Bradycardia - Tired of being confused.

Hi!  I've posted here before - you all are so helpful, I really appreciate it.
I've lived with fatigue and low energy for YEARS it seems.  WHen I first mentioned it to a doctor about 5 years ago, he told me I was depressed and offered me Paxil, which I declined.  I'm not depressed.  I'm 28, healthy other than bradycaria which was finally diagnosed when my doctor sent me to a cardiologist in March.  Resting rate in the low 40's.  I used to get dizzy EVERY time I stood up, but increased salt and fluids have helped that.  I do run or at least do some kind of cardio activity every daily; have been for about 6 years.  I know bradycardia is common in fit people, but to be honest I do the working out to try and get my heart rate UP, so I'll fell better.
Family history - My grandmother has(had?) heart block and a pacemaker, mom has mitral valve and sister has a murmur, same grandmother lost a sister in her teens from a heart condition.
My cardiologist says based on the family history and my symptoms, he assumes I have a conduction problem, although an EP study has not been perfomed.  He said the next step is up to me, he'll send me for a second opinion, do the EP study, or put in a pacemaker if I want - it's my choice.  I don't know what to do!  I'm actually scared to step up and say let's do the next study because of that doctor that blew me off and told me it was depression and all in my head.  What if the study cames back normal and it is all in my head?  I don't think it is.  This is not how a young, strong woman in her 20's should feel.  Thyroid tests and blood work have all come back normal.  I've heard a tilt table test mentioned.  What would that prove?  
Thanks for you input.  I'm getting to my wits end at not having the energy to enjoy my life.
Karen

[Cleveland Clinic, MD]

A pacemaker would be a last resort and then only if there is a clear relation between your symptoms and a slow heart rate.  A tilt table test looks for autonomic causes of dizziness and may be a good idea in your case.

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