Pacertool Early Feasibility Study - Safety and Performance

Inclusion Criteria: Part I: * Subject has an indication for coronary angiography or left heart catheterization or cardiac resynchronization therapy. * QRS duration between 90-150ms. * Subject is ≥ 18 years old. * Willingness, ability, and commitment to participate in baseline and follow-up evaluations for the full duration of the clinical study. * Willing and able to give informed consent. Part II: * Subject in sinus rhythm with an indication for implantation of a Cardiac Resynchronization Device (Appendix I) * NYHA Class II-IV (Ambulatory IV) * EF\<35% * QRS duration \>120ms. * Subject is ≥ 18 years old. * Willingness, ability, and commitment to participate in baseline and follow-up evaluations for the full duration of the clinical study. * Willing and able to give informed consent. Exclusion Criteria:¨ * Subject has unstable angina/ acute coronary ischemia/ infarction * Previous myocardial infraction (\<6 months) * History of blood clothing or bleeding disease * Prior history of documented cerebral infarction, TIA or systemic embolism (excluding a postoperative DVT) * Subject has an arterial unstable aneurysm * Subject has severe peripheral vascular disease * Subject has an artificial aortic or mitral valve replacement * Subject has severe aortic valve disease * Subject has a clinically significant infection (bacteriemia or sepsis) * Subject has contraindications to anticoagulation * Patients with a serious allergy to drugs necessary for the procedure such as anticoagulants and protamine * Subject has left atrial/ ventricular thrombus * Patients with severe vascular obstructions in the desired/ presumed insertion path of the catheter * Significant or symptomatic hypotension * NYHA class IV (hospitalized), severe circulation instability or shock * Ongoing/ persistent atrial arrythmias * History of Rheumatic fever * Subject has sensitivity to contrast media * Contraindications to CT or fluoroscopy * Distorted cardiac anatomy due to congenital heart disease * Pregnant or possibly pregnant * Not eligible for thoracotomy procedures * Life expectancy \<1 years * Any other condition that, in the judgement of the investigator, makes the subject a poor candidate for this procedure, the study or compliance with the protocol (includes addictive disease, extensive travel away from the research center) * Clinically significant psychological condition that in the investigator's opinion would prohibit the subject's ability to meet the protocol requirements * Current enrollment in any other study protocol where testing or results from that study may interfere with the procedure or outcome measurements of this study