As my pulse rate continues at 150 and increased medication or another ablation is not sustainable I am now on the list for pace and ablate.

[Texmosart]

it feels a bit final but consultant has said I have complex arrhythmias and living with the tachycardia and HOCM is stressful I am hoping for more stability.

[Borderterriorist]

I'm a similar age to you, I've not had ablations because my flutter is atypical (left sided) so an ablation is a bit more complicated. I was also admitted to A&E with a HR of 150 recently but fortunately they were (eventually) able to bring it down but I've had several medication changes to try to keep it stabilised but I still have frequent debilitating episodes so I'm on the waiting list for pace and ablate. I've done quite a lot of research and have been very reassured, people say it has been "life changing" for them "given them their life back" etc etc. I know it sounds scary but I'd rather rely on well tried technology than my rather unreliable heart. I've got a pacemaker already and generally in the UK I think they like to put that in to get it embedded before doing the ablation. Honestly, nothing to worry about with that and I understand the AV node ablation is very straightforward, easier and quicker than other ablations. You are left with some ability to function in the unlikely event that the pacemaker fails so it's not quite as "final" as it might sound. Good luck.