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..................................................................................................... 16. Appendix ESC Committee for Practice Guidelines (CPG): Stephan Windecker (Chairperson) (Switzerland), Victor Aboyans (France), Stefan Agewall (Norway), Emanuele Barbato (Italy), He ́ctor Bueno (Spain), Antonio Coca (Spain), Jean-Philippe Collet (France), Ioan Mircea Coman (Romania), Veronica Dean (France), Victoria Delgado (The Netherlands), Donna Fitzsimons (UK), Oliver Gaemperli (Switzerland), Gerhard Hindricks (Germany), Bernard Iung (France), Peter Ju ̈ni (Canada), Hugo A. Katus (Germany), Juhani Knuuti (Finland), Patrizio Lancellotti (Belgium), Christophe Leclercq (France), Theresa A. McDonagh (UK), Massimo Francesco Piepoli (Italy), Piotr Ponikowski (Poland), Dimitrios J. Richter (Greece), Marco Roffi (Switzerland), Evgeny Shlyakhto (Russia), Iain A. Simpson (UK), Miguel Sousa-Uva (Portugal), Jose Luis Zamorano (Spain). ESC National Cardiac Societies actively involved in the review process of the 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy: Algeria: Algerian Society of Cardiology, Naima Hammoudi; Armenia: Armenian Cardiologists Association, Armen Piruzyan; Austria: Austrian Society of Cardiology, Julia Mascherbauer; Azerbaijan: Azerbaijan Society of Cardiology, Fuad Samadov; Belarus: Belorussian Scientific Society of Cardiologists, Andrei Prystrom; Belgium: Belgian Society of Cardiology, Agnes Pasquet; Bosnia and Herzegovina: Association of Cardiologists of Bosnia and Herzegovina, Jasmin Caluk; Bulgaria: Bulgarian Society of Cardiology, Nina Gotcheva; Croatia: Croatian Cardiac Society, Bosko Skoric; Cyprus: Cyprus Society of Cardiology, Hera Heracleous; Denmark: Danish Society of Cardiology, Niels Vejlstrup; Estonia: Estonian Society of Cardiology, Maarja Maser; Finland: Finnish Cardiac Society, Risto Juhani Kaaja; The Former Yugoslav Republic of Macedonia: Macedonian FYR Society of Cardiology, Elizabeta Srbinovska- Kostovska; France: French Society of Cardiology, Claire Mounier- Vehier; Georgia: Georgian Society of Cardiology, Tamar Vakhtangadze; Germany: German Cardiac Society, Karin Rybak; Greece: Hellenic Society of Cardiology, George Giannakoulas; Hungary: Hungarian Society of Cardiology, Robert Gabor Kiss; Iceland: Icelandic Society of Cardiology, Inga S. Thrainsdottir; Ireland: Irish Cardiac Society, R John Erwin; Israel: Israel Heart Society, Avital Porter; Italy: Italian Federation of Cardiology, Giovanna Geraci; Kosovo: Kosovo Society of Cardiology, Pranvera Ibrahimi; Kyrgyzstan: Kyrgyz Society of Cardiology, Olga Lunegova; Latvia: Latvian Society of Cardiology, Iveta Mintale; Lebanon: Lebanese Society of Cardiology, Zeina Kadri; Libya: Libyan Cardiac Society, Hisham Benlamin; Lithuania: Lithuanian Society of Cardiology, Jurate Barysiene; Luxembourg: Luxembourg Society of Cardiology, Cristiana A. Banu; Malta: Maltese Cardiac Society, Maryanne Caruana; Moldova: Moldavian Society of Cardiology, Cristina Gratii; Morocco: Moroccan Society of Cardiology, Laila Haddour; The Netherlands: Netherlands Society of Cardiology, Berto J. Bouma; Norway: Norwegian Society of Cardiology, Mette-Elise Estensen; Poland: Polish Cardiac Society, Piotr Hoffman; Romania: Romanian Society of Cardiology, Antoniu Octavian Petris; Russian Federation: Russian Society of Cardiology, Olga Moiseeva; San Marino: San Marino Society of Cardiology, Luca Bertelli; Serbia: Cardiology Society of Serbia, Bosiljka Vujisic Tesic; Slovakia: Slovak Society of Cardiology, Juraj Dubrava; Slovenia: Slovenian Society of Cardiology, Mirta Kozelj; Spain: Spanish Society of Cardiology, Raquel Prieto-Are ́valo; Sweden: Swedish Society of Cardiology, Eva Furen€as; Switzerland: Swiss Society of Cardiology, Markus Schwerzmann; Tunisia: Tunisian Society of Cardiology and Cardio-Vascular Surgery, Mohamed Sami Mourali; Turkey: Turkish Society of Cardiology, Necla Ozer; Ukraine: Ukrainian Association of Cardiology, Olena Mitchenko; United Kingdom: British Cardiovascular Society, Catherine Nelson-Piercy. Recommendations for drug use in pregnancy Before pharmacological treatment in pregnancy is started, it is recommended to check drugs and safety data (see Table 7) I C In the absence of clinical safety data, it is recommended to check the Supplementary Data and www.safefetus.com for pre-clinical safety data. I C Decision making based on former FDA categories alone is no longer recommended. III C Class III drugs should not be used in prolonged QTc. Cardioversion of AF and atrial flutter should generally be preceded by anticoagulation (see below).146 AF = atrial fibrillation; aPTT = activated partial thromboplastin time; AS = aortic stenosis; AT = atrial tachycardia; CT = computed tomography; DBP = diastolic blood pressure; DCM = dilated cardiomyopathy; ECG = electrocardiogram; FDA = US Food and Drug Administration; HCM = hypertrophic cardiomyopathy; HFrEF = heart failure with reduced ejection fraction; LMWH = low molecular weight heparin; LV = left ventricular; LVEF = left ventricular ejection fraction; MRI = magnetic resonance imaging; MS = mitral stenosis; PAH = pulmonary arterial hypertension; PPCM = peripartum cardiomyopathy; SBP = systolic blood pressure; STEMI = ST-elevation myocardial infarction; SVT = supraventricular tachycardia; UFH = unfractionated heparin; VKA= vitamin K antagonist; VT = ventricular tachycardia; VTE = venous thrombo-embolism; WPW = Wolff–Parkinson–White. aLow-dose VKA: warfarin <5 mg/day, phenprocoumon <3 mg/day, or acenocoumarol <2 mg/day. High-dose VKA: warfarin >5 mg/day, phenprocoumon >3 mg/day, or acenocoumarol >2 mg/day. bAV nodal blocking agents should not be used in patients with pre-excitation on resting ECG or pre-excited AF. cFlecainide and propafenone should be combined with AV nodal blocking agents for certain atrial tachycardias, but structural heart disease, reduced left ventricular function, and bundle branch block should be excluded. Downloaded from academic.oup.com/eurheartj/article/39/34/3165/5078465 by guest on 07 October 2026