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Introduction: Excitability in cardiomyocytes is dependent on the subthreshold current required to raise transmembrane potential to the activation threshold and subsequent recruitment of voltage gated sodium channels to trigger an action potential. Conduction in cardiomyocytes is dependent on the robustness and speed of action potential propagating through tissue. Both are equally important for normal heart function and claim to be linear correlated (i.e if conduction decreases, excitability decreases) Cardiac sodium channels are densely expressed in the intercalated disc within the perinexus, which is two orders of magnitude narrower than bulk extracellular interstitium. The biphasic relationship between conduction and perinexus is well-researched and consistent between computations models. We hypothesized a biphasic relationship between Excitability and perinexal width (Wp). In addition, we hypothesize that the relationship between excitability and conduction is not linear but dependent on the original width of the perinexus. Methods/and Results: Ex vivo guinea pig hearts were epicardially paced and optically mapped to assess ventricular conduction and excitability. Strength-duration curves were constructed for pacing stimuli to measure rheobase (inversely correlated to excitability). Computation models incorporating ephaptic coupling and sodium channel localization to cleft widths between cardiomyocytes demonstrate these findings. Conclusion: Models and experiments reveal that the excitability and perinexus relationship is biphasic where narrowing and widening perinexus decreases conduction and excitability thus showing a linear relationship between excitability and conduction. However, the excitability and conduction become overly complex in the transition phase from release of self-attenuation to reduced self-activation. Therefore, targeting ephaptic coupling and monitoring plasma ions may be a novel strategy for increasing the efficacy and efficiency of cardiac pacemakers. Doctor of Philosophy The heart is a muscular organ that uses electrical impulses to function. The heart is made of cells called cardiomyocytes that allow for electricity to flow through the cells. They are connected via different junctions such as gap junctions, adherens, etc. Any loss of electrical coordination leads to irregular heartbeats which can lead to heart death. There are two ways to study electrical coordination, excitability, how easy is for the current to start in the tissue, and conduction, how easy can that current travel through the tissue. Since the 1900s researchers have stated that if excitability decreases conduction decreases. In other words, if you need more current to start the heart (excitability decreases) then that current will travel slower through the tissue (conduction decreases) thus increasing one chances of irregular heartbeats. However, the understanding of how conduction works has changed but not of excitability. For example, originally current was thought to travel through channels called gap junctions. If you have limited availability of gap junctions, current increases (aka excitability decreases) and conduction decreases. However, other species such as frogs, fishes have limited number of gap junctions and can survive. Therefore, a new mechanism was proposed called ephaptic coupling. There is space next to the gap junctions called perinexus which is rich in a channel called Na channels, which is the main driving force for excitability and conduction. The lab has shown that if you change that space between cells, you can change the conduction response. In other words, if you decrease the space between the cells, conduction will not change therefore reducing the chances of irregular heartbeats. Therefore, my project is to understand if by changing this space between cells, is excitability and conductions are still correlates of each other. Using mathematical and animal models, this dissertation shows excitability and conduction have a very complicated relationship.