Cardiac alternans is a beat-to-beat alternation in action potential duration ͑APD͒ and intracellular calcium ͑Ca 2+ ͒ cycling seen in cardiac myocytes under rapid pacing that is believed to be a precursor to fibrillation. The cellular mechanisms of these rhythms and the coupling between cellular Ca 2+ and voltage dynamics have been extensively studied leading to the development of a class of physiologically detailed models. These have been shown numerically to reproduce many of the features of myocyte response to pacing, including alternans, and have been analyzed mathematically using various approximation techniques that allow for the formulation of a low dimensional map to describe the evolution of APDs. The seminal work by Shiferaw and Karma is of particular interest in this regard ͓Shiferaw, Y. and Karma, A., "Turing instability mediated by voltage and calcium diffusion in paced cardiac cells," Proc. Natl. Acad. Sci. U.S.A. 103, 5670-5675 ͑2006͔͒. Here, we establish that the key dynamical behaviors of the Shiferaw-Karma model are arranged around a set of switches. These are shown to be the main elements for organizing the nonlinear behavior of the model. Exploiting this observation, we show that a piecewise linear caricature of the Shiferaw-Karma model, with a set of appropriate switching manifolds, can be constructed that preserves the physiological interpretation of the original model while being amenable to a systematic mathematical analysis. In illustration of this point, we formulate the dynamics of Ca 2+ cycling ͑in response to pacing͒ and compute the properties of periodic orbits in terms of a stroboscopic map that can be constructed without approximation. Using this, we show that alternans emerge via a period-doubling instability and track this bifurcation in terms of physiologically important parameters. We also show that when coupled to a spatially extended model for Ca 2+ transport, the model supports spatially varying patterns of alternans. We analyze the onset of this instability with a generalization of the master stability approach to accommodate the nonsmooth nature of our system. © 2010 American Institute of Physics. ͓doi:10.1063/1.3518362͔Beat-to-beat patterns of alternating activity seen in whole heart electrocardiograms are often taken as a sign of an abnormal rhythm that may lead to sudden cardiac death. The initiation and maintenance of such pathological cardiac alternans can be linked to dynamics at the single cell level. Here, it also manifests itself as a beat-to-beat alternation, although this time in the duration of action potentials. These electrical spikes of activity ultimately control the contraction of heart muscle fibers. Because of the known link between cellular alternans and cardiac arrhythmias, understanding the mechanism of their generation is vital for developing preventative clinical treatments. Experiments have shown that cellular alternans arise from an interplay of membrane voltage dynamics and intracellular Ca 2+ cycling. However, these studies have not been able t...