背景:最近有报道称电子游戏是易感个体中危及生命的心律失常的诱发因素。
目的:本研究的目的是描述处于危险中的人群,心脏事件的性质,以及与电子游戏相关的心律失常相关的游戏类型。
方法:进行了一系列疑似或证实儿童电子游戏过程中心律失常的多站点国际病例,并对文献进行了系统回顾。
结果:22例患者(病例系列中18例,经系统评价4例;年龄7-16岁;19例男性[86%])被确定为在电子游戏期间经历过疑似或证实的室性心律失常;6例(27%)经历过心脏骤停,4人(18%)突然死亡。在游戏事件发生之前,有7名(31%)患者进行了心律失常性心脏诊断,之后又有12名(54%)进行了诊断。10例患者(45%)有儿茶酚胺能多形性室性心动过速,4人(18%)有长QT综合征,2(9%)是先天性心脏手术后,2例(9%)患有“特发性”心室纤颤,1(川崎病后)有冠状动脉缺血。在3名患者(14%)中,包括2人死亡,诊断仍然未知。在13名(59%)知道电子游戏细节的患者中,8(62%)是战争游戏。
结论:电子游戏可以在易感儿童中诱发致死性心律失常。发病率似乎很低,但是这种情况下的晕厥应该彻底调查。在患有心律失常性心脏病的儿童中,特别是电子战游戏是一种有效的心律失常触发因素。
Electronic gaming has recently been reported as a precipitant of life-threatening cardiac arrhythmia in susceptible individuals.
The purpose of this study was to describe the population at risk, the nature of cardiac events, and the type of game linked to cardiac arrhythmia associated with electronic gaming.
A multisite international case series of suspected or proven cardiac arrhythmia during electronic gaming in children and a systematic
review of the literature were performed.
Twenty-two patients (18 in the case series and 4 via systematic
review; aged 7-16 years; 19 males [86%]) were identified as having experienced suspected or proven ventricular arrhythmia during electronic gaming; 6 (27%) had experienced cardiac arrest, and 4 (18%) died suddenly. A proarrhythmic cardiac diagnosis was known in 7 (31%) patients before their gaming event and was established afterward in 12 (54%). Ten patients (45%) had catecholaminergic polymorphic ventricular tachycardia, 4 (18%) had long QT syndrome, 2 (9%) were post-congenital cardiac surgery, 2 (9%) had \"idiopathic\" ventricular fibrillation, and 1 (after Kawasaki disease) had coronary ischemia. In 3 patients (14%), including 2 who died, the diagnosis remains unknown. In 13 (59%) patients for whom the electronic game details were known, 8 (62%) were war games.
Electronic gaming can precipitate lethal cardiac arrhythmias in susceptible children. The incidence appears to be low, but syncope in this setting should be investigated thoroughly. In children with proarrhythmic cardiac conditions, electronic war games in particular are a potent arrhythmic trigger.