title: Assessment of mean respiratory rate from ECG recordings for risk stratification after myocardial infarction.
abstract: BACKGROUND
  We recently reported that nocturnal respiratory rate (NRR) predicts non-sudden cardiac death in survivors of myocardial infarction (MI). Here, we present the details of the technique deriving NRR from ECG recordings.
  
  
  METHODS
  Continuous ECG and respiratory chest excursions were simultaneously recorded in 941 MI survivors who were followed-up for 5-years. Mean respiratory rate was derived from the ECG based on RR intervals, QRS amplitudes, and QRS vectors and compared to chest belt measurements. NRR was calculated from Holter-ECGs accordingly using the same ECG processing.
  
  
  RESULTS
  Directly-measured and ECG-derived respiratory rates were in good agreement. Areas under the ROC curve for 10-min-ECG- and Holter-derived respiratory rate were well in the confidence intervals of that of the chest belt measurement. The optimum dichotomy of NRR for the prediction of mortality was ≥18.6 breaths per minute.
  
  
  CONCLUSIONS
  The mean respiratory rate can be precisely derived from continuous ECGs.
authors.affiliation: Medizinische Klinik der Technischen Universität München, Munich, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sinnecker
authors.affiliation: Medizinische Klinik der Technischen Universität München, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Dommasch
authors.affiliation: Medizinische Klinik der Technischen Universität München, Munich, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Barthel
authors.affiliation: Medizinische Klinik der Technischen Universität München, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Müller
authors.affiliation: Medizinische Klinik der Technischen Universität München, Munich, Germany.
authors.forename: Ralf J
authors.initials: RJ
authors.lastname: Dirschinger
authors.affiliation: Institut für Medizinische Statistik und Epidemiologie der Technischen Universität München, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hapfelmeier
authors.affiliation: Medizinische Klinik der Technischen Universität München, Munich, Germany.
authors.forename: Katharina M
authors.initials: KM
authors.lastname: Huster
authors.affiliation: Medizinische Klinik der Technischen Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Aliance).
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.affiliation: St. Paul's Cardiac Electrophysiology, University of London, and Imperial College, London, England. Electronic address: marek.malik@btinternet.com.
authors.forename: Marek
authors.initials: M
authors.lastname: Malik
authors.affiliation: Medizinische Klinik der Technischen Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Aliance).
authors.forename: Georg
authors.initials: G
authors.lastname: Schmidt
mesh_terms: D000368:Aged; D000465:Algorithms; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D056152:Respiratory Rate; D018570:Risk Assessment
keywords: ECG; Myocardial infarction; Nocturnal respiratory rate