In ECG data compression, maintaining reconstructed signal with desired quality is crucial for clinical application. In this paper, a linear quality control design based on the reversible round-off non-recursive discrete periodized wavelet transform (RRO-NRDPWT) is proposed for high efficient ECG data compression. With the advantages of error propagation resistance and octave coefficient normalization, RRO-NRDPWT enables the non-linear quantization control to obtain an approximately linear distortion by using a single control variable. Based on the linear programming, a linear quantization scale prediction model is presented for the quality control of reconstructed ECG signal. Following the use of the MIT-BIH arrhythmia database, the experimental results show that the proposed system, with lower computational complexity, can obtain much better quality control performance than that of other wavelet-based systems.