Sudden cardiac death (SCD) might have an inherited cardiac condition background. Genetic testing supports post-mortem diagnosis and screening of relatives at risk. Our aim is to determine the feasibility of a Czech national collaboration group and to establish the clinical importance of molecular autopsy and family screening. From 2016 to 2021, we have evaluated 100 unrelated SCD cases (71.0% males, age: 33.3 (12.8) years). Genetic testing was performed by next-generation sequencing utilizing a panel of 100 genes related to inherited cardiac/aortic conditions and/or whole exome sequencing. According to autopsy, cases were divided into cardiomyopathies, sudden arrhythmic death syndrome, sudden unexplained death syndrome, and sudden aortic death. We identified pathogenic/likely pathogenic variants following ACMG/AMP recommendations in 22/100 (22.0%) of cases. Since poor DNA quality, we have performed indirect DNA testing in affected relatives or in healthy parents reaching a diagnostic genetic yield of 11/24 (45.8%) and 1/10 (10.0%), respectively. Cardiological and genetic screening disclose 83/301 (27.6%) relatives at risk of SCD. Genetic testing in affected relatives as starting material leads to a high diagnostic yield offering a valuable alternative when suitable material is not available. This is the first multidisciplinary/multicenter molecular autopsy study in the Czech Republic which supports the establishment of this type of diagnostic tests. A central coordinator and proper communication among centers are crucial for the success of a collaboration at a national level.

1st Department of Internal Medicine Cardiology and Laboratory of Cardiogenomics University Hospital Olomouc and Palacky University Olomouc Czech Republic

Department of Biology and Medical Genetics 2nd Faculty of Medicine Charles University and Motol University Hospital 5 Úvalu 84 150 06 Prague 5 Czech Republic

Department of Biology and Medical Genetics University Hospital Ostrava Ostrava Czech Republic

Department of Cardiology Center for Inherited Cardiovascular Diseases IKEM Vídeňská 1958 9 140 21 Prague 4 Czech Republic

Department of Forensic Medicine and Toxicology Liberec Regional Hospital Liberec Czech Republic

Department of Forensic Medicine Faculty of Medicine in Hradec Králové Charles University and University Hospital Hradec Králové Prague Czech Republic

Department of Forensic Medicine Faculty of Medicine University Hospital Bulovka Charles University 2nd Prague Czech Republic

Department of Medical Genetics University Hospital Pilsen Pilsen Czech Republic

Faculty of Medicine Children's Heart Centre Charles University and Motol University Hospital 2nd Prague Czech Republic

Forensic Department Hospital České Budějovice České Budějovice Czech Republic

Forensic Department of Military University Hospital Prague Czech Republic

Institute for Forensic Medicine 3rd Faculty of Medicine Charles University Prague Czech Republic

Institute of Forensic Medicine and Toxicology 1st Faculty of Medicine Charles University Prague Czech Republic

Institute of Forensic Medicine Faculty of Medicine in Pilsen Charles University Prague Czech Republic

Institute of Forensic Science and Medical Law University Hospital Olomouc and Palacký University Olomouc Czech Republic

Institute of Medical Genetics University Hospital Olomouc and Palacky University Olomouc Czech Republic

Institute of Pathological Physiology University Hospital Olomouc and Palacky University Olomouc Czech Republic

Paediatric Department 3rd Faculty of Medicine Charles University Prague Czech Republic

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