Abstract: Background: The loss of effective atrial contraction is associated with an increased thromboembolic risk.

Aim: To study the electromechanical coupling of the atria in patients with paroxysmal atrial fibrillation (time of occurrence of the episodes <48 hours) using pulsed-wave tissue Doppler imaging.

Materials and methods: The study included 51 patients (26 men, 25 women; mean age 59.84±1.60 years) and 52 controls (26 men, 26 women; 59.50±1.46 years) without evidence to date for episodes of atrial fibrillation. We studied atrial electromechanical delay in lateral mitral annulus (P-A'_MV) (ms) and tricuspid annulus (P-A'_TV) (ms) as well as interatrial dyssynchrony (IAD) ((P-A'_MV) - (P-A'_TV)) (ms). The echocardiographic study in patients was performed on the twenty fourth hour and twenty-eighth day after the restoration of sinus rhythm. In controls the echocardiographic indicators were defined once.

Results: P- A'_MV in patients with PAF was significantly prolonged compared to controls on the twenty-fourth hour as well as twenty-eighth day after the restoration of sinus rhythm (124.7±5.54 vs 106.80±2.30 ms, p=0.002; 123.2±6.12 vs 106.80±2.30 ms, p=0.006 respectively). The measurement of P- A'_TV showed no difference in the indicator in patients and controls (91.24±4.79 vs 87.64±1.85 ms, p=0.44; 91.70±4.92 vs 87.64±1.85 ms, p=0.38 respectively). There is an increased IAD in patients with PAF compared to controls in both measurements (31.63±3.57 vs 18.64±1.35 ms, p<0.001; 31.55±2.75 vs 18.64±1.35 ms, p<0.001).

Abstract:  A 12-year-old boy was referred to our hospital with a chief complaint of repetitive right lower acute abdominal pain and inguinal swelling for 7-hours. Physical examination found no palpable testis in the right scrotum and a painful mass of 3.0 x 2.5 centimeters in the right groin. Doppler ultrasonography revealed it without flow signals in the inguinal canal. Immediate surgical explorations confirmed a 720 -degree clockwise rotation of right testis, with dark surface. After receiving manual detorsion and warming, the testis was spared. Then bilateral orchidopexy was performed. The post-operative diagnosis was torsion of right undescended testis with hemorrhagic infarction. Careful physical examination and early surgical intervention may thus be strongly recommended in cases of suspected testicular torsion with cryptorchidism.