After a failed dissection to access the cephalic vein at the deltopectoral groove, the subclavian vein was accessed using the Seldinger's technique and lead electrodes introduced.The electrode was fixed into the right ventricular apex under flouroscopic guidance. The pulse generator was placed in an already created subcutaneous pocket. The pacemaker was set at 1.5V (range of rate 60 - 130 / min. The wound was closed and sterile dressing applied. Procedure well tolerated.