Significant progress has been made in the management of ventricular arrhythmias in 2025, characterized by three paradigm shifts: earlier therapeutic intervention, expanded management dimensions, and continuous technological innovation. The European Heart Rhythm Association, in collaboration with multiple societies, released the first international consensus statement on epicardial ventricular arrhythmia ablation, establishing standardized protocols encompassing anatomical considerations, substrate identification, access techniques, and complication prevention. The European Heart Rhythm Association, in collaboration with the Heart Rhythm Society, has released the first-ever consensus document on patient selection, target definition, and data transfer for stereotactic radiotherapy in ventricular tachycardia. This document represents the first comprehensive technical summary of stereotactic radiotherapy for the treatment of ventricular tachycardia in the field. Three landmark clinical trials have reshaped clinical practice, VANISH2 demonstrated that catheter ablation as first-line therapy was superior to antiarrhythmic drugs in reducing composite endpoints in ischemic cardiomyopathy patients with ventricular tachycardia. POTCAST pioneered a metabolic intervention approach by showing that actively maintaining serum potassium in the high-normal range (4.5-5.0 mmol/L) significantly reduced ventricular tachycardia events and hospitalizations in implantable cardioverter defibrillator recipients. VCAS validated the feasibility of high-voltage pulsed field ablation for structural ventricular tachycardia, achieving transmural lesions via endocardial-only approach in humans and dramatically reducing arrhythmia burden. Collectively, these advances, spanning from treatment strategies and clinical concepts, to ablation technologies, are shaping a more comprehensive and proactive paradigm for ventricular arrhythmia management, offering evidence-based guidance for clinical decision-making.