Note finally held in own pitch (5)
I believe the answer is:
heave
'pitch' is the definition.
(I've seen this in another clue)
'note finally held in own' is the wordplay.
'finally' says to take the final letters.
'held in' is an insertion indicator.
'own' becomes 'have' (synonyms).
The last letter of 'note' is 'e'.
'e' going into 'have' is 'HEAVE'.
(Other definitions for heave that I've seen before include "cast like this" , "Express" , "Throw with force - retch" , "Lift or throw with great effort" , "Pull something heavy" .)