Abstract: An implantable cardiac stimulation and rhythm management device includes an impedance measuring circuit which determines a patient's intra-thoracic impedance and the resistance and reactance components of the impedance. The device includes a microcontroller which calculates a ratio (Z/R) which equals the reactance (Z) divided by the resistance (R). The microcontroller is configured to use the calculated ratios to establish a baseline intra-thoracic fluid level, an upper bound relative to the baseline, and a lower bound relative to the baseline, and to monitor the Z/R ratio relative to the baseline and upper and lower bounds. When the Z/R ratios are outside of the established bounds, operating parameters of the stimulation and rhythm management may be altered by the microcontroller.