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Modern heart rate monitors usually comprise two elements: a chest strap transmitter and a wrist receiver or mobile phone (which usually doubles as a watch or phone). In early plastic straps water or liquid was required to get good performance. Later units have used conductive smart fabric with built-in microprocessors which analyse the EKG signal to determine heart rate.
Strapless heart rate monitors now allow the user to just touch two sensors on a wristwatch display for a few seconds to view their heart rate. These are popular for their comfort and ease of use though they don't give as much detail as monitors which use a chest strap.
More advanced models will offer measurements of heart rate variability, activity, and breathing rate to assess parameters relating to a subject's fitness. Sensor fusion algorithms allow these monitors to detect core temperature and dehydration.