The invention is directed to methods and apparatus for automatically
changing from bi-ventricular pacing, in which an implantable medical
device (IMD) applies pacing stimuli to both ventricles of a heart during
a cardiac cycle, to single-ventricle pacing, in which the IMD paces one
ventricle and inhibits pacing of the other. An IMD applying the
techniques of the invention automatically changes from bi-ventricular
pacing to single-ventricle pacing, or vice versa, as a function of the
reliability of left ventricular pacing. Exemplary techniques for
determining the reliability of left ventricular pacing include impedance
measurement, capture testing, capture threshold testing, or any
combination thereof.