BACKGROUND: Psoriatic arthritis (PsA) is a chronic inflammatory systemic disease that is associated with cardiovascular comorbidities, particularly with an increased risk of arrhythmias. Despite the evidence, a structured population-based risk stratification that relates ECG parameters to clinical characteristics in PsA is still lacking. METHODS: Data from patients diagnosed with PsA who presented to our centre between 2014 and 2022 as well as from an age-matched and sex-matched control group of cardiovascular patients were collected. A variety of established ECG parameters associated with atrial and ventricular repolarisation and atrioventricular conduction as well as a comprehensive set of clinical variables were evaluated. RESULTS: A total of 725 patients with PsA alongside 725 matched cardiovascular patients were enrolled (mean age 52.5±13.4 years). The median duration of PsA was 2 years. Patients with PsA had similar rates of first-degree atrioventricular block (AVB I°) with the control group (9.5% vs 10.2%; p=0.725). After excluding patients with known atrial arrhythmias, patients with PsA had higher rates of significant P-wave terminal force in V1 versus controls (30.2% vs 14.1%; p<0.001). Furthermore, patients with PsA had a longer corrected Tpeak-Tend interval (0.26±0.04 vs 0.23±0.05; p<0.001). After adjusting for age, among patients with PsA, male sex (16.4% vs 7.1%; p=0.006) as well as long disease duration (18.0% vs 6.9%; p<0.001) were associated with AVB I°. CONCLUSION: Patients with PsA are at a significantly increased risk for ECG abnormalities related to both atrial and ventricular repolarisation as well as atrioventricular conduction. Non-invasive, ECG-based tools for structured risk stratification could facilitate the early detection of patients at risk.