Combination Oral Acetazolamide and Intravenous Furosemide on Acute Decompensated Heart Failure Outcomes

This study is testing whether a combination of two diuretics (water pills) — oral acetazolamide and intravenous furosemide — works better than furosemide alone for people admitted to the hospital with worsening heart failure. When the heart is not pumping well, fluid builds up in the body, and diuretics help the kidneys remove that excess fluid. This study wants to know if the combination is more effective. **You may be eligible if...** - You have been diagnosed with acute worsening heart failure with signs of fluid buildup (such as leg swelling, fluid around the lungs, or belly fluid) - You have been taking oral diuretics (at least 40 mg furosemide) for at least 1 month - Your heart failure marker (NT-proBNP) is significantly elevated **You may NOT be eligible if...** - You have an acute heart attack (acute coronary syndrome) or are in cardiogenic shock - Your kidney function is severely reduced (eGFR < 20 mL/min) - You are on dialysis or kidney replacement therapy - You have had acetazolamide within the past month - You are pregnant or breastfeeding - You have congenital heart disease requiring surgery Talk to your doctor to see if this trial is right for you.