Compatibility with the N64's Bio Sensor makes Tetris 64 something a bit different. The Bio Sensor is clipped to the players ear and measures their pulse rate and speeds up the rate of the game along with the players pulse in reverse Bio Tetris mode. (Thankfully the normal Bio Tetris mode slows down the game speed as your heart speeds up.) This version of Tetris also offers four player match ups and a Giga Tetris mode where the giant blocks break up into smaller units. Features some nice photogenic backgrounds such as a man on the moon or a Thai temple.
Second hand. Bio Sensor is sold separately and not included. Import friendly English menus. Complete with registration card. Very slight impression near top edge of manual. Reverse of box concave. Slight box scuffing and creasing.
Biosensor available here....
https://www.genkivideogames.com/japanese_imported_video_games.asp?pagetoshow=search&KeywordText=biosensor