Efficientpeaks detection is the key to the accurate analysis of electrocardiogram (ECG) signals which is a benefit to the early detection of cardiovascular diseases. In recent years, many effectivepeaks detection methods have been proposed, however, the false detection rate is relatively high when the noisy ECG signal is involved. Based on the property of MTEO that it could enhance the features of signal, a novelpeaks detection algorithm is proposed in this paper to deal with ECG signals with low SNR. The algorithm includes two stages. In the first stage, a band-pass filter is used for eliminating noise, then the first-order forward differentiation and MTEO are used to transform the ECG signals, at last, the output of MTEO is smoothed with a Moving Averaging filter. In the second stage, the adaptive thresholds method and efficient decision rules are applied to detect the truepeaks. The efficiency and robustness of the proposed method are substantiated …