A delivery system and methods for achieving orthogonal implantation of a cardiac pacing lead into a target cardiac tissue. The delivery system comprises an elongated delivery sheath containing a cardiac pacing lead and an elongated stylet, wherein the cardiac pacing lead and the elongated stylet are independently advanceable within the sheath. The distal end of the elongated stylet comprises a first electrode configured to provisionally anchor into the target cardiac tissue at a shallow depth of about 1-3 millimeters. With the stylet anchored, the delivery sheath is manipulated to achieve an approximately orthogonal orientation relative to the target cardiac tissue by pushing forward to correct an acute approach angle, pulling back to correct an obtuse angle, applying torque to correct a tilted plane of approach, or a combination thereof. Once orthogonal orientation is achieved, the cardiac pacing lead is deployed at a position adjacent to the distal end of the elongated stylet, and the stylet and sheath are withdrawn.