【Background】It has been reported that atrial fibrillation（AF）may contribute to impairment of baroreflex sensitivity（BRS）. However, the difference of BRS between patients with persistent AF（PeAF）and those with paroxysmal AF（PAF）is unknown. We tested the hypothesis that patients with PeAF have a more impaired BRS compared with those with PAF.【Methods and Results】From October 2015 onwards, a total of 67 patients（14 women［20.9%］；mean age 65.2±10.1 years）with PAF（n＝46, 68.7%）and PeAF（n＝21, 31.3%）, who underwent catheter ablation, were prospectively enrolled. The baseline BRS was evaluated during sinus rhythm. Baseline BRS in patients with PeAF was significantly lower than those with PAF（2.97［0.52-6.62］ms/mmHg versus 4.70［2.36-8.37］ms/mmHg, P＝0.047）. BRS was significantly depressed after catheter ablation in all patients（4.66 ［1.80-7.37］ms/mmHg versus 0.55［−0.15 to 1.22］ms/mmHg, P＜0.001）. However, the depression of BRS because of catheter ablation appeared more attenuated in patients with PeAF compared with those with PAF. The difference of BRS before and after ablation in patients without recurrence was significantly greater than those in patients with recurrence in PAF group.【Conclusions】Our findings demonstrated that baseline BRS was more depressed in patients with PeAF compared with PAF. Catheter ablation depressed BRS irrespective of the type of AF, with a greater effect in patients with PAF than PeAF.

Heart failure（HF）and atrial fibrillation（AF）are common diseases that lead to increased mortality in elderly patients. Recently, catheter ablation for AF has become increasingly popular, and several studies assessing the impact of catheter ablation on prognosis in AF with HF have been reported. The majority of these studies have enrolled AF patients with HF and reduced ejection fraction（HFrEF）, but the recommendation grade of catheter ablation for HFrEF patients in guidelines is relatively low. Our study evaluated long-term trajectories of cardiac disorder（systolic dysfunction, diastolic dysfunction, high BNP level, left atrial dilation, and mitral regurgitation）, revealed risk factors for predicting the improvement of each cardiac disorder and HF hospitalization, and raised concern for the impact of catheter ablation on diastolic dysfunction. We explain our study’s results and consider it to be an important report for judging the indication of catheter ablation in AF with HF and several kinds og cardiac disorders.

【Purpose】Radiofrequency catheter ablation can obtain a therapeutic effect by performing radiofrequency energization between the dispersive electrode attached to the body surface and the ablation catheter in contact with the myocardium. However, there are few reports about the effect of dispersive electrode position on radiofrequency ablation lesion size. We investigated the effect of the attachment position of the dispersive electrode on the ablation lesion formation using an in vitro model.【Methods】Using a 7F open-tip irrigated catheter with a contact force sensor, radiofrequency applications were delivered to beef slabs by two protocols of dispersive electrode position in an in vitro model（8 lesions for each protocol, 20 seconds, power of 50W, contact force of 10g）. The first position of the dispersive electrode was arranged in the forward direction of the catheter tip. The other position was in the opposite direction of the catheter tip. The interrelation between lesion formation and dispersive electrode position was evaluated.【Results】Lesions with the dispersive electrode arranged in the forward direction of catheter tip were significantly deeper than opposite direction（4.3±0.5mm vs 2.9±0.4mm, p=0.01）. Lesion width（5.9±0.8mm vs 5.6±0.7mm）and impedance drop（20±11mm vs 19±9.3mm）were not significantly different between each patch position.【Conclusion】The position of the dispersive electrode may affect ablation lesion size, especially depth.

【Objective】To compare the usefulness and problems of the automatic recording of the external loop recorder（ELR）with the continuous 24-hour recording（equivalent to a 24-hour Holter electrocardiograph）and patient events（equivalent to an event button loop recorder）recorded during the same period and in the same patients.【Subjects and Methods】A total of 204 adult patients who were fitted with ELR in our hospital from February 2018 to March 2021 were included（104 males, age range 20-94 years, mean age 62.7 years, mean duration about 13.7 days）.【Results】The number of arrhythmia detections in the automated recording was higher than in the 24-hour recording or patient events for any of the arrhythmia findings（PAC run, NSVT, VT, PSVT, Paf, and Pause）. In addition, the number of days required to detect arrhythmia findings was faster with automated recording than with patient events. However, there were 43 times as many recorded events as patient events, and only about 31％ of the judgments were accurate.【Discussion】Although analysis of automated recordings is complicated, its ability to detect arrhythmia findings is high, and it may be useful in arrhythmia diagnosis.