The Tp-e interval and Tp-e/QT ratio as markers of ventricular repolarization dispersion and atrial conduction heterogeneity following electrical injury: A retrospective case-control study

BACKGROUND Electrical injuries are a significant cause of cardiovascular morbidity and life-threatening arrhythmias. This study aimed to evaluate markers of ventricular repolarization dispersion and atrial conduction heterogeneity, specifically, the Tp-e interval, Tp-e/QT ratio, and P-wave dispersion, in patients presenting with electrical injury METHODS: In this retrospective case-control study, 50 patients with electrical injury were compared with 59 age- and sex-matched healthy controls. Standard 12‑lead electrocardiograms were obtained for all participants. Key parameters, Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio, and P-wave dispersion, were manually measured by two blinded cardiologists with excellent interobserver reliability. A subgroup analysis was also performed within the injury cohort based on troponin status RESULTS: The Tp-e interval was significantly prolonged in the electrical injury group compared to controls (median 85.0 ms vs. 80.0 ms, p < 0.001). The Tp-e/QT ratio (0.24 vs. 0.21, p < 0.001), Tp-e/QTc ratio (0.20 vs. 0.19, p = 0.005), and P-wave dispersion (45.0 ms vs. 25.0 ms, p < 0.001) were also elevated in patients with electrical injury. Notably, no significant differences in these electrocardiographic parameters were observed between troponin-positive and troponin-negative subgroups CONCLUSION: Electrical injury is associated with significant acute abnormalities in ventricular repolarization and atrial conduction heterogeneity, independent of troponin elevation. The Tp-e interval, Tp-e/QT ratio, and P-wave dispersion may serve as potential electrocardiographic markers of arrhythmic risk in this population, though their prognostic utility requires validation in prospective studies.