Experimental data accumulated over the past decade show the emerging importance of the late sodium current (I (NaL)) for the function of both normal and, especially, failing myocardium, in which I (NaL) is reportedly increased. While recent molecular studies identified the cardiac Na+ channel (NaCh) alpha subunit isoform (Na(v)1.5) as a major contributor to I (NaL), the molecular mechanisms underlying alterations of I (NaL) in heart failure (HF) are still unknown. Here we tested the hypothesis that I (NaL) is modulated by the NaCh auxiliary beta subunits. tsA201 cells were transfected simultaneously with human Na(v)1.5 (former hH1a) and cardiac beta(1) or beta(2) subunits, and whole-cell patch-clamp experiments were performed. We found that I (NaL) decay kinetics were significantly slower in cells expressing alpha + beta(1) (time constant tau = 0.73 +/- A 0.16 s, n = 14, mean +/- A SEM, P < 0.05) but remained unchanged in cells expressing alpha + beta(2) (tau = 0.52 +/- A 0.09 s, n = 5), compared with cells expressing Na(v)1.5 alone (tau = 0.54 +/- A 0.09 s, n = 20). Also, beta(1), but not beta(2), dramatically increased I (NaL) relative to the maximum peak current, I (NaT) (2.3 +/- A 0.48%, n = 14 vs. 0.48 +/- A 0.07%, n = 6, P < 0.05, respectively) and produced a rightward shift of the steady-state availability curve. We conclude that the auxiliary beta(1) subunit modulates I (NaL), produced by the human cardiac Na+ channel Na(v)1.5 by slowing its decay and increasing I (NaL) amplitude relative to I (NaT). Because expression of Na(v)1.5 reportedly decreases but beta(1) remains unchanged in chronic HF, the relatively higher expression of beta(1) may contribute to the known I (NaL) increase in HF via the modulation mechanism found in this study.