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But running on a big 55" 4K TV. With the normal PC display, it doesn't happen. I guess you play on TV, too?
Go there:
C:\Users\[your name]\Documents\My Games
Go in your Isaac folder (depends on which DLCs you have or not), open the options.ini file, change the line "VSync=1" to 0. It should disable it (I mean, it's the pupose of this line).
In win11 display settings change your refresh rate to 60hz, this works for me, no screen tearing anymore.
Vsync 1
Refresh rate 60hz
Full screen 1920x1080
I play on TV connected to my notebook
Hope this help someone