A physiological monitoring device and large noise handling method for use on such a device in which a reliable estimate of a physiological parameter is ensured by identifying and replacing large noise components of a physiological signal prior to estimation. An estimation period for a physiological parameter is segmented into time windows. Noisy time windows within the estimation period are identified. The noisy time windows are replaced with replacement time windows having a baseline amplitude. An estimate of the physiological parameter for the estimation period is calculated using the replacement time windows in lieu of the noisy time windows, and is outputted. If the share of noisy time windows exceeds a predetermined limit share, calculating and/or outputting of an estimate may be precluded. The physiological parameter may be heart rate.