An optical perfusion sensor may monitor blood oxygen saturation of blood-perfused tissue, which may be referred to as tissue perfusion, until a tissue perfusion value is within a threshold range of a reference value, and, in some examples, for at least a minimum period of time. The tissue perfusion value may indicate an absolute blood oxygen saturation level or a relative change in blood oxygen saturation level. The reference value may be, for example, determined by an oxygen (O2) variation index that indicates a change in blood oxygen saturation of tissue. In some examples, the optical perfusion sensor may be activated upon detecting a cardiac event, such as a cardiac arrhythmia. In addition, in some examples, cardiac signal monitoring may be activated upon detecting a threshold change in tissue perfusion.
