If the TTM is going to be done for a patient with a pacemaker no preparation is necessary. The patient should call the number provided by the physician and then place the TTM over the device. The data stored on the pacemaker will then be transmitted through the phone line to be stored and analyzed later.

If the TTM is going to be done while the patient is wearing a portable EKG (e.g., a Holter monitor) then the device will need to be properly placed. A portable EKG measures heart activity while the patient is “on the move” instead of in a physician’s office. The heart's electrical activity is recorded on a portable tape inside the machine. There are two categories of ambulatory electrocardiography (AECG) recorders:

As with the in-office EKG, the patient is hooked up to electrodes that are connected to the monitor. Once the electrodes are firmly attached, patients are instructed on monitor use and sent home to go about their usual daily activities. Bathing is prohibited while using the machine, but most other daily activities are acceptable.

Patients should keep a diary of activities and any symptoms that take place during the monitoring period so the physician can compare this to the data received from the device. In order to transmit the data over the telephone, an electronic monitoring device is attached to the patient’s skin and to the telephone on the other end. 

It is important to note that data cannot be transmitted to a monitoring station by cordless phone, including cell phones because of electronic interference.

EKG information that is sent over the phone to a monitoring station is received and printed out on standard EKG readout paper. The information may be received by a technician, nurse, physician or computer. During non-business hours, an answering machine with special recording capabilities can be used to receive the transmissions. If a phone is not immediately accessible to the patient, he or she can record the event on an intermittent recorder that will store the data in its memory until such a time that it can be transmitted across phone lines for evaluation.

It is important to note that medical personnel do not recognize an EKG that has been read by a computer alone as an EKG that has been interpreted or evaluated. Technology that allows data to be transmitted over phone lines is not a substitute for physician evaluation or the physician-patient relationship.