I have a PM. My heart rate without is 30-40. With the PM it is 62. But I also have AFib. So I take a blood thinner to keep strokes from occurring. I do take Metoprolol and another drug called Pacerone. My first cardiologist I went to wanted to do an atrial ablation. which is very invasive. When I suggested something a little less invasive he more or less cast me to the winds. Ablations such as that cost approx 80 grand...and the average rate of them working 1st time is about 15-20%...Talk about paying for the Beemer or Mercedes. Doc I finally got hooked up with got the AFib straightened out. the PM does very little for the AFib but it keeps the heart rate up so I don't pass out...but it lets them know if it does happen.