Novel Cardiac Pacing to Initiate Cardiac Remodeling in Heart Failure

This project utilizes a novel cardiac pacing approach hypothesized to initiate beneficial cardiac conditioning and remodeling over a period of time.

Inclusion Criteria:Non-Ischemic CardiomyopathyEjection Fraction </= 35% despite at least 3 months stable standard medical managementNew York Heart Association Class II-III symptomsDual chamber implantable cardioverter defibrillator in place or Biventricular ICD in place (over 3 months old)Normal Atrioventricular conduction or Biventricular ICDQRS < 120 msec (inherent conduction or paced with BiV ICD)Exclusion criteria:Age < 18 yearsInability to ambulate safelyCongenital or primary valve diseaseLeft Ventricular thrombusSevere peripheral arterial diseaseAdmission for life-threatening condition (eg heart failure, stroke) in the past 3 monthsMajor surgery in the past 3 months or anticipated during the period of the trialPaced or intrinsic QRS >120 msecLife expectancy < 1 yearHemodialysisHematocrit < 30%Severe Chronic lung diseasePregnancyICD battery longevity < 1 yearUnsuppressed atrial arrhythmiasAlready participating in an exercise programusion Criteria