According to Barash, IHSS (HoCM) treatments include :
- alcohol ablation of the interventricular septum
- Pacing, using mode DDD with a short AV delay. This pre-excites the LV apex, resulting in paradoxical septal motion. The result is decreased ejection velocity, no SAM, and reduced LVOT gradient.
- septal myomectomy
Goals include :
- myocardial depression, often with volatiles
- preload full, afterload increased (e.g. phenylephrine)
- rate normal, rhythm sinus