When Constantine was diagnosed with non-obstructive hypertrophic cardiomyopathy (HCM) at 18 months old, his life wasn’t drastically affected. HCM is a heart condition characterized by abnormal thickening of the heart muscle.
“It didn’t really impact his life,” his mother, Bethany, says. Outside of avoiding contact sports, Constantine wasn’t restricted from doing many things. He was able to play baseball and do jiu-jitsu. He just needed to be monitored yearly. However, this all changed when he had a cardiac arrest in October 2025 at 9 years old.
After being transferred from their local hospital in Du Bois, Pa. to UPMC Children’s Hospital of Pittsburgh, his family began discussing treatment options with Constantine’s doctors. The team felt that he would make a good candidate for an extravascular implantable cardioverter defibrillator (EV-ICD).
The Heart Institute at UPMC Children’s is part of a limited number of pediatric centers in the United States currently able to implant EV-ICDs in children. This less invasive treatment option provides defibrillator protection for small patients without having to open the chest.
After discussing various options, Constantine’s family felt assured that the EV-ICD was the best path to take.
“We felt confident about the decision,” Bethany says. “He stayed that night after the surgery for observation and went home the next day. The surgery went great and he recovered really well.”
Bethany feels grateful to the entire team and the clear communication they provided throughout the surgical process.
“Every single person we came in contact with was incredible,” she says. “There were so many different people that came to weigh in on his situation and talk to us. Everything was super thorough, I never felt like they were ignoring anything. They kept us super well informed.”
Implantation of this device relies on close collaboration between the pediatric and adult cardiology and cardiothoracic surgery teams.
“The process seemed pretty streamlined,” Bethany says. “The team communicated pretty well amongst each other, so when they came to meet with us, we were all on the same page.”
Constantine received his EV-ICD in December 2025. Nearly six months later, he continues to do well with the device. His six-month follow-up appointment confirmed that everything is looking good and he’s starting to get back to his favorite day-to-day activities, like playing baseball and going to gym class at school.
“I’m so thankful that it’s working well and he seems to be thriving,” Bethany shares.
At the Heart Institute at UPMC Children’s, early adoption of EV-ICDs reflects a coordinated effort to adapt adult electrophysiology advances safely and effectively into pediatric care, with ongoing evaluation of outcomes, durability, and long-term implications as the team’s clinical experience increases.