Electrocardiogram (ECG) data is essential for evaluating cardiac health conditions. Long-term ECG signal monitoring needs a considerable amount of memory for storage, impacting data bandwidth allocation. The ECG data compression is challenging in preserving significant features, using low computational resources, and achieving a higher compression ratio at lower reconstruction error. This paper proposes an innovative QRS-complex and plateau (Non-QRS) region segregation for QRS-complex subsegment bank formation and integer cosine transform-based ECG data compression. An adaptive QRS-complex subsegment template bank is formed by: (i) QRS and Non-QRS region segmentation; (ii) QRS region identification; (iii) QRS region alignment; (iv) Dc equalization and sub-template formation of the QRS region. A discrete integer cosine transform, quantization, and grouping with a significance map are used on the non-QRS segment of the ECG. Both the QRS and non-QRS regions are coded by lossless arithmetic encoding. Experiments are enumerated on the MIT BIH arrhythmia database, which validates the potential of the proposed approach by achieving an average value equal to 31.51, 0.84, and 28.57 for compression ratio, percentage-root-mean-square-difference, and quality-score, respectively. The average distortion measure for the proposed ECG compressor is less than 2%, which is within the clinically acceptable limit. The proposed method is also compared to existing state-of-the-art ECG compression techniques. It performs better in terms of compression ratio and preservation of ECG features. Additionally, this method typically requires less computational resources and is easy to implement, which is an advantage over other ECG compression methods.