Conundrum of the tpeak-tend interval

Over the past years, many publications appeared dealing with the clinical utility of the electrocardiographic interval between the peak and the end of the T wave (the Tpe interval). A recently published meta-analysis concluded [1] that the Tpe interval is “a useful risk stratification tool in different diseases and in the general population”. This conclusion broadly agrees with the article by Yu et al in this issue of the Journal [2] who report that prolonged Tpe interval predicts arrhythmic events in the acute phase of ST elevation myocardial infarction. Hence, if quickly scanning through all this, conclusion can easily be made that the usefulness of Tpe interval for the prediction of arrhythmic risk has now been proven beyond reasonable doubt. However, when considering the topic of the usefulness of Tpe interval with proper research care, serious doubts remain. In this text, we therefore comment not only on the report by Yu et al but also on serious shortcomings in the recent meta-analysis by Tse et al [1] and discuss the frequent misunderstanding of the electrophysiologic basis of the Tpe interval. Since some of the enthusiasm for this ECG measurement might have been exaggerated, we intentionally present a critical view of the topic