An electrocardiogram (ECG) data compression scheme is presented using the gain-shape vector quantization. The proposed approach utilizes the fact that ECG signals generally show redundancy among adjacent heartbeats and adjacent samples. An ECG signal is QRS detected and segmented according to the detected fiducial points. The segmented heartbeats are vector quantized, and the residual signals are calculated and encoded using the AREA algorithm. The experimental results show that with the proposed method both visual quality and the objective quality are excellent even in low bit rates. An average PRD of 5.97% at 127 b/s is obtained for the entire 48 records in the MIT-BIH database. The proposed method also outperforms others for the same test dataset.