Techniques are provided for measuring ventricular evoked response within
the heart of a patient during atrial fibrillation. An intrinsic
ventricular depolarization (i.e. a QRS complex) is sensed within the
right ventricle and then a pacing pulse is applied to the left ventricle
prior to intrinsic depolarization thereof. In this manner, the left
ventricle contracts solely in response to the pacing pulse and possible
fusion between the pacing pulse and a conducted P-wave/A-pulse from the
atria is avoided. The evoked response generated in the left ventricle is
then measured by the pacemaker. The technique permits reliable detection
of left ventricular evoked response, even during atrial fibrillation when
atrial contractions are frequent and erratic, but the technique may also
be employed during normal sinus rhythm. Features of the evoked response
are analyzed to detect heart failure, evaluate its severity and track its
progression. Appropriate therapy is then automatically delivered to the
patient.