{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T03:05:17Z","timestamp":1775703917996,"version":"3.50.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Right atrial (RA) diverticulum is a rare malformation that can, in some cases, harbour an accessory pathway (AP). This report describes the case of a patient with RA diverticulum associated with a high-risk right posteroseptal AP. Successful radiofrequency catheter ablation was performed, eliminating the AP and resolving the patient\u2019s pre-excitation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 33-year-old man with a 15-years history of an AP presented with two isolated, self-limited episodes of palpitations. A 12-lead ECG during normal sinus rhythm showed pre-excitation consistent with a right posteroseptal AP. The electrophysiological study identified an inducible antidromic atrioventricular tachycardia (tachycardia cycle length = 220\u2005ms) due to a high-risk AP with robust conduction in both antegrade and retrograde directions. The AP was localized inside a RA diverticulum near the tricuspid annulus, confirmed through angiography and 3D high-density mapping. Radiofrequency ablation was successfully performed at the top of the diverticulum at a site recording an AP potential. To further characterize the diverticulum, a cardiac magnetic resonance was performed, and showed a maximum dimension of 20 \u00d7 16\u2005mm. Since the diverticulum did not cause any haemodynamic impact, surgical intervention was deemed unnecessary.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>\u2018Anatomical\u2019 APs are rare, often described in the literature as diverticula of the coronary sinus. However, RA diverticula associated with APs are exceedingly uncommon, with only a few cases reported. This case underscores the importance of considering structural abnormalities like RA diverticula in patients presenting with unusual arrhythmic patterns and highlights the effectiveness of radiofrequency ablation as a definitive treatment in such complex scenarios.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf236","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T03:53:14Z","timestamp":1747799594000},"source":"Crossref","is-referenced-by-count":1,"title":["High-risk accessory pathway associated with a rare right atrial diverticulum: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3267-4105","authenticated-orcid":false,"given":"Alessio","family":"Petrone","sequence":"first","affiliation":[{"name":"Arrhythmia Unit, AOU Careggi Hospital , Largo Giovanni Alessandro Brambilla, 3, Florence 50134 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