title: Reimplantation surgery in patients with implantable cardioverter defibrillators: A qualitative study.
abstract: OBJECTIVE
  The purpose of this study was to examine the experience of recurrent surgery for patients with implantable cardioverter defibrillators (ICD).
  
  
  BACKGROUND
  Device replacement is typically required every 4-7 years due to battery depletion. Furthermore, recurrent surgery may be related to lead malfunction or pocket infection.
  
  
  METHODS
  Ethnographic methods were used for data collection with 23 ICD reimplanted recipients, 12 men and 11 women, 26-85 years of age. Data were analyzed using a with-in case and cross-case method.
  
  
  RESULTS
  Three major themes were identified: Anticipation regarding implantation with three sub-themes of logistics and social considerations, decisions regarding replacement, and financial considerations. Relinquishing control and somatic changes frame perceptions related to the operative and postoperative periods.
  
  
  CONCLUSIONS
  The frequency of ICD reimplantation differentiates it from other surgical interventions. Perceptions varied according to past experiences and present day social, financial, and somatic differences. Recipients are resolved to life-long surgery aided by their trust in health care professionals.
authors.affiliation: School of Nursing, Duquesne University, Pittsburgh, PA 15282, USA. Electronic address: jakubk@duq.edu.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Jakub
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Margarete
authors.initials: M
authors.lastname: Sandelowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000706:statistics & numerical data*; D012086:Reoperation
keywords: Conscious sedation; Defibrillator; Recurrent surgery; Reimplantation; Threshold testing