Electrocardiogram (ECG) monitoring plays a vital role in the early detection and diagnosis of cardiovascular diseases. Traditional ECG systems are often confined to clinical environments and lack continuous monitoring capabilities. With the advancement of Electrical and Electronics Engineering, smart ECG monitoring systems have emerged as an effective solution for real-time and remote health monitoring. These systems integrate sensors, microcontrollers, wireless communication tech-nologies, and cloud platforms to enable continuous acquisition, processing, and transmission of cardiac signals.

This review paper presents an overview of smart ECG monitoring systems, including their system architecture, key components, and enabling technologies such as Internet of Things (IoT) and artificial intelligence (AI). Various signal processing techniques used for noise reduction and feature extraction are also discussed. Furthermore, the paper reviews recent research developments in wearable ECG devices and automated arrhyth-mia detection methods.

The advantages, limitations, and challenges associated with smart ECG systems are analyzed, along with their applications in remote patient monitoring, healthcare, and fitness tracking. Finally, the paper highlights future research directions aimed at improving accuracy, portability, and integration with advanced healthcare technologies. Smart ECG monitoring systems have the potential to transform modern healthcare by providing accessible, efficient, and continuous cardiac monitoring solutions.

Index Terms—Electrocardiogram (ECG), Smart Healthcare, Internet of Things (IoT), Wearable Devices, Remote Patient Monitoring, Signal Processing, Arrhythmia Detection, Wireless Communication