Early Feasibility Study of the FIRE1™ System in Heart Failure Patients

Main Inclusion Criteria Adults 18 years or older Patients meeting diagnostic criteria for heart failure diagnosis for greater than 90 days and are on optimally tolerated medical therapy for at least 30 days, as recommended according to current AHA/ACC guidelines regardless of ejection fraction as evidenced by: A heart failure decompensation resulting in a hospitalisation or heart failure failure related treatment in a hospital day-care setting or unscheduled visit to a healthcare provider for administrator of an intravenous diuretic up to 12 months prior to enrolment and Chronic heart failure, as evidenced by a screening B-type natriuretic peptide (BNP) ≥300 pg/mL or N-terminal-pro-B type natriuretic peptide (NT-proBNP) ≥1000 pg/mL, or BNP ≥500 pg/mL or NT-proBNP ≥1,600 pg/mL for subjects presenting with atrial fibrillation at screening. For subjects treated with an angiotensin receptor neprilysin inhibitor (ARNI) in the 4 weeks prior to screening only NT-proBNP values should be considered, and Patients must also be on a daily oral loop diuretic dose of 40mg or greater furosemide equivalents for the 2 weeks prior to screening. Signed patient informed consent form Main Exclusion Criteria: Significant comorbidity that, in the investigator's opinion, would results in the patient being unable to safely undergo the procedure or participate in the clinical investigation. Patients with an estimated Glomerular Filtration Rate (eGFR) < 25 ml/min/1.73m2 Patients with an in vivo IVC filter, abnormal IVC or femoral venous anatomy or known congenital malformation or absence of IVC or occlusive or free-floating thrombus in the IVC. Patients who have severe right sided valvular disease or a right sided mechanical valve. Patients with a cardiac resynchronization therapy device implanted ≤ 3 months to prior to screening. Patients who have undergone invasive cardiac surgery in the 3 months prior to screening. Patients who have undergone percutaneous valve / structural heart intervention in in the 3 months prior to screening. Patients who have received heart transplant or a ventricular assist device or planned for advanced therapies within the next year. Patients with conditions associated with occlusion of the IVC, iliac or common femoral veins.