The AIM HIGHer Clinical Trial is checking if a new heart therapy called **Cardiac Contractility Modulation (CCM)** helps people with heart failure. Heart failure happens when the heart doesn't pump blood well. In this trial, they are using a special device called the **Optimizer System** to help the heart pump better. The trial is for adults with a certain heart strength, called **Left Ventricular Ejection Fraction (LVEF)**, between 40% and 60%. About 150 locations in the US and 75 outside the US will participate.

Participants will be divided into two groups: one where the CCM is turned on and another where it's off. This will last for 18 months. After that, those who had the CCM off will get it turned on. This trial will help determine if CCM is safe and effective based on how well people can do physical activities and their overall health.

• **Duration:** The study lasts 18 months.
• **Visits:** Participants must attend regular health check-ups.
• **Compensation:** Varies by location; discuss with your doctor.

To join, you need to be 18 or older, have heart failure, and meet other health criteria. Some people cannot join, like those with certain heart conditions or other health issues. Talk to your doctor to see if you qualify.