Effects of muscle-to-electrode distance on the human diaphragm electromyogram

It has been suggested that esophageal recordings of the diaphragm electromyogram (EMGdi) are influenced by changes in chest wall configuration. Whether the changes are of physiological or artifactual origin is unclear. For example, the distance between the esophageal electrode and the diaphragm is likely to alter with chest wall configuration and may lead to misinterpretations of EMGdi. The aims of this study were 1) to evaluate and quantify the effect of the muscle-to-electrode (ME) distance filter on EMGdi, as obtained with a multiple-array esophageal electrode, 2) to take advantage of the ME distance filter to locate the position of the diaphragm with respect to the electrode, and 3) to evaluate the influence of lung volume and chest wall configuration on EMGdi center frequency (CF) while controlling for the ME distance filter and signal quality. Five subjects performed six static contractions of the diaphragm at each of seven chest wall configurations, as evaluated by the method of K. Konno and J. Mead (J. Appl. Physiol. 22: 407–422, 1967). EMGdi was measured with seven pairs of electrodes mounted on an esophageal catheter. The pair of electrodes whose EMGdi power spectra were the least filtered by the ME distance was assumed to be closest to the diaphragm. The results of the study indicated that 1) EMGdi power spectra were strongly affected by the distance between the diaphragm and the electrodes. CF decreased by approximately 1 Hz/mm displacement away from the electrode pair closest to the diaphragm; and 2) no systematic relationship was found between changes in chest wall configuration and CF, when CF was measured from the electrode pair closest to the diaphragm. We conclude that the EMGdi CF can be reliably measured with a multiple-array esophageal electrode that covers the span of diaphragmatic excursion and by selecting the pair of electrodes that is the closest to the diaphragm.