Journal of electrocardiology
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Review Comparative Study
Development of three methods for extracting respiration from the surface ECG: a review.
Respiration rate (RR) is a critical vital sign that can be monitored to detect acute changes in patient condition (e.g., apnea) and potentially provide an early warning of impending life-threatening deterioration. Monitoring respiration signals is also critical for detecting sleep disordered breathing such as sleep apnea. Additionally, analyzing a respiration signal can enhance the quality of medical images by gating image acquisition based on the same phase of the patient's respiratory cycle. Although many methods exist for measuring respiration, in this review we focus on three ECG-derived respiration techniques we developed to obtain respiration from an ECG signal. ⋯ Over the last five years, we have performed six studies using the above methods: 1) In 1907 sleep lab patients with >1.5M 30-second epochs, EDR achieved an apnea detection accuracy of 79%. 2) In 24 adult polysomnograms, use of EDR and chest belts for RR computation was compared to airflow RR; mean RR error was EDR: 1.8±2.7 and belts: 0.8±2.1. 3) During cardiac MRI, a comparison of EMGDR breath locations to the reference abdominal belt signal yielded sensitivity/PPV of 94/95%. 4) Another comparison study for breath detection during MRI yielded sensitivity/PPV pairs of EDR: 99/97, RSA: 79/78, and EMGDR: 89/86%. 5) We tested EMGDR performance in the presence of simulated respiratory disease using CPAP to produce PEEP. For 10 patients, no false breath waveforms were generated with mild PEEP, but they appeared in 2 subjects at high PEEP. 6) A patient monitoring study compared RR computation from EDR to impedance-derived RR, and showed that EDR provides a near equivalent RR measurement with reduced hardware circuitry requirements.