| CPC A61N 1/36592 (2013.01) [A61B 5/283 (2021.01); A61B 5/349 (2021.01); A61N 1/365 (2013.01); A61N 1/3704 (2013.01); A61N 1/37217 (2013.01); A61N 1/37247 (2013.01); A61N 1/39622 (2017.08); A61N 1/3987 (2013.01); A61B 5/316 (2021.01); A61B 5/35 (2021.01); A61B 5/363 (2021.01); A61B 5/364 (2021.01); A61B 5/4836 (2013.01); A61B 5/6869 (2013.01); A61B 5/7282 (2013.01); A61N 1/0504 (2013.01); A61N 1/0563 (2013.01)] | 18 Claims |

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1. A medical device comprising:
a therapy delivery circuit configured to generate pacing pulses;
a sensing circuit configured to:
receive at least one cardiac signal;
set an R-wave sensing threshold to a starting value;
adjust the R-wave sensing threshold from the starting value according to auto-adjusting threshold control parameters;
sense a cardiac event in response to the at least one cardiac signal crossing the R-wave sensing threshold; and
a control circuit coupled to the sensing circuit and configured to, in response to the cardiac event sensed by the sensing circuit, determine that P-wave oversensing criteria are met based on the at least one cardiac signal;
wherein the sensing circuit is further configured to continue adjusting the R-wave sensing threshold according to the auto-adjusting threshold control parameters in response to the control circuit determining that the P-wave oversensing criteria are met;
the control circuit being further configured to:
start a pacing interval; and
detect an expiration of the pacing interval after determining that the P-wave oversensing criteria are met; and
the therapy delivery circuit being further configured to deliver a cardiac pacing pulse in response to the control circuit determining that the P-wave oversensing criteria are met and detecting the expiration of the pacing interval.
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