An implantable medical device (IMD) includes a detector for detecting the presence of x-ray radiation, where the presence of x-ray radiation is detected in response to the strength of the x-ray radiation exceeding a first threshold. In one embodiment, the IMD includes a processor for adjusting a cardiac stimulation rate IMD in response to determining that the strength of the detected x-ray radiation exceeds a second threshold. The second pre-selected x-ray radiation threshold is greater than the first pre-selected x-ray radiation threshold. In another embodiment, the implantable device includes a detector for detecting the presence of any amount x-ray radiation and a processor for adjusting a stimulation rate provided by the IMD in response to detected x-ray radiation to reduce the chance of over-sampling artifacts or inappropriate therapy delivery.