ECG Steganography ensures protection of patient data when ECG signals embedded with patient data are transmitted over the internet. Steganography algorithms strive to recover the embedded patient data entirely and to minimize the deterioration in the cover signal caused by the embedding. This paper presents a Continuous Ant Colony Optimization (CACO) based ECG Steganography scheme using Discrete Wavelet Transform and Singular Value Decomposition. Quantization techniques allow embedding the patient data into the ECG signal. The scaling factor in the quantization techniques governs the tradeoff between imperceptibility and robustness. The novelty of the proposed approach is to use CACO in ECG Steganography, to identify Multiple Scaling Factors (MSFs) that will provide a better tradeoff compared to uniform Single Scaling Factor (SSF). The optimal MSFs significantly improve the performance of ECG steganography which is measured by metrics such as Peak Signal to Noise Ratio, Percentage Residual Difference, Kullback-Leibler distance and Bit Error Rate. Performance of the proposed approach is demonstrated on the MIT-BIH database and the results validate that the tradeoff curve obtained through MSFs is better than the tradeoff curve obtained for any SSF. The results also advocate appropriate SSFs for target imperceptibility or robustness. © 2015 Elsevier Ltd. All rights reserved.