A medical device comprising: a pulse generator configured to generate ventricular pacing pulses; a cardiac electrical signal sensing circuit configured to sense ventricular event signals; a control circuit configured to: determine a first ventricular cycle length ending with a ventricular pacing pulse generated by the pulse generator; determine a rate smoothing pacing interval based on at least the first ventricular cycle length; determine a second ventricular cycle length ending with a ventricular event signal sensed by the cardiac electrical signal sensing circuit; determine a post-sense ventricular pacing interval based on the second ventricular cycle length; start a ventricular pacing interval set to the post-sense ventricular pacing interval in response to the ventricular event signal sensed by the cardiac electrical signal sensing circuit; and determine that the post-sense ventricular pacing interval expires; wherein the pulse generator is configured to generate a second ventricular pacing pulse in response to the expiration of the post-sense ventricular pacing interval; and the control circuit is configured to start the ventricular pacing interval set to the rate smoothing pacing interval in response to the pulse generator generating the second ventricular pacing pulse at the expiration of the post-sense ventricular pacing interval. a pulse generator configured to generate ventricular pacing pulses; a cardiac electrical signal sensing circuit configured to sense ventricular event signals; a control circuit configured to: determine a first ventricular cycle length ending with a ventricular pacing pulse generated by the pulse generator; determine a rate smoothing pacing interval based on at least the first ventricular cycle length; determine a second ventricular cycle length ending with a ventricular event signal sensed by the cardiac electrical signal sensing circuit; determine a post-sense ventricular pacing interval based on the second ventricular cycle length; start a ventricular pacing interval set to the post-sense ventricular pacing interval in response to the ventricular event signal sensed by the cardiac electrical signal sensing circuit; and determine that the post-sense ventricular pacing interval expires; determine a first ventricular cycle length ending with a ventricular pacing pulse generated by the pulse generator; determine a rate smoothing pacing interval based on at least the first ventricular cycle length; determine a second ventricular cycle length ending with a ventricular event signal sensed by the cardiac electrical signal sensing circuit; determine a post-sense ventricular pacing interval based on the second ventricular cycle length; start a ventricular pacing interval set to the post-sense ventricular pacing interval in response to the ventricular event signal sensed by the cardiac electrical signal sensing circuit; and determine that the post-sense ventricular pacing interval expires; wherein the pulse generator is configured to generate a second ventricular pacing pulse in response to the expiration of the post-sense ventricular pacing interval; and the control circuit is configured to start the ventricular pacing interval set to the rate smoothing pacing interval in response to the pulse generator generating the second ventricular pacing pulse at the expiration of the post-sense ventricular pacing interval.