Requirements for basic perioperative monitoring in pa- tients undergoing CABG, including heart rate, blood pres- sure, peripheral oxygen saturation, and body temperature, are well accepted. Additional intraoperative standards established by the American Society of Anesthesiologists, including the addition of end-tidal carbon dioxide measurement in the intubated patient, are uniformly applied.711 Specialized mon- itoring of cardiac and cerebral function varies among centers and includes the use of PACs, TEE, or other forms of echocardiography (Section 2.1.7); noninvasive monitors of cardiac output; processed electroencephalographic monitor- ing; and cerebral oximetry with near-infrared spectroscopy. Given the added expense and potential hazards of such monitors (eg, pulmonary artery rupture with PAC, false- positive changes with cerebral oximetry or processed electro- encephalogram), substantial controversy exists about indica- tions for their use. None of these monitoring methods is routinely recommended. Electrocardiographic monitoring includes an assessment of heart rate and rhythm as well as the morphology and deviation of the QRS complex and ST segments for evidence of ischemia, infarction, or abnormal conduction.690 Continu- ous telemetric monitoring of cardiac rate and rhythm is recommended for 48 to 72 hours after surgery in all patients because of the high incidence of post-CABG AF, which most often occurs 2 and 4 days after surgery.606,613,690,691,697,698 In addition, other arrhythmias and conduction abnormalities may occur in patients with ischemia because of incomplete revascularization or in those undergoing concurrent valve replacement. Uncertainty continues with regard to the utility of PAC in low-risk patients undergoing CABG.712 Several observational studies suggest that such patients can be managed only with monitoring of central venous pressure, with insertion of a PAC held in reserve should the need arise. 