“…It has been used since the beginning of the era of endocavitary pacemaker lead placement [1,2] and has often been the preferred access technique for many operators. When we did a literature review, we found few cases where there was bleeding immediately after pacemaker insertion [4,[6][7][8][9][10][11][12]. Some of these cases had only minor haemoptysis [4,6,8] as in our case, but few had signi icant pulmonary haemorrhage causing hemothorax [11] or requiring transcatheter arterial embolization for pulmonary artery injury [12].…”