Various techniques are described for preventing pacemaker mediated tachycardia
(PMT) within biventricular pacing systems and for detecting and terminating PMT
should it nevertheless arise. In a first prevention technique, refractory periods
applied to the atrial channel are synchronized to begin with a second of a pair
of ventricular pacing pulses to more effectively prevent T-wave oversensing on
the atrial channel. In a second prevention technique, the sensitivity of the atrial
channel is reduced during T-waves also to prevent T-wave oversensing. In a third
prevention technique, template matching is performed on the ventricular channels
to prevent T-wave oversensing. In a fourth prevention technique, T-wave detection
windows are applied to both the ventricular and atrial channels subsequent to any
paced or sensed events. In a first detection technique, PMT is detected based upon
a degree of variation within V-pulse to P-wave pacing intervals. In a second detection
technique, PMT is detected based upon a degree variation within ventricular pacing
intervals. In either case, if the degree of variation is too low, indicative of
PMT, ventricular refractory periods are expanded to terminate the PMT.