• Efficacy
  
• The primary efficacy endpoint is weight loss measured immediately and 48 hours after ultrafiltration.
  

• Quality of life will be assessed by the NYHA classification at 48 hours.
  
• Likert scales addressing global heart failure and shortness of breath symptoms at 48 hours.
  

This is a pilot study to assess the feasibility, effectiveness, safety and patient acceptance of ultrafiltration in ambulatory patients with heart failure and hypervolemia. The results will be useful in planning a larger clinical trial.

Inclusion Criteria:

• Patients will be recruited from the cardiology clinic at Hennepin County Medical Center. Patients are eligible for the study if they are:

  1. Older than 18
  2. Not pregnant
  3. Have heart failure with worsening hypervolemia despite oral diuretics
  4. Have at least two of the following signs or symptoms of hypervolemia: JVD, edema >1+, rales pulmonary edema on chest x-ray, orthopnea or PND
  5. Not more than 10 kg above their usual baseline weight

  6. Have, in the opinion of the treating physician, a need for a minimum of 2 liters of volume removal

     Exclusion Criteria:

  1. Systolic blood pressure < 90 mmHg
  2. Serum creatinine > 3.0 mg/dL
  3. Hematocrit >45 %
  4. Uncontrolled arrhythmias
  5. Need for hospitalization
  6. Require renal replacement therapy
  7. Contraindication to anticoagulation with heparin

  8. Poor venous access.

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