This study seeks to assess the utility of "routine" flow guided HD monitoring via the Nexfin systems for patients with known heart failure. Patients enrolled in the study will include those who are classified as New York Heart Association (NYHA) Functional Classification of three or greater and have Objective Assessment Classification of B or greater. Once consented, the patients will have the device placed for 5 minutes during their clinic visits. The care team will have the data displayed to them to evaluate the device. It is important to note that this study is an observational survey study to evaluate if heart failure specialists find the device useful. The data shown to the team will not be used to guide treatment and it will not be captured in the chart. Rather the clinicians will be surveyed to evaluate the clinical utility of this device (see primary outcome marker above). It is the hope of the investigators that the heart failure specialists do report to find the device useful based on the results of this study. If so the investigators will submit for a research study (new IRB submission) to evaluate the clinical impact of implementing this device in this setting.