Electronic games can cause potentially fatal heart rhythm problems in predisposed children

Video games can trigger life-threatening heart arrhythmias in susceptible children whose susceptibility may have gone unrecognized, according to a new report in Heart rhythm. Researchers have documented an unusual but distinct pattern among children who pass out while playing electronic (video) games.

“Video games may pose a serious risk to some children with arrhythmic conditions; they can be fatal for patients with predisposing but often previously unrecognized arrhythmic conditions,” explained lead researcher Claire M. Lawley, MBBS, Ph.D., Children’s Heart Center, Sydney Children’s Hospital Network, Sydney, Australia. “Children who suddenly faint while playing electronic games should be seen by a cardiologist, as this could be the first sign of a serious heart problem.”

The researchers conducted a systematic review of the literature and began an international effort to identify cases of sudden loss of consciousness in children while playing video games. Among the 22 cases they found, multiplayer war games were the most common trigger. Some children died after a cardiac arrest. Subsequent diagnoses of multiple heart rhythm disorders put children at constant risk. Catecholaminergic polymorphic ventricular tachycardia (CPVT) and congenital long QT syndrome (LQTS) types 1 and 2 were the most common underlying causes.

Among the patients, there was a high frequency of potentially relevant genetic variants (63%), with significant implications for their families. In some cases, examination of a child who has lost consciousness during video games have resulted in many family members being diagnosed with an important familial heart rhythm problem. “Families and medical professionals should think security measures around electronic games in children who have a condition where dangerously fast heart rhythms are a risk,” noted Dr Lawley.

Researchers attribute the pathophysiological basis of this phenomenon to adrenergic stimulation associated with the emotionally charged environment of electronic games. Electronic games are not always a “safe alternative”. sports competitions it is often considered. At the time of the cardiac incidents, many of the patients were in excited states, having just won or lost or entered into a conflict with comrades.

“We already know that some children have heart conditions that can put them at risk during competitive sports, but we were shocked to find that some patients experienced life-threatening blackouts while playing video games,” added one of the researchers, Christian Turner, MBBS, Children’s Heart Centre, Sydney Children’s Hospital Network, Sydney, Australia. “I used to think that video games would be an alternative to ‘safe activities.’ This is a really important discovery. We need to make sure everyone knows how important it is to get tested if someone passes out in these conditions.”

The study notes that while this phenomenon is not common, it is becoming more common. “After caring for children with heart rhythm problems for over 25 years, I was surprised to see how widespread this phenomenon was and found that some children had even died from it. All staff want to publicize this phenomenon so that our colleagues around the world can recognize it and protect these children and their families,” said one of the study’s researchers, Jonathan Skinner, MBChB, MD, also from Sydney.

As an accompanying editorial Daniel Sohinky, MD, MS, Cardiology, Augusta University, Georgia, USA, and co-authors noted that “exertion should be understood as an activity outside of traditional athletic competition. Appropriate counseling regarding the risks of intense video gaming should be directed at children diagnosed with cardiac proarrhythmias, as well as any child with a history of exertional syncope of unknown etiology. Furthermore, any future screening programs aimed at identifying athletes at risk for malignant arrhythmias should include athletes being considered for eSports participation.”