@velvetsummerrain I would suggest you consider yet another ablation before the 'last resort' of a pacemaker. Not that I am qualified to give anyone medical advice, and I don't know your history, but there are fantastic, world-class, electrophysiologists out there who are almost certain to be able to help you..................if you are interested and have both the time and the means to travel. Two I know of are Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin (he has privileges at many hospitals around the country and does travel), and Dr. Pasquale Santangeli at Cleveland Clinic. Both are at the top of the heap.