A cardiac therapy pulse delivery system includes a plurality of electrodes, an ECG signal processor circuit, and a pulse generator circuit. Each of the electrodes has at least one therapy element and at least one monitor element that are electrically insulated from one another. The ECG signal processor circuit is electrically coupled to each monitor element on each electrode and is operable to convert ECG signals detected by the monitor elements into ECG data. The cardiac pulse generator circuit is electrically coupled to each therapy element on each electrode and is operable to supply one or more cardiac therapy pulses thereto.