Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Mild cardiomegaly is unchanged from prior exam . Mediastinal silhouette and hilar contours are normal . There is interval placement of a left pectoral biventricular pacer with adequate position of a right ventricular lead . The presumed left ventricular lead appears to terminates on the diaphragmatic surface of the left ventricle . Lungs are clear . There is a small right pleural effusion but no pneumothorax . Cholecystectomy clips project over the right upper quadrant .
    OUTPUT:
    
Left pectoral biventricular pacer placement with adequate placement of right ventricular lead . Left ventricular lead appears to terminate along the diaphragmatic surface of the ventricle .