I got a request to explain the procedure for an AICD (defibrillator) implant as the person is scheduled to have one implanted in a couple of weeks. As is my norm, I like to share me replies with the world. So here is AICD Implant – My Truth.
After receiving the shocking news that I have heart failure and that I would need to have an AICD implanted in my chest, I decided to wait a week or so to decide what I wanted to do. Needless to say I decided to go with it.
The operation is done with local anesthesia and from what I remember the procedure was less than an hour. Please note that this is my experience and will not necessarily be the same for every person.
Before being wheeled into the operating room, I was given a shower cap type thing to put on my head to cover my hair. I was wheeled in and the procedure explained to me again (it was explained by the doctor’s assistant in the prep room). I was positioned under the big bright light and was told to turn my head to the right. A sheet of surgical paper or cloth was placed over my face so I could not see what was going on at my left. A bunch of sensors were attached to different parts of my body including the head, hands and legs. Large self stick defibrillator paddles were attached to my back and center of my chest.
The anesthesiologist introduced himself and explained that after the AICD was implanted, I would be put under with gas so that they can artificially place my heart into afib to see if the defibrillator is working properly. If for any reason the defibrillator did not work or malfunctioned, the paddles attached to my back and chest would shock my heart back to a normal rhythm.
Local anesthesia was then injected into my left chest just below the clavicle. After a few minutes the doctor tested the area for any feeling, and I reminded him that I was resistant to anesthesia. He reminded me to tell him the minute I felt anything so he could administer more.
When he was sure the area was numb, he began the procedure, all the while explaining what he was doing to his assistant. An incision was made below the clavicle and they then located a vein through which the leads for the AICD would be fed to the heart. I am sure I did not imagine it, but I felt that wire snake through my body and into my heart. The leads are screwed into the heart wall to keep them in place. I did not actually feel that part, but I felt there was something in my heart, and although it did not hurt, it was a very strange feeling. I closed my eyes and just took deep breaths. It was about this time I felt the local begin to wear off. I told the doctor I could feel them working on my chest and they gave me a few more injections.
At this point the leads were connected to the defibrillator and I was told they would now put me under. They assured me they would make sure that I was out before they conducted the test. It took a minute or two for the anesthesia to kick in and I passed out. Next thing I knew they were calling my name and bringing me out. I was told the test was successful and they would now finish up. I was a bit groggy for a couple of minutes but was wide awake in about five minutes.
I again felt pressure on my chest when they implanted the defibrillator into its pocket under my skin. I was about to say something when the doctor said “All done”. As I was (and still am) on plavix, a pressure bandage was placed on my chest at the incision site to prevent bleeding. I was taken to a recovery room, and then to my room where I was hooked up to monitors. I was left upright in bed and was told I needed to stay elevated.
I had no pain after the operation and stayed overnight. By the next morning, my chest was sore, but I did not take any pain killers, even though I was offered. Later on in the morning the doctor came to check on me and told me that they were going to take off the pressure bandage. Prednisone thins your skin, and being on plavix, I bruise easily. Bandage adhesives also do not agree with me. I told the doctor to slowly remove the pressure bandage as I bruise easily, but he ignored me and said to pull it off in one straight shot quickly was best. Before I could protest, he yanked the bandage off and with the bandage went a layer of skin. That’s the first time I ever saw a doctor get terrified and say “Fuck!”. He apologized over and over as he and the nurse cleaned up the area. They applied some lotion to the area, but it did not help when I had to get dressed. They did not want to bandage it again for fear of it ripping again. So I had to put on my shirt over the raw area, which hurt like hell.
When I got home I just rested for the rest of the week and was very mindful not to raise my arm over my shoulder, as I was instructed to do for six weeks. To avoid doing so unconsciously I slept with my left arm tucked inside my shirt, and not through the arm sleeve.
So that is my memory of what happened. Sorry it is not more detailed, but it will be five years this year since I had it done, so a lot of details have flown away.
There was however a large emotional aspect of this whole procedure which I will write about in a future entry.