Ablation or pacemaker?

I wouldn't dream of second-guessing your cardiologist or PCP, and don't know what he/she has related to you, nor what any symptoms you currently experience are. Just taking your facts as you report them, and if I can assume you don't have any shortness of breath, no syncope, no fainting and falls, and your heart responds well when you stand or move about, you heart rate doesn't sound worrying to me. Many of us have sleeping HRs in the low 50's and even into the high 40's. It doesn't necessarily mean it's dangerous. Your body will let you know if it's too low.

It might be better to record your BP several times each day. If it never drops below 100 systolic and 65 diastolic, I would day you're probably doing well...even enviably well. But as soon as you start to get signs that your heart is actually weakening, and that you are experiencing dizziness, closed off vision, falls, shortness of breath....that would be the time to squawk to your PCP or cardiologist.

You are asking about a pacemakers, so perhaps you have already received advice and a caution that your BP and/or HR are getting too low....and I would never disagree. Not that I'm trained medically, so certainly not going to disagree. I would expect an increased rate to improve your O2 perfusion, help with organ function, eyesight, help you to keep warm, to move better, maybe digest better....all sorts of improvements. So, if a pacemaker it must be, yes, I would hope and be optimistic that I will feel better in general. The surgeon will discuss settings with you and you would both agree on something sensible and sustainable. Even so, there's a good chance you'll need a rate adjustment at least once in the weeks following.

Thanks very much. I think I will learn something from your comments and plan to go over them carefully to assess things further.

Far as I know ablations are done for tachycardia, NOT bradycardia. And pacemakers don't correct blood pressure issues, high or low. Pacemakers may improve symptoms caused by bradycardia by raising the heart rate to levels more commensurate with the patient's activity, but pacemakers cannot be expected to relieve symptoms from causes unrelated to the heart rate activity. For a patient taking medication to control tachycardia, who also has symptomatic bradycardia due to side effects of this medication, a pacemaker may allow the patient to take high enough amounts of that medication to control the tachycardia without the heart rate going too low.

Pacemaker or no pacemaker is a discussion to have with your cardiologist, who's familiar with you and your medical history.