First, 5 stars to the retailer, heart rate monitors: good communication, fast delivery, well packed, fair price. The problem with the design is two fold, starting with the fact that my monitor only takes one and only one cuff (adult sized). The problem with this cuff is the velcro falls exactly over the tubing, making for less contact area. One reason this is a problem is that the number of uses until failure is drastically lowered. Even as new, It may decrease accuracy, and/or require finger pressure to keep it secure when in use, in order to avoid feeling/hearing velcro loops popping. My bicep is 12 inches, which isn't unusual. I will get a monitor that using the D-ring cuff next time, as I was told by the manufacturer (haven't personally verified) there isn't that kind of interference.