Video games can cause life-threatening cardiac arrhythmias in susceptible children

Video games can cause life-threatening cardiac arrhythmias in susceptible children

Electronic gaming can trigger life-threatening cardiac arrhythmias in vulnerable children whose predisposition may not have been previously recognized, according to a new report in Heart Rhythm, the official journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society and the Pediatric & Congenital Electrophysiology Society, published by Elsevier. Researchers documented an unusual but distinct pattern of children losing consciousness while playing electronic (video) games.

Video games can pose a serious risk to some children with cardiac arrhythmias; They can be fatal in patients with predisposing but often previously unrecognized cardiac arrhythmias. Children who suddenly lose consciousness while playing electronic games should be seen by a heart specialist as this could be the first sign of a serious heart problem.”

Claire M. Lawley, MBBS, PhD, Principal Investigator, The Heart Center for Children, Sydney Children’s Hospitals Network, Sydney, Australia

The researchers conducted a systematic literature review and initiated a multi-site international outreach effort to identify cases of children who suddenly lost consciousness while playing video games. In the 22 cases found, multiplayer war gaming was the most common trigger. Some children died as a result of cardiac arrest. Later diagnoses of multiple cardiac arrhythmias continue to endanger children. The most common causes were catecholaminergic polymorphic ventricular tachycardia (CPVT) and congenital long QT syndrome (LQTS) types 1 and 2.

Patients experienced a high incidence of potentially relevant genetic variants (63%), which has significant implications for their families. In some cases, examining a child who lost consciousness while playing video games led to many family members being diagnosed with a serious familial heart rhythm problem. “Families and health care teams should consider safety precautions related to electronic gaming in children who have a condition that poses a risk of dangerously fast heart rhythms,” noted Dr. Lawley.

The researchers cited adrenergic stimulation associated with the emotionally charged electronic gaming environment as the pathophysiological basis for this phenomenon. Electronic gaming is not always the “safe alternative” to competitive sports as it is often considered. At the time of the cardiac events, many of the patients were in an agitated state, had just won or lost games, or were involved in conflicts with their companions.

“We already know that some children have heart conditions that can put them at risk when playing competitive sports, but we were shocked to find that some patients had life-threatening fainting spells while playing video games,” added co-investigator Christian Turner, MBBS. The Children's Heart Center, Sydney Children's Hospitals Network, Sydney, Australia. "Video games were something I previously thought would be an alternative 'safe activity'. This is a really important discovery. We need to make sure everyone knows how important it is to get checked if someone has a blackout episode in these circumstances."

The study notes that while this phenomenon is not common, it is becoming more common. "After caring for children with cardiac arrhythmias for more than 25 years, I was amazed at how widespread this emerging condition is and discovered that a number of children had even died from it. All staff are committed to spreading the word." phenomenon so that our colleagues around the world can recognize it and protect these children and their families,” noted study co-investigator Jonathan Skinner, MBChB, MD, also of Sydney.

In an accompanying editorial, Daniel Sohinki, MD, MSc, Department of Cardiology, Augusta University, Augusta, GA, USA, and co-authors noted that "exertion should be understood to include activities outside of traditional competitive sports. Appropriate advice regarding the risks of." Intense video gameplay should be targeted in children with a proarrhythmic cardiac diagnosis and in any child with a history of exertional syncope of unknown etiology. “In addition, future screening programs to identify athletes at risk for malignant arrhythmias should include athletes being considered for participation in eSports.”

Source:

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Reference:

Lawley, CM, et al. (2022) Life-threatening cardiac arrhythmias and sudden death during electronic gaming: An international case series and systematic review. heart rhythm. doi.org/10.1016/j.hrthm.2022.08.003.

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