A system for engaging heart tissue includes an engagement catheter defining a first lumen therethrough and having a suction port at or near a distal end and a vacuum port at or near a proximal end, a delivery catheter defining a delivery catheter lumen therethrough and configured for slidable insertion into the first lumen of the engagement catheter, and an implantable device capable of insertion into the delivery catheter lumen such that at least part of the implantable device extends from a delivery catheter distal end upon implantation into a patient, where the suction port is operable to removably attach to a targeted tissue on an interior wall of a heart of the patient after the engagement catheter has been advanced through a blood vessel and into the heart, thereby forming a reversible seal with the targeted tissue when a vacuum source is operatively coupled to the vacuum port.