The defibrillator box is typically placed beneath your left armpit during the implantation procedure. Before beginning, the area is thoroughly sterilised with antiseptic solution and allowed to dry. Anaesthetic medications will be administered through an intravenous drip during the procedure. A combination of quick- and long-acting local anaesthetics is also used to numb the site, which will remain numb for several hours after the procedure.

The defibrillator implantation involves making a cut at the implantation site and another, smaller cut near the base of the breastbone. The defibrillator wire is then tunneled from the defibrillator to the bottom of the breastbone and up the side of the breastbone. In rare cases, a third small incision may be needed higher up the breastbone.

After the local anaesthetic wears off, some pain may be experienced, and the area may remain sore for a few days. Pain relief can be provided with paracetamol, and the nursing staff should be informed if additional pain relief is needed during the hospital stay. The length of the procedure varies depending on several factors but may take several hours.

Following the procedure, you may have an ice pack in place which will be removed after 2 hours. Some patients will have a skin adhesive that should remain dry for 24 hours, after which it can get wet but should not be scrubbed, picked or soaked. The adhesive will naturally peel off over the next few weeks. The stitches in the wound will dissolve and do not require removal.

After the procedure, a chest x-ray will be taken and the defibrillator will be checked using a special computer called a programmer. The programmer is used to check the defibrillator and make any necessary changes to the device to meet your individual needs. If everything checks out and you feel well, you will be discharged home on a short course of antibiotics.

For the defibrillator implantation procedure, infection prevention is crucial. Dr. Hsieh and his team takes great care to ensure sterile technique and administer antibiotics to reduce the risk of infection. It's important to check your wound daily for signs of infection, such as redness, fever, increased swelling, or drainage, and promptly report any concerns to Dr. Hsieh. Avoid tampering with the operating site yourself.

For individuals with a defibrillator, it is important to note that the Roads and Traffic Authority does not permit the holding of a commercial license unless under exceptional circumstances. However, for private vehicles, you may be able to obtain a conditional license with regular medical review. If you've had a cardiac arrest, you're not permitted to drive for 6 months, and for a preventative defibrillator, you should wait 2 weeks if you haven't experienced symptoms and 4 weeks if you have. If you've had a routine generator change, you should wait 2 weeks before driving.

Patients with defibrillators need lifetime monitoring, usually every 3 to 6 months, though these checks can be less frequent if you participate in a remote monitoring program. If you experience any unusual symptoms like chest pain, dizziness, difficulty breathing, hiccups, or signs of infection, report them to your doctor.

To alert medical and security personnel about your implanted device, keep your Medical Device ID card. Note that metal components of the device may set off airport security alarms, and airport security wands can temporarily affect the device. To avoid electromagnetic interference, mobile phones should be used on the opposite side, and seek advice from the device manufacturer if there are doubts about any equipment. If your device shocks you, find a place to sit and catch your breath. Inform your doctor, who may ask you to visit the office or be admitted to the hospital for further evaluation and treatment.

Subcutaneous device implantation is a safe procedure with a low risk of complications compared to traditional transvenous defibrillators. While complications are rare, they can still occur in a small percentage of patients.

The most common side effect is bruising at the procedure site, occurring in less than 3% of patients, and up to 10% for those on blood thinning medications. Requiring re-operation or blood transfusion is rare, happening in less than 1% of cases. There is a slight risk of lead displacement, which occurs in about 1% of cases and may require a repeat procedure. Infection is a rare but serious complication, occurring in less than 1% of patients. Every precaution is taken to prevent infection, but if it occurs, the device may need to be removed. Electromagnetic interference can also prevent the device from working. The risk of death is less than 1 in 500 cases.

Long-term risks include infection or erosion, lead failure, inappropriate detection of an arrhythmia, and premature battery depletion or device failure. In some cases, the device may not end an arrhythmia or eliminate all of its symptoms, leaving patients to still experience lightheadedness, dizziness, or fainting. Despite these risks, subcutaneous device implantation remains a safe and effective option for patients with certain types of arrhythmias.