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Changes in the T wave segment of an ECG can provide both diagnostic and prognostic information and may be affected by a variety of intrinsic and extrinsic factors related to drug administration. To add, regulators in their guidance encourage sponsors to provide analysis on treatment\u2010emergent T wave morphology changes when submitting clinical study reports. Despite the T wave representing an important element of an ECG and impacting QT interval measurement, there is often a lack of recognition and incomplete understanding of the different T wave configurations that would affect subject management. Moreover, this topic has not been formally incorporated in pharmaceutical research. Therefore, this comprehensive review aims to profile normal and abnormal T wave morphologies that scientists and principal investigators might encounter during study conduct that would influence patient management and safety. This includes commentary on T wave pathophysiology, prognostic information, and short\u2010 and long\u2010term management strategies when T wave abnormalities are present.<\/jats:p>","DOI":"10.1111\/cts.70145","type":"journal-article","created":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T20:56:12Z","timestamp":1742676972000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Surfing the T Wave: A Primer on ECG T Wave Morphologies Encountered in Clinical Trials and Impact on the QT Interval and Patient Safety"],"prefix":"10.1111","volume":"18","author":[{"given":"Robert M.","family":"Lester","sequence":"first","affiliation":[{"name":"Celerion Inc.  Tempe Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Paglialunga","sequence":"additional","affiliation":[{"name":"Celerion Inc.  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