34
Treatment
Figure 5. Heart Failure Algorithm
Patients With HCM
LVEF <50%
and LBBB
YES
NO
Systolic function
LVEF <50% LVEF ≥50%
Obstructive
physiology?
Continue current
management
(1)
YES NO
YES
Evaluate for heart
transplant
(1)
NYHA class
III-IV
Symptoms
after CRT
NO
NYHA class
I-II
NYHA class
III-IV
Discontinue
negative
inotropic agents
(verapamil,
diltiazem,
disopyramide)
(2a)
GDMT
per Heart
Failure
Guideline
(1)
ICD
(2a)
Interrupt or
discontinue
myosin
inhibitor
(1)
Evaluate
for
other
causes of
reduced EF
(1)
CRT
(2a)
