Systems and methods to monitor cardiac mechanical vibrations using information indicative of lead motion are described. In an example, a system including an implantable medical device can include an excitation circuit configured to provide a non-tissue stimulating, non-therapeutic electrical excitation signal to a portion of an implantable lead. A receiver circuit can be configured to obtain information indicative of a mechanical vibration of the implantable lead due at least in part to one or more of an impact of at least a portion of the heart to the implantable lead, or friction contact between the implantable lead and cardiac tissue. The system can include a processor circuit configured to determine one or more of a lead mechanical status, or information indicative of valvular activity using the information indicative of the mechanical vibration of the implantable lead.