Integrated Diagnostics Driven Diuretic and Chronic Medication Management for Heart Failure

Inclusion Criteria: * Subject (or subject's legally authorized representative) is willing and able to provide written informed consent * Subject has been implanted with a CRT device for at least 9 months and has had a wireless Medtronic CRT-D device for at least 34 days * Subject has \>1 year life expectancy * Subject's CRT-D device has at least 18 months of device longevity left * Subject has an eGFR\> 25 ml/min/1.73 m2 * Subject is NYHA Class II or III * Subject is NYHA Class II or III • Subject has elevated BNP values (BNP\>400 or NTpro BNP\>800) within the last 3 months OR Subject has had at least one OptiVol threshold crossing in the last 9 months OR Subject has had a HF event within the last 9 months HF event is defined as meeting any one of the following two criteria: 1. Subject was admitted to the hospital for worsening HF OR 2. Subject has received Intravenous HF therapy (e.g. IV diuretics/vasodilators) or ultrafiltration at any settings including: * Emergency Department * Ambulance * Observation Unit * Urgent Care * HF/Cardiology Clinic * Patient's Home * Subjects who are currently prescribed and taking medications for the management of heart failure and are able to tolerate transient increases in diuretic dosage * Subject is willing and able to comply with the protocol, including screening, baseline and programming visit(s), remote care directions, follow-up visits, and exit visit * Subject can send device transmissions and daily biometric data with in-home patient devices Exclusion Criteria * Subject has systolic BP of \< 90 mmHg at the time of enrollment * Subject not responsive to diuretic therapy or is on chronic renal dialysis * Subject unable to undergo one round of medication intervention (3 day up-titration of diuretic) without requiring safety check * Subjects enrolled in a concurrent study that may confound the results of this study without documented pre-approval from a Medtronic study manager * Subject weighs more than 500 pounds * Subject is younger than 18 years of age * Subject has hemodynamic monitoring device implanted