Cardiac rhythm management system with optimization of cardiac performance using heart rate

A method comprising:

• using a processor-based pacer to pace at least one cardiac chamber with a plurality of pacing mode and inter-site delay configurations, each configuration corresponding to a plurality of sites associated with the same cardiac chamber;
• determining cycle length (CL) values for instances of the plurality of configurations;
• computing CL features for the plurality of configurations;
• calculating a first central tendency value of the CL features over the instances of each configuration and determining a particular configuration as the configuration yielding the largest first central tendency value;
• determining from among the instances associated with the configuration yielding the largest first central tendency value a second central tendency value and a maximum value of CL features;
• and
• programming a pacer to the particular configuration when the difference between a ratio of the maximum value and the second central tendency value is less than a threshold value.