A system and method for long-term monitoring of cardiac conditions such as arrhythmias is disclosed. The invention includes a pulse generator including means for sensing an arrhythmia. The pulse generator is coupled to at least one subcutaneous electrode or electrode array for providing electrical stimulation such as cardioversion/defibrillation shocks and/or pacing pulses. The electrical stimulation may be provided between multiple subcutaneous electrodes, or between one or more such electrodes and the housing of the pulse generator. In one embodiment, the pulse generator includes one or more electrodes that are isolated from the can. These electrodes may be used to sense cardiac signals.