Systems and methods to monitor cardiac function using information indicative of lead motion are described. In an example, a system including an implantable medical device can include a receiver circuit configured to be electrically coupled to conductor comprising a portion of an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The system can include a sensing circuit configured to obtain information indicative of cardiac electrical activity. The system can include a processor circuit configured to construct a template representative of a contraction of the heart, where the template can be constructed using the information indicative of the movement of the implantable lead due at least in part to the motion of the heart during the contraction, and using the information indicative of the cardiac electrical activity sensed during the contraction.