中文摘要：

背景：CARTO 系统指导的底层修正被介绍了在心肌的梗塞(MI ) 以后便于心室性心博过速(vt ) 的线性脱离。然而，没有为画这些脱离线可得到的通常接受的标准途径。因此，现在的学习的目的是实际上这次精制消费过程。方法：底层修正用 CARTO 系统在 MI 以后与经常的 vt 在 23 个连续病人被执行。起始的目标地点(它的) 因为脱离被印射的步(下午) 在 vt 期间在室性节律或乘火车踱步(他们) 期间识别。根据起始的目标地点，二条途径被使用。在途径一的起始的目标地点从刺激作为 vt 和间隔有类似的 QRS 形态学到=的 QRS ( S-QRS )的发作 50 ms 在在室性节律或在间隔和 vt 上踱步的柱子的差别的下午期间骑车长度= 30 ms 在隐藏的乘火车期间 vt 踱步；在途径二的起始的目标地点作为 vt 和 【 的 S-QRS 有类似的 QRS 形态学 50 ms 在在室性节律的下午期间。结果：总的来说， 50 根线被执行与一段(35 +/- 11 ) 公里。平均的过程时间(232 +/- 56 ) 分钟，荧光检查时间(10 +/- 8 ) 分钟。十六个病人开始被包含进途径一。在 1 脱离衬里的 3 +/- 的结束以后，没有进一步的 vt 在 13 个病人是可诱导的。留下 3 个病人被换到选择接近的使用。然而，在没有，他们，其他的途径是成功的。途径二开始在 7 个病人被使用。在 1 脱离衬里的 3 +/- 的结束以后，没有进一步的 vt 在仅仅 2 个病人是可诱导的。留下 5 个病人被换到接近一个，它在他们中的 4 个导致了 vt 的 noninducibility。起始的成功的率在途径二的组在与那相比的途径一的组是显著地更高的(13/16 病人对 2/7 病人， P 0.026 ) 。结论：为在 MI 以后的 vt 的底层修正的途径能被在慢传导的地区以内与特定的特征识别适当起始的目标地点优化。精制途径可以便于 vt 的线性脱离，并且进一步减少过程和荧光检查时间。

英文摘要：

Background Substrate modification guided by CARTO system has been introduced to facilitate linear ablation of ventricular tachycardia （VT） after myocardial infarction （MI）. However, there is no commonly accepted standard approach available for drawing these ablation lines. Therefore, the aim of the present study was to practically refine this time consuming procedure. Methods Substrate modification was performed in 23 consecutive patients with frequent VTs after MI using the CARTO system. The initial target site （ITS） for ablation was identified by pace mapping （PM） during sinus rhythm and/or entrainment pacing （EM） during VT. According to the initial target site, two approaches were used. The initial target site in approach one has a similar QRS morphology as VT and an interval from the stimulus to the onset of QRS cmplex （S-QRS） of ≥50 ms during PM in sinus rhythm or a difference of the post pacing interval and VT cycle length ≤30 ms during concealed entrainment pacing of VT; The initial target site in approach two has an similar QRS morphology as VT and an S-QRS of 〈50 ms during PM in sinus rhythm. Results Overall, 50 lines were performed with a length of （35±11） mm. Procedure time averaged （232±56） minutes, fluoroscopy time （10±8） minutes. Sixteen patients were initially involved into approach one. After completion of 3±1 ablation lines, no further VT was inducible in 13 patients. The remaining 3 patients were switched to use the alternative approach. However, in none of them the alternative approaches were successful. Approach two was initially used in 7 patients. After completion of 3±1 ablation lines, no further VT was inducible in only 2 patients. The remaining 5 patients were switched to approach one, which resulted in noninducibility of VT in 4 of them. The initial successful rate was significantly higher in the group of approach one compared to that in the group of approach two （13/16 patients vs 2/7 patients, P=-0.026）. Conclusions The approach for