Impact of Barostimulation on Hemodynamics in Adults With Heart Failure

Inclusion Criteria:

* Diagnosis of heart failure with reduced ejection fraction (defined as ejection fraction ≤ 35% for the purposes of this study) (should be within 12 months of screen)
* Symptoms consistent with one of:

  1. current New York Heart Association (NYHA) Class III or
  2. current NYHA Class II and historical NYHA Class III
* Laboratories with last N-terminal pro-B-type natriuretic peptide (NT-proBNP) \< 1600 pg/ml (should be within 3 months of screen)
* Management with maximally-tolerated GDMT medications and devices
* Age \>= 18 years

Exclusion Criteria:

* Age \< 18 years
* Myocardial infarction (MI), syncope, cerebrovascular accident (CVA), aborted sudden cardiac death (SCD) (and implantable cardioverter defibrillator (ICD) therapy) within 3 months of screening
* Bilateral carotid bifurcations located above the level of the mandible
* Carotid artery stenosis greater than 50% caused by atherosclerosis
* Ulcerative plaques in the carotid artery
* Baroreflex failure or autonomic neuropathy
* Symptomatic un-controlled bradyarrhythmias
* Severe chronic lung disease
* Current treatment with inotropes
* Pacemaker or ICD within 3 months of screening
* Cardiac resynchronization therapy (CRT) devices within 6 months of screening or anticipated to be placed in the next 90 days following screening
* Prior surgery, radiation, endovascular stent in the carotid sinus
* History or consideration of solid organ transplantation
* History or consideration of left ventricular assist device (LVAD)
* Life expectancy \<1 year from time of screening
* Non-cardiovascular conditions interfering with 6MWT distance assessment
* Inability to fulfill protocol requirements
* Known allergy to silicone or titanium