To test the hypothesis that direct contact between sympathetic neurons and myocytes regulates expression and function of cardiac Ca channels, we prepared cultures of neonatal rat ventricular myocytes with and without sympathetic ganglia. Contractile properties of myocytes were assessed by an optical-video system. Contractility-pCa curves showed a 60% greater increase in contractility for innervated myocytes compared with control cells at 63 mM [Cab (n = efficacy of Bay K 8644 was maintained for at least 24 h after denervation produced by removal of ganglia from the culture. Dihydropyridine binding sites were assessed with the L channel-specific radioligand 3[HJPN200-110. PN200-110 binding sites were increased by innervation (51±5 to 108±20 fmol/mg protein, P < 0.01), with no change in KD. Peak current-voltage curves were determined by whole-cell voltage clamp techniques for myocytes contacted by a neuron, control myocytes, and myocytes grown in conditioned medium. Current density of Ltype Ca channels was significantly higher in innervated myocytes (10.5±0.4 pA/pF, n = 5) than in control myocytes (5.9±03 pA/pF, n = 8, P < 0.01) or myocytes grown in conditioned medium (6.2±0.2 pA/pF, n = 10, P < 0.01). Thus, physical contact between a sympathetic neuron and previously uninnervated neonatal rat ventricular myocytes increases expression of functional L-type calcium channels as judged by contractile responses to Cao and Bay K 8644, as well as by electrophysiological and radioligand binding properties. (J.