An implantable medical device implantable within a patient's heart, the IMD comprising: two or more sensors including a motion sensor; a controller operatively coupled to the two or more sensors, the controller configured to: identify a plurality of heart beats using one or more of the sensors, each of the plurality of heart beats having a systole phase and diastole phase; identify each of two or more of the plurality of heart beats as an intrinsically initiated heart beat or a pace initiated heart beat; for an intrinsically initiated heart beat, identify a motion level of the IMD using the motion sensor, and compare the identified motion level of the IMD to a motion level of the IMD identified for one or more previous intrinsically initiated heart beats, and identify a motion level of the patient based at least in part on the comparison; for a pace initiated heart beat, identify a motion level of the IMD using the motion sensor, and compare the identified motion level of the IMD to a motion level of the IMD identified for one or more previous pace initiated heart beats, and identify the motion level of the patient based at least in part on the comparison; and set a pacing rate parameter based at least in part on the identified motion level of the patient. two or more sensors including a motion sensor; a controller operatively coupled to the two or more sensors, the controller configured to: identify a plurality of heart beats using one or more of the sensors, each of the plurality of heart beats having a systole phase and diastole phase; identify each of two or more of the plurality of heart beats as an intrinsically initiated heart beat or a pace initiated heart beat; for an intrinsically initiated heart beat, identify a motion level of the IMD using the motion sensor, and compare the identified motion level of the IMD to a motion level of the IMD identified for one or more previous intrinsically initiated heart beats, and identify a motion level of the patient based at least in part on the comparison; for a pace initiated heart beat, identify a motion level of the IMD using the motion sensor, and compare the identified motion level of the IMD to a motion level of the IMD identified for one or more previous pace initiated heart beats, and identify the motion level of the patient based at least in part on the comparison; and set a pacing rate parameter based at least in part on the identified motion level of the patient. identify a plurality of heart beats using one or more of the sensors, each of the plurality of heart beats having a systole phase and diastole phase; identify each of two or more of the plurality of heart beats as an intrinsically initiated heart beat or a pace initiated heart beat; for an intrinsically initiated heart beat, identify a motion level of the IMD using the motion sensor, and compare the identified motion level of the IMD to a motion level of the IMD identified for one or more previous intrinsically initiated heart beats, and identify a motion level of the patient based at least in part on the comparison; for a pace initiated heart beat, identify a motion level of the IMD using the motion sensor, and compare the identified motion level of the IMD to a motion level of the IMD identified for one or more previous pace initiated heart beats, and identify the motion level of the patient based at least in part on the comparison; and set a pacing rate parameter based at least in part on the identified motion level of the patient.