Modification of cardiac sensing and therapy

A medical device system comprising:

• a plurality of electrodes;
• a memory configured to store a respective value for each of a plurality of parameters for at least one of anti-tachyarrhythmia shock therapy or cardiac sensing, and, in association with each of a plurality of heart position states, a respective modification of at least one of the plurality of parameters;
• and
• processing circuitry configured to:
• determine a current one of the plurality of heart position states of the patient;
• modify the at least one parameter value according to the modification associated with the current heart position state;
• and
• control at least one of the delivery of the anti-tachyarrhythmia shock therapy or the cardiac sensing via the plurality of electrodes according to the modified at least one parameter value.

A method comprising,

• by processing circuitry of a medical device system:
• determining a heart position state of a patient;
• modifying a vector comprising at least two of a plurality of electrodes of the medical device system based on the determined heart position state;
• and
• controlling the medical device system to at least sense a cardiac electrogram or deliver cardiac therapy via the modified vector comprising the at least two of the plurality of electrodes.