Bio Refine for Functional Mitral Regurgitation - a Safety & Feasibility Study

Inclusion Criteria: * Local heart team has determined that mitral valve surgery will not be offered as a treatment option * Symptomatic secondary mitral regurgitation (3+ or 4+) * Adequately treated in compliance with optimal guideline-directed medical therapy for heart failure for at least 90 days * NYHA functional class II, III or ambulatory IV * LVEF ≥30%. * Written informed consent has been obtained Exclusion Criteria: * Untreated clinically significant coronary artery disease requiring revascularization. * CABG, PCI or TAVR within the prior 90 days. * Aortic or tricuspid valve disease requiring surgery or transcatheter intervention or severe tricuspid regurgitation. * COPD requiring continuous home oxygen therapy or chronic outpatient oral steroid use. * CVA or TIA within prior 180 days. * Hypotension * Any history of ventricular arrythmia * Patients implanted with any kind of CIED * Life expectancy \<12 months due to non-cardiac conditions * Prior mitral valve leaflet surgery or any currently implanted prosthetic mitral valve, or any prior transcatheter mitral valve procedure * TEE is contraindicated or high risk * Pregnant or planning pregnancy within next 12 months * Currently participating in an investigational drug or another device study that has not reached its primary endpoint