DNA/RNA Analysis of Blood and Skeletal Muscle in Patients Undergoing Cardiac Resynchronization Therapy (CRT)

Inclusion Criteria: * Patients with poor LV function and an EF of ≤35% * Patients who are symptomatic with Class II or Class III heart failure on optimal medical therapy. * Patients with EKG showing QRS duration of greater than 120 ms and meet criteria for Bi-ventricular ICD implantation. Exclusion Criteria: * Patients with other co-morbid conditions which could contribute to cachexia, such as end stage renal disease, ongoing malignancy, chronic or acute liver failure, age greater than 80yrs. * Patients who are unable to walk and are wheelchair bound or need assistance to walk for reasons other than CHF. * Patients with muscular dystrophies and myopathies. * Patients with untreated hyper or hypothyroidism. * Patients on Dialysis. * Patients with recent (\<12 weeks) revascularization. * Patients with recent (\<12 weeks) myocardial infarction.