In which of the following conditions Radioactive iodine can be used in grave&;s disease

Disaadvantages of radio active iodine include exacerbation of cardiac arrhythmias, paicularly in older patients, possible fetal damage in pregnant women, worsening ophthalmic problems, and rare but possibly life-threatening thyroid storm Patients who have Graves disease refractory to RAI also should be considered for thyroidectomy Source: Sabiston 20th edition Pg : 892