Heart conditions may be causing gaming 'black outs'

New research from Sydney Children's Hospitals Network has found electronic gaming can trigger potentially dangerous heart arrhythmias in susceptible children.

The report, published today in Heart Rhythm, the official journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, identified an uncommon, but distinct, pattern among children who lose consciousness while playing electronic (video) games and have an underlying heart condition.

Led by Dr Claire Lawley, Professor Jon Skinner and Dr Christian Turner in the Heart Centre for Children, the report reviewed 22 cases around the globe, where the child had experienced a sudden loss of consciousness while gaming, with subsequent cardiac conditions identified in 12 patients and seven patients having a prior cardiac history. 

“Video games may represent a serious risk to some children with arrhythmic conditions; and sadly, in our study, we have found that they have been lethal in patients with predisposing, but often previously unrecognized arrhythmic conditions,” Dr Lawley said.

Of these 22 cases, six patients were resuscitated following a cardiac arrest and four died suddenly.

While the research does highlight a dangerous new phenomenon, Dr Lawley says the children at risk of a 'black out' episode is very small.

"While worrying, the number of children and teenagers at risk of these episodes is extremely small. The main thing we want people to be aware of is that fainting or collapsing while playing a video game could be a sign of something more serious and if a child experiences an episode like this, it is really important to seek medical attention," Dr Lawley said.

"Many faints are not dangerous, but there are certain types of blacking out that are dangerous which can even be life-threatening. It is vital that the dangerous forms of blacking out are picked up by a doctor as these children and teenagers can be kept safe and healthy with well-established medical treatment."

Most faints ("blackouts") don’t signify a dangerous heart rhythm disturbance; these common faints typically occur with standing, on hot days, often with dehydration and usually have warning signs like dizziness, nausea or visual disturbance. Loss of consciousness associated with dangerous heart rhythm disturbances are typically unheralded, occur suddenly and most typically occur during periods of high excitement or during exercise.

At the time of their cardiac incident, many of the patients were in excited states, having just won or lost games, or were engaging in conflict with companions. Multiplayer war games were also identified as the most common trigger.

"We already know that some children have heart conditions that can put them at risk when playing competitive sports, and what this shows is that the same applies to electronic gaming," Dr Turner said.

"This is a really important discovery. We need to ensure everyone knows how important it is to get checked out when someone has had a blacking out episode in these circumstances."

The study further found 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 majority of underlying heart rhythm conditions identified in this report do have causative genetic variants. Therefore, family members might then also be at risk of having the same underlying condition and should be offered testing," Prof Skinner said.

"Family members identified to have the same condition can then be offered potentially lifesaving medical treatment."

Study investigators reinforced the research was not cause for public alarm, but highlighted the importance of seeking medical help should an episode like this occur.

"Children playing games electronically are at no greater risk than playing school sports or being physically active but if a child does experience a new black out, faint, collapse or seizure while gaming, they should be checked out by their local or family doctor to determine if further tests are necessary," Dr Turner said.