The human human ether-à-go-go-related gene (hERG) potassium channel plays a critical role in the repolarization of the cardiac action potential. Changes in hERG channel function underlie long QT syndrome (LQTS) and are associated with cardiac arrhythmias and sudden death. A striking feature of this channel and KCNH channels in general is the presence of an N-terminal Per-Arnt-Sim (PAS) domain. In other proteins, PAS domains bind ligands and modulate effector domains. However, the PAS domains of KCNH channels are orphan receptors. We have uncovered a family of positive modulators of hERG that specifically bind to the PAS domain. We generated two single-chain variable fragments (scFvs) that recognize different epitopes on the PAS domain. Both antibodies increase the rate of deactivation but have different effects on channel activation and inactivation. Importantly, we show that both antibodies, on binding to the PAS domain, increase the total amount of current that permeates the channel during a ventricular action potential and significantly reduce the action potential duration recorded in human cardiomyocytes. Overall, these molecules constitute a previously unidentified class of positive modulators and establish that allosteric modulation of hERG channel function through ligand binding to the PAS domain can be attained.he human ether-à-go-go-related gene (hERG; or KCNH2) encodes the voltage-gated potassium channel that conducts I Kr (delayed rectifier potassium current), a critical cardiac repolarizing current (1, 2). Mutations in hERG (3) or channel block can cause long QT syndrome (LQTS) and catastrophic ventricular arrhythmias (reviewed in ref. 4). Because most drugs causing acquired LQTS block I Kr channels (5), lead compounds in development are counterscreened using a hERG cell-based safety test (6) to reduce the incidence of sudden cardiac death caused by off-target drug effects (7).A defining feature of hERG and its relatives in the potassium channel family, KCNH (8), is a large cytoplasmic region with an N-terminal Per-Arnt-Sim (PAS) domain (9). Within the hERG PAS domain, there are two functionally and structurally distinct regions: the PAS-Cap (residues 1-25) and the globular region (residues 26-135). NMR and crystallographic structures of the isolated PAS domain show that the PAS-Cap region is partially unstructured (10-12). The globular region interacts with a C-terminal domain, which, because of sequence homology with cyclic nucleotide binding domains, is termed the cyclic nucleotide binding homology (CNBh) domain (13,14). Truncations and mutations of the PAS-Cap and PAS clearly affect the gating mechanisms of the channel, which is particularly apparent in the deactivation kinetics (9,(15)(16)(17)(18). PAS domains within the tetrameric hERG channels exert a suppressive effect by slowing channel activation and recovery from inactivation, the two parameters that predominantly determine current amplitude during an action potential (AP) (19). These properties are genetically tuned in native I Kr produce...