Clinical Trials

Inclusion Criteria:

1. Age >18 years
2. Willingness and ability to provide informed consent
3. Hospitalization for AHF with at least 1 symptom (dyspnea, orthopnea, or edema) AND 1 sign (rales on auscultation, peripheral edema, ascites, pulmonary vascular congestion on chest radiography, BNP > 250 ng/mL or NTproBNP > 1000 ng/mL) of congestion
4. Persistent congestion despite at least 18 hours of IV therapy, defined by the presence of at least 2 or more of the following at the time of consent:
   1. Peripheral edema
   2. Rales
   3. Elevated JVP
   4. Ascites
   5. BNP > 250 ng/mL or NTproBNP > 1000 ng/mL
5. Total anticipated daily IV furosemide dose (at time of screening) >80-200mg (or equivalent)/day
6. Anticipated need for at least 24 more hours of parenteral diuretic therapy

Exclusion Criteria:

1. Severe renal dysfunction (eGFR< 30 ml/min/1.73m2)
2. Requirement for inotropes (other than digoxin) or mechanical support during hospitalization
3. Clinically significant electrical instability during hospitalization
4. Ongoing need for other intravenous therapies beyond diuretics (vasodilators, antibiotics, etc.)
5. Anticipated need for ongoing parenteral electrolyte repletion
6. Planned discharge to location other than home (e.g., hospice, skilled nursing facility, etc.)
7. Anticipated cardiac transplantation or left ventricular assist device within the next 30 days
8. Primary hypertrophic cardiomyopathy, infiltrative cardiomyopathy, acute myocarditis, constrictive pericarditis or tamponade
9. Known or anticipated pregnancy in the next 30 days
10. Prior use of a subcutaneous furosemide pump or current use of any subcutaneous pump, on-body infusion devices or patients who give regimented injections at the intended site of the sc2Wear on body infusion pump
11. Other psychosocial or physical barriers to following the protocol and using SQ pump device outside the hospital setting
12. Known allergy to furosemide
13. Known sensitivity or allergy to medical adhesive tape