An improved system and method for performing autocapture/autothreshold
detection in an implantable cardiac stimulation device or any device
capable of stimulating some organ or tissue in the body. In some existing
systems, loss-of-capture and capture decisions are based upon two
consecutive cardiac events. However, such systems may be subject to
subthreshold stimulation pulses that capture and lose capture on
alternating pulses, trigeminy PVC sequences, or the like that require a
higher stimulation pulse amplitude but cannot make this determination due
to the two consecutive event requirement. Accordingly, in the present
invention, the determination of whether there is a loss-of-capture is
determined only according to paced events, i.e., ignoring intrinsic and
PVC beats. Furthermore, the loss-of-capture determination is based upon X
out of the last Y beats, where Y is greater than 2 and X is less than Y.
Accordingly, consecutive loss-of-capture events are no longer required in
determining the threshold level. In a further aspect, a preferred
embodiment monitors cardiac events to detect a sequence of patterns that
could indicate a trigeminy pattern and, if detected, the pacing rate is
increased to attempt to break the pattern and thus permit the threshold
level to be detected.