The structure and function of every cell in the body depend on genetic material passed down generationally. Changes in genes of the heart can impair its function and increase the risk of arrhythmias and sudden cardiac arrest. Conditions like arrhythmogenic right ventricular dysplasia, hypertrophic cardiomyopathy, long QT syndrome, and Brugada syndrome have a genetic basis that can be passed down from parent to child. Many of these conditions have characteristic findings on electrocardiogram that may otherwise be the only finding in an asymptomatic person. Early genetic screening is important for risk stratification and guiding treatment plans. The goal of treatment for any affected family or individual is to prevent sudden cardiac death.