A system for automatically evaluating the sensing and detection of
physiological processes by an implantable medical device, such as an
implantable cardiac stimulation device. The system includes an automatic
testing algorithm which iteratively adjusts at least one of the threshold
and gain settings of the device and evaluates the accuracy of the
detection for refining the programming of the device. The algorithm can
include sampling the physiological process beginning at a relatively low
rate to avoid excessive burden on the processing and battery capacity
available and progressively increasing the rate to obtain higher
resolution data. The algorithm can also evaluate the observed
physiological process for periodicity and can determine repetition of an
irregular pattern, such as bigeminy, and use the determined pattern for
predictive purposes to refine the programming of the device. The
algorithm employs observation of a change in observed pattern as indicia
for loss of proper detection.