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[Music] so the way that we determine who are the most appropriate candidates for cardiomims is first by seeing if they meet criteria the two criteria is if theyve had a heart failure hospitalization in the last 12 months and also if theyre a new york heart association functional class three how we determine if theyre a new york heart association class three is by if they walk less than a block without getting short of breath or less than a flight of stairs without getting short of breath not all patients are new york heart association threes when we see them in the clinic they might be a two at that time so we take an average of what they are over the last 30 days we also consider very strongly implanting heart failure with preserved ejection fraction those are your hep patients or your chronic diastolic heart failure patients we dont have much out there to treat those patients right now the other patients we like to implant are patients with obesity because its very hard to tell