The control of intracellulur calcium is central to regulation of contractil
e force in cardiac muscle. This review illustrates how analysis of the cont
rol of calcium requires an integrated approach in which several systems are
considered. Thus, the calcium content of the sarcoplasmic reticulum (SR) i
s a major determinant of the amount of Ca2+ released fi om the SR and the a
mplitude of the Ca2+ transient. The amplitude of the transient, in turn, co
ntrols Ca2+ fluxes across the sarcolemma and thence SR content. This: contr
ol of SR content influences the response to maneuvers that modify, for exam
ple, the properties of the SR Ca2+ release channel or ryanodine receptor. S
pecifically, modulation of the open probability of the ryanodine receptor p
roduces only transient effects on the Ca2+ transient as a result of changes
of SR content. These interactions between various Ca2+ fluxes are modified
by the Ca2+ buffering properties of the cell. Finally, we predict that, un
der some conditions, the above interactions can result in instability (such
as alternans) rather than ordered control of contractility.