Techniques for providing capture verification during overdrive pacing are
described. If an overdrive pacing pulse fails to evoke capture (i.e. a
loss of capture occurs), a high voltage backup pulse is automatically
delivered. Once a second loss of capture occurs during a single sequence
of overdrive pacing pulses, an overdrive pulse capture threshold
detection search, described herein, is performed while overdrive pacing
continues. Various techniques for providing rate recovery are also
described herein. The rate recovery techniques are designed to avoid
problems that might arise from possible fusion of intrinsic beats and
overdrive pacing pulses that fail to evoke capture. In a first rate
recovery technique, capture detection is suspended during rate recovery
due to the possibility of fusion. Instead, an extra safety margin is
added to the overdrive pulses. Once two intrinsic beats are detected,
automatic capture verification is reactivated for the next two beats to
verify capture before the new overdrive rate is finally established. In a
second rate recovery technique, capture verification is maintained
throughout rate recovery but the pulse magnitude is increased to a high
output mode voltage to avoid any risks of fusion. After the output is
increased to the high output mode voltage, a subsequent loss of capture
is considered to be an intrinsic event for the purposes of terminating
rate recovery. In a third rate recovery technique, capture verification
is maintained during rate recovery and the output energy is not increased
to the high output mode voltage unless loss of capture is first detected.
Subsequent loss of capture events are then counted as P-waves.