{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:53:10Z","timestamp":1791899590237,"version":"4.3.4"},"reference-count":161,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Stereotactic arrhythmia radioablation (STAR) has emerged as a promising non\u2010invasive therapy for refractory ventricular tachycardia, yet its biological mechanisms remain poorly defined. While conventional catheter ablation achieves arrhythmia control through structural remodelling, radiotherapy was initially assumed to act similarly. However, STAR reduces ventricular arrhythmia burden within weeks, preceding the development of radiation\u2010induced structural remodelling. This temporal mismatch indicates that early anti\u2010arrhythmic effects are probably driven by functional adaptations. Human tissue findings and preclinical large\u2010 and small\u2010animal models have provided the first insights into how the myocardium responds to focal high\u2010dose radiation, yet experimental data on STAR's underlying cellular mechanisms remain limited. Across these studies, a consistent observation is the temporal dissociation between early functional effects and delayed structural remodelling, which provides a key framework for interpretating STAR's anti\u2010arrhythmic action. In this review, we synthesize current evidence on cell\u2010type\u2010specific responses to ionizing radiation by integrating insights from the emerging STAR literature, oncology and radiation heart disease models. By linking time\u2010resolved cellular responses to clinical observations, we aim to distinguish mechanisms most relevant to early therapeutic effects from those contributing to delayed remodelling, and to define key knowledge gaps for guiding safe and effective clinical implementation.\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tjp70835-gra-0001-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1113\/jp291160","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:27:17Z","timestamp":1791898037000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ionizing radiation\u2010induced remodelling of the heart: Cellular pathways and crosstalk relevant to stereotactic arrhythmia radioablation (STAR)"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9247-9478","authenticated-orcid":false,"given":"Luka","family":"Nys","sequence":"first","affiliation":[{"name":"Laboratory of Experimental Cardiology Department of Cardiovascular Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2007-377X","authenticated-orcid":false,"given":"Eva","family":"Goethals","sequence":"additional","affiliation":[{"name":"Cardiology, Department of Cardiovascular Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2078-3271","authenticated-orcid":false,"given":"Ana\u00efs","family":"Saint\u2010Martin\u2010Willer","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology Department of Cardiovascular Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8296-920X","authenticated-orcid":false,"given":"Bert","family":"Vandenberk","sequence":"additional","affiliation":[{"name":"Cardiology, Department of Cardiovascular Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0488-2410","authenticated-orcid":false,"given":"Eef","family":"Dries","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology Department of Cardiovascular Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"4","key":"e_1_2_2_2_1","first-page":"730","article-title":"Low\u2010dose cardiac radiation improves electrical function and reduces ventricular arrhythmogenesis in mice with nonischemic cardiomyopathy","volume":"12","author":"Abhyankar D. 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