IHSS: Treatment

Clinical - Cardiovascular

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


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