Calmodulin (CaM) binds constitutively to an IQ motif (residues 1901-1927, NaV1.2IQp) in the cytosolic C-terminal tail of the a-subunit of the neuronal voltage-gated sodium channel NaV1.2. Solution structures of CaM C-domain (CaMC) bound to NaV1.2IQp showed calcium binding reverses the orientation of (Ca2+)2-CaMC (2M5E.pdb) relative to apo CaMC (2KXW.pdb). Our structure of full-length apo human CaM bound to human NaV1.2IQp showed that only CaMc interacts with NaV1.2IQp. Thermodynamic and NMR analysis of the CaM-NaV1.2IQp complex showed no evidence for CaMN-NaV1.2IQp interactions, and indicated nearly identical affinity for calcium binding to the 4 EF-hand sites of CaM. Residues in NaV1.2IQp had different chemical environments when bound to apo and (Ca2+)4-CaM, consistent with the calcium-trigged change observed in the (Ca2+)2-CaMC-NaV1.2IQp interface (2M5E.pdb). Apo human CaM carrying cardiomyopathy-causing mutations [N53I(N54I), D95V(D96V), A102V(A103V), E104A(E105A), D129G(D130G), and F141L(F142L)] all bound tightly to NaV1.2IQp. However, mutations in CaMC inhibited Ca2+-mediated conformational changes of CaM bound to NaV1.2IQp. This suggests that high cytosolic Ca2+ levels would not be sufficient to trigger reversal of the orientation of these CaMC mutants. The effects of other recently described disease-causing CaM mutations are being investigated. NIH R01 GM57001 (MAS), NIH T32 NS045549 (RM), UI CCOM FUTURE in Biomedicine (AMK)