A medical device is configured to perform a method for modulating vagal nerve signals to reduce inflammation. A sensing module of the medical device is enabled to receive an electrical signal from selected electrodes electrically coupled to the medical device. A controller coupled to the sensing module is configured to determine an inflammation metric from the sensed electrical signal. The metric is compared to an inflammation detection threshold. A pulse generator is controlled to selectively deliver electrical stimulation pulses via the plurality of electrodes in response to the metric meeting the inflammation detection threshold to modulate vagal nerve signals to cause an anti-inflammatory response.