Novel Cardiac Pacing to Initiate Cardiac Remodeling in Heart Failure

Inclusion Criteria: * Non-Ischemic Cardiomyopathy * Ejection Fraction \</= 35% despite at least 3 months stable standard medical management * New York Heart Association Class II-III symptoms * Dual chamber implantable cardioverter defibrillator in place or Biventricular ICD in place (over 3 months old) * Normal Atrioventricular conduction or Biventricular ICD * QRS \< 120 msec (inherent conduction or paced with BiV ICD) Exclusion criteria: * Age \< 18 years * Inability to ambulate safely * Congenital or primary valve disease * Left Ventricular thrombus * Severe peripheral arterial disease * Admission for life-threatening condition (eg heart failure, stroke) in the past 3 months * Major surgery in the past 3 months or anticipated during the period of the trial * Paced or intrinsic QRS \>120 msec * Life expectancy \< 1 year * Hemodialysis * Hematocrit \< 30% * Severe Chronic lung disease * Pregnancy * ICD battery longevity \< 1 year * Unsuppressed atrial arrhythmias * Already participating in an exercise programusion Criteria