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A single channel wireless, wearable ECG smart sensor has been developed for long-term monitoring of patients at risk of life-threatening cardiac arrhythmias. The battery-operated sensor can be applied in virtually any orientation on the upper left quadrant of the chest, and monitors patient health continuously for up to three days. An embedded microcontroller calculates heart rate and monitors the ECG signal for life-threatening arrhythmias, which are transmitted wirelessly to a central server and relayed to a respondent device. Tests on human subjects demonstrated signal amplitude from the closely-spaced smart sensor electrodes to be one-half that of the best vector from traditional limb lead placement. Tests with motion and muscle artifact showed superior noise immunity by the smart sensor as compared to a state-of-the-art telemetry monitor.