Electromyographic (EMG) measurements of the respiratory muscles provide a convenient and noninvasive way to assess respiratory muscle function and detect patient activity during assisted mechanical ventilation. However, surface EMG measurements of the diaphragm and intercostal muscles are substantially contaminated by cardiac activity due to the vicinity of the cardiac muscles. Many algorithmic solutions to this problem have been proposed, yet a conclusive performance comparison of the most promising candidates currently is missing. The objective of this work is to provide a quantitative performance comparison of six previously proposed cardiac artifact removal algorithms operating on single-channel EMG measurements, and two newly proposed, improved versions of these algorithms. Algorithmic performance is evaluated quantitatively based on four different measures of separation success, using both synthetic validation signals and electromyographic measurements of the respiratory muscles in eight subjects. The compared algorithms are two versions of the empirical template subtraction algorithm, two model-based Bayesian filtering procedures, a wavelet denoising approach, an empirical mode decomposition (EMD) based approach, and classical high-pass filtering. Different algorithms perform well with respect to different performance measures. Template subtraction algorithms yield the best results if the characteristics of the raw signal are of interest, while filtering algorithms like simple high-pass filtering, wavelet denoising, and EMD-based denoising show superior performance for calculating a cleaned envelope signal. No algorithm completely removes the cardiac interference, but the characteristic errors introduced by the considered algorithms differ. Hence, the choice of the algorithm to use should be made depending on the target application. Finally, we also demonstrate that our empirical SNR measure, which can be calculated without knowledge of the true, undisturbed signals, correlates strongly with the exact reconstruction error. Thus, it represents a reliable indicator for algorithm performance on real measurement data.
