Techniques are provided for delivering
cardiac pacing therapy to the heart of a patient using an epicardial left ventricular
satellite pacing device in conjunction with primary pacemaker having at least a right
ventricular pacing lead. In one embodiment described herein, right ventricular pulses generated by the primary pacemaker are detected by the
satellite pacer and analyzed to determine the timing pattern employed by the primary pacemaker. The timing pattern is then used to specify the delivery times of epicardial left ventricular pulses so as to be synchronized with right ventricular pulses. In another embodiment described herein, the primary pacemaker modulates the right ventricular pulses to
encode timing information, which is then detected and decoded by the
satellite pacemaker. In this manner, biventricular pacing therapy, such as
cardiac resynchronization therapy, may be conveniently delivered using a non-biventricular pacemaker in combination with an epicardial satellite pacer.