Optimizing cardiac preload based on measured pulmonary artery pressure involvesvarying, for each repetition of an acute burst protocol, a parameter of pacingapplied to a patient's heart during the acute burst protocol. Pulmonaryartery pressure is measured during the repetitions of the acute burst protocol.An optimum ventricular preload is determined based on the measured pulmonaryartery pressure. Pacing therapy is provided using a value of the parameter thatis selected based on the determination of optimum ventricular preload.