An implantable medical device (100) is connectable to an epicardial left ventricular lead (30) having at least one epicardial electrode (32, 34, 36) and a myocardium penetrating catheter (50) with at least one endocardial electrode (52, 54) and present in a lumen (35) of the lead (30). The device (100) comprises a pulse generator controller (130) that controls a ventricular pulse generator (140) to generate pulses to be applied to the epicardial (32, 34, 36) and endocardial (52, 54) electrodes. The controller (130) uses an endocardial-to-epicardial time interval or epicardial-to-endocardial time interval to coordinate endocardial and epicardial activation of the left ventricle to thereby achieve cardiac pacing that closely mimics the natural electrical activation pattern of a healthy heart (15).
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