A method and apparatus for providing positive fixation of medical components to a portion of pericardial tissue via both vacuum- and/or mechanically-assisted means. A source of vacuum couples via a lumen to a recessed portion of a body structure deployed into the pericardial space. The recessed portion is adapted to form a seal around its periphery with adjacent pericardial tissue so that when the recessed portion is evacuated, the tissue is drawn into the recessed portion. Then, a sharpened instrument, such as a stylet, is deployed through the lumen and pierces the tissue, thus anchoring the body structure. A source of fluid may also be included for delivery to the pericardial space (e.g., contrast media; saline solution; biological, genetic and pharmaceutical substances and the like).