@mbaisley
I am on my 3rd ICD/Pacemaker device. My first was back in 2006. It is normally an outpatient surgical procedure and millions are done.

The pacing of your heart will prevent the 40 bpm. I too had tons of PVCs and low pulse rate. The EP (electrophysiologist) worked with me over time to find a good pulsing rate. We first had 50 bpm but PVCs still there. Then we raised it to 50, 60, and found that at 70 bpm rate as reducing PVCs.

PACs and PVCs can play a critical role in getting tachycardia (per EP).

You are normally put into wa wa land and will not remember the procedure at all. After ward you will have a foreign device in your body and you will feel it. I assume yours will be put under your skin. Mine was put under my chest muscle as my skin was to thin to do it that way. Thus I have a little more feeling as is below my chest muscle.

Per my EP it takes about a year for the body to encapsulate the device. When that happens the feeling of something there greatly diminishes. There is not going to be much pain at least for me. After surgery you have to be careful with moving your left arm for a couple of months. Your doctors will go over instructions of what to do and not do.

For me, and I have 3 device surgeries, I had very little pain each time. I am scheduled for another device implant in 1 year. I did not have an post op pain. But again you just had surgery and the skin (if you have put in that way) was surgically cut and a device placed in with wires going to your heart. So you will have some discomfort but for me and three surgeries had very little pain. I had to learn though to not pick up anything heavy for awhile and not use my left arm in extremes movements.

It is a very common procedure with high success outcome for helping you with your symptoms. I am glad I got mine. I have a dual device both a pacemaker and ICD.