Powered by Algorithms: How My Heart Now Runs on AI
From open-heart surgery to algorithmic pacing, John Duffield shares how the future of medicine isn’t wearable tech... it’s embedded intelligence inside his body.
You couldn’t have written this script.
Just a year ago, I was using AI to help make sense of my heart condition. Now, AI is literally keeping my heart beating.
On June 5th, I joined a lucky group of fellow patients walking around with a Medtronic AV2 leadless pacemaker - this thing is an astonishing feat of medical engineering that weighs just 1.75 grams, is smaller than a AAA battery, and sits inside my heart, running algorithms that manage my heartbeat in real time.
Yes, I’m the guy who talks about the future of healthcare. But now, I literally am the future patient.
Algorithms in my body, working around the clock
I had the opportunity to speak with a Medtronic technical field engineer after the implant. What they described is still pretty hard to wrap my head around.
This pacemaker doesn’t rely on wires or external leads like the traditional ones. It uses an accelerometer to sense my atrial contractions, analyzing changes in blood flow velocity. These aren’t one-time settings, this is adaptive pacing that changes moment to moment.
Throughout the day and night, the pacemaker runs internal tests, gathers measurements, and adapts to my physiology. It’s always watching. Always adjusting. Quietly optimizing from inside my body.
And the data it collects? That’s where things get even more astonishing. With just a wave of a wand, the external “paddle", my heartbeat data is wirelessly transferred from the device to my care team through Medtronic’s CareLink system.
The first time I tested this (just two days after returning from the hospital), I uploaded my data myself. I was curious. I’m a tech guy, I worked it all out. I couldn’t resist.
Within minutes, I got a phone call.
“Hi John, we haven’t even given you the onboarding experience yet and you’ve already worked it out!
Implanted through a vein. No chest incision. No wires.
The AV2 pacemaker is 93% smaller than traditional models. It was implanted while I was under anesthesia, delivered through the femoral vein in my groin via catheter, and positioned directly inside the right ventricle of my heart. No surgical opening in my chest, thank goodness. And no visible scar.
Dr. Charles Rouse, my electrophysiologist, performed the procedure. He’s a pioneer in the field… he was the first to implant leadless pacemakers at not one but two major hospital networks in the Northeast. I was in the best hands.
Once the device was placed and activated, it became my new rhythm regulator. A backup conductor to my heart’s struggling electrical orchestra.
During follow-up visits, my care team can run diagnostics or adjust settings with a simple tap of an iPad to control an RF paddle they place over my chest in office. They can literally turn the pacemaker off and on.
At my first visit, Dr Rouse told me, “Ok John, you may feel a little lightheaded. We’re going to temporarily switch off the device and run a test. Your natural pacemaker should take over for a few seconds.”
But mine didn’t unfortunately. Well, not well enough anyway.
I have Mobitz type II heart block: a more serious conduction issue where electrical signals from the atria don’t reliably reach the ventricles. My heart needed help.
And now it has it.
Freedom and resilience in a 1.75g capsule
The marvel of this technology isn’t just how small it is, but how little it restricts my life.
I can travel. I can fly. I can ride roller coasters. I can live.
There are a few small precautions though: like not standing too close to a microwave for too long, not keeping my phone in my shirt pocket over the heart. But after a few months, the risk of dislodgment becomes really low. My heart tissue will grow around the device and anchor it in place. At that point, it will even be able to withstand the impact of a car accident without shifting.
So whats he battery life? Median 16 years. And when it expires, they don’t remove it. Because it’s so small they simply implant a new one nearby. They even told me there’s enough room in the heart to hold up to five of them over time!!
That blows my mind.
This isn’t my last heart chapter.. It’s a launch point
After two open-heart surgeries, a 43-night hospital stay, multiple infections, and more procedures than I can count, getting this pacemaker feels like closing a hard chapter in my heart journey. The kind of chapter that tested everything.. my body, my mindset, and my family’s resilience.
But oddly, this device also feels like the beginning of something much bigger.
Because now, I’m not just a patient who talks about innovation. I am innovation.
I’ve seen how far the marvels of modern medicine can go. I’ve lived it. And I believe we’re only at the beginning of what’s possible when we combine precision hardware, machine intelligence, precision treatment and the human spirit.
This isn’t wearable tech. It’s embedded intelligence.
My heart has become a living interface. A place where biology and algorithms meet to give me more life, more clarity, and more time.
And with that time, I plan to keep pushing. To shine a light on stories like this to help patients ask better questions, feel less fear, and know that the future of medicine isn’t this unachievable thing.
It’s already here. And in my case, it’s already beating.
John Duffield
TheFuturePatient