Methods and systems may identify a vector or a vector configuration, such as a combination of electrodes, for monitoring ischemia. The method may include: selecting a first combination of sensors as a first candidate to be used for monitoring ischemia detecting a shift in a ST segment of one of an electrocardiogram and a cardiac electrogram using the first candidate selecting a second combination of sensors as a second candidate to be used for monitoring ischemia detecting a shift in a ST segment of one of an electrocardiogram and a cardiac electrogram using the second candidate comparing the ST shifts for the first and second candidates and identifying one of the first and second candidates for monitoring ischemia based on the comparison. A multi-electrode implantable cardiac device may include a controller configured to effectuate such functions.
