| a. New York Heart Association (NYHA) Class IV Heart Failure | 
      
        | b. Not eligible for heart    transplantation | 
      
        | c. Have failed to respond to optimal medical management    (including beta-blockers, and ACE inhibitors if tolerated) for at least 45 of    the last 60 days, or have been balloon pump dependent for 7 days, or IV    inotrope dependent for 14 days; and, | 
      
        | d. Have a left ventricular ejection fraction (LVEF) < 25%;    and, | 
      
        | e. Have demonstrated functional limitation with a peak oxygen    consumption of ≤ 14 ml/kg/min unless balloon pump or inotrope dependent or    physically unable to perform the test. |