The following instructions pertain to the transtelephonic monitor shown to the left. Should you have a different transtelephonic monitor, please click here and select the appropriate instructions for your device.

Refer to the Instruction Manual provided with each system for complete instructions on transtelephonic monitoring.

It is essential that clear, rhythmic sounds be heard from the TTM for the resulting report to be readable. If you hear continual sounds, scratching, or buzzing it is likely that skin electrodes are making poor contact. Recheck skin electrode adhesion and lead connections.

Equipment Preparation

  • Ensure that the battery in the TTM transmitter is fresh.
  • Have your pacemaker system in its normal position with the antennas in place and the transmitter ON.
  • The skin beneath the electrode buttons must be clean. Shave any hair where the skin electrodes need to be positioned and clean skin with alcohol.
  • Apply the electrodes to the skin as shown to the right. For bilateral systems, have all three electrodes in place prior to calling. For unilateral systems, only two electrodes need to be in place.
  • Snap the BLACK lead to the electrode placed in the center of the breastbone. Plug the BLACK plug into the “INDIFFERENT” jack on the TTM transmitter.
  • Snap the WHITE lead onto the left electrode. Plug the WHITE plug into the “SIGNAL” jack on the TTM transmitter.
  • Slide the TTM “ON/OFF” switch to “ON”
  • Set the TTM transmitter down on a non-metallic surface and listen for rhythmic cardiac tones and pacer transmitter stimuli.
  • Do not hold the TTM transmitter during the report as the metallic pads are conductive and the received signal will be affected.
  • Slide the TTM “ON/OFF” switch to “OFF”
  • Have the information requested TTM Information Sheet available and ready.


TTM Lead Configuration

Dial the number for the TTM Receiving Station, using the USA country code if necessary: 631-864-1620

After several rings you will hear the following message indicating that you are connected to the receiving station and that you may begin the testing procedure:

“…This is the transtelephonic monitoring receiving center. Begin by providing the information requested on the TTM information sheet. Spell the patient’s last name. Please tell us on what side you are starting the TTM. If you get cut off and call back, state the patient’s name and tell us on what side you are resuming the TTM. The TTM analysis results will be reported to your physician. Thank You.”

  • Provide as much information as possible as described on the TTM Information Sheet.
  • Ensure that the ‘POWER’ and ‘SIGNAL’ lights are illuminated. The TTM is now is SIGNAL MODE. Place the telephone in the TTM as shown in the illustration provided in the inside cover of the TTM transmitter.
  • For bilateral systems, disconnect the right side antenna.
  • After 30 seconds, press the ‘SIGNAL’ button. The ‘SIGNAL’ light will go out. The TTM is now in pulse mode. Transmit for another 30 seconds.
  • For unilateral systems, the TTM is now complete. You may now hang up.
  • For bilateral systems, place the WHITE lead onto the right skin electrode. Reconnect the right side antenna and disconnect the left side antenna.
  • Press the ‘SIGNAL’ button. The ‘SIGNAL’ light will turn on. The TTM is now in SIGNAL MODE.
  • After 30 seconds, press the ‘SIGNAL’ button. The ‘SIGNAL’ light will go out. The TTM is now in PULSE MODE. Transmit for another 30 seconds.

The TTM is now complete. Reconnect the left side antenna and hang up the phone.


If the TTM fails to sound, or a buzzing signal is heard:

  • Check that the electrode buttons are making good skin contact, the leads are properly connected to the electrode buttons, and the leads are properly connected to the jacks of the TTM transmitter.
  • Ensure that ambient room noise is low.
  • Use a standard, corded telephone instead of a cordless or mobile phone whenever possible.
  • If the ‘POWER’ light is flashing, the TTM battery needs to be replaced.

If after thorough checking, you still do not get rhythmic sounds, call the TTM Receiving Station and leave a message detailing the problem along with a telephone number where you could be reached. Our technical services department will contact you at the next opportunity.

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