A system (100: 200; 300) for detecting cardiac events from a patient, the system (100: 200; 300) comprising: a memory circuit configured to store physiologic event episodes recorded by a medical device (110; 310) from a patient; and a control circuit, including a detection control circuit configured to perform simulations on the stored physiologic event episodes at different first and second detection settings, comprising: determine a presence of a target cardiac event in one or more of the stored physiologic event episodes under the first detection setting; provide the determined presence of the target cardiac event under the first detection setting to a user; receive from the user an adjudication of the provided determined presence of the target cardiac event under the first detection setting; re-determine a presence of the target cardiac event in the one or more of the stored physiologic event episodes under the second detection setting different than the first detection setting; provide the re-determined presence of the target cardiac event in the one or more stored physiologic event episodes under the second detecting setting to the user; and receive, based on to the provided re-determined presence of the target cardiac event and the received adjudication, a selected detection setting for a subsequent determination of the presence of the target cardiac event in the patient. a memory circuit configured to store physiologic event episodes recorded by a medical device (110; 310) from a patient; and a control circuit, including a detection control circuit configured to perform simulations on the stored physiologic event episodes at different first and second detection settings, comprising: determine a presence of a target cardiac event in one or more of the stored physiologic event episodes under the first detection setting; provide the determined presence of the target cardiac event under the first detection setting to a user; receive from the user an adjudication of the provided determined presence of the target cardiac event under the first detection setting; re-determine a presence of the target cardiac event in the one or more of the stored physiologic event episodes under the second detection setting different than the first detection setting; provide the re-determined presence of the target cardiac event in the one or more stored physiologic event episodes under the second detecting setting to the user; and receive, based on to the provided re-determined presence of the target cardiac event and the received adjudication, a selected detection setting for a subsequent determination of the presence of the target cardiac event in the patient. determine a presence of a target cardiac event in one or more of the stored physiologic event episodes under the first detection setting; provide the determined presence of the target cardiac event under the first detection setting to a user; receive from the user an adjudication of the provided determined presence of the target cardiac event under the first detection setting; re-determine a presence of the target cardiac event in the one or more of the stored physiologic event episodes under the second detection setting different than the first detection setting; provide the re-determined presence of the target cardiac event in the one or more stored physiologic event episodes under the second detecting setting to the user; and receive, based on to the provided re-determined presence of the target cardiac event and the received adjudication, a selected detection setting for a subsequent determination of the presence of the target cardiac event in the patient.