I can't argue with the good doctor, not without knowing much more, including his rationale. Did he explain why he recommends putting off a third ablation in favour of the PM? I CAN see the logic, in a way. If you really are in bradycardia much of the time, a pacemaker makes more sense than an ablation because your arrhythmia might be a distant second in terms of its contribution to how you feel when you're lightheaded. IOW, it's the bradycardia that presents the greater danger of a fall and feeling dizzy and alarmed, not any arrhythmia that might/might not be going on at the time. In fact, the bradycardia might be so objectionable to your now-remodeled heart (post AF and two ablations, plus the aging since then) that the cardioversion was really mostly needed to fix your rate, and that if you can do that via a PM it will stave off any further arrhythmia...which you can always undergo another CA if it returns later on. Maybe?

I can just give you an "I understand" your frustration. I am mid-process to addressing my symptoms -- similar to your own. I am now trying to adjust to CPAP machine since I have mild sleep apnea. I go in for a breathing test next week. I do not have an afib diagnosis...just heart palpitations, but have the same symptoms as you. Just wondering if you or your doctor have explored looking at apnea and breathing solutions before the more intrusive rememdies.