Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: New left - sided pacemaker has leads in the right atrium and ventricle . There is no pneumothorax or pleural effusion . The lungs are clear . The aorta is tortuous and moderate cardiomegaly is unchanged . Hiatal hernia measures 8 cm .
    OUTPUT:
    
New left - sided pacemaker is in adequate position without complication .