Current practices in the investigation of sudden cardiac death in Southeastern Europe countries: results of a multinational survey

Introduction Sudden cardiac death (SCD) is the leading cause of of non traumatic death among young individuals, with a significant proportion of cases potentially related to inherited heart diseases. Beyond the profound emotional impact on the affected families, these deaths also represent a social and economic burden. Comprehensive autopsy protocols and specialized registries may improve epidemiological accuracy, guide healthcare policy, and enable early identification and monitoring of at-risk family members. The aim of this study was to identify whether standardized autopsy protocols for SCD are implemented across different centers and to determine the existence of specialized registries. Methods Group of authors developed the survey consisting of 17 structured questions, focusing on autopsy procedures, guidelines implementation, genetic testing, and registry availability. The survey was distributed electronically via e-mail to professionals primarily involved in the investigation and management of SCD. Results A total of 88 respondents from multiple centers across 14 countries, predominantly in Southeastern Europe, completed the survey. The findings reflect self-reported practices among participating professionals rather than a representative overview of national practice in each country and indicate variability in autopsy practice, particularly regarding guideline adherence, toxicological testing, and the use of genetic analyses. Only six centers with regional SCD registries were identified, and in most cases, affected family members were not enrolled in structured medical follow-up programs. Discussion These findings highlight the need to increase awareness of the importance of autopsy in cases of SCD, to ensure appropriate and continuous education of professionals involved in ordering and performing autopsies in such cases to achieve standardized and high-quality autopsy practice, and to promote the establishment of registries in order to support family surveillance and national healthcare policy.