ECG recordings normally use three electrodes?two for the differential inputs of the ECG amplifier and the third for ground. We analyze those situations where the ground electrode can be eliminated. We propose a model for the source of electrical interference and determine various parameter values. Making use of experimentally obtained data for the model parameters we suggest optimal design for a two-electrode amplifier. The two-electrode design is useful for biotelemetry, portable Holter monitors, and portable arrhythmia monitors. Under certain circumstances it may be useful for grounded monitoring equipment. The two-electrode technique has the advantage that it improves patient safety by eliminating the ground electrode. Fewer electrodes make patient attachment easier and lower electrode costs.