"They might be lethal in patients with predisposing, but often previously unrecognized, arrhythmic conditions.
"Children who suddenly lose consciousness while electronic gaming should be assessed by a heart specialist as this could be the first sign of a serious heart problem."
She added: "They may not always be a safe alternative to sports for children who have a condition in which dangerous fast heart rhythms are a risk."
The study in the journal Heart Rhythm identified an "uncommon, but distinct pattern" among vulnerable children.
A systematic review of medical literature identified 22 cases of fainting - mostly occurring during war games involving multiple players.
Some died following a cardiac arrest. Subsequent diagnoses of several heart rhythm conditions put the children at continuing risk.
The most common underlying causes were CPVT (catecholaminergic polymorphic ventricular tachycardia) and LQTS (long QT syndrome).
The former leads to a rise in calcium levels inside cells. The latter delays the heart's electrical system. The congenital conditions each affect up to one in 2,000 children.
Almost two in three patients carried mutations linked to irregular heartbeats - which has significant implications.
(ESB Professional via Shutterstock)
In some cases, the investigation of a child who lost consciousness during video gaming led to many family members being diagnosed with a life-threatening heart rhythm problem.
Dr. Lawley said: "Families and healthcare teams should think about safety precautions around electronic gaming in children who have a condition where dangerous fast heart rhythms are a risk."
At the time of the incidents, many were in excited states, having just won or lost games, or were engaging in conflict with companions.
"But we were shocked to discover some patients were having life-threatening blackouts during video gaming.
"Video gaming was something I previously thought would be an alternative 'safe activity.'
"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."
Heart problems are becoming increasingly prevalent in younger people. Last month air pollution was linked to a rise in irregular beats among otherwise healthy teenagers.
Co-author Professor Jonathan Skinner, head of research at the Heart Centre for Children, said: "Having looked after children with heart rhythm problems for more than 25 years, I was staggered to see how widespread this emerging presentation is, and to find a number of children had even died from it.
"All of the collaborators are keen to publicize this phenomenon so our colleagues across the globe can recognize it and protect these children and their families."
He wrote: "Exertion should be understood to encompass activities outside of traditional competitive athletics.
"Appropriate counseling regarding the risks of intense video gameplay should be targeted in children with a pro-arrhythmic cardiac diagnosis, and in any child with a history of exertional fainting of undetermined cause.
"Further, any future screening programs aimed at identifying athletes at risk for malignant arrhythmias should encompass athletes being considered for participation in eSports."
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