Publications by authors named "Janet K Han"

24 Publications

  • Page 1 of 1

Incessant Atrial Tachycardia as First Presentation of Cardiac Angiosarcoma.

JACC Case Rep 2021 Apr 21;3(4):619-624. Epub 2021 Apr 21.

UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA.

Primary cardiac angiosarcomas are rare malignant tumors with a very poor prognosis. We present a case of a 48-year-old man with no previous cardiac history who developed an incessant focal atrial tachycardia complicated by tachycardia-mediated cardiomyopathy as a consequence of cardiac angiosarcoma. ().
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http://dx.doi.org/10.1016/j.jaccas.2021.02.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302794PMC
April 2021

How Feeling Like an Imposter Can Impede Your Success.

JACC Case Rep 2021 Feb 17;3(2):347-349. Epub 2021 Feb 17.

Department of Cardiology, St. Louis Heart and Vascular, St. Louis, Missouri, USA.

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http://dx.doi.org/10.1016/j.jaccas.2021.01.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310963PMC
February 2021

Ginkgo Biloba: Plant-Based Proarrhythmic Potential?

JACC Case Rep 2020 Jun 17;2(6):968-972. Epub 2020 Jun 17.

VA Greater Los Angeles Healthcare System, Division of Cardiology and Cardiac Electrophysiology, Los Angeles, California.

Ginkgo biloba is a commonly used herbal supplement in the United States. We describe a 63-year-old man with a significant ventricular ectopic burden (32.7%) that was refractory to metoprolol tartrate (41.7%) and resolved (<1%) when Ginkgo was discontinued. This case supports a potential proarrhythmic side-effect of over-the-counter Ginkgo leaf extract. ().
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http://dx.doi.org/10.1016/j.jaccas.2020.04.041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302014PMC
June 2020

Raft of Otters: Women in Cardiology: Let Us Stick Together.

JACC Case Rep 2020 Oct 21;2(12):2040-2043. Epub 2020 Oct 21.

Barts Heart Center, St Bartholomew's Hospital, London, United Kingdom.

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http://dx.doi.org/10.1016/j.jaccas.2020.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299232PMC
October 2020

An Ominous ECG.

Circulation 2021 Jul 19;144(3):246-248. Epub 2021 Jul 19.

UCLA Cardiac Arrhythmia Center, Los Angeles, CA (A.S., J.K.H., Z.F.).

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http://dx.doi.org/10.1161/CIRCULATIONAHA.121.055225DOI Listing
July 2021

Women in Cardiology Twitter Network: An Analysis of a Global Professional Virtual Community From 2016 to 2019.

J Am Heart Assoc 2021 Feb 23;10(5):e019321. Epub 2021 Feb 23.

Division of Cardiology Department of Medicine University of California Los Angeles CA.

Background Social media is an effective channel for the advancement of women physicians; however, its use by women in cardiology has not been systematically studied. Our study seeks to characterize the current Women in Cardiology Twitter network. Methods and Results Six women-specific cardiology Twitter hashtags were analyzed: #ACCWIC (American College of Cardiology Women in Cardiology), #AHAWIC (American Heart Association Women in Cardiology), #ilooklikeacardiologist, #SCAIWIN (Society for Cardiovascular Angiography and Interventions Women in Innovations), #WomeninCardiology, and #WomeninEP (Women in Electrophysiology). Twitter data from 2016 to 2019 were obtained from Symplur Signals. Quantitative and descriptive content analyses were performed. The Women in Cardiology Twitter network generated 48 236 tweets, 266 180 903 impressions, and 12 485 users. Tweets increased by 706% (from 2083 to 16 780), impressions by 207% (from 26 755 476 to 82 080 472), and users by 440% (from 796 to 4300), including a 471% user increase internationally. The network generated 6530 (13%) original tweets and 43 103 (86%) amplification tweets. Most original and amplification tweets were authored by women (81% and 62%, respectively) and women physicians (76% and 52%, respectively), with an increase in original and amplification tweets authored by academic women physicians (98% and 109%, respectively) and trainees (390% and 249%, respectively) over time. Community building, professional development, and gender advocacy were the most common tweet contents over the study period. Community building was the most common tweet category for #ACCWIC, #AHAWIC, #ilooklikeacardiologist, #SCAIWIN, and #WomeninCardiology, whereas professional development was most common for #WomeninEP. Conclusions The Women in Cardiology Twitter network has grown immensely from 2016 to 2019, with women physicians as the driving contributors. This network has become an important channel for community building, professional development, and gender advocacy discussions in an effort to advance women in cardiology.
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http://dx.doi.org/10.1161/JAHA.120.019321DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174265PMC
February 2021

Fifty-second flat-line: A dramatic case of ictal asystole.

HeartRhythm Case Rep 2020 Oct 18;6(10):794-797. Epub 2020 Aug 18.

UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, California.

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http://dx.doi.org/10.1016/j.hrcr.2020.08.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573472PMC
October 2020

Smartphones, Smartwatches, and CIED Patient Safety: So Far, So Good.

Authors:
Janet K Han

JACC Clin Electrophysiol 2020 09;6(9):1167-1170

Electrophysiology Section, Division of Cardiology, Department of Medicine, VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA. Electronic address:

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http://dx.doi.org/10.1016/j.jacep.2020.05.016DOI Listing
September 2020

HRS/EHRA/APHRS/LAHRS/ACC/AHA worldwide practice update for telehealth and arrhythmia monitoring during and after a pandemic.

J Arrhythm 2020 Jun 25. Epub 2020 Jun 25.

Society Washington US.

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), started in the city of Wuhan late in 2019. Within a few months, the disease spread toward all parts of the world and was declared a pandemic on March 11, 2020. The current health care dilemma worldwide is how to sustain the capacity for quality services not only for those suffering from COVID-19 but also for non-COVID-19 patients, all while protecting physicians, nurses, and other allied health care workers.
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http://dx.doi.org/10.1002/joa3.12389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361598PMC
June 2020

COVID-19 and cardiac arrhythmias: a global perspective on arrhythmia characteristics and management strategies.

J Interv Card Electrophysiol 2020 Nov 3;59(2):329-336. Epub 2020 Jun 3.

Cooper University Hospital, Camden, NJ, USA.

Background: Cardiovascular and arrhythmic events have been reported in hospitalized COVID-19 patients. However, arrhythmia manifestations and treatment strategies used in these patients have not been well-described. We sought to better understand the cardiac arrhythmic manifestations and treatment strategies in hospitalized COVID-19 patients through a worldwide cross-sectional survey.

Methods: The Heart Rhythm Society (HRS) sent an online survey (via SurveyMonkey) to electrophysiology (EP) professionals (physicians, scientists, and allied professionals) across the globe. The survey was active from March 27 to April 13, 2020.

Results: A total of 1197 respondents completed the survey with 50% of respondents from outside the USA, representing 76 countries and 6 continents. Of respondents, 905 (76%) reported having COVID-19-positive patients in their hospital. Atrial fibrillation was the most commonly reported tachyarrhythmia whereas severe sinus bradycardia and complete heart block were the most common bradyarrhythmias. Ventricular tachycardia/ventricular fibrillation arrest and pulseless electrical activity were reported by 4.8% and 5.6% of respondents, respectively. There were 140 of 631 (22.2%) respondents who reported using anticoagulation therapy in all COVID-19-positive patients who did not otherwise have an indication. One hundred fifty-five of 498 (31%) reported regular use of hydroxychloroquine/chloroquine (HCQ) + azithromycin (AZM); concomitant use of AZM was more common in the USA. Sixty of 489 respondents (12.3%) reported having to discontinue therapy with HCQ + AZM due to significant QTc prolongation and 20 (4.1%) reported cases of Torsade de Pointes in patients on HCQ/chloroquine and AZM. Amiodarone was the most common antiarrhythmic drug used for ventricular arrhythmia management.

Conclusions: In this global survey of > 1100 EP professionals regarding hospitalized COVID-19 patients, a variety of arrhythmic manifestations were observed, ranging from benign to potentially life-threatening. Observed adverse events related to use of HCQ + AZM included prolonged QTc requiring drug discontinuation as well as Torsade de Pointes. Large prospective studies to better define arrhythmic manifestations as well as the safety of treatment strategies in COVID-19 patients are warranted.
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http://dx.doi.org/10.1007/s10840-020-00789-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268965PMC
November 2020

If You Can't See It, You Can't Be It: Mentorship for Female Internal Medicine Residents.

JACC Case Rep 2020 May 20;2(5):840-842. Epub 2020 May 20.

Division of Cardiology, Department of Medicine, University of California-Los Angeles, Los Angeles, California.

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http://dx.doi.org/10.1016/j.jaccas.2020.03.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301685PMC
May 2020

Guidance for cardiac electrophysiology during the COVID-19 pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association.

Heart Rhythm 2020 Sep 1;17(9):e233-e241. Epub 2020 Apr 1.

Cooper Medical School of Rowan University, Camden, New Jersey.

Coronavirus disease 2019 (COVID-19) is a global pandemic that is wreaking havoc on the health and economy of much of human civilization. Electrophysiologists have been impacted personally and professionally by this global catastrophe. In this joint article from representatives of the Heart Rhythm Society, the American College of Cardiology, and the American Heart Association, we identify the potential risks of exposure to patients, allied healthcare staff, industry representatives, and hospital administrators. We also describe the impact of COVID-19 on cardiac arrhythmias and methods of triage based on acuity and patient comorbidities. We provide guidance for managing invasive and noninvasive electrophysiology procedures, clinic visits, and cardiac device interrogations. In addition, we discuss resource conservation and the role of telemedicine in remote patient care along with management strategies for affected patients.
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http://dx.doi.org/10.1016/j.hrthm.2020.03.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118697PMC
September 2020

Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association.

Circulation 2020 05 31;141(21):e823-e831. Epub 2020 Mar 31.

Cooper Medical School of Rowan University, Camden, NJ (A.M.R.).

Coronavirus disease 2019 (COVID-19) is a global pandemic that is wreaking havoc on the health and economy of much of human civilization. Electrophysiologists have been impacted personally and professionally by this global catastrophe. In this joint article from representatives of the Heart Rhythm Society, the American College of Cardiology, and the American Heart Association, we identify the potential risks of exposure to patients, allied healthcare staff, industry representatives, and hospital administrators. We also describe the impact of COVID-19 on cardiac arrhythmias and methods of triage based on acuity and patient comorbidities. We provide guidance for managing invasive and noninvasive electrophysiology procedures, clinic visits, and cardiac device interrogations. In addition, we discuss resource conservation and the role of telemedicine in remote patient care along with management strategies for affected patients.
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http://dx.doi.org/10.1161/CIRCULATIONAHA.120.047063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243667PMC
May 2020

Real-World Adherence and Persistence to Direct Oral Anticoagulants in Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Circ Cardiovasc Qual Outcomes 2020 03 9;13(3):e005969. Epub 2020 Mar 9.

Western University of Health Sciences, College of Pharmacy, Pomona, CA (A.F.O., A.S.C., Q.T.L., C.A.J.).

Background: Stroke reduction with direct oral anticoagulants (DOACs) in atrial fibrillation (AF) is dependent on adherence and persistence in the real-world setting. Individual study estimates of DOAC adherence/persistence rates have been discordant. Our aims were to characterize real-world observational evidence for DOAC adherence/persistence and evaluate associated clinical outcomes in patients with AF.

Methods And Results: PubMed, EMBASE, and CINAHL were searched from inception to June 2018. Observational studies that reported real-world DOAC adherence/persistence in patients with AF were included. Study quality was assessed using the Newcastle-Ottawa Scale. Meta-analyses for pooled estimates were performed using DerSimonian and Laird random-effects models. Outcomes included DOAC mean proportion of days covered or medication possession ratio, proportion of good adherence (proportion of days covered/medication possession ratio ≥80%), persistence, DOAC versus vitamin K antagonists persistence, and clinical outcomes associated with nonadherence/nonpersistence. Forty-eight observational studies with 594 784 unique patients with AF (59% male; mean age 71 years) were included. The overall pooled mean proportion of days covered/medication possession ratio was 77% (95% CI, 75%-80%), proportion of patients with good adherence was 66% (95% CI, 63%-70%), and proportion persistent was 69% (95% CI, 65%-72%). The pooled proportion of patients with good adherence was 71% (95% CI, 64%-78%) for apixaban, 60% (95% CI, 52%-68%) for dabigatran, and 70% (95% CI, 64%-75%) for rivaroxaban. Similar patterns were found for pooled persistence by agent. The pooled persistence was higher with DOACs than vitamin K antagonists (odds ratio, 1.44 [95% CI, 1.12-.86]). DOAC nonadherence was associated with an increased risk of stroke (hazard ratio, 1.39 [95% CI, 1.06-1.81]).

Conclusions: Suboptimal adherence and persistence to DOACs was common in patients with AF, with 1 in 3 patients adhering to their DOAC <80% of the time, which was associated with poor clinical outcomes in nonadherent patients. Although it is convenient that DOACs do not require laboratory monitoring, greater effort in monitoring for and interventions to prevent nonadherence may be necessary to optimize stroke prevention. Increased clinician awareness of DOAC nonadherence may help identify at-risk patients.
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http://dx.doi.org/10.1161/CIRCOUTCOMES.119.005969DOI Listing
March 2020

Thiamine and Heart Failure: Challenging Cases of Modern-Day Cardiac Beriberi.

Mayo Clin Proc Innov Qual Outcomes 2019 Jun 27;3(2):221-225. Epub 2019 May 27.

Department of Medicine, Hospitalist Division, VA Greater Los Angeles Healthcare System, Los Angeles, CA.

Cardiac beriberi, or heart failure due to thiamine deficiency, is considered rare in the developed world. The diagnosis is often only considered in limited populations such as those with chronic alcoholism. Alternatively, the disease can be mislabeled as "alcoholic cardiomyopathy" or "nonischemic cardiomyopathy." The following 2 cases illustrate the need to expand our vigilance to other at-risk populations.
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http://dx.doi.org/10.1016/j.mayocpiqo.2019.03.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543258PMC
June 2019

Cardiovascular Care in Women Veterans.

Circulation 2019 02;139(8):1102-1109

Division of Cardiology, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, CA (J.K.H., R.E.).

Cardiovascular disease is the number one cause of death for women in the United States. Of the 1.3 million active duty service members, 16.3% are currently women, and the number of women veterans is expected to increase. Women veterans have higher rates of cardiovascular disease than civilian women and present a unique population. We focus on 5 key areas regarding cardiovascular disease care for women veterans: (1) the rapidly changing demographic; (2) prevalence of traditional risk factors; (3) prevalence of less traditional risk factors (eg, homelessness, military sexual trauma, and mental health disorders); (4) treatment and outcomes of cardiovascular disease; and (5) the current state and future directions of research in this area. This review is a call to action for continued improvements in the cardiovascular care and research for this rapidly growing, at-risk, and under-represented population. Visual Overview: A visual overview is available for this article.
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http://dx.doi.org/10.1161/CIRCULATIONAHA.118.037748DOI Listing
February 2019

Tweeting the Meeting.

Circ Cardiovasc Qual Outcomes 2018 11;11(11):e005018

Division of Cardiology (M.T.T., H.L.N., B.H.W., W.H.S., J.K.H.), University of California Los Angeles.

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http://dx.doi.org/10.1161/CIRCOUTCOMES.118.005018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383719PMC
November 2018

Arrhythmias and myocardial fragility in Ehlers-Danlos syndrome: Complications after routine ICD placement.

HeartRhythm Case Rep 2018 Jul 5;4(7):301-303. Epub 2018 Apr 5.

Department of Cardiology, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, Los Angeles, California.

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http://dx.doi.org/10.1016/j.hrcr.2018.03.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050467PMC
July 2018

Patient Characteristics and Clinical Outcomes with Low-Dose Dabigatran.

Front Cardiovasc Med 2017 10;4:42. Epub 2017 Jul 10.

Department of Cardiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.

Background/aims: Dabigatran, an oral direct thrombin inhibitor, is used in patients with non-valvular atrial fibrillation to reduce thromboembolic events. Whereas the 150 mg dosing regimen has been extensively studied in clinical setting, to date, there is no clinical data on the 75 mg (low dose, "LD") regimen. In this study, we evaluated patient characteristics and clinical outcomes in 49 patients treated with LD dabigatran.

Methods: Electronic medical records were utilized to compare patients from one medical center treated with LD dabigatran to those from the warfarin arm of the RE-LY trial.

Results: Compared to those from the warfarin arm of the RE-LY trial, the LD dabigatran patients were significantly older (82.6 vs. 71.6 years,  < 0.001), had higher prevalence of diabetes (42.9 vs. 23%,  < 0.001), were predominantly male (100 vs. 63.3%,  < 0.001), and had higher CHADS2 score (2.8 vs. 2.1,  < 0.001). Only 9 (18%) patients had creatinine clearance of <30 ml/min and none were on concomitant medications that required dose adjustment to LD dabigatran. During a mean follow up of 10.1 months, there were no thromboembolic events, no cerebrovascular events, and seven bleeding events in the LD dabigatran group of which only two required blood transfusion.

Conclusion: In this database, most patients received LD dabigatran based on characteristics not related to the approved indications for this dose. The exploratory clinical outcomes of using LD dabigatran outside of the current approved indications are promising in this high-risk population and deserve further investigation to better understand the role of LD dabigatran in clinical practice.
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http://dx.doi.org/10.3389/fcvm.2017.00042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502329PMC
July 2017

Cardiovascular and endothelial effects of fish oil supplementation in healthy volunteers.

J Cardiovasc Pharmacol Ther 2007 Sep;12(3):213-9

David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, Torrance, CA 90502, USA.

Consumption of fish oil (FO) is associated with reduced adverse cardiovascular events. In a randomized, blinded, placebo-controlled trial, 26 subjects (17 men and 9 women; mean age [+/- SD] 31 +/- 3.7 years) received 1 g FO capsule (n = 14) or placebo (1 g of corn oil, n = 12) for 14 days. At day 0 and day 14, heart rate (HR), blood pressure, endothelium-dependent brachial artery flow-mediated vasodilation (EDV), and endothelium-independent nitroglycerin-mediated vasodilation (EIDV) were assessed with ultrasound. FO supplementation resulted in a significant increase in EDV (20.4% +/- 13.2% vs 9.9% +/- 5.4%; P = .036) and EIDV (32.6% +/- 16.8% vs 18.0% +/- 14.9%; P = .043). Resting HR decreased by a mean of 5.9 +/- 9.4 bpm (FO) compared with placebo (mean increase of 0.73 +/- 4.8 bpm [P = .05]). FO supplementation in healthy subjects is associated with improved endothelial function and decreased resting HR.
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http://dx.doi.org/10.1177/1074248407304749DOI Listing
September 2007
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