TTM Instructions

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

TTM Lead Configuration

  • Ensure that the battery in the TTM transmitter is new before beginning the test.
  • Have your pacemaker system in its normal position with the antenna(s) 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 skin electrodes to the skin as shown to the right. If you are paced bilaterally (on both sides), all three skin electrodes should be in place before you record. For unilateral systems, two skin electrodes (indifferent and right or left) should be in place before you record.
  • The “signal” skin electrodes are placed just below the last rib. Use one skin electrode for each side. The third skin electrode is placed in the middle of the breastbone.
  • Snap the circular end of the white lead onto the left skin electrode snap.
  • Snap the black “indifferent” lead onto the “indifferent” skin electrode located in the center of the breastbone.
  • Snap the black “indifferent” lead onto the left (“L”) snap on the rear of the TTM device.
  • Snap the white “signal” lead onto the right (“R”) snap on the rear of the TTM device.

If you have a bilateral system, you will be changing the white “signal” lead from the left skin electrode (by the lower rib cage) over to the right skin electrode (by the lower rib cage) after the left diaphragm signal is recorded.

TTM Recording

  • Disconnect the right side antenna.
  • Press the ORANGE record button for at least one second.
  • The TTM device will sound an ascending tone. After a few seconds you should hear rhythmic cardiac tones and pacer transmitter stimulations emitted from the TTM device.
  • After 30 seconds, the TTM will enter a 30 second “wait” state after which the GREEN LED indicator will flash once indicating a single recorded event.
  • For unilateral systems, the TTM recording is complete. Proceed to “Transmitting the TTM”.
  • For bilateral systems, move the WHITE signal lead to the right side skin electrode, reconnect the right side antenna and disconnect the left side antenna.
  • Press the ORANGE record button for at least one second.
  • The TTM device will sound an ascending tone. After a few seconds you should hear rhythmic cardiac tones and pacer transmitter stimulations emitted from the TTM device.
  • After 30 seconds, the TTM will enter a 30 second “wait” state after which the GREEN LED indicator will flash twice indicating two recorded events.
  • For bilateral systems, the TTM recording is complete. Reconnect the left side antenna and proceed to “Transmitting the TTM”.

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

Transmitting the TTM

  • Have the TTM Information Sheet ready.
  • Ensure that the “TEL/GSM” switch is in the “TEL” position.
  • Dial the number for the TTM Receiving Station, using the USA country code as required: 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 transmitting 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.

  • Give as much information as possible from your TTM Information Sheet. Speak into the telephone mouthpiece slowly and clearly. Please spell the patient’s last name.
  • The telephone mouthpiece should now be placed against the speaker outlet on the top center of the TTM device.
  • Press the GRAY send button for at least one second.
  • You will now hear the recorded transmissions being sent.
  • After all recordings have been sent, hang up the telephone.

Resetting the TTM

  • After transmitting the data by telephone, the TTM device memory must be cleared in order to record additional events.
  • Press the GRAY send button and the ORANGE record button simultaneously for at least two seconds. There will be five intermittent beeps and the two LED indicators will be on. The GREEN LED indicator will stop flashing after the reset.
  • The device is now ready for a new sequence of recordings.

Removal of the battery will not reset the memory.

TTM Battery

  • The TTM device uses a single 1.5V size AAA (LR03) battery, such as the Duracell MN2400.
  • If the YELLOW battery indicator is flashing, the battery needs to be replaced.
  • The battery cover on the rear of the TTM device is removed by pushing as indicated on the cover.

Removal of the battery will not reset the memory.

Troubleshooting

If the TTM fails to sound, or a buzzing signal is heard, check your skin electrodes and lead connections for good contact. If after thorough checking, you still do not get rhythmic sounds, call us at (USA) 631-864-1620. Leave a message that there is a problem with the TTM system along with a phone number where you can be reached.