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To resolve the problem of complex operation of the linear approximation distance threshold (LADT) algorithm, some improved researches were made to the algorithm by taking the characteristic of electrocardiograph (ECG) signal and the advantages of field programmable gate arrays (FPGA) into account. The paper puts forward a real time compression method with much less mathematical operation and much easier real-time implementation. With the artificial and experimental verification, it turned to be that the arithmetic has the advantages of low distortion and in real time. In the application of improved fast LADT algorithm, the paper designed the hardware system of ECG data compression based on FPGA and the program of the algorithm based on very high speed integrated circuit hardware description language (VHDL). And the experiment results of this system turned to be good performance. The approach can be easily extended to other similar applications.