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MAX30003 always need 3 leads, how to work with just two?

Category: Hardware
Product Number: MAX30003

When using the MAX30003WING board with 3 leads, I get clean ECG data.  However, just using two leads, all I seem to get is a lot of noise.  Touch the ground lead and the signal is again very good.  

I am powering it from a battery and sending the received data over a BLE link so the unit is galvanically isolated. 

I've gone through the datasheet but I don't know why the ground lead should be needed for an isolated system.  I was hoping to just need the two leads, but I cannot seem to get that working.  Any pointers would be welcome!  

[edited by: GenevaCooper at 6:18 PM (GMT -5) on 11 Dec 2023]