A far-field radio frequency (RF) telemetry system for communicating with an implantable medical device includes a diversity antenna system. Multi-frame messages each including multiple outgoing data frames are transmitted to the implantable medical device. In response, the implantable medical device transmits response data frames each following one or more of the outgoing data frames, according to a predetermined communication protocol. An antenna control circuit selects an antenna of the diversity antenna system for transmitting the outgoing data frames and/or receiving the response data frames based the quality of signal reception associated with the response data frames.