Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker device is noted with leads terminating in the right atrium and right ventricle . Epicardial pacing leads are also in unchanged positions . The heart size is normal . Mediastinal and hilar contours are unremarkable . Lungs are clear and the pulmonary vasculature is normal . No pleural effusion or pneumothorax is seen . There are no acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary process .