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We give a diagrammatic characterization of the knots in the three-sphere and lens spaces which admit large Dehn surgeries to manifolds with Heegaard Floer homology of next-to-minimal rank. This is inspired by a corresponding result for knots which admit large Dehn surgeries to manifolds with Heegaard Floer homology of minimal rank due to Greene-Lewallen-Vafaee.

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