Arrhythmic manifestation in beta-thalassemia cardiomyopathy: a complex management

A young male with beta-thalassemia major was implanted with a single-chamber Implantable cardioverter-defibrillator (ICD) for a cardiac arrest due to ventricular fibrillation. He received multiple inappropriate shocks due to atrioventricular nodal re-entrant tachycardia (AVNRT) treated with radiofrequency catheter ablation and then to high-rate atrial tachycardia refractory to amiodarone and not inducible during electrophysiological study. He refused empirical pulmonary vein isolation. Upgrading to biventricular ICD and performing atrioventricular node ablation avoided further inappropriate shocks.