POsition of Leads in Advanced heaRt Failure: the POLAR Study - A 6 Month, Observational, Mult-centered, Blinded, Randomized Study to Determine if Lead Positioning in the Lateral Wall of LV in Patients Meeting Criteria for CRT Plays a Role in Determining Myocardial Function and Affect the Severity of Mitral Regurgitation

• Subject meets the general indications for an implantable cardioverter defibrillator (ICD) with LV systolic function ≤ 35% as defined by echocardiography.

• Subject has moderate or severe heart failure, defined as NYHA Class III-IV for at least 90 days prior to enrollment.

• Subject has optimal pharmacological heart failure therapy for at least 30 days prior to enrollment.

• Subject has a 12-lead electrocardiogram (ECG) obtained no more than 90 days prior to enrollment documenting a sinus rate > 50 bpm and PR interval < 320 ms measured from any two leads.

• 12 lead ECG with left bundle brunch block morphology and a QRS duration of at least 120 msec.

• Subject has creatinine < 2.5 mg/dL obtained no more than 30 days prior to enrollment.

• Subject has left ventricular ejection fraction < 35% by echocardiogram no more than 1 year prior to enrollment.

• Subject is willing and capable of undergoing a device implant and participating in all testing associated with this clinical investigation.

• Subject has a life expectancy of more than 180 days, per physician discretion.

• Subject is age 18 or above, or of legal age to give informed consent specific to state and national law.