A qualitative study of adults with familial cardiomyopathy found perceptions of disease severity, family history, and safety uncertainties shaped how people viewed gene therapies for inherited heart disease. Participants weighed promise against concerns, with uncertainty acting as a key brake on enthusiasm. The findings matter for clinical program design in rare cardiovascular genetics: beyond manufacturing and efficacy, developers need clearer risk framing, longitudinal safety data communication, and family-centered counseling structures to translate trial participation into durable adoption.