Clinical significance of fat infiltration in the moderator band and right ventricular myocardium in multislice CT, and its association with abnormal conduction seen in electrocardiogram

Two apparently remote types of ventricular tachycardia from a single right bundle branch focal source

“…Spatial dissociation between the superior and inferior spread of ectopic activation might relate to the MB thickness (mean 4.5 ± 1.8 mm) and its anatomic insertion at the medial level of the RV septum at roughly one-half to two-thirds of the distance from the tricuspid valve to the RV apex 4 . Alternating exits beneath or above the MB insertion might be facilitated by slight shifts of the ectopic impulse origin within the Purkinje fibers inward-downward the MB or backward-upward the septum, and/or by anisotropic conduction, which is supported by findings of fat infiltration 5 or elements of endocardium that in the form of streaks penetrate the muscular tissue of the MB and its septal insertion 6 …”

Fatty foci within the heart and the accompanying changes in the coronary arteries diagnosed in electrocardiogram-gated multislice computed tomography of the heart

“…In the cardiac CT studies it was found that the incidence of fatty changes within the heart increases with the age of the patients [5,8,9,16]. Physiologic fat is located in the anterolateral RV free wall, RV outflow tract, and sometimes in RV trabeculae and the apex of the heart.…”