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T wave morphology (TWM) can distinguish cLQTS subtypes but its role in acquired LQTS (aLQTS) is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic databases were searched using the terms \u201cLQTS,\u201d \u201clong QT syndrome,\u201d \u201cQTc prolongation,\u201d \u201cprolonged QT,\u201d and \u201cT wave,\u201d \u201cT wave morphology,\u201d \u201cT wave pattern,\u201d \u201cT wave biomarkers.\u201d Whole text articles assessing TWM, independent of QTc, were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventeen studies met criteria. TWM measurements included T\u2010wave amplitude, duration, magnitude, Tpeak\u2010Tend, QTpeak, left and right slope, center of gravity (COG), sigmoidal and polynomial classifiers, repolarizing integral, morphology combination score (MCS) and principal component analysis (PCA); and vectorcardiographic biomarkers. cLQTS were distinguished from controls by sigmoidal and polynomial classifiers, MCS, QTpeak, Tpeak\u2010Tend, left slope; and COG <jats:italic>x<\/jats:italic> axis. MCS detected aLQTS more significantly than QTc. Flatness, asymmetry and notching, J\u2010Tpeak; and Tpeak\u2010Tend correlated with QTc in aLQTS. Multichannel block in aLQTS was identified by early repolarization (ERD<jats:sub>30%<\/jats:sub>) and late repolarization (LRD<jats:sub>30%<\/jats:sub>), with ERD reflecting hERG\u2010specific blockade. Cardiac events were predicted in cLQTS by T wave flatness, notching, and inversion in leads II and V<jats:sub>5<\/jats:sub>, left slope in lead V<jats:sub>6<\/jats:sub>; and COG last 25% in lead I. T wave right slope in lead I and T\u2010roundness achieved this in aLQTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Numerous TWM biomarkers which supplement QTc assessment were identified. Their diagnostic capabilities include differentiation of genotypes, identification of concealed LQTS, differentiating aLQTS from cLQTS; and determining multichannel versus hERG channel blockade.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.13015","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T06:00:32Z","timestamp":1667887232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The diagnostic role of T wave morphology biomarkers in congenital and acquired long QT syndrome: A systematic review"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2770-1574","authenticated-orcid":false,"given":"Daniel T.","family":"Tardo","sequence":"first","affiliation":[{"name":"Cardiac Electrophysiology Laboratory Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"},{"name":"Department of Cardiology St. Vincent's Hospital  Darlinghurst New South Wales Australia"},{"name":"School of Medicine University of Notre Dame Australia  Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Peck","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Laboratory Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh\u00a0N.","family":"Subbiah","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Laboratory Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"},{"name":"Department of Cardiology St. Vincent's Hospital  Darlinghurst New South Wales Australia"},{"name":"St. Vincent's Clinical School, Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3859-3716","authenticated-orcid":false,"given":"Jamie I.","family":"Vandenberg","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Laboratory Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"},{"name":"St. Vincent's Clinical School, Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam. 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