Chronic myocardial hypoxia results in elevated nitric oxide (NO) production and increased current through the sarcolemmal K ATP channel. We hypothesized these two processes are related and determined whether NO alters the electrophysiology of Purkinje fibers obtained from rabbits (n=12/group) raised in a normoxic (F I O 2 =0.21) or hypoxic (F I O 2 =0.12) environment from birth to 9 days of age. Action potential duration (APD) 90 was shorter (112±3 ms v 126±3 ms) and maximum diastolic potential (MDP) was more negative (−84±2 mV v−80±1 mV) in hypoxic hearts compared with normoxic controls. In normoxic hearts the NO donors, S-nitrosoglutathione (GSNO) 50 μM and spermine NONOate (50μM ) shortened APD 90 and increased MDP to levels present in chronically hypoxic hearts. This effect was completely abolished by the K ATP channel blocker glibenclamide (3 μM) and by a nitric oxide trap, Carboxy-PTIO (100 μM). The NO carrier glutathione (50 μM) and decomposed spermine NONOate had no effect on APD 90 or MDP. GSNO had no effect in hypoxic hearts; however, when GSNO was combined with glibenclamide APD 90 increased, and MDP decreased to normoxic values. 8-Bromo cGMP (100 μM) shortened APD 90 and increased MDP to levels present in chronically hypoxic hearts. This effect was abolished by glibenclamide. A soluble guanylyl cyclase inhibitor, ODQ (10 μM), had no effect on action potentials in normoxic hearts but in hypoxic hearts resulted in an increase in APD 90 to levels present in normoxic hearts and a decrease in MDP. The effect of ODQ could not be reversed by GSNO. We conclude that NO activates the sarcolemmal K ATP channel in normoxic and chronically hypoxic hearts by a cyclic GMP-dependent mechanism.