Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual lead pacemaker / ICD device appears similar with leads again terminating in the right atrium and ventricle , respectively . The cardiac , mediastinal and hilar contours appear unchanged including mild cardiomegaly . There is similar relative elevation of the left diaphragm with associated streaky opacification suggesting minor atelectasis . There is no pleural effusion or pneumothorax . The bones appear demineralized . Mild degenerative changes are noted throughout the thoracic spine . There is similar moderate rightward convex curvature centered along the mid thoracic spine .
    OUTPUT:
    
No evidence of acute disease .