A pacing mode is provided, in one embodiment, that permits missed or skipped ventricular beats. The mode monitors a full cardiac cycle (A-A interval) for the presence of intrinsic ventricular activity. If ventricular activity is present, a flag is set that is valid for the next cardiac cycle. At the beginning of the next cardiac cycle, the device determines if the flag is present. So long as the flag is present, the device will not deliver a ventricular pacing pulse in that cycle, even if there is no intrinsic ventricular activity. If there is no flag present at the start of a given cardiac cycle, a ventricular pacing pulse is delivered and this ventricular activity sets a flag for the subsequent cardiac cycle.
