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. 2017 Nov;22(6):e12462.
doi: 10.1111/anec.12462. Epub 2017 Jun 15.

ECG-derived Cheyne-Stokes respiration and periodic breathing in healthy and hospitalized populations

Adelita Tinoco  1 , Barbara J Drew  1 , Xiao Hu  1 , David Mortara  1 , Bruce A Cooper  1 , Michele M Pelter  1
Affiliations

ECG-derived Cheyne-Stokes respiration and periodic breathing in healthy and hospitalized populations

Adelita Tinoco et al. Ann Noninvasive Electrocardiol. 2017 Nov.

Abstract

Background: Cheyne-Stokes respiration (CSR) has been investigated primarily in outpatients with heart failure. In this study we compare CSR and periodic breathing (PB) between healthy and cardiac groups.

Methods: We compared CSR and PB, measured during 24 hr of continuous 12-lead electrocardiographic (ECG) Holter recording, in a group of 90 hospitalized patients presenting to the emergency department with symptoms suggestive of acute coronary syndrome (ACS) to a group of 100 healthy ambulatory participants. We also examined CSR and PB in the 90 patients presenting with ACS symptoms, divided into a group of 39 (43%) with confirmed ACS, and 51 (57%) with a cardiac diagnosis but non-ACS. SuperECG software was used to derive respiration and then calculate CSR and PB episodes from the ECG Holter data. Regression analyses were used to analyze the data. We hypothesized SuperECG software would differentiate between the groups by detecting less CSR and PB in the healthy group than the group of patients presenting to the emergency department with ACS symptoms.

Results: Hospitalized patients with suspected ACS had 7.3 times more CSR episodes and 1.6 times more PB episodes than healthy ambulatory participants. Patients with confirmed ACS had 6.0 times more CSR episodes and 1.3 times more PB episodes than cardiac non-ACS patients.

Conclusion: Continuous 12-lead ECG derived CSR and PB appear to differentiate between healthy participants and hospitalized patients.

Keywords: Cheyne-Stokes; ECG derived respiration; Holter; acute coronary syndrome; periodic breathing.

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Figures

Figure 1
Figure 1
Top: Cheyne‐Stokes respiration; bottom: periodic breathing over 180 s. In each figure the top line is the mean QRS amplitude in 1/4 μV and is used to measure tidal volume. The bottom line is a myogram signal with arbitrary units used to detect tidal volume. In Cheyne‐Stokes respiration apnea is seen as a flat line in both the QRS amplitude and the myogram waveforms
See this image and copyright information in PMC

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