We present the rare case of a patient with pulmonary hypertension in the context of the stiff left atrial syndrome after extensive catheter ablation, a unique constellation characterized by high pulmonary artery and pulmonary artery wedge pressures due to left atrial dysfunction but normal left ventricular end‐diastolic pressure, normal mitral valve, and absence pulmonary vein stenosis. This patient was surprisingly oligosymptomatic, however, which may have been due to a persistent post‐puncture atrial septal defect, which may have allowed for controlled left atrial decompression, which is in line with the novel concept of the catheter‐based creation of an intracardiac shunt as a treatment for heart failure.

No abstract