We read with interest the excellent article “ Ultrafiltration in decompensated heart failure: Is time to look forward?” by Sinagra and Fabris [1]. As the authors point out, guidelines recommend that treatment for heart failure patients be aimed at achieving euvolemia. Intravenous loop diuretics induce rapid diuresis that reduces lung congestion. However, the effectiveness of loop diuretics declines with repeated exposure and unresolved congestion may lead to high re-hospitalization rates. Ultrafiltration is an alternative strategy to diuretic therapy for the treatment of patients with decompensated heart failure.