Recent technology advancements have resulted in ADCs with a combination of speeds, resolution, and power that were impossible before. At the same time, the necessity for low-cost and low-power ECG machines has increased, imposing constraints on engineers and designers to make systems more and more affordable. This paper examines how to use the latest high-performance delta-sigma (ΔΣ) ADCs from Texas Instruments as components of an ECG AFE system, and discusses how to optimize the cost of an ECG AFE from a system design perspective.