The air that we breathe and the food that we eat reach their confluency in the mitochondria to derive the energy that the cell is dependent upon. The heart is the most aerobic of organs and has little anaerobic reserve compared to the constant demands placed upon it. At rest the arterial-venous oxygen extraction from the blood is the greatest from the heart and this only goes up with exercise. Common to all cell types residing in the heart is the need for energy and mitochondrial dysfunction is a significant contributor to cell death across the spectrum of cardiac disorders. Mitochondrial failure within any one cell type creates varying complications that eventually manifest as heart failure.The field of mitochondrial biology has under gone several paradigms shifts since the early nineties. The pioneering work of Krebs, Chance, and others had brought the field to a plateau with the focus on ATP generation. It was not until the implications of mitochondria's role in apoptosis and the cell's health, was there a strong resurgence of interest in mitochondrial biology [1,2]. Since then, a second major road of significance, dug predominantly by D. Wallace, has been in identifying the participation of mitochondria DNA (mtDNA) alterations and damage as a common pathology in unrelated symptoms [3,4]. And third avenue, that mitochondria are not just the isolated organelles pictured in electron micrographs, but dynamic entities that undergo significant morphological changes as a course of their normal function [5].The mitochondrial genome is a circular double-stranded DNA of more than 16 Kb in humans. It codes for 37 genes including 13 of the more than 1000 proteins indigenous to the mammalian mitochondria. Mitochondrial disorders are a heterogeneous group of diseases that may be characterized by maternal inheritance, heteroplasmy, and threshold effect. Mitochondrial dysfunction and mtDNA damage has been reported in diabetes, alcoholism, cancer, skeletal muscle disorders, and neurodegenerative diseases such as Barth Syndrome, MELAS, ALS, or LHON [6-9]. As one example, several mtDNA mutations have been identified that represent a high risk for the development of diabetes [10][11][12][13]. Mutations may take the form of deletions, rearrangements, or missense mutations that interfere with protein synthesis. The etiology for the accumulation of mtDNA mutations and deletions is not completely understood [14][15][16].This is an open