The Counter HF Clinical Study for Heart Failure

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The Counter HF Clinical Study for Heart Failure CAUTION: C-Pulse is an investigational device. It is limited by Federal (or United States) Law to investigational use only. 13-111-B

Agenda Heart Failure C-Pulse Heart Assist System Counter HF Clinical Study 2

What is Heart Failure? Heart Failure, also known as congestive heart failure (CHF), means your heart cannot pump enough blood to meet your body s needs The heart muscle becomes weak and works harder to keep blood flowing to the rest of your body 3

Heart Failure Symptoms Feeling tired and weak Shortness of breath Reduced ability to walk or exercise Swelling of legs and ankles 4

How Common is Heart Failure? Affects over 5 million Americans¹ Each year 500,000 new cases are reported¹, 1.2 million suffer from moderate or Class III heart failure¹ ² Responsible for more than 1 million hospitalizations in the United States each year³ Many people are not aware they have it because symptoms are mistaken for aging 1. Heart Disease and Stroke Statistics. American Heart Association 2013 Update. Circulation. 2013;127: e6-e245. 2. Farwell D. et al. Eur Heart J. 2000;21:1246-1250. 3. Blecker S, et al. J Am Coll Cardiol. 2013;61(12):1259-1267. 5

Heart Failure Classifications NYHA Class Class I (Mild) Class II (Mild) Class III (Moderate) Class IV (Severe) Patients with Cardiac Disease Description of HF Related Symptoms You have no limits on daily activities. You are able to do all your normal daily activities without becoming tired, short of breath, or having heart palpitations. You have some limits to your daily activities. You are comfortable at rest, but normal activities may cause you to be tired, short of breath or have heart palpitations. You are very limited in your daily activities. You are comfortable at rest, but unable to do your daily activities without becoming tired, short of breath, or having heart palpitations. You are unable to do any physical activity without discomfort. You become tired, short of breath, and possibly have heart palpitations even when you are at rest. Any physical activity makes your discomfort worse. 6

Heart Failure Treatments Heart failure is a serious illness that can affect how long you live Proper treatment and careful management can help you feel better and live longer In general, your treatment will depend on your NYHA classification and underlying medical condition Your doctor will help determine the best treatments for your heart failure condition 7

Heart Failure Treatments Lifestyle changes Heart medications Surgery for correctable problems: Coronary artery bypass Balloon/stents Heart valve repair or replacement Implantable devices Cardiac resynchronization therapy (CRT, CRT-D) Implantable Cardioverter Defibrillator (ICD) Left ventricular assist device (LVAD) Heart transplant (reserved for NYHA Class IV) 8

C-Pulse Heart Assist System Investigational treatment designed for patients with moderate to severe heart failure Implanted system that is intended to help the heart pump blood C-Pulse cuff and balloon C-Pulse Driver Note: Images not to scale 9

C-Pulse System Components EXTRA-AORTIC CUFF ECG SENSING LEAD INTERFACE LEAD DRIVER 10

How Does the C-Pulse System Work? The Cuff wraps around the outside of the ascending aorta. It inflates and deflates in time with the heart s pumping motion, using information from the Sensing Lead that monitors the heart s rhythm. When the cuff inflates, it produces a surge of blood that flows to the heart muscle 1 Cuff deflates as the heart pumps blood, reducing workload 2 Cuff inflates as the heart refills wth blood, giving a secondary pulse of blood to the heart muscle 11

C-Pulse System - Potential Benefits C-Pulse is designed to treat HF symptoms by: Reducing the workload of the heart Providing more oxygen-rich blood going to the heart muscle Improving overall heart function 12

C-Pulse System - Potential Benefits Allows you to remain active when in use Blood thinner medications not required unless otherwise indicated by your doctor Assists heart rather than replaces heart - device can be disconnected if needed Has the potential to reduce the need for hospital visits resulting from your HF condition Has the potential to delay the progression of your HF condition 13

C-Pulse System - Potential Risks Some potential risks associated with participation in this clinical study include: Risks related to the screening tests and procedures Risks related to the surgery to implant the device including general anesthesia and the surgical procedure itself Risks related to the investigational device There may be additional risks, which are unknown More information on potential risks is provided in the Informed Consent Document. Your doctor will discuss these with you. 14

C-Pulse System FAQs Q. How is it implanted? A. An incision is made in the chest and the Cuff is wrapped around the aorta. The Sensing Lead is attached to the outside of the heart. No incisions are made into the heart and a heart-lung bypass machine is not required. Q. How long is the hospital stay after the procedure? A. 7 to 14 days. You and your caregiver will be educated on how to manage the Driver and care for the exit site dressings. Your doctor will determine your discharge date, based on your medical condition. Q. Are blood thinners required after the procedure? A. No. The C-Pulse System does not come in contact with the blood stream, you are not required to be on blood thinners. Your doctor will determine what medications are needed after your surgery. 15

C-Pulse System FAQs Q. Do I need to stay connected to the C-Pulse System at all times? A. Because the system works to assist the heart and not replace the heart function, it can be safely disconnected for short periods of time. However, you doctor will want you to stay connected to the system at all times except for personal hygiene. Q. Can I have a CRT, CRT-D, or ICD device if I have the C-Pulse System implanted? A. Yes. The C-Pulse System can be used in combination with other approved devices and/or medications for treating heart failure. 16

The HF Clinical Study Study to evaluate the safety and effectiveness of the C-Pulse System for the treatment of moderate to severe heart failure Up to 40 clinical sites in North America are participating in the study Up to 388 patients will be enrolled in the study 17

HF Study Phases Screening & Eligibility Randomized Treatment Study Follow-up Eligibility qualifications Chest X-ray and CT scan information Standard tests and questionnaires to confirm eligibility C-Pulse Group (50% chance) Optimal Medical Therapy Group (50% chance) Doctor visits 6 times over first 2 years for study purposes Doctor visits once/year for next 3 years for study purposes 18

Key Qualification Criteria Class III or early Class IV heart failure Left ventricular ejection fraction (LVEF) 35% Taking appropriate HF medications as prescribed by your doctor Have been evaluated for CRT, CRT-D, or ICD therapy 19

HF Study FAQs Q. Can I receive the C-Pulse System without joining the HF Study? A. No, it is an investigational device and is only available through this study to those that are randomized to the C-Pulse System group. Q. Can I pursue other treatments for my heart failure during the study? A. Yes, your doctor will closely monitor your condition and recommend other HF treatments if necessary. 20

Further Information To learn more about the HF Clinical Study, and to see if you might qualify, please contact: 21