there are a lot of questions I had. Are you living far away from her ? does she have home care? Do you have contact with the hospital/ cardiology department to discuss your questions or with the family doctor at home? What does the electr.cardiography say? Your mother is definitely suffering from a right heart failure in spite of the pacemaker, she has. I am not entitled to recommend an additional medication, I can only say that a year ago I developed a left and right heart failure in spite of a pacemaker I have (female 73 years old). the cardiologist decided to add Digitoxine to the other medication. I quickly recovered. But as I said, every patient is different.