Suggest Treatment For Tachy And Brady Syndrome

I am a 50 year old female. I have a pacemaker since 1989. I have both tachy and brady syndrome, as well as vasovagal syncope. I also get migranes. I take aspirin, midodrine as needed, and propronolol for my pressure. Lately, I m been feeling lightheaded again, when checking my pressure at times, it could be 140/107 pulse rate 110, other times it could be 90/70 , rate 130 both times at rest (sitting). I haven t missed any of my medications. These feeling come randomly, without warning.