I've treated with heat alone now twice. Do keep it over 86 for two full weeks just in case. Fish can have ich without it being visible (in their gills). Two weeks may be longer than needed, but it is so very easy to quit too early and then have to start over.
If the temperature spent any time under 86, start all over.
Be sure your thermostat is accurate; I always go to 88 or 89 just to be sure, as there may be parts of the tank cooler than others.
Vacuuming with the heat treatment has negligible impact. While you may be removing some tomont (reproducing form in the substrate) you cannot possibly get them all, and it only takes one to start it all over. The main recommendation for vacuuming is when using medicines since the medicines are less effective with high organic compounds in the tank - vacuuming removes the organics and makes medicines more effective. It does little for heat or heat + salt treatment.
Don't mix up temperatures. Heat only or heat + salt - over 86 degrees. Medicine - warm, like 82. Do not get these backwards. Doing heat treatment but not getting over 86 is about the worst you can do, as it speeds the lifecycle without killing the parasite.
My two courses with heat were non-events - fish and plants and snails and shrimp were perfectly happy, a bit more hungry than usual.