A lead delivery system configured to deliver a lead to the bundle of His from below the tricuspid valve in the right ventricle, the delivery system comprising: an outer guide catheter having a proximal end, a distal end, a distal tip, a lumen having an opening at the distal tip of the outer guide catheter, and a preformed curve in the distal end of the outer guide catheter, the curve in the distal end of the outer guide catheter being approximately 180 degrees, the outer guide catheter being configured to be introduced transvascularly and extend down the superior vena cava and position the curve of the outer guide catheter within the right ventricle; an inner guide catheter having a proximal end, a distal end, a lumen having a opening on the distal end, at least one electrode on the distal end for locating a target site, at least one conductor extending from the electrode to the proximal end, and a curve in the distal end, the inner guide catheter being configured to be moved within the lumen of the outer guide catheter and extended from the opening of the outer guide catheter, the curve in the distal end of the inner guide catheter being dimensioned to point the opening of the lumen of the inner guide catheter at a target area immediately below the tricuspid valve in the right ventricle extending about 15 millimeters down the septal wall proximate the bundle of His when the curve of the outer guide catheter is within the right ventricle and the curve of the inner guide catheter is extended out of the lumen of the outer guide catheter; and an anchor wire having a proximal end, a distal end, and a fixation element on the distal end of the anchor wire, the anchor wire being flexible and configured to be moved within the lumen of the inner guide catheter and extended from the opening of the inner guide catheter, the fixation element configured to penetrate tissue of the target site to anchor the anchor wire to the tissue of the target site. an outer guide catheter having a proximal end, a distal end, a distal tip, a lumen having an opening at the distal tip of the outer guide catheter, and a preformed curve in the distal end of the outer guide catheter, the curve in the distal end of the outer guide catheter being approximately 180 degrees, the outer guide catheter being configured to be introduced transvascularly and extend down the superior vena cava and position the curve of the outer guide catheter within the right ventricle; an inner guide catheter having a proximal end, a distal end, a lumen having a opening on the distal end, at least one electrode on the distal end for locating a target site, at least one conductor extending from the electrode to the proximal end, and a curve in the distal end, the inner guide catheter being configured to be moved within the lumen of the outer guide catheter and extended from the opening of the outer guide catheter, the curve in the distal end of the inner guide catheter being dimensioned to point the opening of the lumen of the inner guide catheter at a target area immediately below the tricuspid valve in the right ventricle extending about 15 millimeters down the septal wall proximate the bundle of His when the curve of the outer guide catheter is within the right ventricle and the curve of the inner guide catheter is extended out of the lumen of the outer guide catheter; and an anchor wire having a proximal end, a distal end, and a fixation element on the distal end of the anchor wire, the anchor wire being flexible and configured to be moved within the lumen of the inner guide catheter and extended from the opening of the inner guide catheter, the fixation element configured to penetrate tissue of the target site to anchor the anchor wire to the tissue of the target site.