Methods, systems and computer program products for cardiac pacing are provided. For pacing using biventricular synchronization in a patient, a first stimulation signal is applied to a first region of a heart of the patient at a first time and a second stimulation signal applied to a second region of the heart of the patient at a second time to provide biventricular synchronization stimulation of the heart. Cardiac function of the patient associated with application of the first and the second stimulation signals is sensed and a timing relationship of the first stimulation signal to the second stimulation signal is adjusted based on the sensed cardiac function. Additionally, a cardiac timing interval, such as the A-V timing interval, may be adjusted by applying stimulation to a heart of the patient utilizing a cardiac timing interval, detecting a change in cardiac function by sensing cardiac function associated with application of the stimulation using the cardiac timing interval and adjusting the cardiac timing interval directly from the detected change in cardiac function.
