Ultrafiltration Versus IV Diuretics in Worsening Heart Failure

Inclusion Criteria: * 18 years or older * Man, or non-pregnant woman * Admitted to the hospital with a diagnosis of acute decompensated heart failure * On regularly prescribed oral loop diuretics, Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors or a Mineralcorticoid Receptor Antagonists (MRA) prior to admission * Fluid overload manifested by at least three clinical indications (e.g., edema, an excess of at least 10 pounds of fluid, etc.) * Provide written informed consent Exclusion Criteria: * New diagnosis of heart failure * Acute coronary syndromes * Creatinine ≥ 3.0 mg/dl or planned renal replacement therapies at the time of enrollment * Contraindications to systemic anticoagulation * Severe concomitant disease expected to prolong hospitalization or cause death in less than 90 days * Sepsis or ongoing systemic infection * Active myocarditis * Constrictive pericarditis or restrictive cardiomyopathy * Severe aortic stenosis * Any condition in the opinion of the investigator that would prevent the patient from follow-up/survival