This study is looking at a new way to help people with **Acute Decompensated Heart Failure (ADHF)**. ADHF means the heart can't pump blood well, causing fluid build-up in the body. The study compares a new tool called the **Reprieve System** with standard water pill treatments, called **Optimal Diuretic Therapy (ODT)**, to see which works better at removing excess fluid from the body. **Key Points**: - The study requires a hospital stay of more than 24 hours. - Participants must be at least 22 years old and take a daily loop diuretic (a water pill). - Participants cannot be pregnant, have certain severe health conditions, or be in another clinical trial. If you join the study, you will help researchers learn if the new Reprieve System is better than regular treatments. However, you must be able to stay in the hospital for at least one day. Make sure to talk with your doctor to see if joining is right for you.