were it around 100,000 thousand, id say pull the one head. were it 100,000-180,000 thousand, id say pull both heads. since you are above that, if it were me, id like to at least know what shape the bottom end is in. Id pull it and put it on a stand, pull the heads off, and then flip it over to check the bearings, crank, and the main/rod caps. If the caps and crank look ok, i personally would put in some new bearings, a new oil pump, and pick up tube. And id be doing this while both heads were off being worked. Replace the bad valve, grind the seats, check the guides, and grind the good valves. Thats simply my opinion, and what i would do if the budget allowed.
Having said that, it is pruly up to you. Original bearings can go for 300,000 or more. If the budget doesnt allow both heads, i would just pull the one, even with high mileage, then id save money up knowing i would be going through the whole thing later.