The ALLAY-HFrEF Study is looking into a new way to help people with heart failure with reduced ejection fraction (HFrEF). HFrEF means the heart isn't pumping blood as well as it should, with a left ventricular ejection fraction (LVEF) of 40% or less. The study uses a special device called the Alleviant ALV1 System to create a tiny passage between two heart chambers to help blood flow better.

Here are some things to know:

• **Length of Study:** Participants will be randomly assigned to either receive the treatment or a fake procedure (sham), and neither the patient nor the doctor will know which one was given.
• **Visits Needed:** Participants must have frequent check-ups to ensure everything is working well and to monitor any side effects.
• **Compensation:** Details about compensation for participating are not provided, but you can ask the study team for more information.

To join, you must have stable heart failure treatment and cannot have advanced heart failure or expect to live less than one year. If you are interested, talk to your doctor for more information!