According to a new study, computer games could create life-threatening cardiac arrhythmias in vulnerable young people whose tendency may not have been reported before.
Researchers have observed an unusual but distinct pattern in children who lose consciousness while playing video games.
The study results have been published in the Journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society.
“Video games can pose a serious risk to some children with arrhythmias; they can be fatal in patients with predisposing, but often previously unrecognized, arrhythmias,” explained lead researcher Claire M. Lawley, MBBS , PhD, The Heart Center for Children, Sydney Children’s Hospital Network, Sydney, Australia. “Children who suddenly lose consciousness while playing electronic games should be seen by a cardiologist as this could be the first sign of a serious heart problem.”
Investigators conducted a systematic literature review and launched an international, multi-site outreach effort to identify cases of children exhibiting sudden loss of consciousness while playing video games. In the 22 cases they found, multiplayer war games were the most common trigger. Some children have died from cardiac arrest. Subsequent diagnoses of several heart rhythm disorders put children at continued risk. Catecholaminergic polymorphic ventricular tachycardia (CPVT) and congenital long QT syndrome (SQTL) types 1 and 2 were the most common underlying causes.
There was a high incidence of potentially relevant genetic variants (63%) among the patients, which has important implications for their families. In some cases, the investigation of a child who passed out while playing video games led to the diagnosis of many family members with a significant family heart rhythm problem. “Families and healthcare teams should consider safety precautions regarding electronic games in children who have a condition where dangerous rapid heart rhythms pose a risk,” Dr. Lawley noted.
Researchers have attributed adrenergic stimulation related to the emotionally charged electronic gaming environment as the pathophysiological basis for this phenomenon. Electronic gaming is not always the “safe alternative” to the competitive sports it is often considered. At the time of cardiac incidents, many patients were in a state of excitement, having just won or lost matches, or were in conflict with companions.
“We already know that some children have heart problems that can put them at risk when playing competitive sports, but we were shocked to find that some patients had fatal memory loss while playing video games,” added co-investigator Christian Turner, MBBS, The Heart Center for Children, Sydney Children’s Hospitals Network, Sydney, Australia. “Gaming was something that I previously thought was an alternative ‘safe activity’. This is a really important discovery. We need to make sure everyone knows how important it is to get checked out when someone has had a blackout under these circumstances.”
The study notes that although this phenomenon is not a common phenomenon, it is becoming more and more widespread. “Having cared for children with heart rhythm disorders for over 25 years, I was amazed at how widespread this emerging presentation is and to find that several children have even died from it. this 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 from Sydney.
In an accompanying editorial, Daniel Sohinki, MD, MSc, Department of Cardiology, University of Augusta, Augusta, GA, USA, and coauthors emphasized that “effort should be understood to encompass activities outside of traditional competitive athletics Appropriate counseling regarding the risks of intense video gaming should be targeted in children with a proarrhythmic cardiac diagnosis, and in any child with a history of exertional syncope of undetermined etiology. Additionally, any future screening program aimed at identifying athletes at risk for malignant arrhythmia should include athletes considered for participation in esports.
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