Seven-Day Holter Monitoring Substantially Improves Detection of Low-Burden Atrial Fibrillation - Results From a Large Japanese Multicenter Cohort

Circ J. 2026 Jun 25;90(7):903-905. doi: 10.1253/circj.CJ-25-1126. Epub 2026 Mar 6.

Abstract

Background: Atrial fibrillation (AF) burden and longest duration are important predictors of heart failure and embolism. However, burden-specific detection rates on 7-day Holter ECG remain unclear.

Methods and results: Among 25,817 recordings, 2,289 cases of paroxysmal AF and 571 cases of persistent AF were identified. Low-burden AF was common, and 7-day monitoring substantially improved detection, particularly for AF burden <10% (2.6-fold increase vs. 24-h). AF burden correlated with the longest duration (r=0.79).

Conclusions: 7-day Holter monitoring improved low-burden AF detection and confirmed a strong correlation between AF burden and longest duration.

Keywords: Arrhythmia detection; Atrial fibrillation; Holter monitoring.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / physiopathology
  • East Asian People
  • Electrocardiography, Ambulatory* / methods
  • Humans
  • Japan
  • Time Factors

Supplementary concepts

  • Japanese people