Hi, welcome to the Dysauto forum.
I have a few questions for clarification. First, was your husband on HIGH blood pressure medication before (when they were mentioning the diagnosis of overmedication with blood pressure medication, for example), but now he has been put on midodrine?
Second, was the "bradycardia with missed beats" diagnosed based off of the 24 hour monitor? When you say 24 hour monitor, are you referring to a Holter monitor? (I ask because I'm making sure you're not referring to 24 hour ambulatory blood pressure monitoring.)
Do you recall what the result of the EP study was? Also, what were the results of the tilt table test? Presumably it was positive for something, and thus the midodrine, or am I missing something? Did they explain any of this in detail to you? (If not, I am definitely LOUDLY seconding Tonya's opinion that you consider seeking a second opinion.)
Depending on what the results of the EP study and the tilt were, a pacemaker could either be a possible solution to the bradycardia or a crummy idea (it can be ineffective with some types of conditions which can show up on tilt table test).
Have they discussed his blood pressure in relation to these tests at all, in addition to heart rate? (It would be relevant as well whether any blood pressure medications were being taken or were ceased during the tests, as this would affect interpretation of course.)
Oh, and I almost forgot to ask ... "missed beats" ... did they say whether these were PVCs, PACs??? Most skipped beats (aka. ectopic beats) are benign; do you recall if the docs have said if these are benign or not?
My final thought is that if the tilt table test was positive for some form of dysautonomia, the nearest autonomic clinic to you is (by my rough estimate dragging a dot around your state on google maps) about 6 hours away at the farthest, which is VERY lucky for you, because there are very few of these in the country. Because the one at Mayo (Rochester, MN) is in a state neighboring yours, there's a decent chance that your insurance would cover there. Medicaid usually covers states that share borders; according to Mayo's website they do take IA Medicaid. Medicare would be good there as well. For more info on insurance coverage there:
http://www.mayoclinic.org/billing-rst/#assistance
For the contact info for the autonomic clinic, see our health page on dysautonomia clinics/specialists (the hospital clinics are the ones that have the comprehensive diagnostic facilities):
http://www.medhelp.org/health_pages/Neurological-Disorders/Dysautonomia-Specialists/show/717?cid=196
Of course, if the tilt was NOT positive for some form of dysautonomia, than sorry to have wasted your time with that info. (Either way, you may want to get the original records from the tilt—not just the interpretation summary, but the FULL tracings and everything—if you go to another specialist; tilt table tests are a bit notorious for being misinterpreted by well-meaning cardiologists who don't have much experience diagnosing the various forms of dysautonomia.)
Sorry to ask so many questions; the more information you can give, the more I can target my responses to be useful to your situation.
Best,
-Heiferly.