Lethal cardiac arrhythmias may be triggered in susceptible children by electronic gaming

Electronic gaming can precipitate life-threatening cardiac arrhythmias in susceptible children whose predisposition may have been previously unrecognized, according to a new report in Heart Rhythm journal.

The investigators performed a systematic review of literature and initiated a multisite international outreach effort to identify cases of children with sudden loss of consciousness while playing video games. Across the 22 cases they found, multiplayer war gaming was the most frequent trigger. Some children died following a cardiac arrest. Subsequent diagnoses of several heart rhythm conditions put the children at continuing risk. Catecholaminergic polymorphic ventricular tachycardia (CPVT) and congenital long QT syndrome (LQTS) 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 significant implications for their families. In some cases, the investigation of a child who lost consciousness during video gaming led to many family members being diagnosed with an important familial heart rhythm problem.

The investigators 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 competitive sports it is often considered. At the time of the cardiac incidents, many of the patients were in excited states, having just won or lost games, or were engaging in conflict with companions.

Reference:

"Life-threatening cardiac arrhythmia and sudden death during electronic gaming: An international case series and systematic review," by Claire M. Lawley, MBBS, PhD, FRACP, Matthew Tester, BSc, Shubhayan Sanatani, MD, FHRS, Terence Prendiville, MD, Cheyenne M. Beach, MD, Jeffrey M. Vinocur, MD, Minoru Horie, MD, PhD, Jae-Sun Uhm, MD, Apichai Khongphatthanayothin, MD, Mark D. Ayers, MD, Luke Starling, MBBS, FRCPCH, Yoko Yoshida, MD, Maully J. Shah, MBBS, FHRS, Jonathan R. Skinner, MBChB, FHRS, MD, and Christian Turner, MBBS, FRACP (https://doi.org/10.1016/j.hrthm.2022.08.003).