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IHSS: Treatment

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

Other References

  1. Keys to the Cart: May 08, 2017; A 5-minute video review of ABA Keywords Link