Conclusion
Insertion of a pacemaker lead through the subclavian artery is extremely rare and believed to be markedly underreported. Adverse events resulting from this iatrogenic complication includes pneumothorax, arterial injury and thromboembolic events. Immediate identification and diagnosis of this complication is essential. Careful interpretation of post-implantation ECG lead is of extreme value to identify this complication. Proper utilization of imaging modalities including lateral chest x-ray view and echocardiography should be adopted whenever improper lead placement is suspected.