“…Though such simplification was beneficial for computational modeling and enabled the development of relatively straightforward biophysical models based on non-linear dynamics and oscillatory theory, it recently became evident that this simple “random collision model” is inadequate to explain the emerging experimental results which highlight microdomain-specific regulation of cardiomyocyte physiology (reviewed in details elsewhere, Zaccolo and Pozzan, 2002 ; Warrier et al, 2007 ; Best and Kamp, 2012 ; Balycheva et al, 2015 ; Vinogradova et al, 2018 ). In the SAN, these include findings on a complex spatial-temporal coupling between the membrane- and Ca 2+ clocks confirmed in various species, including human ( Kim et al, 2018 ; Tsutsui et al, 2018 ), synchronization of spontaneous LCRs between discrete RyR clusters ( Stern et al, 2014 ; Torrente et al, 2016 ), compartmentalized autonomic regulation of pacemaker ion channels which relies on tightly confined cAMP signaling ( Barbuti et al, 2004 ; St Clair et al, 2017 ; Vinogradova et al, 2018 ), as well as microdomain-specific remodeling of ion channels secondary to structural alterations including changes in scaffolding proteins ( Le Scouarnec et al, 2008 ; Alcalay et al, 2013 ; Bryant et al, 2018 ). The emerging results demonstrate that the functioning of the complex pacemaking machinery at the cellular level depends on tightly regulated spatiotemporal signals which are restricted to precise subcellular microdomains and associated with discrete clusters of different ion channels, transporters and regulatory receptors.…”