An implantable medical device to deliver cardioverting energy to cardiac tissue in synchrony with detected ventricular depolarizations having a DC-DC flyback converter. The primary coil of the converter is periodically coupled and decoupled to ground by a timing circuit to effect charging of a high voltage output capacitor from a low voltage source through the secondary coil. A supply voltage detector alters the time period of the timing circuit to regulate the amount of current drawn by the primary coil. As the low voltage power supply depletes, its impedance increases tending to prolong the charging time of the output capacitor. Further regulating circuitry alters the one-shot time period to avoid loading down the supply voltage which could affect operation of other circuits. The preferred embodiment further includes a pacer, programmable memory and logic for controlling modes of operation of the pacer-cardioverter and parameters of the detection of arrhythmias and the pacing and cardioverting stimulus, and telemetry for telemetering out memory contents, heart signals and other data.