The last few years witnessed an increased interest in utilizing field programmable gate array (FPGA) for a variety of applications. This utilizing derived mostly by the advances in the FPGA flexible resource configuration, increased speed, relatively low cost and low energy consumption. The introduction of FPGA in medicine and health care field aim generally to replace costly and usually bigger medical monitoring and diagnostic equipment with much smaller and possibly portable systems based on FPGA that make use of the design flexibility of FPGA. Many recent researches focus on FPGA systems to deal with the well-known yet very important electrocardiogram (ECG) signal aspects to provide acceleration and improvement in the performance as well as finding and proposing new ideas for such implementations. The recent directions in ECG-FPGA are introduced in this paper.