A medical electrical trans-septal pacing lead includes a lead body, a tine-like structure terminating a distal end of the lead body and a distal electrode coupled to the lead body at a position proximal to and in close proximity to the structure. A method for delivering left ventricular pacing to a heart includes inserting the trans-septal pacing lead through an inter-ventricular septal wall of the heart, from a right ventricle to a left ventricle, and positioning the distal electrode in a left ventricular endocardial surface of the septal wall.