Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Tripolar AICD again noted with leads extending into the region the right atrium , right ventricle and coronaries sinus . The heart remains moderately enlarged . Mediastinal contour is normal . Lungs are clear without focal consolidation , large effusion or pneumothorax . Imaged osseous structures appear intact . Previously noted skin ___ of been removed .
    OUTPUT:
    
Persistent cardiomegaly . No signs of pneumonia or CHF .