Circulation Journal · Mar 6, 2026

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

By Inoue Y, Nakatsuji K, Kumagai K et al.

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.

doi.org/10.1253/circj.cj-25-1126Open accessPubMed 41795916Biomarkers