A Single ECG Lead-Based Oscillation Index for the Quantification of Periodic Breathing in Severe Heart Failure Patients

Periodic breathing is a sleep-disordered breathing characterized by the alternation of central hypopneas/apneas and hyperventilation, and is associated with increased mortality in patients with severe heart failure in most studies. In this paper, we present a new strategy to detect mild to severe patterns of periodic breathing using a single electrocardiogram signal in patients with severe heart failure. We first compute three time series, extracted from the ECG signal namely Heart-Rate Variability, R-Wave Amplitude and Mean Cardiac Axis. Then, these series are used to estimate an oscillation index that can quantify periodic breathing through time and a one-minute decision is made using an experimental thresholding to decide whether periodic breathing is absent or present. Eight patients with normal to severe periodic breathing are selected to test our method. The results obtained are compared to those performed by experts.