A cardiac pacemaker that delivers cardiac pacing therapy that includes delivering the cardiac pacing therapy from a cardiac pacing device, sensing a pacing event from a plurality of electrodes of the pacing device, and sensing an electromechanical signal from an electromechanical sensor of the pacing device. A pre-ejection period is determined in response to the sensed electromechanical signal, and a left ventricular ejection time is determined in response to the sensed electromechanical signal. The pacemaker device performs one or both of adjusting a pacing parameter setting and generating an alert in response to the determined pre-ejection period and the determined left ventricular ejection time.
