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Robert Johnson

Robert Johnson

Digital Twin Active
MRN: 847291 67 years old Male San Francisco, CA
Atrial Fibrillation Type 2 Diabetes Hypertension Blue Shield PPO

Robert's Digital Twin

AI-powered health model • Last synced 2 min ago

Live Monitoring
Digital Twin initialized with complete health history, 847 days of wearable data, and 23 patient conversations.
Robert's Digital Twin Today, 8:45 AM

Morning Health Summary:

Based on overnight wearable data, I've detected several patterns worth noting:

  • Irregular heart rhythm detected between 3:00-4:30 AM — consistent with atrial fibrillation episodes. This is the 3rd occurrence this week.
  • Average heart rate during sleep: 72 bpm (elevated from baseline of 64 bpm)
  • Sleep quality score: 62/100 — fragmented sleep with 4 awakenings
  • Blood glucose (CGM): Stable overnight, fasting level 128 mg/dL

Recommendation: Consider reviewing current rate control medication. The increasing AF frequency may warrant rhythm control strategy discussion.

Apple Watch Dexcom G7 Sleep Data
Dr. Sarah Chen Today, 9:12 AM

Show me the AF episode details and compare to previous occurrences. Also, what's his current medication adherence looking like?

Dr. Chen
Robert's Digital Twin Today, 9:12 AM

AF Episode Analysis:

Last Night's Episode (3:02 AM - 4:28 AM)

Duration 86 minutes
Avg HR 112 bpm
Peak HR 138 bpm
HRV 23 ms
Irregular Rhythm Detected

Comparison to Previous Episodes (Last 30 Days):

Feb 3
52 min
Feb 1
34 min
Jan 28
22 min
Jan 20
18 min

Trend: Episode duration and frequency increasing. Episodes went from monthly to 3x/week over 45 days.

Medication Adherence (Last 30 Days):

Metoprolol 50mg
93%
Eliquis 5mg
100%
Metformin 1000mg
78%
Lisinopril 20mg
96%

Metformin adherence dropped — patient mentioned GI discomfort in chat 5 days ago.

Dr. Sarah Chen Today, 9:18 AM

What did Robert say about the GI symptoms? And has he mentioned anything about the AF episodes - is he symptomatic?

Dr. Chen
Robert's Digital Twin Today, 9:18 AM

Relevant Patient Conversations:

Conversation with Robert — Jan 31, 2:34 PM
Robert: "The metformin is really bothering my stomach lately. I've been skipping it some days when I know I'll be out. Is there something else I can take?"
AI Assistant: "I understand the GI discomfort is frustrating. Some patients find taking it with food helps. There are also extended-release formulations that may be gentler. I'll flag this for Dr. Chen to discuss alternatives with you."
Conversation with Robert — Feb 4, 7:15 AM
Robert: "Woke up feeling my heart racing again last night. It's happened a few times recently. Should I be worried?"
AI Assistant: "I can see from your Apple Watch that you had an irregular rhythm episode last night. Given your AF history, this warrants attention. Are you experiencing any other symptoms like dizziness, shortness of breath, or chest discomfort?"
Robert: "A little short of breath when it happens. And sometimes lightheaded when I get up. But it goes away."
AI Assistant: "Thank you for sharing that. The combination of increasing AF episodes with symptoms like shortness of breath and lightheadedness is important for Dr. Chen to know. I'm escalating this for physician review today."

Summary: Patient IS symptomatic during AF episodes (palpitations, SOB, lightheadedness). Combined with increasing episode frequency and the Metformin adherence issue, I recommend scheduling a comprehensive medication review visit.

Robert Johnson

Chat with Robert Johnson

Last active 2 hours ago

Previous Conversations
January 28, 2026

Topic: AF Episode Follow-up

"I wanted to check in after the episode last week..."

January 15, 2026

Topic: Lab Results Discussion

"Your A1C came back at 7.8%, which is slightly elevated..."

December 20, 2025

Topic: Medication Adjustment

"Based on your recent readings, I'd like to adjust..."

Current Conversation
Robert
Robert Johnson Today, 7:23 AM

Good morning Dr. Chen. I wanted to let you know about last night - my watch alerted me again about irregular heartbeat. It happened around 3 AM and I felt pretty uncomfortable. Racing heart, a bit short of breath.

Robert

This is the third time this week. I'm getting a bit worried. Is this something we should look at more seriously?

7:24 AM
Robert
Apple Watch Screenshot

Here's the screenshot from my watch showing the irregular rhythm alert.

7:25 AM
Digital Twin Draft Response Suggested

Good morning Robert. Thank you for reaching out and sharing this with me. I've reviewed your wearable data and I can see the AF episode from last night - it lasted about 86 minutes with your heart rate averaging 112 bpm.

Given that this is your third episode this week and you're experiencing symptoms (shortness of breath, palpitations), I think we should discuss adjusting your treatment approach. Your current rate control with Metoprolol may not be sufficient anymore.

I'd like to schedule a telehealth visit this week to discuss the following options:

  • Increasing your Metoprolol dose
  • Adding or switching to a rhythm control strategy
  • Possible referral to electrophysiology for ablation consultation

In the meantime, please continue taking your Eliquis as prescribed - this is very important for stroke prevention. Are you available Thursday or Friday for a video visit?

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