Electrocardiogram (ECG) telemedicine is effective way to obtain better clinical service timely. Limited by network and clinical experience, a progressive ECG transmission schema is required. In this paper, a timedomain multi-resolution ECG transmission schema is proposed. This schema supports multi-segment, multisample, multi-lead and any ECG compression algorithm. It has proved that the schema has high scalability and practical for ECG telemedicine._____________________________ 978-1-4244-3930-0/09/$25.00 ©2009 IEEE