Arrhythmia electrotherapy device and method with provisions for inferring patient discomfort from evoked response

An electrotherapy apparatus for treating a patient experiencing an arrhythmia, the apparatus comprising:

• a power source adapted to supply energy for operation of the apparatus;
• electrotherapy administration circuitry electrically coupled to the power source and to a set of patient terminals, and constructed to generate electrotherapy pulses using the energy from the power source and apply a series of the electrotherapy pulses via the patient terminals in response to a control signal;
• monitoring circuitry electrically coupled with the power source and the set of patient terminals, and constructed to monitor the patient for indicia of the arrhythmia;
• controller circuitry electrically coupled with the power source, the electrotherapy administration circuitry, and the monitoring circuitry, the controller circuitry including a processor and a data storage device containing instructions that, when executed by the processor, cause the controller circuitry to read an output of the monitoring circuitry and determine any presence of the arrhythmia based on that output, and to generate the control signal causing the electrotherapy administration circuitry to apply the series of electrotherapy pulses;
• and
• evoked response sensing circuitry electrically coupled to the controller circuitry, the evoked response sensing circuitry being constructed to sense indicia of movement by the patient, and the controller circuitry being further configured to infer whether the movement is an evoked response to the administration of the electrotherapy pulses, and to adjust application of subsequent electrotherapy pulses in response to an inference of the evoked discomfort response.