Trayanova Lab Digital Twin Approach to Ventricular Tachycardia Ablation Published in NEJM

Results from our lab's first clinical trial of cardiac digital twin–guided ablation were published April 1, 2026 in the New England Journal of Medicine, and the work has since received broad coverage across major outlets.

The trial, led by Dr. Jonathan Chrispin and developed in collaboration with our group here at the Trayanova Lab, enrolled 10 patients with ventricular tachycardia (VT) — a potentially fatal arrhythmia responsible for tens of thousands of sudden cardiac deaths in the United States each year. Working with FDA clearance, we constructed patient-specific digital twins of each participant's ventricles using high-resolution MRI data, assigning distinct electrical properties to healthy and damaged tissue regions. Computational simulations then modeled how electrical signals propagate, stall, and re-enter — revealing the circuits responsible for dangerous rhythms. Virtual ablations were performed on these models to identify optimal targets before any catheter ever entered the patient.

The results were striking. All 10 patients remained free of sustained arrhythmias through follow-up, and most were able to discontinue antiarrhythmic drug therapy entirely. The digital twin guidance also dramatically shortened procedure time — from roughly three hours under standard approaches down to approximately 30 minutes — reducing patient exposure to prolonged sedation. As Prof. Trayanova has described it: "We treat the twin before we treat the patient."

The work is receiving significant attention:

• JHU HUB Press Release: hub.jhu.edu/2026/04/01/digital-twin-hearts-arrhythmia-trial/
• CNN Health: edition.cnn.com/2026/04/03/health/heart-health-digital-twin
• Associated Press: apnews.com/article/heart-disease-arrhythmia-ventricular-tachycardia-73086c0c3df8758380bef539940fa826
• Science News: sciencenews.org/article/digital-heart-replica-guide-ablation
• NEJM: https://www.nejm.org/doi/10.1056/NEJMc2517822

This trial represents a first clinical validation of a technology our lab has been developing for years, translating computational cardiac modeling directly into patient care. Larger multicenter studies are planned, and we have already launched a parallel trial applying the digital twin approach to atrial fibrillation. We are grateful to all collaborators and patients who made this milestone possible.

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