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Figure 6, all conditions · pregnancy
| Condition | ++ First/safest choice | +- Second choice | x Evidence of foetal or infant toxicity or no data on safety |
|---|---|---|---|
| Aortic disease | Beta-blockers, celiprolol | ACE-I, ARB, atenolol | |
| Arrhythmias | Adenosine, metoprolol, nadolol, propranolol, digoxin, flecainide | Sotalol, propafenone, dofetilide | Amiodarone, disopyramide, dronedarone, atenolol |
| Cardiomyopathies (see specific indications) | Metoprolol, propranolol, nadolol, flecainide | Sotalol | ACE-I, ARB, ARNI, disopyramide, direct renin inhibitors, MRA, SGLT2-I, mavacamten, atenolol |
| Channelopathies (see specific indications) | Quinidine, nadolol, propranolol, flecainide | Mexiletine | |
| Coronary artery disease | Metoprolol, carvedilol, labetalol, furosemide, verapamil, low-dose ASA | Clopidogrel, bisoprolol, statins (if established ASCVD) | Atenolol, diltiazem, ranolazine, PCSK9-I, ezetimibe |
| Heart failure | Metoprolol, propranolol, carvedilol, labetalol, furosemide | Bisoprolol, hydralazine, isosorbide dinitrate, glycerin trinitrate | ACE-I, ARB, ARNI, MRA, SGLT2-I, ivabradine, aliskiren, atenolol |
| Heart transplantation (immunosuppressants) | Azathioprine, corticosteroids, cyclosporine, tacrolimus | Sirolimus | Mycophenolate (6-wk pre-pregnancy and 1° trimester), everolimus |
| Hypertension | Methyldopa, nifedipine, labetalol, propranolol, metoprolol, amlodipine | Hydralazine, hydrochlorothiazide, indapamide | ACE-I, ARB, aliskiren, atenolol |
| Pulmonary arterial hypertension | Iloprost, sildenafil | Bosentan, ambrisentan, riociguat, selexipag, vericiguat | |
| Thrombotic disorders | LMWH, UFH, low-dose ASA | VKA, clopidogrel, fondaparinux, alteplase | DOACb, ticagrelor |
| Valvular heart disease | Beta-blockers, diuretics, LMWH, UFH (labour) | VKA (in case of mechanical valves, see specific indications) |
++ First/safest choice in pregnancy, lactation and breastfeeding. +- Second choice in pregnancy, lactation, and breastfeeding. x Evidence of foetal or infant toxicity or no data on safety. a Except candesartan. b See text for details. ACE-I, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor/neprilysin inhibitor; ASA, acetylsalicylic acid; ASCVD, atherosclerotic cardiovascular disease; DOAC, direct oral anticoagulant; LMWH, low-molecular-weight heparin; MRA, mineralocorticoid receptor antagonist; PCSK9-I, proprotein convertase subtilisin/kexin type 9 inhibitor; SGLT2-I, sodium–glucose co-transporter-2 inhibitors; UFH, unfractionated heparin; VKA, vitamin K antagonist; wk, week.
Figure 6, printed p4494, transcribed from the figure image [FIG]Educational summary of the 2025 ESC Guidelines. It does not replace clinical judgement or local protocol.
Supplement Table S6 — ventricular arrhythmia drug doses
| Administration | Drug | Dosage |
|---|---|---|
| i.v. | Procainamide | 100 mg bolus |
| i.v. | Sotalol | 0.5–1.5 mg/kg |
| i.v. | Flecainide | 1–2 mg/kg |
| i.v. | Verapamil | 5–10 mg bolus |
| i.v. | Adenosine | 6–18 mg bolus |
| i.v. | Propranolol | 1–3 mg |
| i.v. | Isoproterenol | 0.5–10 µg/min |
| p.o. | Quinidine | 200 mg/3 h |
i.v., intravenous; p.o., per os (by mouth). Printed doses only.