Computer games may cause life-threatening cardiac arrhythmias in vulnerable teens whose predisposition has not been previously reported, a new study suggests.
Researchers observed an uncommon but unique pattern in children who lost consciousness while playing video games.
The results of the study were published in the journals of the Heart Rhythm Society, the Society for Cardiac Electrophysiology, and the Society for Pediatric and Congenital Electrophysiology.
“Video games can pose serious risks to some children with arrhythmias; they can be fatal in patients with susceptible but often previously undetected arrhythmias,” explained lead researcher Claire M. Lawley, MBBS, PhD, Children’s Heart Centre, Sydney Children’s Hospital Network, Sydney, Australia. “Children who suddenly lose consciousness while playing video games should be evaluated by a heart specialist, as this may be the first sign of serious heart problems.”
The researchers conducted a systematic review of the literature and launched a multi-site international outreach effort to identify cases of children who suddenly lost consciousness while playing video games. In the 22 cases they found, multiplayer wargames were the most common trigger. Some children died after cardiac arrest. Subsequent diagnoses of several arrhythmias put the children at continued risk. Catecholaminergic polymorphic ventricular tachycardia (CPVT) and congenital long QT syndrome (LQTS) types 1 and 2 are the most common underlying causes.
The prevalence of potentially associated genetic variants among patients was high (63%), which had a significant impact on their families. In some cases, investigations of children who have lost consciousness during video games have resulted in many family members being diagnosed with significant familial heart rhythm problems. “Families and medical teams should consider safety precautions for video games in children at risk for dangerously fast heart rhythms,” Dr. Lawley noted.
The researchers attribute the adrenaline stimulation associated with emotionally charged video game environments to the pathophysiological basis of this phenomenon. Video games are not always considered a “safe alternative” to competitive sports. At the time of the cardiac event, many patients are in a state of excitement, have just won or lost a game, or are having a conflict with a partner.
“We already knew that heart disease in some children could put them at risk when playing competitive sports, but we were shocked to find some patients experienced life-threatening blackouts during video games,” added MBBS co-investigator Christian Turner. Sydney Children’s Hospital Network Children’s Heart Centre, Sydney, Australia. “Video gaming is another ‘safety activity’ that I thought before. This is a very important finding. We need to make sure everyone knows how important it is to check out when someone has a coma event in this situation. “
While the phenomenon is uncommon, it is becoming more common, the study noted. “For over 25 years caring for children with heart rhythm problems, I was amazed at how widespread this emerging presentation is and how many children have even died from it. All the collaborators are keen to spread the word about this phenomenon so that we can Colleagues across the globe were able to identify it and protect these children and their families,” said study co-investigator Jonathan Skinner, MD, also from Sydney.
“Exercise should be understood to include activities beyond traditional competitive sports. Appropriate counseling regarding exercise risks Intense video games should target children with a diagnosis of arrhythmic heart disease, and any children with a history of exertional syncope of undetermined etiology. Additionally, any future screening programs aimed at identifying athletes at risk for malignant arrhythmias should Including athletes under consideration for esports.”