An implantable cardiac stimulation device controls dynamic atrial overdrive pacing
based, in part, on sensor indicated rate. In one example, the stimulation device
adjusts an overdrive pacing rate based on the sensor indicated rate by periodically
decreasing the overdrive pacing rate by a programmed rate decrement whenever a
difference between the current overdrive pacing rate and the sensor indicated rate
falls outside predetermined acceptable range while the sensor indicated rate is
decreasing. The overdrive pacing rate is decreased in this manner until a) the
overdrive pacing rate falls below the base rate, rest rate or the sensor indicated
rate or until b) an event triggers an increase in the overdrive pacing rate, such
as the appearance of intrinsic breakthrough heart beats. The overdrive pacing rate
is not decreased if the sensor indicated rate is increasing or stable. With this
process, the overdrive pacing rate is controlled to typically remain slightly above
the intrinsic rate without being constrained by a preprogrammed number of pacing
cycles. Hence, the overdrive pacing rate can be made to closely track the intrinsic
rate regardless of whether the intrinsic rate is changing rapidly or is fairly stable.