in accordance with the Act.

The initial response to your enquiry correctly advised that most of the
information you requested was not held by NICE and directed you to the
NICE website where remaining information could be obtained. At all times
you were provided with advice and assistance including the option to
discuss your enquiry by telephone with one of the enquiry team. The
response to the second request provided advice on the remit of NICE and
the clarified the status of its guidance recommendations and other NICE
guidance that might be of assistance to you.

The response to your first request was provided within the statutory 20
working day deadline and the response to the follow-up request slightly in
excess of this due to a member of staff being on leave.

I therefore do not uphold your complaint and re-affirm the decisions
previously given.

If you are unhappy with this decision you can write to the Information
Commissioner’s Office and request they review our handling of your request
and they can be contacted at:

The Information Commissioner’s Office,

Wycliffe House,

Water Lane,

Wilmslow,

Cheshire

SK9 5AF

 

 

Yours sincerely

 

 

 

Alana Christopher

Associate Director – Corporate Office

 

 

 

The information contained in this message and any attachments is intended
for the addressee(s) only. If you are not the addressee, you may not
disclose, reproduce or distribute this message. If you have received this
message in error, please advise the sender and delete it from your system.
Any personal data sent in reply to this message will be used in accordance
with provisions of the Data Protection Act 1998 and only for the purposes
of the Institute's work.

All messages sent by NICE are checked for viruses, but we recommend that
you carry out your own checks on any attachment to this message. We cannot
accept liability for any loss or damage caused by software viruses.

http://www.nice.org.uk

References

Visible links
1. http://www.nice.org.uk/