Objective To explore the application value of ultra long term ambulatory ECG monitoring in the diagnosis of atrial fibrillation in the elderly. Methods Ninety elderly patients with suspected atrial fibrillation（palpitation

paroxysmal tachycardia

etc.） were selected from Baofeng County People’s Hospital of Henan Province from January 2019 to February 2020. The ECG data of 30 days were monitored by extra-long term ambulatory ECG at admission

and 24 hours ambulatory ECG was performed on the first day of admission

through software playback analysis and comparison of ultra long-term dynamic electrocardiogram monitoring and 24-hour dynamic electrocardiogram detection of atrial fibrillation events. Results Forty-two patients with AF were detected by ultra long term ambulatory ECG monitoring

and the detection rate was 46.67%（42/90）. The detection rate of atrial fibrillation was32.22%（29/90）. The detection rate of elderly patients with atrial fibrillation by ultra long term dynamic electrocardiogram monitoring was higher than that by 24-hour dynamic electrocardiogram monitoring

and the difference was statistically significant（p<0.05）. The detection rate of atrial fibrillation in 20 and 30 days of ultra long term ambulatory ECG monitoring was higher than that in 3 and 10 days of monitoring

and the difference was statistically significant（p<0.05）. Conclusions The application effect of ultra long term ambulatory ECG monitoring in the diagnosis of atrial fibrillation in the elderly is good

which can significantly improve the detection rate of atrial fibrillation.