 10. Patients with New York Heart Association NYHA Class III and IV heart failure, myocardial infarction in the preceding 6 months, and significant conduction abnormalities, including but not limited to 2nd degree AV block type II, 3rd degree block, QT prolongation QTc 500 msec, sick sinus syndrome, ventricular tachycardia, symptomatic bradycardia heart rate 50 bpm, hypotension, light headedness and syncope. Patients with active atrial fibrillation will be excluded. The protocol excludes patients who have within the past year had a stent and by recommendation of their cardiologist need to stay on anticoagulants such as warfarin equivalent vitamin K antagonist. 