Use of the dominant T wave to enhance reliability of T-wave offset identification ★

T-wave offset (Toff) identification may be jeopardized by the presence of a significant inter-method (IMV) and inter-lead (ILV) Toff variability. Thus, the aim of the present study was to investigate if the dominant T wave (DTW) may be used to enhance Toff-identification reliability. DTWs and 15-lead ECG T waves of 46 control healthy subjects (CHS) and 103 acute myocardial infarction patients (AMIP) were analyzed for Toff identification using Zhang et al.’s (M1) and Daskalov and Christov’s (M2) methods. Results indicate that IMV is significantly reduced when identifying Toff from the DTW rather than from single ECG leads in both populations (CHS: 5 ms vs. 5–15 ms; AMIP: 10 ms vs. 10–20 ms). Moreover, when analyzing ILV, Toff was found to be equivalent (correlation = 0.71–0.98; P < 10− 14) to the median Toff among leads, but required only one identification instead of 15. Thus, the DTW can be used to enhance Toff-identification reliability.