A medical device and associated method for detecting and treating tachyarrhythmias acquires a cardiac signal using electrodes coupled to a sensing module. During an initial detection process, a shockable cardiac rhythm is detected by a processing module configured to compare the cardiac signal to a first set of detection criteria. By analyzing the cardiac signal, the processing module establishes at least one patient-specific detection threshold during the initial detection process. Upon establishing the at least one patient-specific detection threshold, the initial detection process is stopped, and a next detection process is started which includes comparing the cardiac signal to a second set of detection criteria including the at least one patient-specific detection threshold. In some embodiments, user programming of tachyarrhythmia detection parameters is not required.