Did you have low heart rates before Midodrine? Your bp's must have been pretty low, were they? Mine are high 90's/50's, so I feel like it's manageable at that, but I'd love to be more functional - just weighing the options.
My hr was high 40-50s, and when I took the Midodrine, it kicked in my vagal nerve lowering my hr to low 40s-upper 30s.
My bp was 90/50-60 (before I got symptomatic 5 yrs ago, it was 120/70, & my hr was 70s).
I had tried other meds, and nothing was working, plus I was at max dose of Florinef-the pacemaker was my next best option.
It wasn't a cure, I still have bp issues, but at least I can somewhat function better & mentally process better since I have more perfusion. (my husband said he didn't hear the "Jeopardy" theme anymore after he asked me a question!)
My minimum daytime hr is 80, & night time is 50 (any high & I can't sleep b/c my body isn't used to the higher hr).