This study evaluated the clinical utility of the HEMOTAG™ recording device—A non-invasive, wearable system that measures cardiac time intervals (CTIs)—in managing patients with acutely decompensated heart failure (ADHF). The prospective, single-center study enrolled 105 patients, including those hospitalized with ADHF and a control group with non-HF-related conditions. Daily measurements of isovolumetric contraction time (IVCT), a key CTI marker, were collected using the HEMOTAG device and compared with NT-proBNP levels obtained on admission and day 3. Among ADHF patients, IVCT decreased in parallel with NT-proBNP levels, indicating volume status improvement with therapy. In contrast, the control group showed no significant change in IVCT or NT-proBNP. An IVCT ≥ 40 ms demonstrated strong sensitivity and specificity to detect ADHF (NT-proBNP ≥ 1800 pg/mL). These findings suggest that IVCT trends measured by HEMOTAG correlate with short-term treatment response in ADHF and could offer a non-invasive method to guide heart failure management. The technology demonstrated feasibility, safety, and clinical relevance, supporting its potential role in future remote management strategies.