An ambulatory medical device, comprising: a stimulation generator circuit configured to generate stimulation for stimulating a target tissue in a patient according to at least one stimulation parameter; a signal sensor circuit including a sense amplifier circuit to sense one or more physiological signals and a filter circuit to generate two or more signal metrics from the sensed one or more physiological signals; a cardiac condition detector circuit including a blending circuit to use the two or more signal metrics to generate a cardiac condition indicator, and a comparator circuit to detect an event of worsening cardiac condition using the cardiac condition indicator; and a stimulation programmer circuit coupled to the cardiac condition detector circuit and the signal sensor circuit, the stimulation programmer circuit configured to: in response to the detection of the event of worsening cardiac condition, determine a parameter value for the at least one stimulation parameter based on information about temporal responses of the two or more signal metrics; and program the stimulation generator circuit with the determined parameter value, characterized in that the medical device further comprises a timer circuit to determine time elapsed during which the at least one stimulation parameter is set and maintained at a specified parameter value, wherein the stimulation programmer circuit is configured to determine the parameter value in response to the elapsed time exceeding a specified threshold. a stimulation generator circuit configured to generate stimulation for stimulating a target tissue in a patient according to at least one stimulation parameter; a signal sensor circuit including a sense amplifier circuit to sense one or more physiological signals and a filter circuit to generate two or more signal metrics from the sensed one or more physiological signals; a cardiac condition detector circuit including a blending circuit to use the two or more signal metrics to generate a cardiac condition indicator, and a comparator circuit to detect an event of worsening cardiac condition using the cardiac condition indicator; and a stimulation programmer circuit coupled to the cardiac condition detector circuit and the signal sensor circuit, the stimulation programmer circuit configured to: in response to the detection of the event of worsening cardiac condition, determine a parameter value for the at least one stimulation parameter based on information about temporal responses of the two or more signal metrics; and program the stimulation generator circuit with the determined parameter value, characterized in that the medical device further comprises a timer circuit to determine time elapsed during which the at least one stimulation parameter is set and maintained at a specified parameter value, in response to the detection of the event of worsening cardiac condition, determine a parameter value for the at least one stimulation parameter based on information about temporal responses of the two or more signal metrics; and program the stimulation generator circuit with the determined parameter value, characterized in that the medical device further comprises a timer circuit to determine time elapsed during which the at least one stimulation parameter is set and maintained at a specified parameter value, wherein the stimulation programmer circuit is configured to determine the parameter value in response to the elapsed time exceeding a specified threshold.