I've only used this HRM with bluetooth. I've used it with bluetooth on my phone when the strava app allowed direct peripheral pairing for running, with a bluetooth dongle on my PC for zwift and with bluetooth on two different Lezyne head units. I've periodically experienced issues with pairing where it will appear to pair but not deliver signal. I've replaced the battery and it didn't seem to impact this sporadic issue. I've also confirmed that the HRM wasn't paired to anything else during these issues. It's a real bummer when you start a zwift workout with it appearing to be connected then it gives no signal 2 minutes in... I will be replacing this after less than 1 year of use.
My Garmin HR monitor finally died altogether after about 6 hard years of abuse. I gave this one a try for the price. It works reliably so far and is well made. Easily as comfortable as my Garmin. I also like that it functions both an Ant+ and Bluetooth.