Inadvertent malposition of pacing leads is a recognized complication of temporary cardiac pacing procedure, which can be fatal particularly if lead placement is in the left ventricular (LV) cavity because of the risk of thromboembolic events.1 Malposition leads can be either due to unrecognized congenital heart defects including atrial or ventricular septal defects, patent foramen ovale or due to iatrogenic perforation of interventricular septum but sometimes it may be due to faulty insertion via trans-arterial instead of trans-venous access.2