An apparatus comprises a cardiac signal sensing circuit configured to sense an electrical cardiac signal from at least one of an atrium or ventricle of a heart of a subject, a therapy circuit configured to provide electrical pacing therapy and electrical neural stimulation therapy to the subject, and a control circuit. The control circuit is configured to initiate delivery of the electrical pacing therapy, initiate a blanking period in a time relationship to the delivery of electrical pacing therapy, and initiate delivery of the electrical neural stimulation therapy to the subject during the blanking period. At least one sense amplifier of the cardiac signal sensing circuit is disabled during the blanking period.