The two arms of the autonomic nervous system, the sympathetic and the parasympathetic nervous system, typically elicit opposite reactions in the mammalian body. In the heart, this often occurs via β-adrenoceptors on the one and muscarinic acetylcholine receptors on the other hand. Thus, the balance between these two receptor systems can be important for the cell function and specifically contractile tone. However, these two receptor systems not only co-exist but also interact with each other acutely and chronically. Such acute interaction appears obvious when β-adrenoceptors and muscarinic receptors of the M 2 -like subfamily are considered, i.e., M 2 and M 4 receptors, as their prototypical signaling pathways include enhanced and reduced cyclic AMP formation, respectively. That such interaction also occurs between subtypes of β-adrenoceptors and those of M 3 -like muscarinic receptors, i.e., M 1 , M 3 , and M 5 receptors, is less obvious but nevertheless consistently found, e.g., in the urinary bladder (Andersson and Arner 2004).Perhaps even more important for disease states or chronic treatment is the long-term interaction between these two systems, and a paper in the current issue of the journal (Benes et al. 2013) exemplifies this based on M 2 receptor knockout mice. In their study, Benes et al. used a general knockout for M 2 cholinoceptors in mice and observed that this was not accompanied by larger changes in hemodynamic parameters. Echocardiography revealed that left ventricular systolic and diastolic function was nearly unchanged, so that left ventricular end-systolic and end-diastolic diameters as well as fractional shortening, mitral flow characteristics, and maximal velocity in the left ventricular outflow tract were similar between wild-type and knockout mice. The explanation given by the results is that the knockout of the cardioinhibitory M 2 cholinoceptors is counter-regulated by a decrease in β 1 or β 2 adrenoceptor density as assessed, e.g., by radioligand binding. Importantly, the catecholamine levels did not differ between the two groups of mice, indicating that the counter-regulation is not on the level of mediator release.