<s>[INST] I have chronic atrial fib. I was taking long term (5 yrs) amiodarone. I have scarring in my lungs and damage to my kidney s. A pacemaker was put in and now I am on Cardizem. Now I have all the symptoms of heart failure. I recently had a stress test and echo. Now the pacemaker is causing the heart to not conduct properly. I want to stop the cardizem and see if the pacemaker can be stopped to see where I am at. The cardiologist wants to add another lead to help the conduction. He is not in favor of stopping the drug. Should I be adamant about seeing where I am at without the drugs or pacemaker. It seems to me all these things are causing more problems [/INST] HI, AF has 2 major treatment-one is oral anticoagulant (which I hope you're taking as you've not mentioned) and second is rate control medicine. Pacemaker with cardio is for the second reason. you'll have to continue them for lifetime. I don't feel you should try yourself stopping them. Talk to your cardiologist or mail him as he may be able to explain to you the need of all. Adding one more lead - I feel it may be due to AV synchrony and may help you. For more detail, you may also have a consultation with an electrophysiologist. </s>