According to one hypothesis, the chaotic excitation dynamics during VF are the result of dynamical instabilities in action potential duration (APD) the occurrence of which requires that the slope of the APD restitution curve exceeds 1. Other factors such as electrotonic coupling and cardiac memory also determine whether these instabilities can develop. In this paper we study the conditions for alternans and spiral breakup in human cardiac tissue. Therefore, we develop a new version of our human ventricular cell model, which is based on recent experimental measurements of human APD restitution and includes a more extensive description of intracellular calcium dynamics. We apply this model to study the conditions for electrical instability in single cells, for reentrant waves in a ring of cells, and for reentry in two-dimensional sheets of ventricular tissue. We show that an important determinant for the onset of instability is the recovery dynamics of the fast sodium current. Slower sodium current recovery leads to longer periods of spiral wave rotation and more gradual conduction velocity restitution, both of which suppress restitution-mediated instability. As a result, maximum restitution slopes considerably exceeding 1 (up to 1.5) may be necessary for electrical instability to occur. Although slopes necessary for the onset of instabilities found in our study exceed 1, they are within the range of experimentally measured slopes. Therefore, we conclude that steep APD restitution-mediated instability is a potential mechanism for VF in the human heart. reentrant arrhythmias; human ventricular myocytes; restitution properties; spiral waves; computer simulation ONE OF THE MOST extensively investigated hypotheses for ventricular fibrillation (VF) is the so-called restitution hypothesis. In its initial form the hypothesis stated that if the action potential duration (APD) restitution curve has a maximum slope steeper than 1, it will lead to APD alternans (16,41). In tissue this APD alternans can result in the fragmentation of a spiral wave, leading to fibrillation-like excitation patterns (21,22,45,48). Modeling studies have confirmed that a steep restitution curve indeed promotes instability. However, modeling studies have also shown that the criterion of an APD restitution slope Ͼ1 is an oversimplification that only holds for very simple models. In more realistic and complex models, it has been shown that other factors such as short-term cardiac memory, electrotonic interactions between cells, conduction velocity (CV) restitution, the range of diastolic intervals (DIs) over which restitution is steeper than 1, and the range of DIs visited during spiral wave rotation all play an important role in determining whether alternans and spiral breakup will occur (5,7,10,11,42,48,64). In an extensive study of restitutioninduced instability, Cherry and Fenton (6), for example, showed that because of strong electrotonic interactions and gradual CV restitution, spiral breakup may not occur even if the APD restitution curve has ...