Screening for Advanced Heart Failure Treatment (SEE-HF)

Inclusion Criteria: * CRT and or ICD device in place. * NYHA class III - IV heart failure * EF \</= 40% * Patient is an out-patient * Patient is on optimal medical management as tolerated and as defined by primary care physician. * Patient has signed an informed consent for data collection. Exclusion Criteria: * Age \<18 years or \>80 years * CRT device that has been implanted \< 3 months prior to enrollment * Coronary revascularization within 3 months prior to enrollment * Patient only has ICD but has CRT planned * Non-cardiac disease resulting in life expectancy \< 2 yrs * Patient is hospitalized or will be hospitalized at this time * Known diagnosis of dementia * Patient is currently on dialysis * Oxygen dependent lung disease * Previously or currently treated with LVAD or heart transplantation