1 and 2 must be met
1. Untreatable Condition (any one should be met)
a. Has patient been ruled out as a candidate for surgical procedures?
b. Has patient declined surgical procedures?
c. Is patient optimally treated for heart disease with diuretics and vasodilators?
d. Is patient unable to be on vasodilators due to medical condition (e.g. hypotension or renal disease)
2. NYHA classification (condition 'a' must be met)
a. Does this CHF or angina patient meet the criteria for NYHA Class IV level?
Is Ejection fraction <20 (if available)
3. History/Progression - Supporting Factor
a. Hx of treatment-resistant symptomatic supraventricular or ventricular arrhythmias?
b. Hx of caridac arrest or resuscitation?
c. Hx of unexplained syncope/fainting?
d. Any brain embolism of cardiac origin?
e. Concomitant HIV disease?