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In patients presenting with refractory ventricular tachycardia (VT) and aortic and mitral mechanical prosthetic valves, traditional catheter ablation is challenging. We describe a case in which a novel noninvasive computational electrocardiogram mapping algorithm localized VT sources originating from substrate near the mechanical valves, in which stereotactic ablative radiotherapy eliminated VT in 1.5-year follow-up. ( Level of Difficulty: Advanced. )., Competing Interests: Dr Krummen was supported by a grant from the University of California San Diego Galvanizing Engineering in Medicine Foundation. Dr Ho was supported by grants from the American Heart Association (19CDA34760021) and National Institutes of Health (1KL2TR001444). Dr Krummen owns equity in Vektor Medical Inc. Dr Ho has received grant support from Abbott Laboratories; and has received fellowship support from Abbott, Boston Scientific, Biotronik, and Medtronic; and owns equity in Vektor Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.