Transseptal puncture for atrial fibrillation ablation is a safe and common procedure, however, complications, such as cardiac tamponade, are possibly fatal if not recognized and treated. Our goal is to report a case in which management of an inadvertent puncture of the posterior wall of the left atrium was accomplished using an unusual technique, followed by successful pulmonary vein isolation, and without the need of subsequent subxiphoid puncture.