Chin A et al. – Autonomic dysfunction is detrimental during chronic heart failure (CHF). Autonomic innervation modification of the heart using an inexpensive left cardiac sympathetic denervation (LCSD) can have a significant antifibrillatory effect. This 2–phased, prospective, randomized trial was designed to test the efficacy and safety of LCSD as an adjunct to guideline–recommended medical therapy for patients with heart failure with reduced ejection fraction. In regions where implantable cardioverter defibrillator therapy and cardiac transplantation are unavailable, LCSD could be a cost–effective alternative if proven to be safe, effective, and feasible.