Techniques are disclosed for a multi-tier system for predicting cardiac arrhythmia in a patient. In one example, a computing device processes parametric patient data and provider data for a patient to generate a long-term probability that a cardiac arrhythmia will occur in the patient within a first time period. In response to determining that the cardiac arrhythmia is likely to occur within the first time period, the computing device causes a medical device to process the parametric patient data to generate a short-term probability that the cardiac arrhythmia will occur in the patient within a second time period. In response to determining that the cardiac arrhythmia is likely to occur within the second time period, the medical device performs a remediative action to reduce the likelihood that the cardiac arrhythmia will occur.