Abstract-The majority of Na channels in the heart are composed of the tetrodotoxin (TTX)-resistant (K D , 2 to 6 mol/L) "cardiac" Na V 1.5 isoform; however, TTX-sensitive (K D , 1 to 25 nmol/L) "neuronal" Na channel isoforms have recently been detected in several cardiac preparations. In the present study, we determined the functional subcellular localization of Na channel isoforms (according to their TTX sensitivity) in rat ventricular myocytes by recording I Na in control and detubulated myocytes. We found that TTX-sensitive I Na (K D , Ϸ8.8 nmol/L) makes up 14Ϯ3% of total I Na in control and Յ4% in detubulated myocytes and calculated that Ϸ80% of TTX-sensitive I Na is located in the t-tubules, where it generates Ϸ1/3 of t-tubular I Na . In contrast, TTX-resistant I Na is located predominantly (Ϸ78%) at the surface membrane. We also investigated the possible contribution of TTX-sensitive I Na to excitation-contraction coupling, using 200 nmol/L TTX to selectively block TTX-sensitive I Na . TTX decreased the rate of depolarization of the action potential by 10% but did not delay the rise of systolic Ca 2ϩ in the center of the cell (transverse confocal line scan), suggesting that TTX-sensitive I Na does not play a role in synchronizing Ca 2ϩ release at the t-tubules; the amplitude of the Ca 2ϩ transient and contraction were also unchanged by 200 nmol/L TTX. The quantity of charge entering via I Ca elicited by control or TTX action potential waveforms was similar, suggesting that the trigger for Ca 2ϩ release is not altered by blocking TTX-sensitive I Na . We conclude that neuronal I Na is concentrated at the t-tubules, but there is no evidence of a requirement for these channels in normal excitation-contraction coupling in ventricular myocytes. (Circ Res.
2006;98:667-674.)Key Words: cardiac myocytes Ⅲ sodium channels Ⅲ excitation-contraction coupling Ⅲ electrophysiology I n mammalian cardiac muscle, release of Ca 2ϩ from the sarcoplasmic reticulum (SR) is the key event linking membrane depolarization and mechanical activity during excitation-contraction (EC) coupling. 1 Ca 2ϩ influx via L-type Ca 2ϩ channels is the major source of trigger Ca 2ϩ , which activates ryanodine receptors in the membrane of the adjacent SR by a process known as Ca 2ϩ -induced Ca 2ϩ release. 2 Ca 2ϩ -induced Ca 2ϩ release may also be triggered by Ca 2ϩ entry via reverse Na-Ca 2ϩ exchange, albeit with lower efficacy. 3 Voltage-gated Na channels play an important role in EC coupling by causing the rapid upstroke of the action potential and the propagation of excitation from cell to cell. 1 Ten genes encoding the ␣ (pore-forming) subunit of the Na channel have been cloned from different mammalian tissues. 4 Until recently, it appeared that the main pore-forming subunit in mammalian cardiac tissue was the Na V 1.5 isoform. 1 However, although Na V 1.5 is highly expressed at the mRNA level in the mammalian heart, other ␣ subunit isoforms have also been detected (Na V 1.1, Na V 1.2, Na V 1.3, Na V 1.4, Na V 1.6, collectively called neuron...