Sudden cardiac death (SCD) caused by cardiovascular disease is the greatest hidden danger to human life, accounting for about 25% of the total deaths in the world. Due to the early concealment of SCD and the heavy medical burden of long-term examination, telemedicine combined with home monitoring has become a potential medical alert method. Among all the existing human cardiac and electrophysiology monitoring methods, optics-based sensors attract the widest attention due to the advantages of low delay, real-time monitoring, and high signal-to-noise ratio. In this paper, we propose an optical sensor with the capabilities of long-term monitoring and real-time analysis. Combining an R-peak recognition algorithm, Lorenz plots (LP), and statistical analysis, we carried out the consistency analysis and result visualization of ECG sequences over 1 h. The results of 10 subjects show that the R-peak recognition accuracy of the optical ECG monitor is higher than 97.99%. The optical system can display abnormal heart rhythm in real-time through LP, and the readability is good, which makes the system suitable for self-monitoring at home. In addition, this paper provides a detailed long-term monitoring assessment method to effectively guide the practical clinical transformation of other optical wearable devices.