A first implantable medical device (IMD) implanted within a patient may communicate with a second IMD implanted within the patient by encoding information in an electrical stimulation signal. The delivery of the electrical stimulation signal may provide therapeutic benefits to the patient. The second IMD may sense the electrical stimulation signal, which may be presented as an artifact in a sensed cardiac signal, and process the sensed signal to retrieve the encoded information. The second IMD may modify its operation based on the received therapy information. Crosstalk between the first and second IMDs may be reduced using various techniques described herein. For example, the first IMD may generate the electrical stimulation signal to include a spread spectrum energy distribution or a predetermined signal signature. The second IMD may effectively remove a least some of the signal artifact in a sensed cardiac signal based on the predetermined signal signature.