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Ambulatory measurement of respiratory sinus arrhythmia and respiration rate

The present study describes a device (AMD43) for ambulatory measurement of respiration rate and respiratory sinus arrhythmia from the combined electrocardiogram (ECG) and thoracic impedance signals. Respiratory time intervals derived from this ambulatory device closely corresponded to those derived from simultaneous recordings with a ‘classical’ laboratory set-up. Good cross-instrument comparison was also found for respiratory sinus arrhythmia parameters derived with both the peak-to-trough and spectral analyses methods. It is discussed how simultaneous measurement of respiration rate, respiratory sinus arrhythmia may be used to asses cardiac vagal tone in real-life situations.

Validation of the thoracic impedance derived respiratory signal using multilevel analysis

The purpose of the current study was to validate the change in thoracic impedance (dZ) derived respiratory signal obtained from four spot electrodes against incidental spirometry. Additionally, a similar validation was performed for a dual respiratory belts signal to compare the relative merit of both methods. Participants were 38 healthy adult subjects (half male, half female). Cross-method comparisons were performed at three (paced) respiration frequencies in sitting, supine and standing postures. Multilevel regression was used to examine the within- and between-subjects structure of the relationship between spirometric volume and the respiratory amplitude signals obtained from either dZ or respiratory belts. Both dZ derived respiratory rate and dual belts derived respiratory rate accurately reflected the pacing frequencies. For both methods, fixed factors indicated acceptable but posture-specific regression on spirometric volume. However, random factors indicated large individual differences, which was supported by variability of gain analyses. It was concluded that both the dZ and dual belts methods can be used for measurement of respiratory rate and within-subjects, posture-specific, changes in respiratory volume. The need for frequent subject-specific and posture-specific calibration combined with relatively large measurement errors may strongly limit the usefulness of both methods to assess absolute tidal volume and minute ventilation in ambulatory designs.