The reservoir computing paradigm is employed to classify heartbeat anomalies online based on electrocardiogram signals. Inspired by the principles of information processing in the brain, reservoir computing provides a framework to design, train, and analyze recurrent neural networks (RNNs) for processing time-dependent information. Due to its computational efficiency and the fact that training amounts to a simple linear regression, this supervised learning algorithm has been variously considered as a strategy to implement useful computations not only on digital computers but also on emerging unconventional hardware platforms such as neuromorphic microchips. Here, this biological-inspired learning framework is exploited to devise an accurate patient-adaptive model that has the potential to be integrated into wearable cardiac events monitoring devices. The proposed patient-customized model was trained and tested on ECG recordings selected from the MIT-BIH arrhythmia database. Restrictive inclusion criteria were used to conduct the study only on ECGs including, at least, two classes of heartbeats with highly unequal number of instances. The results of extensive simulations showed this model not only provides accurate, cheap and fast patient-customized heartbeat classifier but also circumvents the problem of "imbalanced classes" when the readout weights are trained using weighted ridge-regression.