Abstract-To examine the role of sarcolemmal K ATP channels in cardiac function, we generated transgenic mice expressing GFP-tagged Kir6.2 subunits with reduced ATP sensitivity under control of the cardiac ␣-myosin heavy chain promoter. Four founder mice were isolated, and both founders and progeny were all apparently normal and fertile. Electrocardiograms from conscious animals also appeared normal, although mean 24-hour heart rate was approximately 10% lower in transgenic animals compared with littermate controls. In excised membrane patches, K ATP channels were very insensitive to inhibitory ATP: mean K 1/2 ([ATP] causing half-maximal inhibition) was 2.7 mmol/L in high-expressing line 4 myocytes, compared with 51 mol/L in littermate control myocytes. Counterintuitively, K ATP channel density was Ϸ4-fold lower in transgenic membrane patches than in control. This reduction of total K ATP conductance was confirmed in whole-cell voltage-clamp conditions, in which K ATP was activated by metabolic inhibition. K ATP conductance was not obvious after break-in of either control or transgenic myocytes, and there was no action potential shortening in transgenic myocytes. In marked contrast to the effects of expression of similar transgenes in pancreatic -cells, these experiments demonstrate a profound tolerance for reduced ATP sensitivity of cardiac K ATP channels and highlight differential effects of channel activity in the electrical activity of the 2 tissues. Key Words:channels are octameric complexes of 2 distinct subunits, a sulfonylurea receptor (SUR) and a pore-forming Kir6.2. 1-7 SUR confers highaffinity block by sulfonylureas and stimulation by K ϩ channel openers (PCOs) and MgADP. 2,8 -13 ATP inhibits channel activity through an interaction with the Kir6.2 subunit. 3,14 -16 Reconstitution experiments indicate that essential properties of the cardiac K ATP channel are reiterated by coexpression of Kir6.2ϩSUR2A channels, 2,17 and K ATP channels are completely absent in myocyte membranes of Kir6.2 knockout animals, 18,19 although antisense oligonucleotide experiments suggest that SUR1 might be a constituent of neonatal ventricular K ATP channels. 20 Complete metabolic inhibition, or anoxia, leads to opening of K ATP channels in the sarcolemmal membrane, 21 and channel density is so high 21,22 that maximal activation of K ATP can block cell-to-cell conduction and completely suppress action potential generation. 23,24 Both experimental data [25][26][27][28] and modeling 25,29 indicate that activation of only 1% of the available K ATP conductance will be sufficient to shorten the action potential Ϸ50%. For normal cardiac function, therefore, it is critically important that K ATP channels remain substantially closed. Consistent with this notion, action potentials are unaltered in myocytes that completely lack K ATP channels. 18 The major mechanism keeping the channels closed under normal conditions is expected to be the high ATP sensitivity: K 1/2 (cytoplasmic [ATP] causing half-maximal inhibition) is normally 25 t...