ATP is released in the heart during hypoxia, ischaemia or catecholamine stimulation. Both ischaemia and hypoxia lower intracellular pH. However, little is known about the signaling pathways involved in CFTR regulated ATP formation and release in heart.Lactic acid infusion, the mimic of ischaemia, increased left ventricular wall interstitial ATP in anaesthetized rats, which was blocked by inhibitors of CFTR. The signaling mechanism was studied in cardiomyocytes isolated from adult rat heart: lactic acid increased intracellular cAMP, Ca in the near membrane area, and ATP release. Acidosis‐induced ATP release was abolished by CFTR inhibitors or CFTR siRNA. The CFTR potentiator, apigenin, or cAMP‐elevating agents, forskolin and IBMX (F&I), also increased ATP release, confirming the role of CFTR. Inhibition of either the Na+/H+ exchanger (NHE) with amiloride or the Na+/Ca2+ exchanger (NCX) with SN6 abolished acidosis‐induced ATP release. Acidosis or F&I failed to activate ATP release with either BAPTA, an intracellular calcium chelator, or calcium free incubation medium. Thus, both cAMP and calcium activated CFTR opening during acidosis.Forskolin or acidosis‐stimulated ATP release from cardiomyocytes was abolished in bicarbonate free incubation medium, suggesting that the role of CFTR is to permit bicarbonate entry. Bicarbonate increased mitochondrial cytochrome C expression and release of both ATP and cytochrome C from isolated mitochondria; these were inhibited by KH7, a soluble adenylyl cyclase (sAC)‐specific inhibitor, suggesting that mitochondrial cyclic AMP activates mitochondrial PKA, which phosphorylates mitochondrial proteins resulting in increased mitochondrial oxidative phosphorylation and accumulation of cytochrome‐C. Cyclosporin A or V5, mitochondrial permeability transition pore/Bax inhibitors, induced accumulation of cytochrome‐C in mitochondria, whereas they inhibited ATP release from cardiomyocytes, suggesting that cytochrome‐C leaves the mitochondria through mPTP.Pannexin1 inhibitors, caspase inhibitors or pannexin1 siRNA, attenuated the ATP release during acidosis or forskolin treatment, suggesting that Pannexin1, activated by caspase cleavage, functions as the ATP release channel. Immunofluorescence imaging suggested that CFTR was co‐localized with Pannexin1.Hence, we demonstrate for the first time that the CFTR channel is activated by calcium/cAMP signaling during acidosis, allowing the movement of bicarbonate into the cell. The bicarbonate activates the HCO3‐mito‐sAC‐cAMP‐PKA signaling cascade, which serves as a metabolic sensor modulating ATP generation, and subsequently modulates Pannexin1 gating (for ATP release) by activation of caspase.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.