Recommendation	Consensus statement instruction	Ref.
Genetic testing in patients with a potential cardiogenetic condition is performed only with appropriate genetic counselling.		Expert opinion
In patients with a clear specific phenotype, it is appropriate to perform genetic testing analysing genes with definite or strong evidence supporting disease causation.		10, 17, 20, 21, 69
In patients with a clear specific phenotype, it may be appropriate to analyse genes with moderate evidence supporting disease causation.		10, 17, 20, 21, 69
In selected cases with a definite phenotype and no genetic diagnosis after testing of the genes with definite or strong evidence supporting disease causation, broader genetic testing may be considered. Such selected cases may include familial cases, those with atypical features, such as extracardiac manifestations and those with unusual early disease onset.		17
Variant interpretation in the clinical setting is greatly enhanced by the use of disease-specific, multi-disciplinary teams that could include clinical disease experts, clinical geneticists, or genetic counsellors and molecular geneticists.		10, 70–75
Variant interpretation is best performed using standard guidelines for interpretation and can be enhanced by gene-specific rule specifications tailored for the gene and disease under consideration.		17, 76, 77
Reported Variants of Uncertain Clinical Significance (VUS) may be reclassified, i.e. ‘upgraded’ [Likely Pathogenic/Pathogenic (LP/P)] or ‘downgraded’ (Likely Benign/Benign), in multi-disciplinary clinics with access to molecular genetics laboratories, according to robustness of clinical phenotype and/or familial segregation evidence.		10, 70–75, 78
Genetic testing for genes with (i) limited, (ii) disputed, or (iii) refuted evidence should not be performed in patients with a weak (non-definite) phenotype in the clinical setting.		10, 17, 20, 21, 69
In families where a LP/P variant has been identified, detailed genetic counselling and guidance regarding inheritance patterns, variant penetrance, and risk should be offered, and cascade testing facilitated.		Expert opinion
In patients with a high probability of a specific inherited cardiac disease and a molecular screening performed in a pre-NGS era or with an incomplete NGS panel, repetition of the testing should be considered.		Expert opinion