Computer gaming can cause life-threatening cardiac arrhythmias in vulnerable youth with a tendency not previously reported, according to a new study.
Researchers observed an unusual but distinctive pattern in children who lost consciousness while playing video games.
The study’s findings were published in the Journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society and the Pediatric and Congenital Electrophysiology Society.
“Video games may represent a serious risk for some children with arrhythmic conditions; they can be fatal in patients with preexisting but often previously unrecognized arrhythmic conditions,” said principal investigator Claire M. Lawley, MBBS, PhD, The Heart Center for Children, explained. Sydney Children’s Hospitals Network, Sydney, Australia. “Children who suddenly lose consciousness during electronic gaming should be evaluated by a heart specialist as this may be the first sign of a serious heart problem.”
The investigators conducted a systematic review of the literature and launched a multi-site international outreach effort to identify cases of children with sudden loss of consciousness while playing video games. They found that in 22 cases, multiplayer combat gaming was the most frequent trigger. Some children died of heart failure. The subsequent diagnosis of several heart rhythm conditions put the children at continued risk. Catecholaminergic polymorphic ventricular tachycardia (CPVT) and congenital long QT syndrome (LQTS) types 1 and 2 were the most common underlying causes.
The patients had a higher incidence of potentially relevant genetic variants (63 percent), which has important implications for their families. In some cases, multiple family members were diagnosed with a significant familial heart rhythm problem due to a child who lost consciousness during video gaming. “Families and health care teams should think about safety precautions around electronic gaming in children who have conditions where dangerously rapid heart rhythms are a risk,” said Dr. Lawley.
Investigators attributed adrenergic stimulation related to emotionally charged electronic gaming environments as the pathophysiological basis for this phenomenon. Electronic gaming is not always the “safe alternative” to competitive games that it is often assumed. At the time of cardiac events, many patients were in an agitated state, had just won or lost games, or were engaging in conflict with peers.
Christian Turner, MBBS co-investigator said, “We already know that some children have heart conditions that can put them at risk when playing competitive sports, but we were shocked to learn that some patients are exposed to video gaming. A deadly blackout was happening during this time.” The Heart Center for Children, Sydney Children’s Hospitals Network, Sydney, Australia. “Video gaming was something I previously thought would be an alternative ‘safe activity.’ How important is it to get checked out in the situation.”
The study noted that although this phenomenon is not common, it is becoming more prevalent. “After caring for children with heart rhythm problems for more than 25 years, I was shocked to see how widespread this emerging presentation is, and to see that many children had died from it. So that our partners around the world can recognize this and protect these children and their families,” noted study co-investigator Jonathan Skinner, MBCHB, MD, also from Sydney.
As an accompanying editorial noted, Daniel Sohinki, MD, MSc, Department of Cardiology, Augusta University, Augusta, GA, USA, and co-authors stated, “Understanding diligence to include activities outside of traditional competitive athletics Appropriate counseling about risks. Intense video gameplay should be targeted in children with a pro-arrhythmic cardiac diagnosis, and in any child with a history of external syncope of undetermined etiology. Also, of athletes at risk of fatal arrhythmias. Athletes should be included in any future screening programs aimed at identifying athletes for participation in eSports.”