The impact of baseline wander removal techniques on the ST segment in simulated ischemic 12-lead ECGs

Baseline wander removal is one important part of electrocardiogram (ECG) filtering. This can be achieved by many different approaches. This work investigates the influence of three different baseline wander removal techniques on ST changes. The chosen filters were phase-free Butterworth filtering, median filtering and baseline correction with cubic spline interpolation. 289 simulated ECGs containing ischemia were used to determine the influence of these filtering processes on the ST segment. Synthetic baseline wander and offsets were added to the simulated signals. All methods proved to be good approaches by removing most of the baseline wander in all signals. Correlation coefficients between the original signals and the filtered signals were greater than 0.93 for all ECGs. Cubic spline interpolation performed best regarding the preservation of the ST segment amplitude change when compared to the original signal. The approach modified the ST segment by 0.10 mV±0.06 mV at elevated K points. Median filtering introduced a variation of 0.33 mV±0.29 mV, Butterworth filtering reached 0.16 mV±0.14 mV at elevated K points. Thus, all methods manipulate the ST segment.