The Lead Episode 147: Heart Rhythm 2026 Late Breaker Coverage: A Discussion of Proton Beam Cardiac Radioablation for Refractory Ventricular Tachycardia: Results from a Frist-in-Human, Prospective, Non-Randomized Trial

Welcome to the third in this week's series of Lead episodes covering late breaking clinical trials from Heart Rhythm 2026 in Chicago. Join host Michael Lloyd, MD, FHRS, and his guests Christopher Kowalewski, MD and Karin Benali, MD, PhD for this discussion. This first-in-human, prospective study presented at Heart Rhythm 2026 evaluated noninvasive proton beam cardiac radioablation for patients with refractory ventricular tachycardia who had failed prior ablation and medical therapy. In a small, high-risk cohort, proton therapy was feasible and demonstrated substantial reductions in VT burden (approximately 80%) with no significant treatment-related toxicity observed during follow-up. These early findings highlight proton beam radioablation as a promising, highly targeted, noninvasive treatment option, though larger studies are needed to confirm long-term safety and durability.   Learning Objectives: Describe the principles of cardiac radioablation and the advantages of proton beam therapy compared with photon-based approaches for treating ventricular tachycardia.  Evaluate early feasibility, safety, and efficacy outcomes of proton beam therapy in patients with refractory ventricular tachycardia.  Assess the potential role of noninvasive cardiac radioablation in the treatment algorithm for patients with drug- and ablation-refractory ventricular tachycardia.    Podcast Contributors Michael S. Lloyd, MD, FHRS Christopher Kowalewski, MD Karin Benali, MD, PhD   Host and Contributor Disclosure(s): M. Lloyd •Honoraria/Speaking/Teaching/Consulting: Medtronic •Membership on Advisory Committees: Boston Scientific K. Bemali Nothing to disclose. D. Chew Nothing to disclose.