Abstract: An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.