RELIVE (Randomized Evaluation of Less Invasive Ventricular Enhancement) Trial

Inclusion Criteria:

1. 18 years old or older

2. LV Aneurysm or Scar Presence: Defined by presence of a contiguous acontractile (akinetic and/or dyskinetic) non-calcified scar

3. LV Aneurysm/Scar Location: Defined as a scar involving anterior, apical oranterolateral ± septal regions of the left ventricle as evidenced by cardiac imaging (Viability of myocardium in regions remote from area of intended scar exclusion asevidenced by cardiac imaging)

4. Left Ventricular Ejection Fraction < 40%

5. Left ventricular end-systolic volume index ≥60 mL/m2

6. Suffering from heart failure symptoms as defined by NYHA Classification > 2 notresponsive to medical therapy

7. Patient completed 6 Minute Walk Test and KCCQ Quality of Life Questionnaire (can beperformed at baseline visit)

8. Patient is on adequate Guideline Directed Medical Therapy (GDMT)

9. Subject or a legally authorized representative must provide written informed consent

10. Agree to required follow-up visits

11. Female subject of childbearing potential does not plan pregnancy for at least oneyear following the index procedure. For a female of childbearing potential, apregnancy test must be performed with negative results known within seven days priorto index procedure

Exclusion Criteria:

Candidates will be excluded from the study if ANY of the following conditions is present:

1. Cardiac Resynchronization Therapy (CRT) or ICD pacing lead placement ≤ 90 days priorto enrollment

2. Valvular heart disease, which in the opinion of the investigator, will requireintervention (transcatheter or surgical)

3. Mitral Regurgitation greater than moderate (>2+)

4. Need for coronary revascularization, in the opinion of the investigator

5. Peak Systolic Pulmonary Arterial Pressure > 70 mm Hg via echo or right heartcatheterization

6. Myocardial Infarction within 90 days prior to enrollment

7. Within the last six months, a prior CVA or TIA, or intracranial hemorrhage

8. Co-morbid disease process with life expectancy of less than one year or activemalignancy not in remission

9. Severe pulmonary disease that would preclude general anesthesia

10. Any solid organ transplant or is on waiting list for any solid organ transplantother than cardiac

11. Chronic renal failure with a GFR<30ml/min

12. Subject is currently participating in another clinical trial that has not yetcompleted its primary endpoint