Download PDF
Methods Inf Med 2010; 49(05): 462-466
DOI: 10.3414/ME09-02-0047
Special Topic – Original Articles
Schattauer GmbH

Central Sleep Apnea Detection from ECG-derived Respiratory Signals

Application of Multivariate Recurrence Plot Analysis
C. Maier
1   Department of Medical Informatics, Heilbronn University, Heilbronn, Germany
,
H. Dickhaus
2   Department of Medical Informatics, University of Heidelberg, Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

received: 29 October 2009

accepted: 17 January 2010

Publication Date:
17 January 2018 (online)

    Permissions and Reprints

Summary

Objectives: This study examines the suitability of recurrence plot analysis for the problem of central sleep apnea (CSA) detection and delineation from ECG-derived respiratory (EDR) signals.

Methods: A parameter describing the average length of vertical line structures in recurrence plots is calculated at a time resolution of 1 s as ‘instantaneous trapping time’. Threshold comparison of this parameter is used to detect ongoing CSA. In data from 26 patients (duration 208 h) we assessed sensitivity for detection of CSA and mixed apnea (MSA) events by comparing the results obtained from 8-channel Holter ECGs to the annotations (860 CSA, 480 MSA) of simultaneously registered polysomnograms.

Results: Multivariate combination of the EDR from different ECG leads improved the detection accuracy significantly. When all eight leads were considered, an average instantaneous vertical line length above 5 correctly identified 1126 of the 1340 events (sensitivity 84%) with a total number of 1881 positive detections.

Conclusions: We conclude that recurrence plot analysis is a promising tool for detection and delineation of CSA epochs from EDR signals with high time resolution. Moreover, the approach is likewise applicable to directly measured respiratory signals.

Keywords

Central sleep apnea - ECG-derived respiration - multivariate recurrence plot analysis
 

  • References

  • 1 Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: pathophysiology and treatment. Chest 2007; 131: 595-607.
    CrossrefPubMedGoogle Scholar
  • 2 Moody GB, Mark RG, Zoccola A, Mantero S. Derivation of respiratory signals from multi-lead ECGs. Computers in Cardiology 1985; 12: 113-116.
    PubMedGoogle Scholar
  • 3 Moody GB, Mark RG, Bump MA, Weinstein JS, Berman AD, Mietus JE, Goldberger AL. Clinical validation of the ECG-derived respiration (EDR) technique. Computers in Cardiology 1986; 13: 507-510.
    PubMedGoogle Scholar
  • 4 Eckmann JP, Kamphorst SO, Ruelle D. Recurrence plots of dynamical systems. Europhysics Lett 1987; 4: 973-977.
    CrossrefPubMedGoogle Scholar
  • 5 Maier C, Rödler V, Wenz H, Dickhaus H. ECG Fingerprints of Obstructed Breathing in Sleep Apnea Patients. IEEE Eng Med Biol Mag 2009; 28 (06) 41-48.
    PubMedGoogle Scholar
  • 6 Takens F. Detecting strange attractors in turbulence. In: Rand DA, Young LS. editors. Dynamical Systems and Turbulence. Lecture Notes in Mathematics, 898. Berlin, New York: Springer; 1981. pp 366-381.
    Google Scholar
  • 7 Marwan N, Wessel N, Meyerfeldt U, Schirdewan A, Kurths J. Recurrence-plot-based measures of complexity an their application to heart rate variability data. Phys Rev E 2002; 66 (02) 026702.
    CrossrefPubMedGoogle Scholar