A seriously ill man has been told he cannot have a potentially life-saving operation on the NHS because his local primary care trust will not pay for it.
Paul Carter, 66, of Malvern, was told by a specialist he needed biventricular pacing fitted for his enlarged heart.
But Worcestershire Primary Health Care Trust has refused, saying the advanced pacemaker surgery would cost £8,000.
It said it could not afford the £400,000 it would cost each year to provide the surgery to patients.
The primary care trust's Dr Richard Harling said: "Any funding would have to come from other services.
'Very upset'
"For the PCT to justify introducing (biventricular pacing) we would have to be sure that it was a better use of this money than our other local services."
Mr Carter's wife Marjorie said: "We are very upset. Working all your life and having to face an operation and then you can't get it done is a bit distressing."
The National Institute for Health and Clinical Excellence (Nice), which offers guidance to primary care trusts over whether a treatment is cost effective, is due to make a decision over the treatment in July.
The Department of Health said, until Nice's guidance was published, the final decision on funding lay with individual trusts.