A medical electrical lead includes a proximal insulation segment, a distal insulation segment, a conductor extending within the proximal and distal segments, and an electrode coupled to the conductor and disposed in proximity to a distal end of the distal insulation segment. A fixation element of the lead is coupled to a distal end of the proximal insulation segment and includes a wire wound in a helix, which extends distally from the proximal segment, over the distal insulation segment.