Cardiac monitoring and/or stimulation methods and systems provide for monitoring, diagnosing, defibrillation and pacing therapies, or a combination of these capabilities, including cardiac systems incorporating or cooperating with neuro-stimulating devices, drug pumps, or other therapies. Embodiments relate generally to implantable medical devices employing automated cardiac activation sequence monitoring and/or tracking for arrhythmia discrimination. Embodiments are directed to devices and methods involving sensing a plurality of composite cardiac signals using a plurality of implantable electrodes. A source separation is performed using the sensed plurality of composite cardiac signals and the separation produces one or more cardiac signal vectors associated with one or more cardiac activation sequences that is indicative of ischemia. A change of the one or more cardiac signal vectors is detected using the one or more cardiac signal vectors. Cardiac arrhythmias are discriminated using the one or more cardiac signal vectors.