Implantable cardioverter defibrillator with automatically adaptable sensing configuration

An implantable cardioverter defibrillator (ICD) comprising:

• a lead having a tip electrode, a ring electrode, and a coil electrode;
• a true bipolar (TB) sensing circuit for delivering a true bipolar sensing signal from the tip electrode and the ring electrode;
• an integrated bipolar (IB) sensing circuit for deriving an integrated bipolar sensing signal from the tip electrode and the coil electrode;
• a control unit that compares the TB sensing signal and the IB sensing signal and selects one of the TB and IB sensing signals as a basis for therapy;
• and
• a therapy delivery circuit for delivering therapy through at least one of the electrodes based on the sensing signal selected.

A method of delivering therapy with an implantable cardioverter defibrillator (ICD), the method comprising:

• simultaneously sensing EGM signals with a first electrode pair and a second electrode pair;
• determining, based on the EGM signals, which electrode pair produced a more accurate detection of cardiac events;
• and
• determining whether to deliver therapy based on EGM signals from the electrode pair selected.