Long QT syndrome (LQT) is an autosomal dominant disorder that can cause sudden death from cardiac arrhythmias. We recently discovered that mutations in HERG, a K+-channel gene, cause chromosome 7-linked LQT, Heterologous expression of HERG in Xenopus oocytes revealed that HERG current was similar to a well-characterized cardiac delayed rectifier K+ current, I-Kr, and led to the hypothesis that mutations in HERG reduced I-Kr, causing prolonged myocellular action potentials, To define the mechanism of LQT, we injected oocytes with mutant HERG complementary RNAs, either singly or in combination with wild-type complementary RNA, Some mutations caused loss of function, whereas others caused dominant negative suppression of HERG function, These mutations are predicted to cause a spectrum of diminished I-Kr and delayed ventricular repolarization, consistent with the prolonged QT interval observed in individuals with LQT.