This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Goals of Proposed Study: We hypothesize that EMS will result in a significant reduction in two prognostic indicators of HF, namely, minute ventilation (VE)/carbon dioxide production (VCO2) slope and brain natriutic peptide (BNP). We also hypothesize that cessation of EMS will result in reversal of positive physiologic adaptations. Additionally, EMS will result in a significant improvement in peak oxygen consumption (VO2) and VO2 at ventilatory threshold (VT) as well as significant improvement in perceived quality of life and functional capacity. SPECIFIC AIMS It has been shown that patients with moderate to severe chronic heart failure undergo significant increases in peak VO2, VO2 at VT and perceived quality of life following a five to eight week EMS training program. However, additional measures of prognosis in CHF patients have not been investigated following EMS. Furthermore, no investigations have assessed the impact cessation of EMS has on physiologic and psychological measures. The primary aims of the proposed study is to: 1. Determine the effect of a five week home based EMS training program on the VE/VCO2 slope, BNP level, peak VO2, VO2 at VT, perceived quality of life and perceived functional capacity in subjects diagnosed with CHF. 2. Examine changes in the previously outlined outcome measurements five weeks after cessation of the EMS training program.