Electrocardiogram derived respiratory rate from QRS slopes and R-wave angle

A method for estimating respiratory rate from electrocardiogram (ECG) signals is presented. It is based on QRS slopes and R-wave angle, which reflect respiration-induced beat morphology variations. The 12 standard leads, 3 leads from vectorcardiogram (VCG), and 2 additional non-standard leads derived from VCG loops were analyzed. The following series were studied as ECG derived respiration (EDR) signals: slope between the peak of Q and R waves, slope between the peak of R and S waves, and the R-wave angle. Information from several EDR signals was combined in order to increase the robustness of estimation. Evaluation is performed over two databases containing ECG and respiratory signals simultaneously recorded during two clinical tests with different characteristics: tilt test, representing abrupt cardiovascular changes, and stress test representing a highly non-stationary and noisy environment. A combination of QRS slopes and R-wave angle series derived from VCG leads obtained a respiratory rate estimation relative error of 0.50 ± 4.11% (measuring 99.84% of the time) for tilt test and 0.52 ± 8.99% (measuring 96.09% of the time) for stress test. These results outperform those obtained by other reported methods, both in tilt and stress testing.