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March 16, 20260 citationsOpen Access

Measuring respiratory surface EMG with ECG electrode leads

AOAndra OltmannJGJan GraßhoffNLNils Lange

Key Result

ECG leads achieved an SNRbase of 6.00 ±3.04 dB during quiet breathing, demonstrating their potential for monitoring respiratory muscle activity without compromising cardiac signals.

Key Points

  • The aim is to evaluate the effectiveness of ECG leads for monitoring respiratory effort compared to standard methods.
  • Investigated the use of ECG leads in respiratory monitoring among 20 subjects.
  • Subjects performed both quiet and resistance breathing exercises.
  • Quantified performance using signal-to-noise ratios between inspiratory activity and noise as well as expiratory activity.
  • ECG leads proved suitable for monitoring respiration.
  • Performance improved when ECG leads were combined with sEMG electrodes.
  • Significant enhancement in detecting inspiratory activity over baseline noise.

Structured PICO

Do standard ECG leads provide adequate signal-to-noise ratios for monitoring respiratory surface EMG compared to dedicated chest electrodes in healthy subjects?

P
Population
20 healthy subjects, mean age 26.7±3.33 years, BMI 24.00±2.91 kg/m2
I
Intervention
Standard 12-lead ECG leads (Einthoven and Wilson) and differential leads combining one ECG electrode with one chest electrode
C
Comparator
Reference differential lead between LMCL3 and RMCL3
O
Outcome
Signal-to-noise ratios (SNRbase and SNRexp) between inspiratory activity and baseline noise or expiratory activitysurrogate

Standard ECG leads can be repurposed to monitor respiratory muscle activity, with performance enhanced by adding a single respiratory sEMG electrode, facilitating integrated cardiopulmonary monitoring.

Main Result

Effect estimate: null (95% CI null)

p-value: p=<0.05

Limitations

  • Small sample size of healthy subjects
  • Need for validation in intensive care patient cohorts
  • Needs to be validated with an intensive care subject cohort in the future

Abstract

Surface electromyography (sEMG) offers potential for analyzing patient-ventilator interactions and respiratory effort. Despite promising in monitoring respiration, it is not clinically established, unlike electrocardiography (ECG), which shares the same physiological principle for cardiac monitoring. This study investigates ECG leads for respiratory monitoring in 20 subjects performing quiet and resistance breathing. Performance was quantified by signal-to-noise ratios between inspiratory activity and (1) baseline noise and (2) expiratory activity. ECG leads were suitable for monitoring respiration, with performance enhanced by combining ECG electrodes with sEMG electrodes. The findings support integrating respiratory sEMG into clinical practice using ECG electrodes without compromising cardiac monitoring.

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Cite This Study

Oltmann et al. (2025) studied Respiratory muscle activity measurement (n=20). ECG leads for measuring respiratory sEMG vs. Standard electrode leads was evaluated on Signal-to-noise ratio (SNR) for inspiratory activity and baseline noise (null, 95% CI null, p=<0.05). ECG leads achieved an SNRbase of 6.00 ±3.04 dB during quiet breathing, demonstrating their potential for monitoring respiratory muscle activity without compromising cardiac signals.

synapsesocial.com/papers/69b79e6e8166e15b153abbfahttps://doi.org/10.18416/automed.2026.2500
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