Estimated ECG Subtraction method for removing ECG artifacts in esophageal recordings of diaphragm EMG

The accuracy of diaphragm electromyogram (EMGdi) derived parameters, as used in critically ill intensive care unit (ICU) patients, can be compromised due to electrocardiographic (ECG) interference the EMGdi signal. Removal ECG contamination from esophageal recordings is challenging spectral overlapping EMG and signals because variability shape amplitude. Therefore, we designed an Estimated Subtraction (EES) method, based on three steps: (1) identification timing artifact without reference channel, (2) estimation normalized ECG, considering noise, (3) subtraction denormalized estimate recordings. We evaluated EES method against use a single wavelet-based adaptive filter. Using ten ICU patients simulated contaminated EMG, demonstrated that yields uncontaminated EMGdi, showed it more effective than filter only. Implementation this technique may offer means improve activity monitoring control clinical practice.