Iranian Heart Association Iranian Heart Journal 23 4 2022 10 01 Evaluation of Different Arrhythmias and Cardiac Iron Overload Status in β-Thalassemia Major: A Cross-Sectional Study 60 68 158147 EN Amir Farjam Fazelifar Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Mona Heidarali Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Mohammad Reza Kiarsi Electrophysiology Research Center, Ahvaz University of Medical Sciences, Ahvaz, IR Iran. Saeed Abrotan Rohani Hospital, Babol University of Medical Sciences, Babol, IR Iran. Elahe Baghizadeh Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Farnaz Rafiee Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran. 0000-0002-8404-8858 Journal Article 2021 05 26 Background: Cardiac involvement due to iron deposition in β-thalassemia major remains the main cause of mortality. We assessed the effects of cardiac iron overload on the incidence of arrhythmias in β-thalassemia major. Methods: The present cross-sectional study enrolled patients with β-thalassemia major referred to a tertiary cardiovascular care center in Tehran, Iran, between January 2019 and January 2020. The patients’ characteristics were collected using hospital records. Cardiac iron overload status was assessed using cardiac T2* magnetic resonance (severe ≤10 ms, moderate =10–20 ms, and mild =20 ms). Results: The present study recruited 81 β-thalassemia major cases with a mean age (SD) of 30.69 (11.12) years. Mild, moderate, and severe iron overload statuses were reported in 44.4%, 22.2%, and 33.3% of the stud population, respectively. Of 44 patients (54.3%) with arrhythmias, supraventricular tachyarrhythmias were seen in 24.7%, ventricular tachycardias in 19.8%, and atrioventricular blocks in 9.9%. A significant association was reported between iron overload status and the presence of arrhythmias (P<0.001). There was a significant association between iron overload and dilated atria (P=0.004). The left ventricular ejection fraction (LVEF) was not associated with cardiac iron status, but it was associated with the presence of arrhythmias (P<0.001). Desferal therapy was considerably associated with cardiac iron status (P=0.04). Conclusions: According to iron chelation therapy, patients with more severe iron overload had a higher incidence rate of arrhythmias. Additionally, patients with lower LVEF values had a higher incidence rate of arrhythmias. There was no statistically significant association between LVEF and cardiac iron overload status. (Iranian Heart Journal 2022; 23(4): 60-68)

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