A medical device and medical device system for delivering left ventricular pacing that includes a subcutaneous sensing device having a subcutaneous electrode to sense a subcutaneous cardiac signal and an emitting device to emit a trigger signal in response to the sensed cardiac signal, an intracardiac therapy delivery device to deliver the left ventricular pacing in response to the emitted trigger signal, and a processor configured to determine whether the medical device system is in one of a VVD pacing mode and a VVI pacing mode, determine whether the delivered left ventricular pacing captures the left ventricle, determine whether to adjust a pacing parameter in response to the determination of whether the device system is in one of a VVD pacing mode and a VVI pacing mode and the determination of whether the delivered left ventricular pacing captures the left ventricle, and deliver the left ventricular pacing in response to determining whether to adjust the pacing parameter.
