Family Leaders Communicate Risk During Cascade Screening after Sudden Cardiac Death in the Young

Introduction Relatives of a victim of sudden cardiac death in the young (SCDY) may be at risk for hereditary cardiomyopathies and arrhythmias. Family leaders are often responsible for communicating risk to surviving family at a difficult time. Purpose Explore barriers and facilitators to communication about cascade screening in families who have lost a family member to SCDY Methods Semi-structured interviews (n = 14) were conducted with family members of a SCDY decedent. Participants were recruited from the Sudden Arrhythmia Death Syndrome advocacy group. Interviews were conducted until data saturation was reached. Interviews were audio recorded, transcribed, and analyzed using conventional content analysis. Results Five categories were identified from the interviews: 1. Participants understood fundamental risks but the clinical variability in arrhythmia and cardiomyopathy was difficult to interpret and convey; 2. Family leaders felt some family disregarded risk information; 3. Grief interfered with communication; 4. Communication aids were insufficient stand-alone interventions; 5. Families advocated for a “genetic family navigator”. Conclusion The five categories provide practical strategies to improve clinical care and communication for families after a SCDY and emphasize the need for genetic family navigators to facilitate cascade screening. ![Figure][1] ### Competing Interest Statement The authors have no conflicts of interest to disclosure. The SADS Foundation did not provide funding or perform pre-publication review of the manuscript. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB of Northwestern University waived ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Transcripts redacted for participant privacy are available upon request, contingent on appropriate human subjects protection and after execution of an adequate data sharing agreement. [1]: pending:yes