In general, the invention is directed to techniques for detecting and addressing pacemaker syndrome. When a pacemaker detects a risk of pacemaker syndrome, the pacemaker paces one or more chambers of the heart to reduce the risk of pacemaker syndrome. One pacing technique is to apply ventricular paces, thereby reducing the delay between the atrial activation and the ventricular activation. Another technique, available to a patient who receives atrial pacing, is to decrease the atrial pacing rate.