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Case Reports
. 2020 May 5;6(6):313-317.
doi: 10.1016/j.hrcr.2020.02.007. eCollection 2020 Jun.

Video game ventricular tachycardia: The "Fortnite" phenomenon

Dustin Nash  1 , Hae-Rhi Lee  1 , Christopher Janson  1 , Chalese Richardson-Olivier  1 , Maully J Shah  1
Affiliations
Case Reports

Video game ventricular tachycardia: The "Fortnite" phenomenon

Dustin Nash et al. HeartRhythm Case Rep. .
No abstract available

Keywords: Adrenergic-mediated tachycardia; Catecholaminergic polymorphic ventricular tachycardia; Sports participation; Ventricular tachycardia; Video games.

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Figures

Figure 1
Figure 1
A: Graphic trends of ventricular events during 24-hour ambulatory Holter monitoring in case 1 shows increased heart rates (top panel) during the 3 patient notations of (1) playing outside, (2) playing video games, and (3) playing football. During the same periods of time, the histogram (bottom panel) shows increased density of ventricular beats per interval. In the top panel the y-axis shows heart rate (beats per minute [BPM]) and the x-axis shows time of day/night. In the bottom panel the y-axis shows ventricular beats per time interval and the x-axis shows time of day/night. B: Three-channel 24-hour ambulatory Holter monitoring shows continuous polymorphic ventricular tachycardia at 200–230 BPM in case 1 during playing of the Fortnite video game. C: Three-channel 24-hour ambulatory Holter monitoring shows a run of nonsustained ventricular tachycardia at 200–220 BPM followed by ventricular bigeminy in case 1 at the time of playing recreational football.
Figure 2
Figure 2
Remote monitoring in case 2 shows continuous recording of intracardiac electrograms from the patient’s implantable cardioverter-defibrillator (ICD; Visia AF MRI VR SureScan, Medtronic Inc, Minneapolis, MN). Ventricular ectopy is followed by monomorphic ventricular tachycardia (VT) at a cycle length of 220–270 ms (222–270 beats/min) at the time of playing Fortnite followed by an ICD shock. The top channel shows right ventricle (RV)-tip-to-RV-ring electrograms and bottom channel shows can-to-RV-coil electrograms. The programmed ventricular fibrillation detection was 260 ms. Note that VT terminated spontaneously but a defibrillation shock was delivered due to the “Confirmation+” algorithm (nominally programmed to “on”), which prevented cancellation of therapy. Note that the VT electrogram morphology is different from sinus rhythm.
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