A system and method for use in an implantable cardiac device that delivers electrical therapy to a patient's heart determines if a T wave alternan pattern of the patient's heart exists. The system includes a sensing circuit that generates an electrical signal representing electrical activity of the patient's heart. A morphology detector measures a magnitude of a T wave characteristic of each T wave in the electrical signal of a predetermined number of cardiac cycles of the heart. A discriminator then determines, responsive to the measured T wave characteristic magnitudes, if a T wave alternan pattern exists. A T wave alternan pattern may be determined to exist if the number of measured T wave characteristic magnitudes greater than and less than a T wave characteristic magnitude baseline are substantially equal and each greater than a given number.

 
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