A system and method of positioning an atrial pacing lead for delivery of a cardiac pacing therapy that includes sensing electrical activity of tissue of a patient from a plurality of external electrodes and determining a distribution of bi-atrial activation in response to the sensed electrical activity. A target site for delivering the atrial pacing therapy is adjusted based on a change in bi-atrial dyssynchrony that is determined in response to the determined distribution of bi-atrial activation, and placement of the atrial pacing lead for delivery of the atrial pacing therapy is determined in response to the adjusting.
