A mixed-signal ECG front-end that uses aggressive voltage scaling to maximize power-efficiency and facilitate integration with low-voltage DSPs is implemented in a 0.18µm CMOS process. 50/60Hz interference is canceled using mixed-signal feedback, enabling ultra-low-voltage operation by reducing dynamic range requirements. Analog circuits are optimized for ultra-low-voltage, and a SAR ADC with a dual-DAC architecture eliminates the need for a power-hungry ADC buffer. Oversampling and ΔΣ-modulation leveraging near-VT digital processing are used to achieve ultra-low-power operation without sacrificing noise performance and dynamic range. The fully-integrated front-end consumes 2.9µW from a 0.6V supply.