Systems and methods provide for sensing, within a patient and during an event of tachycardia, a signal indicative of a mechanical response of the patients heart to the tachycardia. Regularity of the signal relative to a threshold established for the patient is determined. A state of patient hemodynamics during the tachycardia event is determined based at least in part on the regularity of the signal. One or more anti-tachycardia therapies to treat the tachycardia may be selected based at least in part on the determined state of patient hemodynamics. The selected one or more anti-tachycardia therapies may be delivered to treat the tachycardia.
