Electrocardiogram (ECG) signals are particularly used in the diagnosis and supervision of different cardiovascular diseases. The accurate and efficient classification of ECG signals is of critical importance in clinical applications. FPGA-based systems have been identified to offer an efficient solution to the implementation of real-time ECG signal classification systems because of their parallel processing, reprogrammable nature, and low power consumption. Thus, this review paper aims to explore the existing ECG classification techniques with a focus on FPGA implementation. The review discussed several classification methods, including adaptive algorithms and neural networks, which have been optimized for arrhythmia detection. Notably, Neural network techniques like ANN, CNN, and spiking neural networks are preferable due to their ability to provide superior accuracy. For instance, Mathias et al. developed a high-precision neural network with an impressive accuracy of 99.82%. Similarly, Arona et al. deployed a DCNN on FPGA, achieving accuracies reaching up to 99.67%. Researchers widely used the MIT-BIH dataset to evaluate ECG classification techniques, This paper presents new trends and focuses on future research prospects in this field. Hence, the findings of the present review can help researchers and engineers in developing effective and efficient FPGA-based ECG monitoring and diagnostic systems for clinical and healthcare applications.