This document discusses, among other things, systems, devices, and methods
measure an impedance and, in response, adjust an atrioventricular (AV)
delay or other cardiac resynchronization therapy (CRT) parameter that
synchronizes left and right ventricular contractions. A first example
uses parameterizes a first ventricular volume against a second
ventricular volume during a cardiac cycle, using a loop area to create a
synchronization fraction (SF). The CRT parameter is adjusted in
closed-loop fashion to increase the SF. A second example measures a
septal-freewall phase difference (PD), and adjusts a CRT parameter to
decrease the PD. A third example measures a peak-to-peak volume or
maximum rate of change in ventricular volume, and adjusts a CRT parameter
to increase the peak-to-peak volume or maximum rate of change in the
ventricular volume.