my cardiologist would rather I tried a pacemaker with 190mg of high dose Metoprolol, as AV node abaltion is a last resort, unfortunately this hasn't worked as I could not tolerate more than 145gms Metoprolol - 3mths after having the pacemaker inserted my heart rate went down to 43bpm, I was taken to hospital where they discovered I had 'Twiddlers Syndrome', the pacemaker had to be reset in a new position & a new wire attached. It's been 3mths now & so far everything is OK. In the last month they have now stopped Metoprolol & started me on 7mg Bisoprolol which up to last week was good now I'm starting to feel extremely tired & very SOB, all the things I've enjoyed doing have gone by the by & all I want to do is lie down on my bed. I'm due to see my Cardiologist again on Monday & am seriously thinking about going for the AV node Ablation I'm aware of the consequences of the problem with the pacemaker, but I want some of my quality of life back, life is not worth living as I am now. Can anyone please give me some positive thoughts. Many thanks.