Hi Leah, You likely know that I had the hyperadrenergic form of POTS, so I can certainly relate! My resting heart rate on a tilt table was 164 when I was last tested! Mercy… It took peeling back the layers to get my resting heart rate back to normal (under 70), but it DID happen. One way to tell what is going on is with a close examination of your other symptoms and your triggers (what caused POTS to begin with). For me, I had symptoms of high intracranial pressure and Diamox was a huge help, as was an abdominal binder. When POTS was at its worst, Xanax was a huge help, as was Zyrtec. Do you respond to antihistamines? My kids did not have the adrenergic form of POTS, but their heart rates have returned to normal and they no longer have POTS, thank Heavens. I think it is critical to look at all possibilities before thinking about an ablation. In most cases (but not all), an ablation is contraindicated. A cardiologist can advise you about exercise. I exercised hard (but it had no effect on my POTS). I felt better when I was strong, but some of us have such incredibly high heart rates, I do wonder about the safety of exercise if heart rates spike. Yikes… Hang in, Leah! 😉