The KCNQ1 voltage-gated potassium channel and its auxiliary subunit KCNE1 play a crucial role in the regulation of the heartbeat. The stoichiometry of KCNQ1 and KCNE1 complex has been debated, with some results suggesting that the four KCNQ1 subunits that form the channel associate with two KCNE1 subunits (a 4∶2 stoichiometry), while others have suggested that the stoichiometry may not be fixed. We applied a single molecule fluorescence bleaching method to count subunits in many individual complexes and found that the stoichiometry of the KCNQ1 − KCNE1 complex is flexible, with up to four KCNE1 subunits associating with the four KCNQ1 subunits of the channel (a 4∶4 stoichiometry). The proportion of the various stoichiometries was found to depend on the relative expression densities of KCNQ1 and KCNE1. Strikingly, both the voltage-dependence and kinetics of gating were found to depend on the relative densities of KCNQ1 and KCNE1, suggesting the heart rhythm may be regulated by the relative expression of the auxiliary subunit and the resulting stoichiometry of the channel complex.channel that is expressed in a wide variety of tissues, including human heart, pancreas, kidney, lung, inner ear, and intestine (1-3). Like other Kv channels, each KCNQ1 subunit has six transmembrane segments (S1-S6), with S1-S4 segments serving as a voltage-sensor domain, S5-S6 segments forming a pore domain and four KCNQ1 subunits forming the ion channel (4-7). One of the most prominent features of the KCNQ1 channel is that its gating is dramatically affected by the single transmembrane domain proteins encoded by the KCNE gene family. KCNE1, which is coexpressed with KCNQ1 in the heart and inner ear, drastically slows the activation and deactivation kinetics of the KCNQ1 channel and enhances current amplitude (1,8,9). Another KCNE family member, KCNE3, makes the KCNQ1 channel constitutively open in the intestine (3). The remaining members of the KCNE family, KCNE2, 4, and 5 reduce KCNQ1 current amplitude or modulate the gating (10-12).Although there is little structural information about the KCNQ1 − KCNE1 complex (7, 13), KCNE1 has been shown to directly bind to the pore region of KCNQ1 (14). In addition, a functional interaction between KCNE proteins and the voltagesensor domain of KCNQ1 has been suggested by several reports, and the interaction surfaces have been modeled and mapped by cross linking (15)(16)(17)(18)(19)(20). The interaction studies suggest that KCNE1 resides between two adjacent voltage-sensor domains, at the junction with the pore region (15)(16)(17)(18)(19)(20). This kind of packing would seem to be compatible with a 4∶4 stoichiometry between KCNQ1 and the KCNE subunits. However, several studies concluded that only two KCNE1 subunits bind to four KCNQ1 subunits (4∶2 stoichiometry) (21-23). In contrast, a study of KCNE1 − KCNQ1 fusion proteins suggested the existence of multiple stoichiometries (24).In order to directly observe the number of KCNE1 subunits in the KCNQ1 − KCNE1 complex, we employed a single molecule im...