The Lead Episode 148: HRS 2026 Late-Breaker Coverage, A Discussion of Ventricular Intramyocardial Navigation and Tachycardia Ablation Guided by Electrograms (VINTAGE): First-in-Human Experience with a Novel Therapy for Refractory Ventricular Arrhythmias

Join Digital Education Committee member Jason T. Jacobson, MD, FHRS, and his guests John L. Sapp, Jr., MD, FHRS and Kyoko Soejima, MD for this conversation at Heart Rhythm 2026 in Chicago. This discussion reviews the late-breaking clinical trial Ventricular Intramyocardial Navigation and Tachycardia Ablation Guided by Electrograms (VINTAGE): First-in-Human Experience with a Novel Therapy for Refractory Ventricular Arrhythmia, presented at HRS 2026 in Chicago. Faculty discuss the novel VINTAGE technique, which enables catheter-based navigation and ablation within the myocardial wall to target deep intramural ventricular arrhythmia substrates that are often inaccessible with conventional endocardial or epicardial approaches. The conversation highlights the potential clinical impact of this first-in-human experience, including procedural feasibility, mechanistic innovation, and future implications for the treatment of patients with refractory ventricular tachycardia and complex ventricular arrhythmias.   Learning Objectives Describe the VINTAGE intramyocardial navigation approach and its proposed role in the treatment of refractory ventricular arrhythmias.  Evaluate the clinical challenges associated with mapping and ablating deep intramural ventricular tachycardia substrates using conventional techniques.  Assess the potential implications of first-in-human feasibility and safety findings for future ventricular arrhythmia ablation strategies.    Podcast Contributors Jason T. Jacobson, MD, FHRS John L. Sapp, Jr., MD, FHRS Kyoko Soejima, MD   Host and Contributor Disclosure(s): J. Jacobson • Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, Vektor Medical Inc. • Stocks, Privately Held: Atlas 5D • Research: CardioFocus, Inc. • Membership on Advisory Committees: Abbott Medical, Johnson and Johnson J. Sapp • Honoraria/Speaking/Teaching/Consulting: Medtronic, Varian Medical Systems, Biosense Webster • Research: Abbott Medical, Biosense Webster K. Soejima • Honoraria/Speaking/Consulting: Medtronic Japan, Boston Scientific Japan, Abbott Medical, Abbott Japan, Boehringer Ingelheim, Daiichi Sankyo