Extracorporeal Shockwave Myocardial Revascularization (ESMR) Therapy For The Treatment of Chronic Heart Failure

Inclusion Criteria: 1. Patient is male or female 18 years or older. 2. Patient is diagnosed with a Heart Failure with ischemic etiology. Diagnosis is based on medical history, complete physical evaluation, and echocardiography. 3. Patient has documented myocardial segments with impaired contractility. Diagnosis is based on Rest Echo. 4. Patient is diagnosed with no more than 50% of segments akinetic or dyskinetic Diagnosis is based on echocardiography. 5. Patient is classified as NYHA II to IV. 6. Patient should be on a stable dosage of medication for at least 6 weeks prior to enrollment. 7. Patients Ejection Fraction \< 50%. 8. Patient is stable and without clinical events for \> 3 months. 9. Patient has signed an informed consent form. 10. Patient's condition should be stable and should have a life expectancy of \>12 months. 11. Patient's current and past medical condition and status will be assessed using previous medical history, physical evaluation, and the physicians (principle investigator's)medical opinion. Exclusion Criteria: 1. Patient with intraventricular thrombus. 2. Severe COPD (patients with an FEV1 less than .8 liters). 3. Patient has chronic lung disease including emphysema and pulmonary fibrosis. 4. Patient has active endocarditis, myocarditis or pericarditis. 5. Patient is simultaneously participating in another device or drug study, or has participated in any clinical trial involving an experimental device or drug, including other drugs or devices enhancing cardiac neovascularization or any ESWT machine for neovascularization of a competitor company within 3 months of entry into the study. 6. Patients who are unwilling or unable to cooperate with study procedure. 7. Patients who are unwilling to quit smoking during the study procedure (including screening phase). 8. Patients who are diagnosed with severe valvular disease (regurgitation or stenosis). 9. Patient is pregnant. 10. Patient with a malignancy in the area of treatment without complete remission within 5 years(lungs, thorax, ribs).