In an example, a pacing therapy can be optimized using information indicative of an offset duration between an intrinsic first atrioventricular delay of a subject at rest and a second atrioventricular delay specified to enhance a cardiac output of the subject heart when the subject is at rest. Optimizing the therapy can include receiving information about a heart rate of the subject and receiving information about an intrinsic, heart rate dependent atrioventricular delay. In an example, a therapy parameter, such as a therapy atrioventricular delay, can be adjusted using information about the received heart rate of the subject, the heart-rate-dependent third AV delay, or the offset duration.
