An extra-cardiovascular implantable cardioverter defibrillator (ICD) is configured to induce a tachyarrhythmia by charging a high voltage capacitor to a voltage amplitude and delivering a series of pulses to a patient's heart by discharging the capacitor via an extra-cardiovascular electrode vector. Delivering the series of pulses includes recharging the high-voltage capacitor during an inter-pulse interval between consecutive pulses of the series of pulses.

Apparatus and methods for generating an induction waveform for performing threshold testing in an implantable medical device are disclosed. Such tests may be performed during the implant procedure, or during a device checkup procedure, or routinely during the lifetime of the device. The threshold test may include induction of an arrhythmia (such as ventricular fibrillation) followed by delivery of therapy at various progressively-increasing stimulation parameters to terminate the arrhythmia. As such, the capability to induce fibrillation within the device is desired. Induction of the arrhythmias may be accomplished via delivery of a relatively low energy shock or through delivery of an induction stimulation pulse to the cardiac tissue timed concurrently with the vulnerable period of the cardiac cycle.

An extra-cardiovascular implantable cardioverter defibrillator (ICD) is configured to induce a tachyarrhythmia by charging a high voltage capacitor to a voltage amplitude and delivering a series of pulses to a patient's heart by discharging the capacitor via an extra-cardiovascular electrode vector. Delivering the series of pulses includes recharging the high-voltage capacitor during an inter-pulse interval between consecutive pulses of the series of pulses.