No history of atrial fibrillation or myocardial infarction Unstable angina pectoris or cardiac arrhythmia (except atrial fibrillation); Patients with a known history of serious cardiac arrhythmias requiring treatment (exception: controlled atrial fibrillation, paroxysmal supraventricular tachycardia) Symptomatic atrial fibrillation History of long QT syndrome or clinically significant cardiac arrhythmias (except stable atrial fibrillation) Uncontrolled cardiac arrhythmia (subjects with rate-controlled atrial fibrillation are not excluded). History of arrhythmia that is symptomatic or requires treatment. Patients with atrial fibrillation or flutter controlled by medication are not excluded from participation in the trial. Any ongoing cardiac arrhythmias (including atrial fibrillation) that require medical therapy Ipatasertib-Specific Exclusion Criteria: History of arrhythmia that is symptomatic or requires treatment. Patients with atrial fibrillation or flutter controlled by medication are not excluded from participation in the trial Supraventricular arrhythmias including atrial fibrillation, which are uncontrolled. Have a history of epilepsy or cardiac arrhythmia (atrial or ventricular fibrillation) Known history of cardiac arrhythmias including atrial fibrillation, tachyarrhythmias or bradycardia, unless arrhythmia is controlled and after Cardiology has cleared patient to receive ONC. Receiving therapeutic agents known to prolong QT interval will be excluded History of CHF, or MI or stroke in the last months will be excluded. Known history of cardiac arrhythmias including atrial fibrillation, tachyarrhythmias or bradycardia, unless arrhythmia is controlled and after cardiology has cleared patient to receive ONC ; receiving therapeutic agents known to prolong QT interval will be excluded; history of congestive heart failure (CHF), or myocardial infarction (MI) or stroke in the last months will be excluded Any episode of atrial fibrillation in the prior months. Known history of unstable angina, MI, or CHF present within months or clinically significant cardiac arrhythmia (other than stable atrial fibrillation) requiring anti-arrhythmia therapy. Symptomatic atrial fibrillation or other cardiac arrhythmia for which the therapy is not stable or requiring changes in therapy within month of treatment initiation; atrial fibrillation or other cardiac arrhythmia which is clinically stable on stable therapy is allowed Atrial fibrillation, or other cardiac arrhythmia requiring medical therapy Electrocardiogram (ECG) demonstrating clinically significant arrhythmias that are not adequately medically managed (Note: subjects with chronic atrial arrhythmia, ie, atrial fibrillation or paroxysmal supraventricular tachycardia [SVT], are eligible) Symptomatic atrial fibrillation, or other symptomatic cardiac arrhythmia Known history of unstable angina, MI, or CHF present within months or clinically significant cardiac arrhythmia (other than stable atrial fibrillation) requiring anti-arrhythmia therapy. Known history of unstable angina, MI, or CHF present within months or clinically significant cardiac arrhythmia (other than stable atrial fibrillation) requiring anti-arrhythmia therapy. Clarification: subjects with atrial fibrillation controlled for > days prior to dosing are eligible Patients with persistent and uncontrolled atrial fibrillation even if rate controlled. Uncontrolled cardiac arrhythmia - patients with rate-controlled atrial fibrillation are not excluded Patients with stable atrial fibrillation are allowed in the study provided they do not meet the other cardiac exclusion criteria CLINICAL/LABORATORY CRITERIA: Patients must have corrected QT (QTc) interval =< msec (using the Bazetts formula) on electrocardiogram (ECG) performed within days prior to registration; history or evidence of current clinically significant uncontrolled arrhythmias are not eligible; however, patients with controlled atrial fibrillation for > days prior to randomization are eligible; patients must not have atrial fibrillation > grade on the screening ECG; patients with CTCAE grade - atrial fibrillation on their screening ECG must have a second ECG performed prior to registration and more than days from the screening ECG (either before or after) with the most recent ECG showing stable or improving grade of atrial fibrillation Chronic persistent atrial flutter or atrial fibrillation. Patients with intermittent atrial fibrillation may be enrolled if without episode for >= months and without indication for anti-coagulation Have uncontrolled chronic atrial fibrillation. Uncontrolled cardiac arrhythmia (patients with rate-controlled atrial fibrillation are not excluded.) Persistent or uncontrolled ventricular arrhythmias or atrial fibrillation. Symptomatic arrhythmia (excluding grade ? anemia-related sinusal tachycardia) or any arrhythmia requiring ongoing treatment, and/or prolonged grade ? QT-QTc, or presence of unstable atrial fibrillation. Patients with stable atrial fibrillation on treatment are allowed provided they do not meet any other cardiac or prohibited drug exclusion criterion. Patients with persistent and uncontrolled atrial fibrillation History or evidence of current, clinically significant uncontrolled arrhythmias (exception: patients with controlled atrial fibrillation for > days prior to the initiation of therapy on this protocol are eligible) Atrial fibrillation, or other cardiac arrhythmia requiring medical therapy Atrial fibrillation or other cardiac arrhythmia requiring therapy History of uncontrolled arrhythmias; subjects with controlled atrial fibrillation for > month prior to study enrollment are not excluded Patients must not have a history of heart block or cardiac arrhythmia, including asymptomatic arrhythmias and atrial fibrillation/flutter. Subject has ongoing cardiac arrhythmia that is Grade ? or uncontrolled atrial fibrillation of any grade. Patients with a known history of serious cardiac arrhythmias requiring treatment (exception: controlled atrial fibrillation, paroxysmal supraventricular tachycardia) Subject has ongoing cardiac arrhythmia that is Grade ? or uncontrolled atrial fibrillation of any grade. Subject has ongoing cardiac arrhythmia (including atrial fibrillation) that is grade ? Persistent or uncontrolled ventricular arrhythmias or atrial fibrillation. Uncontrolled cardiac arrhythmia (patients with rate-controlled atrial fibrillation are not excluded.) Cardiac arrhythmia requiring medication (does not include asymptomatic atrial fibrillation with controlled ventricular rate) Arrhythmia (example, history of polymorphic ventricular fibrillation or torsade de pointes). However, participants with < Grade atrial fibrillation for a period of at least months may enroll. Grade atrial fibrillation is defined as symptomatic and incompletely controlled medically, or controlled with device (example, pacemaker) or ablation, and is excluded. Participants with paroxysmal atrial fibrillation are permitted to enroll. Atrial fibrillation, or other cardiac arrhythmia requiring medical therapy Unstable atrial fibrillation (ventricular response > bpm) A history or evidence of current clinically significant uncontrolled arrhythmias (exception: subjects with controlled atrial fibrillation for > days prior to randomization are eligible) Atrial fibrillation, or other cardiac arrhythmia requiring medical therapy Serious cardiac arrhythmia requiring medication; this does not include atrial fibrillation Atrial fibrillation, Subject has ongoing cardiac arrhythmia that is Grade ? or uncontrolled atrial fibrillation of any grade. Atrial fibrillation; and Patients with sustained preoperative dysrhythmias, based on literature regarding accuracy of FloTrac (i.e., atrial flutter, atrial fibrillation) Severe comorbidities (atrial fibrillation, pulmonary hypertension, etc...) Patients with active atrial fibrillation or flutter, since the algorithm is not accurate in case of cardiac arrhythmia Clear indication for anticoagulation (e.g., atrial fibrillation) anticipated during the study period Medical history of atrial fibrillation or arrhythmia Atrial fibrillation Have arrhythmia/atrial fibrillation Uncontrolled cardiac arrhythmia (patients with rate-controlled atrial fibrillation are not excluded.) Atrial fibrillation with uncontrolled ventricular response Presence of atrial fibrillation Acute heart disease or history of heart attack, atrial fibrillation, or angina Electrocardiogram (ECG) demonstrating clinically significant arrhythmias; subjects with chronic atrial\r\narrhythmia, (i.e., atrial fibrillation or paroxysmal supraventricular tachycardia), are eligible Serious cardiac arrhythmia (well-controlled atrial fibrillation is permitted) currently or within the past months. Arrhythmia or conduction abnormality requiring medication. Note: patients with atrial fibrillation/flutter controlled by medication and arrhythmias controlled by pacemakers are eligible.