Right posterior atrioventricular ring: A location for different types of atrioventricular accessory connections

We present an unusual case of a 28-year-old female patient with recurrent e pisodes of tachycardias due to participation of two accessory connections l ocated in the posterior tricuspid annulus. Both connections were of the atr ioventricular type, the one with non decremental fast conducting properties at the right posteroseptal area, the other with node-like properties at th e posterolateral tricuspid ring. Both pathways were successfully ablated tr ansvenously with radiofrequency energy application at the same session. Imp lications about a common embryological origin of the two pathways as well a s review of the literature for similar cases are presented.