Is It Normal to Have Heart Palpitations After ASD Closure?

It is completely understandable to feel anxious if you suddenly experience an irregular heartbeat after an atrial septal defect (ASD) closure. You might feel a sudden hard thump, a brief racing feeling, or a “butterfly” sensation in your chest. Experiencing these heart palpitations, skipped beats, or even transient episodes of arrhythmias like atrial fibrillation is a known and relatively common occurrence in the early weeks and months following the procedure ^[1][2]. For most patients, these rhythm disturbances are a temporary reaction to the healing process and will resolve as the heart adapts.

Why do arrhythmias happen after an ASD closure?

When a defect is sealed, your heart undergoes a period of physical and functional adjustment. There are several reasons why this can trigger an irregular heartbeat:

• Tissue Inflammation and Irritation: If you had a transcatheter procedure, the closure device is a foreign object. When it is implanted, it comes into direct mechanical contact with the sensitive tissue of the atrial wall ^[3][4]. This contact naturally causes localized inflammation and a temporary release of cardiac enzymes ^[1]. This irritation is strongly linked to short-term extra heartbeats (supraventricular extrasystoles) ^[1]. If you had a surgical closure, the surgical incisions and healing scar tissue can cause similar electrical irritation.
• Changes in Heart Pressure (Hemodynamics): Closing the defect instantly changes how blood flows through your heart, which alters the pressure in the heart’s chambers ^[5]. The heart muscle—which may have been enlarged prior to the procedure—must now physically adjust in size (a process called reverse remodeling) to handle this new, healthier blood flow pattern ^[5][4]. This structural stretching and shifting can temporarily disrupt the heart’s electrical signaling.

Who is most likely to experience this?

While anyone can experience transient palpitations as their heart heals, certain factors make arrhythmias more likely:

• Age: Patients who are over 40 to 60 years old at the time of their closure procedure have a higher risk of developing new-onset atrial arrhythmias ^[6][7].
• Medical History: Having a prior history of paroxysmal atrial fibrillation (AFib) or atrial flutter before the procedure strongly predicts post-procedure arrhythmias ^[7][8].

How long does it last and how is it managed?

For many patients, these irregular heartbeats are temporary. The localized inflammation typically subsides, and the heart’s electrical system usually stabilizes as the tissue heals. Studies tracking the heart’s electrical adaptability show that the heart generally recovers and adjusts to its new normal around six months after the procedure ^[9].

While you are healing, there are practical ways to manage these symptoms:

• Medical Evaluation: Always inform your care team about new palpitations by sending a portal message or calling your clinic during normal business hours. They may order an EKG or a wearable heart monitor (like a Holter monitor) to record your rhythm ^[6].
• Medication: If the extra beats are bothersome, your doctor might prescribe a temporary medication, such as a beta-blocker, to help calm your heart rate while you heal.
• Lifestyle Adjustments: You can support your heart’s recovery by staying well-hydrated, avoiding excess caffeine or alcohol (which can trigger extra beats), and managing stress.

When to Seek Immediate Medical Help

While transient palpitations are often a normal part of the healing process, you should seek immediate emergency medical care if your palpitations are accompanied by any of the following “red flag” symptoms:

• Sudden, severe chest pain
• Acute shortness of breath or difficulty breathing (dyspnea)
• Fainting (syncope), severe dizziness, or feeling like you might pass out

These specific symptoms can be warning signs of rare but serious complications, such as the device rubbing too deeply against the heart wall (tissue erosion), fluid accumulating around the heart (cardiac tamponade), or the formation of a blood clot ^[10][3]. Prompt evaluation is essential to rule out these emergencies.