The advent of Tiny Machine Learning (TinyML) has unlocked the potential to deploy machine learning models on resource-constrained edge devices, revolutionizing real-time monitoring in Internet of Medical Things (IoMT) applications. This study introduces a novel approach to real-time electrocardiogram (ECG) anomaly detection by integrating TinyML with edge Artificial Intelligence (AI) on low-power embedded systems. We demonstrate the feasibility and effectiveness of deploying optimized models on edge devices, such as the Raspberry Pi and Arduino, to detect ECG anomalies, including arrhythmias. The proposed workflow encompasses data preprocessing, feature extraction, and model inference, all executed directly on the edge device, eliminating the need for cloud resources. To address the constraints of memory and power consumption in wearable devices, we applied advanced optimization techniques, including model pruning and quantization, achieving an optimal balance between accuracy and resource utilization. The optimized model achieved an accuracy of 92.3% while reducing the power consumption to 0.024 mW, enabling continuous, long-term health monitoring with minimal energy requirements. This work highlights the potential of TinyML to advance edge AI for real-time medical applications.