Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with chest radiograph from ___ , there has been little appreciable change . Left - sided ICD with dual leads following their expected course to the right atrium and ventricle . Small right pleural effusion with some pleural thickening . No focal consolidation or pneumothorax . Severe cardiomegaly is unchanged . Mediastinal and hilar contours are stable . There are healed fractures of the right fifth , sixth and seventh posterior ribs .
    OUTPUT:
    
Left - sided ICD with dual leads following the expected course to the atrium and right ventricle . No pneumothorax .