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A new electrocardiogram (ECG) data compression method is presented which employs a two dimensional (2-D) transform. This 2-D transform method utilizes the fact that ECG signals generally show two types of redundancies-between adjacent heartbeats and between adjacent samples. A heartbeat data sequence is cut and beat-aligned to form a 2-D data array. Any 2-D compression method can then be applied. Transform coding using the 2-D discrete cosine transform (DCT) [2-D DCT] is employed here as an example. Using selections from the MIT-BIH arrhythmia and Medtronic databases, results are presented that illustrate substantial improvement in compression ratio over one-dimensional methods for comparable percent root-mean-square difference (PRD).